Every business has risks and the risks in the health system reforms, and generally in a health system, are significant. However, many are well known and can be designed out of a system. Users, providers, suppliers, can abuse the health system (both public and private) and others and many of the patterns are already documented. While some of these risks can be ‘designed out’ of the NHI Fund others cannot, but they can be flagged for investigation and action if they prove to be fraudulent or corrupt activities. The NHI Bill provides for an internal investigation (risk management) unit and for an inspectorate to follow up on reported abuse for referral of these matters to the appropriate role-player in the security and criminal justice cluster.
The risks need to be identified as the new systems are established, and appropriate regulations and operating procedures must be developed.