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Widespread fraud within the VA Hospitals

In what may be the worst advertisement for government run healthcare ever, more news from the Department of Veterans Affairs shows that in an effort to reach a goal of treating veterans within a fourteen day period, not only did some VA hospitals fail to treat three out of five veterans within this goal, there is also evidence that many other patients may have been kept waiting months for care.

Information has recently surfaced from an audit released last week. According to the reports, there was “rampant fraud” throughout the VA hospitals with an estimated “13% of schedulers at 216 VA hospitals instructed to falsify the wait times they reported to VA headquarters.” Unfortunately, the report also indicated that false scheduling was widespread and not consolidated within a few VA hospitals as earlier suspected.

How widespread was fraud and delay of care at VA hospitals?


So how bad was the problem at VA Hospitals? According to information obtained through the Freedom of Information Act, even without the scheduling efforts to conceal wait times, “In the six-month period ending March 31, the VA's 150 VA hospitals and 820 outpatient clinics failed to treat more than 200,000 veterans who came in for first-time primary care appointments in 14 days.”

President Obama first heard about VA issues in 2008 and vowed to make changes to the system, but six years later the issues continue without a resolution. Part of the recent scandal of falsifying records may in fact be tied to some of the strategies which had been implemented over the last several years. For instance, the VA had linked performance bonuses and salary increases to eliminating wait times at VA hospitals, but unfortunately, instead of solving the problem the VA Secretary Eric Shinseki acknowledged that “the tough, 14-day wait time standard may have led scores of schedulers to manipulate records.” Shinseki resigned last week in response to the scandal.

VA hospitals became too focused wait times


Those close to the issue admit that the VA may have “lost focus” of their job by concentrating too heavily on the wait times. The pressure to cut wait times apparently contributed to hospitals creating separate, secret lists to hide the fact that some patients were left waiting months before they were tracked in the official record. Other hospitals were instructing their workers on how to hide the delay of treatment of the veterans.

What has been done to end the fraud?


All bonuses have been cancelled this year, and the investigation into the fraud will continue. But a greater question which should be answered is why it takes a patient over two months to see a doctor at some VA facilities? While lowering wait times should be goal, incentives to meet goals should not be so strong that workers are willing to falsify records. Two wars have increased the numbers of veterans seeking treatment, but why have the number of facilities and doctors available to provide care not also increased with the demand? We need to know why the VA workers felt forced to falsify records and why they didn’t work to ensure patients received the care they needed.

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