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Medical Aids and Doctors

30 July 2012, 15:03

Medical Aids and Doctors

 

Recently the newspaper reported once again on medical aid fraud and of persons and doctors claiming against the medical aid without any actual visits being done, in one case the doctors and patients were involved and shared the funds involved and in the second case the doctors claiming without the patients knowledge.

The whole problem is that the medical aids now allow doctors to claim via the internet and the patients seldom if ever receive an account of the procedure/s involved and when, if they do receive notification from the medical aid it does not contain any detail on the claim.

I visited a specialist this year on two occasions this year and parts of the claim once investigated contain extreme amounts of money involved, that the medical aid just pay because it is according to their tariffs.

A ten minute walk on the treadmill costs R613.10, sonar views of the heart cost R487.10 each (3) views on each occasion, and a further sonar view at R243.50, with the consultation costing R451.80. This all for a 30 minute visit.

Yes the man is a specialist and yes he can identify any potential problems and yes he will be able to extend a persons life expectancy, but the charges do really seem a bit out of touch with reality.

A top of the range treadmill costs in the region of R65,000 and can almost certainly be replaced every month at this rate, the sonar machine comes in at around R170,000 can also be replaced monthly at this rate – this if you consider that the man sees in the region of 100 patients per month. I am sure that factors such as depreciation and tax rebates etc will also be claimed to the full ex tent by these professional gentlemen.

Medical aids keep raising the fees and no one is concerned about the excessively high cost of medical treatment, the members have to carry the burden, while bean counters run the medical aid schemes concerned only about profits and most doctors only about self enrichment and which farm or Porchè to buy next.

Where are the days when a house doctor was just that a guy that was a friend of the family and would come out even in the middle of night to attend to an emergency at your home.

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