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Question ID: 28991
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My relative is a medical doctor. He sees medical aid patients but is often short-paid by medical aids for medicine dispensed, the amounts sometimes not even covering his cost. Also, some medical aids pay much less than others, taking advantage of the current uncertainty and disputes caused by the medical and pharmacy councils and the health dpts regarding medicine pricing in S.A. As yet, a definitive law regarding medicine pricing has not been achieved, so medical aids are exploiting the market, paying what they feel they want to.
He has to see medical aid patients as they form a great percentage of his patients, nor can they afford to pay cash to him and claim back from the medical aid as they are of low income. He has thus adopted a fixed percentage mark-up to all the medical aids based on the price paid by one of the medical aids, as it becomes tedious to know each different medical aid policies for pricing as it is constantly changing. To make up the short-fall for each medical aids payments he adds an extra medicine to cover the difference.
The patients are sometimes made aware of this. What is the ruling on this?

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Asked on April 17, 2008 12:00 am
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Answered on April 17, 2008 12:00 am
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