Preventing fraud and providing services: The private healthcare insurance sector

The private healthcare insurance sector is rarely the subject of criminological analysis unless seen as corrupt. It is even more unusual that it is the subject of analysis as a victim of fraud. This paper is thus different in that it establishes a picture of international private healthcare insurance sectors approach in preventing fraud and providing healthcare services. We start by explaining why the private health insurance markets exist. This is followed by the methods employed to secure innovative data from the private health insurance sector. The results of the research conducted in collaboration with the International Federation of Health Plans are then presented. A discussion on key aspects of this research is then examined before we lastly, consider a way forward and the development of fraud resilience in the private insurance healthcare market

Does corruption follow opportunity? A study of the U.S. Congress

Ninety three of the 1,818 people who served in the U.S. House of Representatives between 1972 and 2012 were investigated for corruption by the Ethics Committee. Eighteen were acquitted and 75 suffered consequences (reprimand/payback/resignation/conviction). Detailed analysis of the data shows that the longer one is in Congress, the more likely is the chance of corruption. In addition, the more powerful one is in Congress, the more likely is the chance of corruption. This article concludes that corruption follows opportunity. In general, the more opportunity members of Congress have to engage in corruption, the more they will ultimately succumb to corruption.Rodrigo Praino and Adam Grayca

Dimensions of authority in oversight agencies: American and Australian comparisons

Fraud, waste, and abuse damage public administration. Responding involves law enforcement and best practice administration. Many jurisdictions create watchdog agencies to perform this role. A model, which includes seven dimensions of jurisdiction and authority that policymakers should consider when creating an oversight entity, is presented. The model goes beyond the simple functional jurisdiction, i.e., who is overseen and how oversight occurs. Four subnational watchdog agencies in two countries are examined to demonstrate the trade-offs that occur in each dimension when the agencies are designed. This analysis demonstrates there are significant balancing issues at stake, which impact watchdog effectiveness.Robin J. Kempf and Adam Grayca

Feminist legal theory and understandings of equality: One step foward and two steps back?

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Law reform: What's in it for women?

C1 - Journal Articles Referee

A response to 'Death and best interests'

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