The report from Sen. Tom Coburn, R-Okla., himself a physician, “aggregates government investigations and media reports to trace a history of fraudulent scheduling practices, budget mismanagement, insufficient oversight and lack of accountability that have led to the current controversy plaguing the VA”, CNN reported.

CNN was the first to break the story that some U.S. military veterans had died after being placed on a “secret waiting list” at the VA medical center in Phoenix, Arizona.

Poor management is costing billions

The VA has since admitted that 23 patients died awaiting care that was delayed months, but Coburn’s report titled “Friendly Fire: Death, Delay and Dismay at the VA” reveals that many more deaths have been linked to system-wide failures at VA hospitals and clinics all over the country.

Coburn stated that if the VA’s budget had been handled properly and the correct management put in place, many of those deaths could have been avoided.

“Over the past decade, more than 1,000 veterans may have died as a result of VA malfeasance”, Coburn, who has survived three bouts with cancer, said.  He believes the government should offer veterans access to private-sector hospitals and clinics.

“Poor management is costing the department billions of dollars more and compromising veterans’ access to medical care,” he said.

Malpractice suits, office remodeling, bonuses

Coburn’s office said that the VA has allocated some $20 billion since the beginning of the Iraq and Afghanistan wars to a number of non-health-related projects, such as office remodels, unused software licenses, undocumented government debit card purchases, the funding of call centers that received just 2.4 calls per day on average and bonuses for top officials, including administrators of the facilities where vets died waiting for care.

As CNN reported:

“In 2013, four VA construction projects in Las Vegas, Orlando, Denver and New Orleans cost an extra $1.5 billion because of scheduling delays and excessive expenditures, the report shows.

“Additional funds have been funneled into legal settlements. Since 2001, the VA has paid about $845 million in malpractice costs, of which $36.4 million was used to settle claims involving delayed health care.”

Additional scrutiny has been applied to the VA’s budget following revelations about the controversial bonus system payments; they allegedly created incentives for administrators and managers to hide the fact that patients had to wait months for care.

At a recent congressional hearing, VA Assistant Secretary for Human Resources and Administration Gina Farrisee confirmed that 78% of senior VA managers qualified for extra pay or other compensation in fiscal year 2013 (fiscal years run from Oct. 1 – Sept. 30), despite the malpractice and treatment delay controversies.

Here’s one of the more egregious examples:

“Former VA Regional Director Michael Moreland received a $63,000 bonus in 2013 for infection prevention policies, for example, but the VA’s Office of Inspector General concluded that his policies failed. Moreland presided over the Pittsburgh VA, where an outbreak of Legionnaires’ disease killed six veterans in 2011 and 2012.”

In addition, Coburn’s report identified crimes that had been committed by VA staff, such as drug dealing, theft and sexual abuse of patients. The incidents spanned the past several years.

Some names and positions might change, but the real answer — getting government out of the healthcare business altogether — won’t.

Coburn — who said he wasn’t surprised by his report — knows; he was trained in a VA hospital.

“The culture in the VA should be people working for veterans, not for the VA, [but] the culture right now is that I work for a system … and the requirements are so low,” he told Politico.