It’s been three years since we learned veterans in Phoenix were forced to wait months for care and many died while they waited on secret lists created by VA employees. Administrators at the VA Hospital in Phoenix doctored wait times to meet wait time goals and collect bonuses.

Wait list manipulation kept 1,700 veterans who had requested appointments off official wait lists and many left without the health care they desperately needed. Investigators identified hundreds of cases where veterans passed away while waiting, some from conditions that may have been treatable if caught in time.

As the years went on, the VA scandal only grew. Investigators discovered manipulated wait times in VA hospitals around the country, and called the problem “systemic.” According to Arizona Central, the newspaper that broke the original story, “VA medical centers nationwide have misrepresented or sidetracked patient scheduling for more than 57,000 former military personnel, and about 64,000 more were not even on the agency’s electronic waiting list for doctor appointments they requested.”

Despite public outcry, congressional hearings, and the resignation of the VA secretary, little has changed in those three years. In some ways, it’s gotten worse. The stories that have come to light demonstrate a toxic culture at the VA that puts unaccountable bureaucrats over the needs of those who served their country.

• In 2014 and 2015, the VA paid out hundreds of millions in bonuses to employees, including senior staffers working at hospitals at the center of the wait list scandal. In one case, a chief of staff was awarded a $5,000 bonus four months before he was fired.

• Between 2004 and 2014, the VA spent about $20 million on artwork for VA hospitals. The VA spent $21,000 for a fake Christmas tree and paid $670,000 for two sculptures at a rehabilitation center for blind veterans.

• In 2015, a Senate committee released a report titled Tragedy at Tomah highlighting the shocking actions of a doctor at the Wisconsin VA hospital nicknamed the “Candy Man” because of “his alleged reputation for dispensing drugs like candy.” Dr. David Houlihan prescribed 712,000 oxycodone pills for around 25,000 veterans. The report tells the heartbreaking story of a Marine veteran who passed away at the facility and was later found to have “a cocktail of over a dozen different drugs in his system when he died.” The Candy Man stayed on paid leave for almost a year before being fired.

• Also in 2015, news organizations began reporting on the debacle that is the VA hospital in Aurora, Colorado. The project had been under construction for years and was supposed to be completed in 2014, but the project was years behind and could wind up costing taxpayers nearly five times the original estimate of around $300 million. The project is expected to be completed in 2018.

This is by no means the only construction debacle for which the VA is responsible. Former Florida Representative Jeff Miller, who chaired the House Veterans Affairs Committee, announced in 2015 that “nearly every major VA hospital-construction project is behind schedule and hundreds of millions over budget.”

• Later in 2015, a group of VA employees were investigated for what they called a “Forum of Hate,” where they passed around messages that used racial slurs and profanity to mock and demean the veterans they were supposed to be serving. Those employees still haven’t been fired.

• In 2016, a USA Today analysis of reports from the VA found 40 medical facilities in 19 states and Puerto Rico had regularly doctored wait times for veterans. In some cases, administrators had been manipulating lists for almost a decade. USA Today also discovered supervisors in seven states gave explicit instructions ordering schedulers to doctor wait times.

• Several months later, another USA Today report found rather than firing bad employees, the VA was simply transferring them to new facilities. The article found the VA had only hired “eight medical center directors from outside the agency” since the VA scandal broke in 2014.

These examples barely scratch the surface of a horrible pattern of waste, fraud, and abuse by those tasked with providing health care for veterans. Serious reform is desperately needed to hold VA employees accountable for their actions.

Last month, a bipartisan coalition in the House passed the VA Accountability First Act of 2017 to give the VA secretary the authority to fire employees found guilty of misconduct. Now it’s up to the Senate to stand up for veterans and pass the legislation. This legislation is so important that for the first time ever, a VA secretary has called on Congress to pass reforms so administrators can start to clean up the agency. It’s time for the VA to put veterans first.

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