Fraud and distortion of managed health care: the case of Colombia

Abstract

The thesis why in Colombia is common to both some insurers as some operators, covered in managed health care, use cunning, deceit or machination in providing health care arises. For this reason, it is necessary to elucidate the fundamentals of practice instituting fraud and cost control through its various operating mechanisms: secret operations to deny services, use skillful actions to invent bureaucratic procedures and denature managed healthcare, mechanisms that are viewed from the concept of fraud and are understood from two different areas: the envi ronment conduci ve to i mmoral i ty and the hi stori cal understanding of the phenomenon.