"Collective": An Exposé of Vast Heath Care Fraud in Romania
27Aug 2021 by ACFE - Rhode Islahd Chapter #33
Liza Ayres
Alexander Nanau's 2019 Academy Award winning documentary "Collective" tells the story of a tragic 2015 nightclub fire that led to the discovery of Romania's vast health care fraud. Even though the fire was the deadliest in the country's history, it wasn't until several victims started dying of non-life-threatening wounds that residents began investigating the links between the nightclub fire deaths and the country's corrupted hospital industry. The incident sparked outrage over the government's health care system and inspired a whistleblower to disclose the internal secrets to the media. Nanau's heartbreaking depiction serves as a rallying cry for whistleblowers to act, especially in cases of life or death.
The tragic event
While gathered to celebrate a band's new album release, Colectiv nightclub attendants were shocked when the band's pyrotechnics ignited flammable materials, causing sparks to spread rapidly. Twenty-seven victims died on-site, many by inhaling poisonous toxins, and at least 180 others were rushed to hospitals for burn wounds, with 37 more people dying over the next few months.
Government officials constantly told the nation that they were providing adequate care for people in critical condition and that the country's hospital infrastructure met all of Europe's exemplary health care standards. However, victims began dying after several weeks in the hospitals, and many friends and family members questioned those outcomes, believing that if the victims had been under the care of a different country's emergency medicine facilities, they would have lived. Rumors quickly spread that the conditions of the hospitals and the negligence of the doctors is what actually killed them. Mass protests ensued, resulting in the resignations of the prime minster and the health minister.
Investigating the situation
Nanau's film revolves around a group of investigative journalists at a Romanian sports newspaper called Sport Gazette who looked into the public hospital mismanagement and corruption connected to the fire. While a current events story such as this one would typically not fall into a sports newspaper's domain, a whistleblower later revealed that she felt confident informing those journalists because she believed they would tell the story truthfully and not bend it to fit a certain political bias. Citizens later questioned what it meant about the state of the national media that the best current events reporting was being done by a newspaper that typically follows athlete successes and challenges.
Sport Gazette journalists launched an investigation into a company called Hexi Pharma that provided disinfectants for 350 state hospitals and, after having the product sent for testing, discovered that the disinfectant ingredients had been diluted in at least 2,000 operating rooms. The company had used fake documents to promote their product, which they then gave to hospitals where the disinfectants were diluted even more and used improperly.
After the newspaper broke the story, the journalists waited for the country's Health Minister to comment, but what he said was vague and incited further suspicion of professional misconduct and lack of quality control. Additionally, a member of one of the government's intelligence agencies came forward and declared he had sent hundreds of documents to hospitals for over eight years, reporting that the disinfectant was killing people, but the hospitals had consistently insisted that those safety reports had gotten lost and that everything was suitable for use.
Further investigation into Hexi Pharma proved that the company's manager, Dan Condrea, had created a system of hospital managers which he used to bribe the government to use his product. Condrea allegedly bought international products and then sold the ingredients at seven times the amount he paid. He had his product in at least 300 hospitals, likely risking the lives of 3.8 million people per year. The government later disclosed that there had been discrepancies in their initial tests of the disinfectants, and every single one of the disinfectants tested at the Hexi Pharma labs was diluted. Soon after, Condrea was suspiciously killed in a car crash, the evidence from which was quickly obstructed before a proper investigation could be completed.
Choosing to reveal the truth
As more incriminating information from the investigations surfaced, and as victims who had only been minimally burned continued to die, a former doctor chose to blow the whistle on the whole health care system in Romania. The whistleblower, believing the doctors were at the point where they cared only about money and not about the patients, remarked that "we were no longer human." She knew she needed to say something.
In her accounts to journalists and to the country's new health minister, the whistleblower detailed the extent of the corruption and mismanagement in the hospitals. Many hospital managers were put into their positions simply because they held an administrative role in a political party, and doctors were allegedly accepting bribes to care for certain patients before others. A former hospital accountant admitted to processing fake invoices worth tens of millions of dollars so that hospital managers could steal the hospital's money for their personal use.
Moreover, the country's previous health minister later admitted he put all the burn victims in the same crowded unit, where many patients were forced to share beds, because he didn't want to pay to transport them abroad where they would get better treatment, fully knowing the country's hospitals were not equipped to care for burn victims.
The whistleblower explained that the doctors blatantly disregarded patients. She said the hospital staff covered victims' faces with sheets so they didn't have to see them, and she showed the health minister a video in which maggots were eating victims because the disinfectants didn't adequately work, but the staff largely did nothing to ameliorate the situation.
Replacing a whole infrastructure
The documentary follows the new health minister's revelation of the deep layers of corruption and his acknowledgement that fixing anything would require an overhaul of the whole system. He created strict regulations for any new hospital manager, but he appeared disheartened at the constant reminders that "the entire selection process is rotten to the core," as he noted. He realized he would need to restructure everything to attempt any eradication of the corruption.
At the end of the documentary, the Social Democratic Party — the party responsible for the initial corruption — swept the election, and the public hospital appointed a manager who was legally unqualified to manage a hospital. Several of the documentary's subjects lacked hope for any improvement to the situation.
While somber, Nanau's exposé reveals haunting truths of what can occur when corruption goes unchecked for years. His documentary offers a lesson in the importance of regular institutional auditing and the powerful strength of whistleblowers to come forward in unjust situations.