The VA had until recently resisted the linkage of dozens of deaths in the Phoenix system directly to the wait-list fraud that has engulfed the agency, and finally forced the resignation of VA Secretary Eric Shinseki. Whistleblowers claimed that 40 veterans died while stuck on paper lists as VA officials cooked the books, denying them access to medical care. Last month the VA finally recognized that 17 veterans at least died while being kept out of the appointment system, and yesterday acting Secretary Sloan Gibson announced that 18 more had been identified — bringing the total to 35 confirmed:

An additional 18 veterans in the Phoenix area whose names were kept off an official electronic Veterans Affairs appointment list have died, the agency’s acting secretary said Thursday – the latest revelation in a growing scandalover long patient waits for care and falsified records covering up the delays at VA hospitals and clinics nationwide.

Acting VA Secretary Sloan Gibson said he does not know whether the 18 new deaths were related to long waiting times for appointments but said they were in addition to the 17 reported last month by the VA’s inspector general. The announcement of the deaths came as senior senators reached agreement Thursday on the framework for a bipartisan bill making it easier for veterans to get health care outside VA hospitals and clinics.

The 18 veterans who died were among 1,700 veterans identified in a report last week by the VA’s inspector general as being “at risk of being lost or forgotten.” The investigation also found broad and deep-seated problems with delays in patient care and manipulation of waiting lists throughout the sprawling VA health care system, which provides medical care to about 9 million veterans and family members.

Richard Griffin, the VA’s acting inspector general, told a Senate committee three weeks ago that his investigators had found 17 deaths among veterans awaiting appointments in Phoenix. Griffin said in his report last week the dead veterans’ medical records and death certificates as well as autopsy reports would have to be examined before he could say whether any of them were caused by delays in getting appointments.

The issue of the whistleblowers is a key point, because that was not exactly a risk-free maneuver. At least 37 whistleblowers have claims of retaliation for their efforts to protect veterans from the fraud and abuse of the wait-list activities, Breitbart’s Kerry Picket reports, and the Office of Special Counsel has opened probes into them:

The U.S. Office of Special Counsel (OSC) announced on Thursday that it is presently investigating allegations from 37 Department of Veterans Affairs (VA) employee whistleblowers at VA facilities in 19 states of retaliation for disclosing improper scheduling practices and other threats to patient care.

The OSC gives three examples of alleged retaliation toward VA whistleblowers they are looking into and were able to provide “interim relief to these employees” through requested stays to the particular VA’s in question. …

“In one case, the OSC requested and obtained a stay of a proposed 30-day suspension without pay for a VA employee who reported the inappropriate and continuous use of patient restraints in violation of VA rules and procedures,” the agency says.

According to the OSC, the employee had never before been punished in over two decades while working for the VA.

In another case at a different VA facility, an employee received a proposed seven-day suspension after conveying concerns to the Inspector General regarding inadequate scheduling and coding procedures at the facility.

One whistleblower called the culture of the VA similar to that of a “crime syndicate.” These cases may end up establishing that this description may be more accurate than even the whistleblower knew.

Meanwhile, the Senate has found a bipartisan compromise on VA reform, which they hope will allow for some quick improvements. There is at least one flaw in this plan, though:

Senators announced a broad proposal Thursday to address health-care failures at the Department of Veterans Affairs that would authorize spending $500 million to hire more doctors and nurses, allow veterans to be cared for outside the overburdened system and give the next veterans secretary greater authority to fire employees for incompetence. …

A key provision of the deal, already approved by the House, would allow the VA secretary to clear out the department’s clotted bureaucracy by immediately firing or demoting senior officials tied to mismanaged or delayed medical care for veterans.

The worker would be immediately removed from the payroll but, in a nod to concerns that career government employees were at risk of losing their due process rights, the Senate deal gives the worker up to seven days to appeal the decision to the Merit Systems Protection Board, a federal panel that hears such appeals. The board would have three weeks to issue a decision.

The agreement also would give veterans greater flexibility to seek medical care at facilities not run by VA if they are experiencing long wait times or live more than 40 miles from the nearest VA hospital or clinic. Veterans could choose instead to seek care at private facilities that accept Medicare, federally qualified health centers, Indian Health Service facilities or medical facilities run by the Defense Department.

The bill would authorize VA to sign leases for 26 major medical facilities in 18 states and Puerto Rico and to use $500 million in unobligated spending on new doctors and nurses with expedited hiring authority to meet growing demand for medical care from older, aging veterans and younger veterans trying to adapt to civilian life after the wars in Iraq and Afghanistan.

Did you spot the flaw? The ability to seek outside care with VA coverage depends on wait times. Just who will be measuring those wait times? Don’t think for a moment that vets spending VA money in private-sector clinics and hospitals won’t produce pressure to block them from doing so, and one way to ensure that will be to insist that wait times aren’t a problem at the local VA. If bonuses incentivized this wait-list fraud, just wait until these incentives come into play.

Veterans should have the unconditional ability to seek care for non-service-related illnesses and injuries wherever they please without asking a bureaucrat for a by-your-leave to do so. Real reform will include allowing for those choices, and anything short will be nothing more than a Band-Aid on a cancer.