Healthcare is a high-risk sector for corruption. It is estimated that between 10% and 25% of global spend on public procurement of health is lost through corruption. Total global spend on healthcare is more than $7 trillion each year. Corruption takes many forms, depending on the country’s level of development and health financing system. No country is exempt from corruption. Patients everywhere are harmed when money is diverted to doctors’ pockets and away from priority services. Yet this complex challenge is one that medical professionals have failed to deal with, either by choosing to enrich them, turning a blind eye, or considering it too difficult.
Transparency International, a watchdog on these matters, defines corruption as the abuse of entrusted power for private gain, which in healthcare encompasses bribery of regulators and medical professionals, manipulation of information on drug trials, diversion of medicines and supplies, corruption in procurement, and overbilling of insurance companies
I will focus on corruption problems in the US healthcare by providing statistics that demonstrates these problems. The United States lost between $82bn and $272bn in 2011 to medical
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Health care is mostly delivered by the private sector, or independent, not-for-profit entities. But the services are paid for by government programs such as Medicare (federal program for the elderly) or Medicaid (state-run programs for the poor), or by commercial insurers who offer health insurance to individuals, to groups or to employers (who buy coverage for their employees as an employment benefit). As explained in a recent piece for The Economist, nearly $100 billion in fraud takes place within the confines of Medicare and Medicaid spending, while the remaining $172 billion occurs elsewhere. This means that payers have no reliable information about which services were performed, or were necessary, other than the word of the