A Secret Death Waiting List - Research Paper Example

The Reward for Serving the Country was a Secret Death Waiting List Research Paper - ment of the Problem Ahsan khan PUAD 625 Table of Contents Table of Contents 2 Abstract 3 TOPIC SELECTION 4 STATEMENT OF THE PROBLEM 4 LITERATURE REVIEW 6 Introduction 6 A Historical Analysis of the Veterans Affairs’ Scandal 7 Pertinent Stakeholders and their Impacts on the State of Affairs 8 Negative Influences and Impacts on American Veterans 11 Required Courses of Action: Towards a Brighter Future for Veterans Affairs 13 Conclusion 15 ORGANIZATIONAL IMPLICATIONS 15 RECOVERY ISSUES 17 References 19 Abstract The current Obama Administration has come under fire in recent times due to the historical scandal involving the nation’s veterans. The Veteran Affairs controversy involves the scandal that occurred within Veteran’s care facilities where an estimated 1500 veterans were to eventually die because of negligence in medical care. The American media was instrumental in bringing this ‘shame’ to the public’s attention, reporting on the wide-ranging suffering that concerned veterans underwent through, while seeking healthcare attention. The U.S. Department of Veterans Affairs was irresponsible in terms of responding to the medical needs of the veterans even after electronic wait-time tracking systems had been installed in the facilities. The scandal exposed the outdated HRM practices within the public sector. This paper will investigate and discuss the Veterans Affairs controversy from a public sector HRM perspective. TOPIC SELECTION STATEMENT OF THE PROBLEM The Obama Administration has come under fire because of the scandal involving veterans. The Veterans Affairs controversy is about a scandal in Veteran’s care facilities where a secret death list of about 1500 names of veterans was created which would result to the death of all of them. It has been stated that more than 1000 veterans might have died because of issues of malpractice, lack of care, fraudulent scheduling practices, insufficient oversight and lack of accountability in primary health care of the veterans (Devine, 2014). The media reported on the suffering that veterans went through in seeking for healthcare attention especially primary care. The main problem is that the systems used in the veterans’ health care facilities forced veterans to wait for longer times to be attended to by the medical personnel. This caused suffering that led to the death of some veterans. The exact number of the veterans who have died because of such inefficiencies in not clear but it is estimated that more than 1000 veterans could have died in the past decade. Poor management especially at the U.S. Department of Veterans Affairs caused the scandal even after the installation of the electronic wait-time tracking at the facilities (Hicks, 2014). The scandal exposed the outdated public sector HRM practices that provided a loophole for the unnecessary delays in the facilities causing suffering and the death of many veterans. An investigation into the scandal revealed that the veteran affairs medical centers (VAMCs) use inadequate scheduling processes, insufficient oversight, poor management and lack of accountability led to long wait times, and delayed care causing harm and death (Devine, 2014). These issues show that innovation has not been a key issue in veteran affairs department. Today, all healthcare facilities require innovative leaders, processes, machinery and equipment to respond to the changing needs of the healthcare sector. VAMCs are not an exception to this fact. However, the scandal clearly shows that the U.S. Veteran Affairs Department has stuck to outdated practices that have led to time wastage and an increased risk to the lives of many veterans some of which have died in the process (Devine, 2014). Today, many healthcare facilities operate using innovative and up-to-date systems and practices ensuring that patients receive care in the least time possible when they seek healthcare services. However, the VAMCs have been left behind thereby engaging in malfeasance. The veterans’ affairs controversy (VA) is important in the study of public sector human resource management (HRM) because it highlights the failures of the public sector HRM in relation to the VA scandal and the lessons that people working in the sector can learn (Vanhala & Stavrou, 2013). Current public sector HRM practices emphasize on innovativeness as one of the key factors in fulfillment of successful HRM practice. Failure to use innovative means while undertaking HRM responsibilities leads to inefficiencies as observed in the veteran affairs controversy (Vanhala & Stavrou, 2013). In conclusion, the Veterans Affairs scandal laid open the HRM problems existing in the U.S. Department of Veterans Affairs and in the VAMCs. It laid open the outdated practices used and the related costs to veterans and the U.S. society. Innovative ways in public sector HRM do not allow issues such as theft, sexual abuse, drug dealing and alteration of appointment data to occur as they occurred as various VAMCs. Innovative measures help to ensure that employees are ethical, accountable and respectful in their practices, thereby increasing efficiency at work places. LITERATURE REVIEW Introduction The current Obama Administration has come under fire in recent times due to the historical scandal involving the nation’s veterans. The Veteran Affairs controversy pertains to the scandal that occurred within Veteran’s care facilities, where an estimated 1500 veterans were to eventually die. Accordingly, as Devine (2014) assets, a secret death list containing the names of about 1500 veterans had been constructed subsequently resulting in their premature deaths. Pertinent to this heated debate, is the fact that it is stated that over 1000 of these veterans might have succumbed due to a variety of healthcare issues. In this regard, key issues under focus included lack of care, medical malpractices, insufficient oversight, a general lack of accountability (in primary healthcare provision), and fraudulent scheduling practices amongst others. The American media was instrumental in bringing this ‘shame’ to the public’s attention, reporting on the wide-ranging suffering that concerned veterans underwent through, while seeking healthcare attention. Of critical concern, was the level or primary care provided, with the main problem emanating from the fact that existing systems did force veterans to wait for longer periods, so as to be attended to by concerned medical staff (Devine, 2014). Unfortunately, the long waits for healthcare provision may have been responsible for the death of a large majority of the estimated 1500 veterans. This is attributable to the inefficiencies experienced, with poor management being primarily responsible for the negative outcomes encountered. A Historical Analysis of the Veterans Affairs’ Scandal As Hicks (2014) portrays, the U.S. Department of Veterans Affairs further escalated the scandal, even after electronic wait-time tracking systems had been installed in the facilities. The scandal exposed the prevailing outdated HRM practices within the public sector, which provided loopholes that resulted in unnecessary delays within concerned facilities. These delays are deemed as being primarily responsible for the premature deaths and suffering of many veterans, as portrayed by subsequent investigation into the scandal (Hicks, 2014). Through further investigation, it was revealed that concerned veteran affairs medical centers (VAMCs) were further negatively affected by insufficient oversight, lack of accountability, inadequate scheduling processes. The delays witnessed, as Devine (2014) further portrays, were the primary cause of not only suffering, but also resulted in deaths. Hence, from the investigation, there was portrayal of technological innovation not being a key issue of concern within the veteran affairs department. Currently, it is a requirement that existing healthcare facilities possess not only innovative leadership and procedural measures/ processes, but also necessary equipment and machinery. This is towards enhancing overall response to the dynamic needs and requirements of the critical healthcare sector. Accordingly, VAMCs are no exception, as part of the drive towards greater availability of health care. However, the scandal clearly indicates the opposite to the above portraying the Veteran Affairs Department negatively (Devine, 2014). This serious scandal thus portrayed the department’s failures in its continued embrace of outdated practices, resulting in time wastage, as well as increased risks to veterans’ lives, which were unfortunately to result in deaths. It is therefore unfortunate that the VAMCs have been left behind, in terms of embracing innovation, hence their engagement in malfeasance. As Vanhala and Stavrou (2013) rightly portray, this is as opposed to current contexts, where a majority of existing healthcare facilities continue operating through utility of up-to-date and innovative systems, as well as procedural measures/ practices. Through this, patients are ensured of receiving pertinent care in the least time possible when engaging healthcare service providers. The VA (veterans’ affairs) controversy is thus important as a case study of the public sector HRM pertinently because it highlights the different forms of failures exposed within the sector. Not only is the controversy vital in terms of learning and improvement, but also as a crucial lesson to others working within this vital sector. It is further important because best practices necessitate continuous utility of innovation as a key factor towards successful fulfillment of pertinent HRM practices (Vanhala & Stavrou, 2013). Conversely, failure to utilize various innovative measures when undertaking vital responsibilities of HRM has thus lead to the inefficiencies observed in the aforementioned controversy. The scandal was to lay open the prevailing HRM problems found within the U.S. Department of Veterans Affairs and the affiliated VAMCs. It was to lay open the out-dated practices that were utilized during official healthcare service provision, in turn being related to costs incurred by American veterans and the larger U.S. society. Pertinent Stakeholders and their Impacts on the State of Affairs The VA scandal poses serious institutional issues within the public health sector, especially about the critical importance of VAMCs (Hicks, 2014). What further infuriates the public at large, is the fact that the Obama administration had received prior notice of the ‘ills’ experienced within the VA, on a time-scale of up to five years ago. McElhatton (2014) avers that the administrations prior knowledge of the injustices and malpractices happening within VA medical facilities, further hurts the administrations current position/ standing on the issue. Reports were indicative of the presence of widespread inaccuracy with regard to veterans’ waiting times, as well as their subsequent experiences of scheduling failures. The two aspects were deemed as direct threats towards denying deserving veterans timely provision of health care. Unfortunately, these problems eventually turned out into the ugly and un-ethical growing scandal. Officials within the Veterans Affairs Departments had given warning to the Obama-Biden transition team, weeks after their 2008 electoral victory. They were warning that the wait times (schedules), as reported by its various facilities, should not be trusted. In essence, the officials were warning that the issues occurring in their facilities were not only about data integrity, but further so in that they affected the overall quality of care provided (McElhatton, 2014). Through reporting of unreliable performance data, quality healthcare was affected in terms of delays, with potential negative impacts. This was through potentially denying deserving veterans of timely healthcare provision. With dozens of veterans having died after waiting for months to receive proper medical and healthcare provision, the issue at hand is no longer one to be ignored, as Culp-Ressler (2014) eludes. Rather, there is need for serious consideration of the impending implications and subsequent consequences, given the important place American veterans hold in the nation. Different investigations have reported that over several years past, delays in such aspects as routine and simple screening procedures have resulted in doctors not being able to diagnose cancer in a timely manner. This has unfortunately resulted in quite a number of deaths, with various specific VA hospitals in the states of Arizona, South Carolina and Georgia portraying dire situations. To display the dire contexts present, the facilities aforementioned were responsible for the placement of thousands of veterans on un-necessary waiting lists, even for straightforward gastro-intestinal procedures such as colonoscopy. Arizona’s Phoenix Veterans Affairs Health Care system was reported as being a leading egregious offender (Culp-Ressler, 2014). Evidence found indicated that different veterans had died because of being placed on a ‘secret’ waiting list, which was secretly not captured electronically, and hence not shared with the Obama Administration. Thus the affected VA hospital, while providing an official list to the government, which portrayed that veterans were receiving pertinent care promptly, was in reality postponing appointments with requisite medical staff. It is the pervasive nature of malpractices experienced by veterans that subsequently caught the attention of Congress. As a result, there was an increase in demand for answers, especially those related to unnecessary deaths that are linked primarily to inadequacies experienced within VA services (Lichtblau, 2014). According to Poteet (2014), the U.S. House Veterans Affairs Committee engaged in the monitoring of the existing long wait times, in addition to attempting to further push for graver consequences for the VA officials involved. Above all, is need to hold responsible, the concerned entities’ top management, on charges of neglect and ‘plausible’ accessory to murder. The case scenario repeats itself in various other institutions, where not only is the long wait present for veterans suffering from ailments such as cancer, but also those suffering from serious mental illnesses. The critical issue at hand is that the lack of promptness in responding to the veterans’ conditions is viewed as having contributed to the occurrence of some deaths that are preventable. Negative Influences and Impacts on American Veterans Due to the nature and negative influences of war, not only on the physical aspect of a human being, but also the psychological/ mental composition, a variety of ailments i.e. Post-Traumatic Stress Disorder, greater suffering has thus been endured. In some cases, some veterans have resulted to committing suicide, during the long periods of time spent on the waiting lists. Unfortunately, this negative dynamic situation threatens to continue, because suicide rates have substantially increased amongst young veterans. What seems to be a ‘catch 22 situation’ is the inevitable spending cuts implemented by the government, in the budget sequester, which threaten to further compromise the already dire situation. While it is not ethical to deem the idea as being genius, it is important to note that it did progressively escalate over the years, despite government notification of the same (Poteet, 2014). The ‘genius’ in the idea may be portrayed in the fact that the Veterans Affairs Department and its concerned affiliates have over the years, accumulated hundreds of thousands of unprocessed medical claims. With approximations reaching the 400,000+ mark, in terms of unprocessed ‘overdue’ compensation claims, it is no wonder that the scandal has elicited such heated debate. Adding to this is the presence of over 250,000 veterans who claimed that their disability benefits had been mistakenly cut or denied. In undertaking these unethical actions, the VA facilities and the Department at large engaged in unlawful practice. This was in terms of denying the deserving veterans, their due right of proper physical and mental health care provision as Cashour (2014) portrays. Reports from the media, which indicated that around 40 veterans had succumbed to their illnesses while awaiting treatment, portray the critical issues necessary to tackle. As extremely disturbing allegations, the malpractices portrayed in VA necessitated Rep. Jeff Miller (Chairman, House Committee on Veterans’ Affairs) to personally issue a public apology, on behalf of the VA Department. In addition, he personally called for a thorough and complete inspector general investigation, into the alleged delays within VA care. This was especially about Phoenix VA Health Care System, as well as department-wide. The gathered evidence was to be shared with the IG all-pertinent evidence acquired through the committees investigation. As quoted, he was of the view that if the alleged malpractices are true, then the charges would only but add to the increasing rates and pattern of veterans succumbing to preventable deaths. Further influenced by such case scenarios would be the gradual rise in patient-safety incidents at different VA medical centers nationally. Further negatively affecting the unfortunate turn of events would be the presence of an assumed shared theme: that of VA’s extreme reluctance, with regard to holding both its executives (management) and pertinent employees accountable. As Rep. Jeff was to elude, it was unfortunate that rather than receive punishment for their role-play in the rampant malpractices at VA Department and affiliated institutions, executives often received glowing performance reviews and/ or bonuses. A case in point was the type of treatment extended to the executives of VA facilities in Atlanta, Pittsburgh, Memphis Tennessee, Columbia, and Augusta, Georgia. To this effect, he was categorical that time had come for all VA leaders to heed the alarms sounded by a majority of the existing veterans community (Cashour, 2014). Required Courses of Action: Towards a Brighter Future for Veterans Affairs In order to tackle this grave and highly emotive subject matter, there was and continues to be need for a dynamic shift, as Parlapiano and Karen, (2014) allude. This is not only in terms of approaches towards enhancing Veterans’ health care provision, but more so the general public sector health system. Hence, this necessitates accountability on the part of their employees, as opposed to rewarding them for various forms of mismanagement that have harmed veterans. Adding to this is need for greater honesty with Congress as well as the public concerning prevailing departmental problems and issues. Additionally, is that as an avenue of regaining public trust and good will, as needed by VA, it would also bring much-needed closure to the hundreds of families affected by the death of their loved ones. A core reason why the idea behind VA’s scandal did not work, was the subsequent pressure and influences exerted on the media and public at large, pertaining the ill practices faced by American heroes. In addition, through critical input from whistle-blowers, the greater American public was able to gain a glimpse of the extent of malpractices present within the VA Department. Hence, attention was subsequently focused on the VA Central Office (VACO), located in Washington, D.C, as well as affiliated facilities nationwide. The reason behind such procedural measures was towards ensuring that there was a limitation and subsequent tackling of the malpractices experienced, with focus being on future reforms (Parlapiano & Karen, 2014). Accordingly as Wood (2014) provides, there was and still is need for greater accountability, especially due to the nature of disturbing allegations with regard to outright fraud purported to have taken place within the sector. Due to the fact that the scandal, a methodical scam devised to aid in dodging set VA timeliness standards, was carried out through stage-managing various requests for healthcare, it is thus necessary for greater oversight. This is at not only local and state levels, but more so on a national scale. This will require a ‘clean-up’ of the Veterans Affairs Department, especially concerning its accounting books and other pertinent data. A strict ‘code of conduct’, with regard to ethics, accountability, truthfulness and management, needs to be enforced. A sort of consolation is that this scandal did not directly involve the adjudicative function of the Veterans Benefits Administration (VBA), but rather VA’s health care delivery system. This is not to say that VBA has been clean, hence need to also continuously inspect the procedural measures undertaken concerning the dispensation of pertinent benefits and claims to the deserving veterans, as well as their family members (Wood, 2014). Further changes need to be implemented within VAs procedural measures, reversing the negative effects of veterans being placed on VA’s Electronic Waiting List. This has been the usual procedure, when new veteran patients are unable to be scheduled, and subsequently provided for clinical appointments within the stipulated 90 days. Accordingly, the core focus should be towards enhancing the timely meeting of set timelines, concerning the scheduling of appointments between veteran patients and pertinent medical officials. In order to inculcate such good conduct, higher financial rewards need to be awarded to those Directors who are able to not only meet but also furthermore, exceed the set timelines. Conversely, those unable to meet such timelines, and hence involved in various malpractices, ought to be strictly dealt with according to American law and jurisprudence. By increasing scrutiny, as well as reductions in bonuses to the Directors, the American public is optimistic on some real changes occurring (Lichtblau, 2014). Conclusion Through innovative measures, the sector is to be aided by ensuring pertinent employees are professional in the best way possible. This should be in terms of ethical practice, accountability and respect for both pertinent practices and the profession, hence increasing overall efficiency at their workplaces. As portrayed through the scandal, there is the need for greater acceptance of innovativeness especially within public sector HRM. This is important towards dealing with core issues such as theft, drug dealing syndicates, sexual abuse and appointment data alteration. Such were common features that occurred at various VAMCs, until the scandal broke out, to be subsequently exposed to the public at large. ORGANIZATIONAL IMPLICATIONS The veterans’ affairs scandal exposed the care that the United States government has accorded the people who once served and protected the country both within and outside U.S. borders. The U.S. Department of Veterans Affairs was charged with ensuring that veterans get a high quality healthcare from the government as part of a plan to take care of the veterans’ needs and ensure that they live a healthy life after a difficult life sometimes in war. The scandal that occurred exposed the vices in the veteran’s medical care program showing that the program requires certain improvements and changes to make it effective in its mandate of protecting the lives of the veterans (Culp-Ressler, 2014). Planning, implementation and evaluation are three key issues that must be included in operations in organizations because they assure successful outcomes for projects or operations. The failure to include the three key components creates a fertile ground for failures that lead to major scandals, for instance the Veteran’s Affairs Scandal. The veterans’ medical care program is an important provision and realizable goal set by the united states of American government. However, the scandal that occurred showed that the program failed and that it needs rethinking and re-planning to ensure that it serves the mandate for which it established. There are several things that should be done to prevent the issues that occurred from happening again. Organizations and its stakeholders suffer when the operations and projects fail. However, to be able to prevent the causes of the failure, planning, implementation and evaluation must be used. Each of the three elements provides a different but equally important addition to the project or operation. For example, planning provides information on what should be done, who should do it and the resources that are required. Implementation provides information on the actual doing, the people who do it and the implementation of the resources required. The evaluation shows whether the resources were used, whether the people implemented the plan as required and also whether the plan was followed. These are the important aspects of the three components. The findings of the Veterans Affairs Scandal have several implications for organizations with regard to planning, implementation and evaluation. The scandal that occurred was because of poor implementation by personnel who were tasked with the responsibility of ensuring that the veterans received quality care. This has an implication for organizations in the sense that organizations have to understand that poor implementation of the core operations lead to failures that affects the particular organization and its stakeholders. Another implication for organizations that the scandal brings about concerns the fact that proper planning without effective mechanisms and personnel to implement those plans becomes a waste of time and resources. The U.S. Veterans Affairs Department planned for the care of the veterans along with the VAMCs that had the mandate of implementing these plans (Culp-Ressler, 2014).. However, these plans were not implemented thereby wasting resources and time. When organizations plan and fail to implement the plans, they waste fundamental resources and time. Therefore, organizations must understand this aspect. Evaluation of the mandate of the VAMCs was not done correctly allowing the scandal to happen without stoppage. This shows that when organizations do not put in place proper evaluation mechanisms, they are bound to fall victim to major scandals caused by their own personnel. As such, organizations should come up with evaluation mechanisms that can adequately measure whether the operations in the organizations are being implemented in the right way and whether these operations meet the purposes for which they were created for. Organizations must learn from the Veterans’ Affairs Scandal and prevent such scandals from occurring by having strong monitoring and evaluation mechanisms in their systems. RECOVERY ISSUES After the Veteran’s Affairs Scandal, there are certain measures that should be taken to address the problem as a recovery plan to ensure that this scandal does not occur gain and also that the veterans who suffered are helped to regain their health. The first recovery plan is to fire all the people who were involved in the scandal starting from the Veterans’ Affairs Department and also in the Veteran’s Affairs Medical Centers (VAMCs). This will allow the appointment of new administrators who can reform the department and the VAMCs. It will also pave way for accountability and openness in the department and care centers that will ensure a better delivery of healthcare services for the veterans. Secondly, all the mechanisms that allow for secrecy and the scandals to happen without notice should all be addressed by formulating new measures and policies that close such loopholes and also clearly define the punitive measures that should be taken on persons who encourage such occurrences. Another recovery mechanism is to ensure that all the affected veterans receive free care because of the pain they underwent while the scandal happened. Despite the fact that this will not compensate the pain they went through, it will serve as a recovery action to show that the administration takes responsibility for its own mistakes and create confidence in veterans that their care will be handled effectively and adequately. The veterans should also be helped to report issues of delays in VAMCs so that those who are responsible for the delays are dealt with appropriately according to the law. References Cashour, C. (2014, Apr 24). Chairman Miller’s Statement Regarding Allegations of Veteran Deaths, Secret Waiting List at PVAHCS. HOUSE COMMITTEE ON VETERANS’ AFFAIRS. Retrieved November 5, 2014 from: https://veterans.house.gov/press-release/chairman-miller-statement-regarding-allegations-of-veteran-deaths-secret-waiting-list Culp-Ressler, T. (2014, Apr 24). Veterans are Dying while they’re waiting for months to get Health Care from the Government. Thinkprogress [Health]. Retrieved November 5, 2014 from: http://thinkprogress.org/health/2014/04/24/3430217/veterans-dying-va-backlog/ Devine, C. (2014). Bad VA care may have killed more than 1,000 veterans, senators report says. CNN.com [Edition].Retrieved October 15, 2014 from: http://edition.cnn.com/2014/06/24/us/senator-va-report/ Hearings in the 112th Congress. Senate Committee on Veterans’ Affairs website, Retrieved November 5, 2014 from: http://www.veterans.senate.gov/hearings?c=112&type=Oversight. Hicks, J. (2014). A guide to the VA health care controversy. The Washington Post. Retrieved October 15, 2014 from: http://www.washingtonpost.com/politics/federal_government/a-guide-to-the-va-health-care-controversy/2014/05/15/0a0c7f04-dc6d-11e3-8009-71de85b9c527_story.html Lichtblau, E. (2014, June 15). V.A. Punished Critics on Staff, Doctors Assert. The New York Times. Retrieved November 5, 2014 from: http://www.nytimes.com/2014/06/16/us/va- punished-critics-on-staff-doctors-assert.html?_r=0. McElhatton, J. (2014, May 18). He KNEW! Obama told of Veterans Affairs health care debacle as far back as 2008. The Washington Times [Politics]. Retrieved November 5, 2014 from: http://www.washingtontimes.com/news/2014/may/18/obama-warned-about-va-wait-time-problems-during-20/?page=all Parlapiano, A. & Karen Y. (2014, May 30). Major Reports and Testimony on V.A. Patient Wait Times. The New York Times. Retrieved November 5, 2014 from: http://www.nytimes.com/interactive/2014/05/29/us/reports-on-va-patient-wait-periods.html?_r=0. Poteet, A. (2014, May 14). The Veteran Administration’s Secret Waiting Lists: Fatal to Veterans. FAMILYS SECURITY MATTERS [Publications]. Retrieved November 5, 2014 from: http://www.familysecuritymatters.org/publications/detail/the-veteran-administrations-secret-waiting-lists-fatal-to-veterans Sen. Coburn, T. (2014). Death, Delay & Dismay at the VA Friendly Fire. (Oversight Report). Vanhala, S. & Stavrou, E. (2013). Human resource management practices and the HRM- performance link in public and private sector organizations in three Western societal clusters. Baltic Journal of Management, 8(4), 416-437. Wood, D. (2014, May 24). VA Mental Health Care Delays, Staff Shortages, Plague Veterans. The Huffington Post. Retrieved November 5, 2014 from: http://www.huffingtonpost.com/2014/05/24/va-mental-health- delays_n_5380739.html.968 Read More