Paridhi Verma
Indore Institute of Law
Introduction:
Doctors and healthcare practitioners are given as the status of god in the country. People rely on the doctors for their health issues more than themselves; it is for the reason that this healthcare sector is known as the noblest of all professions. This area of the sector has become one of the country’s largest sectors in providing revenue and employment[i], perhaps the most essential sector of an economy has had more serious issues also.
Health care fraud is a type of white-collar crime spreading worldwide among the doctors, nurses, pharmacists or other healthcare practitioners. It involves forging and submitting claims for the service rendered to achieve more profit. The National Health Care Anti-Fraud Association (NHCAA) also stated that there are financial losses of several billion dollars due to healthcare fraud and abuse every year.[ii]
Implications of White Coat Crimes:
- Financial loss to the patients
The bill charged by the private hospital is huge, opaque and often arbitrary and irrational. Though India’s healthcare cost is lowest in the world still it is out of the reach for poor people and the majority of citizens.[iii] People do not have adequate knowledge so they become easy prey for exploitation by such professionals.
- Social damage to morals
Professor Sutherland defined White collar criminal as “A person of the upper socio-economic class who violates the criminal law in the course of his occupational or professional activities.” Medical practitioners are violating the social norms of morality and ethics of the society by creating the distrust towards their profession.
- Ethical Malpractice
The healthcare sector is transformed into profitable sectors with profitable motives. Ethical malpractices of the hospital includes-
- Preparation and authorization to carry out the treatment of the victim.
- Personnel procedures.
- Financial and political influences on a hospital.
- Billing norms.
- Sexual abuse of patients.
No fine is imposed for it but it invokes the condemnation of the professionals in the field which often lead to suspension of the Practitioner from the rolls of Medical register.
Health Care Fraud:
When motives are not good that allow for conclusive determination and often lead to health care fraud which does not even accurately reflect the representative cases. These schemes range from the simplistic to the complex. It includes fabrication or alteration of medical bills and other documents, unnecessary treatments, charging more from the patients than the provided service, false or exaggerated disability, fake and misleading advertisement through newspapers, magazines, radio and television through which they make false claims.
There are a number of quacks in the country working as a doctor resulting in the silent murder of the patients across the country due to wrong diagnosis and treatment. There is no such law dealing with quackery expressly, however, there are laws by which these problems are dealt with that to curb and punish.
If any act was done by a person to deceive another person with the intent of either to receive property from others or alter it constitutes to be cheating.[iv] Therefore, the quackeries are deceiving the people of curing them and receives the money, thus it comes to be cheating. The Supreme Court also laid down in the judgment of Shri Bhagwan Samardha v. State of Andhra Pradesh[v] that if somebody represents himself to offers prayers to God for healing the patient and induces to give money, this shall be considered as a fraudulent which will an offence under Section 420 of Indian Penal Code.
If a person fraudulently or dishonestly uses a document as genuine and knows to himself that the document is forged then a person shall be liable under section 471 of Indian Penal Code. Further, it was observed in the case of Mulai Singh[vi] that when a person makes forged copies in lieu of his name and title then he will be held liable under Section 471 of the Indian Penal Code.
If a person does an act negligently and unlawfully by knowing the fact of the spread of being infectious and dangerous to life then a person shall be liable under section 269 of the Indian Penal Code, 1860. In the instant case, Rajesh Kumar vs. A.P. Verma and Ors.[vii], faith healer claimed to cure AIDS by his prayer, tells the other HIV positive patient that he has healed him and this patient in wrong belief has cohabited with his wife who in turn tested positive from him. Therefore, the quack has unlawfully and negligently spread disease and thus held act was punishable under this section.
The Medical Termination of Pregnancy Act, 1971 who are ‘registered medical practitioner’ immune from the offence of miscarriage enumerated in the Indian Penal Code and section 4 of the Act which states that an abortion can be done only in a hospital established and approved by the government but there are quacks who are not registered practitioners and hence they are not immune from these provisions. Therefore, they are liable for miscarriage under section 312 to 318 of the Indian Penal Code, 1860.
Conclusion:
The hospital sector with thrust and profit-making wanted to be regulated and monitored so as to prevent the crime. Though there are legislations to make this profession out of white-collar crimes it is really impossible to know to understand the fraction of the practitioners. There is a need for a regulatory mechanism to prevent and combat with white-collar crimes especially in hospitals because of the fact that such crimes not only generate unjust enrichment but disturb the social stability in a way turning to the human rights violation.
White-collar crime in such an industry is really hazardous for society as well as the mental health of people. This crime is giving profit to the offenders and health issues to the consumers. The concerned authorities should wake up and take the remedial steps to be prevented it as practitioners are earn more and more profit and hence conducting white collar crime.
REFERENCES:
[i] Healthcare Industry in India, India Brand Equity of Foundation, https://www.ibef.org/industry/healthcare-presentation
[ii] The Challenge of Healthcare Fraud, https://www.nhcaa.org/resources/health-care-anti-fraud-resources/the-challenge-of-health-care-fraud
[iii] Manoj Mahadeo Ramugade, Professional Deviance in Medical Field – A Time To Rethink, International Journal of Current Medical and Pharmaceutical Research, https://journalcmpr.com/sites/default/files/issue-files/0628-A-2017.pdf
[iv] Section 420 of Indian Penal Code
[v] AIR 1999 SC 2332
[vi] (1906) 28 AII 402
[vii] AIR 2005 AII 175
