RUSTENBURG, SOUTH AFRICA-- Healthcare experts from across southern Africa and as far afield as the United States have gathered for the 19th annual conference of the Board of Healthcare Funders of Southern Africa taking place this week in this city in South Africa's North West Province.
One of the main issues being discussed is the increase in medical aid fraud cases in the healthcare sector which poses problems for the future of health insurance, such as South Africa's newly adopted National Health Insurance.
The delegates are discussing various strategies to combat the impact of medical aid fraud, heeding the call to uproot fraud and corruption at all levels.
Local and international healthcare experts are also discussing ways to eradicate wastage which can potentially cripple the healthcare sector.
The Principal Officer of South Africa's Government Employees Medical Scheme (GEMS), Guni Goolab, said Tuesday: The size and scale of the problem is significant. The Board of Healthcare Funders has indicated that on annual bases almost 22 billion Rand (about 1.6 billion US dollars) are wasted on fraud, waste and abuse.
A medical insurance fraud special investigator from the United States, David Popik, said: "We are losing 3.0 per cent of 3.3 trillion USD. It's a lot of money and that's just for the United States so I can only imagine what your GDP is.
"By having universal healthcare you might as well have universal healthcare fraud so you got to be able to squash it out from the get go.
With the advent of universal healthcare, law enforcement institutions face a challenge to prevent such fraud, to keep it from contaminating the national healthcare insurance systems.
The head of the South African government's Special Investigation Unit (SIU), Andy Mothibi, said: If we don't deal effectively with corruption and fraud it's going to deplete the capital adequacy and most of the schemes will go down; it is very critical that we lay the base and identify the vulnerable areas.
The conference ends on Wednesday.
Source: NAM NEWS NETWORK