Are There Virtues in Whistleblowing? Perspectives from Health Care Organizations

By Cruise, Peter L. | Public Administration Quarterly, Fall/Winter 2001 | Go to article overview

Are There Virtues in Whistleblowing? Perspectives from Health Care Organizations


Cruise, Peter L., Public Administration Quarterly


ABSTRACT

Another frontier of contemporary ethics is using whistle-blowers as a means to fight fraud and abuse in health care organizations. The federal government does this by increasingly relying on the False Claims Act and qui tam suits brought by whistleblowers. This article argues that this approach is dysfunctional for both the whistleblower and the organizations targeted by them. The article proposes that enhanced standards, informed by virtue ethics and utilized by independent bodies such as the Joint Commission on the Accreditation of Healthcare Organizations or JCAHO during the health care organization accreditation process, offer a better alternative to the current retributive approach now used by the federal government.

INTRODUCTION

Since the mid-1990s, the federal government increasingly relied on whistleblowing as a method to control fraud, waste, and abuse in the Medicare and Medicaid programs. Although not the result of a single, specific policy decision, several factors combined to create the situation. First, in 1986, an amendment to the Federal False Claims Act made the filing of whistleblower suits much easier. Second, in 1995 in an effort to combat fraud, waste, and abuse in both Medicare and Medicaid, the U.S. Department of Justice (DOJ) implemented a new anti-fraud, waste, and abuse program called "Operation Restore Trust" or (ORT).

Elected officials and managers, working in the program offices of both Medicare and Medicaid programs and even in the general public, were confused about fraud. Waste, and abuse for years. Medicare alone lost $20 billion in 1997 to fraud, waste, and abuse, translating to a loss of 11 cents of every Medicare dollar spent in the United States (HCFA, 2000). Although we will not know the exact dollar amount of Medicare and Medicaid funds lost to fraud, waste, and abuse, a reduction of any sort in those losses will not only result in a financial savings for the taxpayers but will provide much needed increase in public confidence in the future integrity of the programs.

As a method of achieving these ends, whistleblowing is not without its hazards. For example, very often during the process of disclosure the individual whistleblower is placed at extreme personal and professional risk. Although the False Claims Act allows for potential financial gain for the successful whistleblower, many whistleblowers ultimately regret their decisions. Moreover, many of the organizations targeted by whistleblowers suffer both during and long after the original allegations (Burton, 1993; Kircheimer and Taylor, 2000).

This article argues that whistleblowing is dysfunctional for both whistleblowers and their organizations. Health care organizations, whose primary mission is to care for the sick and injured in an increasingly competitive marketplace, can ill afford such a dysfunctional situation. Yet, fraud, waste, and abuse in health care persist and public managers and policy-makers should not ignore it.

This article suggests that our health organizations need alternative methods that do not cause disruption and dysfunction to address the problem of fraud, waste, and abuse in health care. According to Fletcher, Sorrell, and Silva (1998), private health care accrediting organizations such as the Joint Commission on the Accreditation of Healthcare Organizations or JCAHO can provide a viable alternative to whistleblowing but only if the JCAHO goes beyond mere compliance with standard practice.

This article argues that the JCAHO accreditation process can provide an alternative to whistleblowing but only if it includes a strong ethical grounding in its approach to health care accreditation. This article examines the potential for virtue ethics, as first described by Aristotle and later developed by Lynch and Lynch (1997), as an ethical mindset for managers in both public and private organizations to provide just such an ethical grounding for the JCAHO standards. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Are There Virtues in Whistleblowing? Perspectives from Health Care Organizations
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.