The Catalysts of Health Care Fraud

An Investigative Study into the Motivations that Contribute to Defrauding Health Systems Worldwide

Healthcare fraud constitutes a significant source of economic waste which affects healthcare systems across the world. Despite increased awareness of the problem and the application of sophisticated anti-fraud mechanisms, individual actors and agencies continue to defraud public health systems, leading to fewer health resources for patients and higher premiums for consumers. It is commonly assumed that healthcare professionals who commit fraud are fundamentally motivated by economic imperatives and career goals.

This research article will examine this assumption in greater depth. It shows that healthcare fraud is a staple form of white-collar crime committed by powerful and privileged actors against weak and vulnerable health systems. Nevertheless, ethical justifications for health fraud persistent. Greater emphasis must be placed upon understanding how organizational pressures shape the actions and decisions of practitioners.

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