Opinion
        

Op-Ed Contributors

How to control medical fraud epidemic

Updated: 2010-12-28 08:06

By Grayson Clarke and Jim Gee (China Daily)

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How to control medical fraud epidemic

In terms of how to tackle fraud, a combination of strategies is required to be adjusted to the particular context of a country's health system. The World Health Organization annual report of 2010 identifies 10 ways of making health resources go further and many of them include addressing aspects of fraud and corruption such as tackling inappropriate and over-prescription of medicines and services, promoting greater use of generic drugs and tackling counterfeit and substandard drugs.

The general thrust of public hospital reform program, from reducing the reliance on income from sale of pharmaceuticals and increasing budget support and introducing performance related pay for doctors to developing clinical pathways to curb unnecessary services and charges shows great promise. But these changes are likely to have a long-term impact only if they are made systematically and resources are made available to monitor and fight fraud on a long-term institutional basis.

Most importantly, the vast and honest majority of medical system staff members and the wider public need to be educated and mobilized to tackle the issue. Staff members at all levels should understand what fraud is and how they can report and be taken seriously without fear of retribution. The public, whose pockets are being picked, need to be told that being involved in frauds like lending their insurance cards may have costly implications for them and their families when they most need help. We have to recognize that the fight against fraud is a fight for our future.

Grayson Clarke is resident fund management expert with the EU-China Social Security Reform Project, and Jim Gee is the chair of the Centre for Counter Fraud Services at the University of Portsmouth and director of counter fraud services for PKF UK Ltd.

 

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