BHEKISISA WATCH | Corruption trap: Why healthcare fraud costs you money

Four in 10 South Africans say corruption is one of the top three things on their minds when deciding where they’ll put their crosses in this year’s elections, a survey of 30,000 people showed last year.

It’s not unexpected. Over the past 10 years, South Africa has been performing poorly, with a score hovering in the low 40s on Transparency International’s Corruption Perception Index which gauges views about dishonest money spends in the public sector. A score closer to 100 means people think their government is clean, and closer to 0 means they think it is highly corrupt.

However, the scourge of corruption mars not only the public sector because private companies also ace dodgy deals. The healthcare sector is not exempt, with fraud costing the industry up to R28bn a year, the Council of Medical Schemes said.

Add in a mention of the National Health Insurance (NHI) fund, which will be like a massive, state-funded medical aid to give everyone the same package of quality health services regardless of their income, and people get worried. How will government be able to stop abuse of a very big pot of money like this if fraud is so rife in the industry, specially with risk and fraud management being the only one of the NHI's five chief directorates that's without a head?

In Bhekisisa’s monthly TV show Health Beat, Mia Malan spoke to Botho Mhozya, who heads healthcare delivery transformation at Discovery Health, about how they’re tackling fraudulent claims and dishonest practices. 

Could South Africa’s largest private medical scheme have some advice for the NHI? 

This story was produced by the Bhekisisa Centre for Health Journalism. Sign up for the newsletter.