MEDIBANK FRAUD (FROM TWO FACES OF DEVIANCE - CRIMES OF THE POWERLESS AND POWERFUL, 1978, BY PAUL R WILSON AND JOHN BRAITHWAITE - SEE NCJ-62117)

• NCJ Number: 62121
• Author(s): P HODGE
• Date Published: 1978
• Length: 9 pages
• Corporate Author: University of Queensland Press
• Publication Format: Document
• Language: English
• Country: Australia

Annotation

FRAUD COMMITTED BY AUSTRALIAN DOCTORS AGAINST THE FEDERAL GOVERNMENT'S HEALTH INSURANCE ORGANIZATION, MEDIBANK, IS EXAMINED AND SAID TO RESULT PARTLY FROM INEQUITABLE LAW ENFORCEMENT EFFORTS.

Abstract

ALTHOUGH DOCTORS OPPOSING MEDIBANK'S ESTABLISHMENT CLAIMED THAT PATIENTS WOULD ABUSE THE SYSTEM, IT HAS BEEN DOCTORS RATHER THAN PATIENTS WHO HAVE ABUSED IT IN THE 3 YEARS SINCE ITS INCEPTION. THE INCOMES OF DOCTORS IN PRIVATE PRACTICE HAVE INCREASED 55 PERCENT IN THE PAST YEAR, PADDED BY ABUSES OF MEDIBANK. ONE FORM OF ABUSE IS PROVIDING UNNEEDED SERVICES, ESPECIALLY UNNECESSARY DIAGNOSTIC TESTS AND SURGERY, TO MEDIBANK PATIENTS. OTHER ABUSES INCLUDE CHARGING FOR SERVICES NEVER RENDERED, CHARGING FEES FOR IMAGINARY PATIENTS, CHARGING FOR LONGER CONSULTATIONS THAN WERE GIVEN, AND CHARGING FOR AFTERHOURS WORK ACTUALLY DONE WITHIN HOURS. FULL FEES HAVE BEEN CHARGED FOR SHORT VISITS INVOLVING LITTLE OR NO TREATMENT TO GERIATRIC PATIENTS IN NURSING HOMES OR HOSPITALS. THE PRACTICE OF BULK BILLING HAS FACILITATED THESE ABUSES. MEDIBANK OFFICIALS HAVE DONE LITTLE TO CONTROL THESE ABUSES. ONLY 40 CASES OF FRAUD HAVE BEEN DISCOVERED BY MEDIBANK OFFICIALS. OFFENDERS HAVE BEEN TREATED LENIENTLY, USUALLY WITH ONLY A WARNING. MOST SETTLEMENTS HAVE BEEN OUT OF COURT. THIS LENIENCY, BASED ON MEDIBANK OFFICIALS' FEAR OF LOSING THE SUPPORT OF DOCTORS, IS TYPICAL OF GOVERNMENT AND MEDIA ATTITUDES AND POLICIES TOWARD WHITE COLLAR CRIME. IN CONTRAST, COMMON CRIMINALS ARE TREATED HARSHLY BY THE CRIMINAL JUSTICE SYSTEM, GIVEN ADVERSE PUBLICITY IN THE MEDIA, AND HAVE DIFFICULTY FINDING FUTURE EMPLOYMENT. THESE DIFFERENCES REFLECT SOCIETY'S ATTITUDE TOWARD WHITE COLLAR CRIME AS WELL AS CRIMINALS' ATTITUDES TOWARD THEMSELVES. WHEN LAW ENFORCEMENT AGENCIES RECOGNIZE THE HARMFUL EFFECTS ON SOCIETY OF WHITE COLLAR CRIME, THE USE OF COMPUTERIZED ACCOUNTING SYSTEMS TO DETECT FRAUD AND INCREASED PUBLICITY AND PENALTIES FOR OFFENDERS, COULD MITIGATE THE PROBLEMS CAUSED BY WHITE COLLAR CRIME. FOOTNOTES WHICH INCLUDE REFERENCES ARE INCLUDED. FOR RELATED ARTICLES ON CRIMES PERPETRATED BY THE POWERFUL AND PROTECTED BY THEIR LAWS, SEE NCJ-62118-62120 AND 62122-62126. (CFW)