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May 28, 2014

Daily Beast: VA Manipulation of Wait Times Was Directed From the Top, In Order to Boost Executives' Performance Bonuses

It is an article of faith on the Left that private sector corporations engage in self-dealing and corrupt practices, which is why we must move virtually all industry under the umbrella of government control.

It seems to escape their notice that people are just as corrupt in a government structure -- and that the government will actually cover up corruption a lot more than any private corporation.

Which seems to be what was happening at the VA, per this must-read expose from Jason Siegel at the Daily Beast.

Emails and VA memos obtained exclusively by The Daily Beast provide what is among the most comprehensive accounts yet of how high-level VA hospital employees conspired to game the system. It shows not only how they manipulated hospital wait lists but why--to cover up the weeks and months veterans spent waiting for needed medical care. If those lag times had been revealed, it would have threatened the executives' bonus pay.

What's worse, the documents show the wrongdoing going unpunished for years, even after it was repeatedly reported to local and national VA authorities. That indicates a new troubling angle to the VA scandal: that the much touted investigations may be incapable of finding violations that are hiding in plain sight.

"For lack of a better term, you've got an organized crime syndicate," a whistleblower who works in the Texas VA told The Daily Beast. "People up on top are suddenly afraid they may actually be prosecuted and they're pressuring the little guys down below to cover it all up."

"I see it in the executives' eyes," the whistleblower added. "They are worried."


50% of an executive's bonus is based on alleged performance improvements, of which reduced wait-times -- or perceived reduced wait-times -- are an important factor.

The Daily Beast's anonymous whistleblower (called "the clinician") reports that the whistle was in fact blown on these practices years ago -- but the VA, after an "investigation," found that the claims could not be "substantiated" and dropped the matter.

This is despite the fact that the Daily Beast has emails that show VA executives directing employees to change the requested date for treatment (to disguise how long the wait had been).

Other emails show more honest employees characterizing these practices as fraud:

The first message in the chain comes from a scheduling coordinator, James Anderson, who tells doctors across the state to use January 2 as the desired date for veterans. The Central Texas VA Chief of Staff, William Harper, then reproaches Anderson, saying, "You cannot do this!!!! This is essentially fraud. The desired date is what it is and if we donít meet the standard then we will work to improve."

...and yet the VA continues the practice.

The VA, of course, blames "lower-level clerks" for "scheduling errors" -- despite emails showing that these changes in the requested date for treatment were directed by higher-level executives and directors.

But the fix was in:

The inspector general's report from January 2012 stated that, according to the hospital's own staff, "appointments were routinely made incorrectly by using the next available appointment date instead of the patient's desired date." The improper scheduling "led to inaccurate reporting of GI [gastro-intestinal] clinic wait times," the report concluded. But the IG stopped there, blaming the practice on lower-level scheduler error--and ignoring evidence that shows the fraudulent scheduling practices were pervasive and consciously directed by higher-level executives.

"Every doctor, nurse, and clerk in the hospital knows it's true, but the VA's investigative team wasn't able to find any evidence," the clinician said. "They didn't interview any of us or really try to find out what was going on. This was reported in 2011 and it's still not fixed today."

Charles C. W. Cooke wrote an important column (which he discussed on last week's podcast).

His point is that while everyone appreciates how government will corrupt health care, many people do not understand that a government takeover of health care will result in health care corrupting government, or, I should say, corrupting it still further.

Having lived for 26 years under the corrupt NHS, Cooke can report how things work in Britain:

Because mistakes in delivering health care are catastrophic for those seeking reelection or trying to push an agenda, politicians in Britain spend the vast majority of their time worrying about perceived rather than actual improvement. Government, by definition, has no competition, which means that those who staff it can lie and spin and cover up mistakes not just with impunity but with the full force of the state at their back. Thus do results become less important than statistics, reforms less important than spending, and patients less important than careers. Dishonesty is widespread. Per the Telegraph, the British National Audit Office discovered in 2013 that
one in four hospitals is recording false waiting list times, with patients waiting on average three weeks longer than NHS records show.

Patients groups have said the findings were "scandalous," and that hospital managers had been able to routinely fiddle figures so they could claim to be hitting Government waiting time targets, when patients were enduring far longer waits for care.

Sound familiar?


The Other Corruption: In a state in which the media are nigh-exclusively strong partisans for one political party, all of the usual potency of external review by an investigative press is negated.

If a government won't check its own corruption of its own volition, we can, sometimes, count on the press forcing the government to do so -- but not when 95% of all reporters are fervently, floridly supportive of the progressive party.

Thus not only does the progressive government cover up its corruption, but the press becomes its mouthpiece and shyster.

Charles C.W. Cooke catches alleged Policy Wonk Ezra Klein claiming in 2009 that the government runs health care better:

Klein is committed to that idea. As he's an extraordinarily ideological and partisan being, idea is central to his identity.

It is doubtful, then, that he'll be providing his readers with any sort of a probing "Voxplanation" for the inherent corrupting nature of a government which not only runs the police and jails but runs an increasingly large segment of America, period.

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posted by Ace at 01:49 PM

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