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September 17, 1997

License to Steal: Why Fraud Plagues America's HealthCare System

Author Affiliations

College of Business Arizona State University Tempe

JAMA. 1997;278(11):949. doi:10.1001/jama.1997.03550110087044

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A book entitled License to Steal with a cover illustration of gowned and masked surgeons appears at first glance to be another inflammatory attack on the ethics of American physicians, but the truism of never judging a book by its cover very much applies to this volume. Malcolm K. Sparrow, formerly a detective chief inspector and head of the Kent County Fraud Squad in England and now a lecturer at Harvard, has written a fascinating and detailed exploration of the problems of fraud in health insurance. Health care fraud is estimated by some to be as high as 10% of all health care costs, but Sparrow reveals that we simply do not know how much fraud occurs in our fee-for-service insurance system.

Sparrow focuses on criminal billing frauds, with research based on visits to health insurers, Medicare intermediaries and carriers, and Medicaid Fraud Control Units. He clearly