Abstract
Up to 2016, Lebanon was ranked the first among the Arab countries in the high level of corruption in its administration and public institutions. This corruption has penetrated the Lebanese healthcare sector deeply and has spread at different levels including hospitalization, medicine, and most notably within the healthcare financing system. The objective of this paper is to highlight the major global corruption practices in health sector while focusing on the current state of Lebanon. Secondary data and statistics are obtained from published reports, statements and interviews. Mainly, there is an irrational high expenditure and relative surplus in the healthcare market especially for medical equipment’s. In addition, there is a gap in health policies in terms of laws, regulations, and governance practices such as lack of accountability; transparency and access to information. Key implications are presented for healthcare practitioners to adapt anti-corruption interventions and coordinate with the guarantors in curbing the financial corruption and raising the social awareness. Future studies can expand this issue empirically and put the discussion into a comparison approach. This paper highlights some of the announced corrupt practices in the Lebanese healthcare sector and proposes proactive anti-corruption interventions for much more hidden violations.
Highlights
Healthcare is a high risk sector which is vulnerable to corruption due to the uncertainty of service demands and variety of parties involved; mainly regulators, providers, consumers, guarantors and suppliers
Corruption is defined as the misuse of entrusted power, bribery and secret deals for private gain ; it can vary based on the level of development and the healthcare financing system in the country (Budi Arsih & Anisah, 2015; Berger, 2014)
It was reported that privately controlled and financed healthcare system may give some indications of possible corrupt practices unlike the public sector that is supposed to be regulated by strong accountability means and efficient civil service codes (European Commission, 2013)
Summary
Healthcare is a high risk sector which is vulnerable to corruption due to the uncertainty of service demands and variety of parties involved; mainly regulators, providers, consumers, guarantors and suppliers. The healthcare system is considered as one of the most privatized sectors globally with a very high out-of-pocket expenditure and it is considered itself a model of inequity This is partly a result of the 1990s’ policies of the World Bank that have authorized the limitation of public healthcare financing in order to enhance the growth of private sector (Berger, 2014; European Commission, 2013). Recent reports of Transparency International regarding the Corruption Perceptions Index have ranked Lebanon 136 among 176 countries with a score of 28 /100 (Transparency International, 2016) This indicates lack of the transparency within government sector and the high level of corruption (Alaaraj & Ibrahim, 2014). The objective of this article is to highlight the most critical corruption practices in the Lebanese healthcare sector and the financing system in particular to suggest healthcare anti-corruption interventions based on reviewing previous reports and literature in the field of the study
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