“Security fraud: who is stealing the money from our health?”, this is the theme treated this Sunday, September 4, 2022 in the program Zone Interdite on M6. An investigation presented as “revolting” by Ophélie Meunier, but which did not quite have the desired effect. Because if viewers were indeed outraged to discover the extent of health insurance scams, they were also shocked by certain practices aimed at plugging them.
This Sunday, September 4, 2022, M6 offered a new number of Restricted zone on the topic of fraudHealth Insurance. A report that began with the example of a young hairdresserofficially in sick leave, but suspected by her boss of actually setting up a parallel business. In an attempt to verify his accusations, he called on a private detective who was quickly able to photograph the comings and goings of the hairdresser at her clients, with professional equipment, vanity, towels etc. In addition to being in perfect health, the professional strived to steal the clientele of the salon that employs her.
Each year, a billion euros go up in smoke, in the pockets of imaginary patients. In question in particular: French people who take advantage of the system but also doctors who are a little too complacent. A journalist from the show thus easily succeeded in obtaining sick leave for his wife and himself, on the grounds of needing to take a family vacation. Huge flaws in the system that Internet users have deplored on twitter. But not as much as the methods of a certain doctor-controller…
According to the report, 83% of stops are never checked. But to reduce the risk of fraud, medical inspectors go to meet certain declared patients, at their homes…. One of these doctors was followed by the cameras of the Forbidden Zone: he went first went to a person in custody, who did not open the door. The ax then fell: considered absent outside the authorized hours, she risks having her daily allowances removed by her employer. On twitter, this sentence was considered severe: what if the person slept or was unable to get up?
A traumatic control
On the road to his next check, the doctor-controller told M6 journalists about the risks of his job. Among other things, he explained that he had already been attacked by dogs, insulted, and even strangled. Working conditions that could only inspire compassion. However, a few minutes later, many tweeters denounced his working methods, which were also deemed “violent”. As he went unannounced to the home of a young man, the doctor carried out a tough and incriminating interrogation in order to understand the causes of his two-week work stoppage. “Do you have a prescription?” he first asked, to which the young man replied in the negative: “I just have the stop”.
He explained that he was very tired, unable to concentrate, waking up every night at 4 a.m. without being able to go back to sleep for two hours, and suffering at work because he was forced to lie to customers. While explaining that he had the impression of endangering his health by pulling on the rope, the doctor-controller seemed a little dubious: “at this point?”, he launched, unconvinced, claiming that a two-week stoppage for these reasons is “excessively long”. “What is the pathology that requires 14 days off? […] The explanation seems to me a bit limited all the same”, he continued coldly. Feeling accused, the patient then detailed that he had called on the work psychologist who considered the break necessary, and that he was content to follow the recommendations of his doctor for his quit. To the question of the journalist “How did you experience this control?”, the young man replied: “I found it a little violent”.
And the twittos were of his opinion. Many of them found the intervention of the examining doctor very harsh or even unfair. Faced with this fragile man who showed all the warning signs of a burnout, his methods were even considered dangerous. According to them, he couldn’t do better to push him further and make him feel guilty…