Impressed? Not everyone is, considering the circumstances, timing, and personnel involved. Congress gave the new Secretary of Veterans Affairs broader powers to dismiss officials who contributed to the VA’s wait-list scandal before leaving on their summer recess. More than two months later, and five months after the resignation of the previous VA Secretary, the VA has finally gotten around to exercising some of that new authority:

The Veterans Affairs Department said it is firing four senior executives as officials move to crack down on wrongdoing following a nationwide scandal over long wait times for veterans seeking medical care, and falsified records covering up the delays.

The dismissals are the first since Congress passed a law this summer making it easier for veterans who experience delays to get care outside VA’s nationwide network of hospitals and clinics. The law also made it easier for the agency to fire senior officials suspected of wrongdoing, shortening their appeals process to 28 days.

Among those being fired were a top purchasing official at the Veterans Health Administration, directors of VA hospitals in Pittsburgh and Dublin, Georgia, and a regional hospital director in central Alabama, the VA said.

Did they say four? Actually, it’s more like three:

But a Republican congressman challenged the VA, saying that at least one of the employees being fired has already announced his retirement. John Goldman, director of the Carl Vinson VA Medical Center in Dublin, Georgia, said last month he was stepping down. Employees at the hospital have admitted to keeping false records to hide long wait times for veterans.

“Bragging about the proposed removal of someone who has already announced his retirement can only be described as disingenuous,” said Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs Committee.

Besides, the list of hospital locations appear to have one key missing entry. What about Phoenix, where the deaths of as many as 239 veterans could be tied to a lack of care resulting from wait-list fraud? The top officials there are still drawing their salaries — and one of those implicated is still on the job, according to Stars and Stripes:

Phoenix VA Health Care System Director Sharon Helman, who is on paid administrative leave, and her chief of staff, Darren Deering, who remains in his job, have come under fire from current and former Phoenix employees, who are perplexed that they still have their jobs.

“Until the VA holds some of those people accountable, nothing is going to change,” said Paula Pedene, a former spokeswoman for the Phoenix VA Health Care System who was reassigned to a basement library after speaking out about systemic problems.

Not much else has changed, either:

Employees of the beleaguered Phoenix VA health care system say many of the problems that led to a nationwide scandal still plague the system five months after revelations of patients dying on secret wait lists, falsified data and a toxic culture.

“As far as the administrative culture, I haven’t seen any change at all,” said Phoenix VA doctor Katherine Mitchell, who was reassigned after reporting problems with emergency care at the hospital. “Certainly, my chain of command hasn’t been changed.”

Disingenuous is a pretty good word to describe the VA’s reform efforts so far. The difficulty in firing poorly performing (or worse) executives was only one small part of the problem that created this scandal. The VA runs for its own benefit, not that of the veterans. That’s obviously not true of many VA employees, but it is true of the organization. Firing a few people won’t change that dynamic, nor improve service in any substantive manner.

The only way to force that kind of change is to force the VA to compete for patients. Veterans deserve the choice of providers for their care, especially care outside of the VA’s acknowledged expertise on combat-related illnesses and injuries. Most of these patients who died waiting for medical care needed attention for non-service-related illnesses that could easily have been addressed by other providers outside of the VA’s closed, single-payer system. Don’t expect any real change at the VA as long as that same structure remains.