A Bitter Pill: Dodgy Prescriptions in South Africa

Doctoring the Books (2004): Around 20% of South Africa’s private healthcare spending is lost on fraud every year. Follow medical forensic units as they try to rid the medical system of corruption.

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In South Africa’s poorest neighbourhoods, doctors have been abusing medical aid assistance in order to make fraudulent claims on behalf of themselves and their patients. From an optometrist who accepts medical aid to sell designer sunglasses to a physician known as ‘Mr. ATM’, doctors exploit some of the poorest in society to fatten their wallets. Now, investigators from various medical schemes have come together to tackle this problem together: using new technology and undercover agents to bust the fraudsters for good.

‘The medical industry has been taken to the cleaners in many respects by a small number of providers who have pushed healthcare costs up.’, says one such investigator.

The victims of fraud are often unsuspecting. Ivy Seikobu is one such victim – her back problems led her to the doctor known as Mr. ATM, who proceeded to file nine claims in her and her husband’s names. However, the problem goes further than individuals. Poverty is a huge driver of medical fraud, and as one healthcare professional puts it: ‘Some are in desperate circumstances. One has to be realistic why it has grown out of proportion’

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SABC Special Assignment – Ref. 2036

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