Racial profiling and intimidation of black doctors need further probe
Recent reports of racial profiling and discrimination against black and Indian doctors by medical aid schemes and their investigation units have finally been revealed to the public.
Doctors have experienced the heavy handedness and bullying tactics for years. However, because it was done on an individual basis it was difficult to make the connection.
Doctors depend on direct payment from the schemes because the majority of patients served by doctors who work in the low socioeconomic strata and poor communities don't have credit cards and cannot afford to pay doctors directly.
Maybe in the suburbs patients are able to pay and get receipts and claim back, but the poorer patients don't have the money nor do they have the resources to send receipts and invoices to medical schemes and then wait for two or three weeks to get reimbursed.
Therefore, the direct payment system to doctors is convenient for both parties and this is the leverage and the blackmail used by medical schemes to target doctors.
A common bullying tactic they use is to approach scheme members at their workplaces, ask them questions and intimidate them. Very often these patients are not told why they are being questioned, they are just given forms to sign.
Patients are expected to recall dates and services from month or years ago within a few minutes and are often under pressure and duress from medical schemes' 'investigators".
The members or patients are not told the true purpose of the questioning nor of implications of them signing the documents given to them. They don't know what they are signing and they are never given copies of their forms.
These statements are then used to intimidate and bully doctors. Many of their rights are violated without them even knowing it.
The direct payment leverage is abused by the schemes to intimidate and virtually blackmail doctors to reveal confidential patient information.
The health minister must get medical aid schemes to release figures of the racial proportions of the doctors they have targeted for investigation.
The schemes use mainly, if not exclusively, white forensic investigating firms. The forensic investigators have an inherent self-interest and a perverse incentive to find things wrong.
The minister must insist the terms of the contracts between the schemes and the investigators. This must be disclosed. What incentives are there for investigators to use entrapment and misdirection to "find faults" so they can earn more money and get more work from the schemes?
The minister must investigate the basis of the contracts the medical schemes give to these forensic investigators and whether there is any percentage of so-called savings that these forensic investigators get back.
No one condones or excuses fraud but the racial profiling and methods used by the schemes are highly unethical and unlawful.
Shaista Mia, Morningside, Durban
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