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What has changed in the two years since news broke that hundreds of veterans died while waiting for care on U.S. Department of Veterans Affairs wait lists?

Sadly, not much.

The VA medical center in Phoenix is exhibit A for the VA’s continued failure. This facility should have been the first one fixed, given its central role in 2014’s secret wait list scandal, but it took until last month for the VA to even begin the process of firing some of the officials responsible for that disgrace. Worse yet, the excessive wait times that likely contributed to veterans’ deaths continue.

Why is this still happening? It all comes down to a lack of accountability.

Back in 2014, we learned from news reports that at least 40 veterans died waiting for care from the Phoenix VA because they had been placed on a secret wait list designed to hide excessive delays in health care appointments. Eventually, it was reported that 293 veterans died while on some sort of wait list at the Phoenix VA. In other words, veterans were swept under the rug.

Fast forward to 2016, and little has changed. More than 100 surgeries were canceled earlier this year because of unaddressed ventilation problems allowing inches of dust to accumulate on medical equipment. According to one whistleblower, this problem could have been addressed long ago, and failure to do so needlessly delayed veterans’ care.

There is clear evidence a toxic work environment contributed to these events. As one doctor noted, VA employees have been discouraged from reporting wrongdoing, because “If they speak out or say anything to anybody about it, they will be fired and they know that.”

With issues like this, it’s no wonder more than 12 percent of health care appointments made across the Phoenix VA system have wait times longer than one month. As of March, there were more than 8,000 appointments with waits longer than 30 days. These excessive delays are dangerous for veterans who urgently need treatment.

This dynamic is playing out at VA hospitals across the country — not just in Phoenix — making it clear that the VA is in dire need of more accountability and other reforms. The Veterans Access, Choice, and Accountability Act of 2014 was a start, but not enough. There must be stronger legislation passed to protect veterans and good VA employees from unprofessional or unethical employees.

For example, Sharon Helman was the director of the Phoenix VA system at the time of the scandal. Although there have been news reports that she was aware of the secret wait lists and even encouraged staff to use them, it took seven months to fire her. Even then, a government board ruled that there was not enough evidence to fire her for the wait lists alone, only upholding her firing on unrelated charges of failing to report donations from lobbyists, to which she pleaded guilty last month.

Or consider the three other Phoenix VA executives the leadership is finally proposing to fire. These executives, including the Phoenix hospital’s chief of staff, were found by the VA Inspector General to have been involved in the use of secret wait lists and to have retaliated against whistleblowers at the Phoenix VA. VA Deputy Secretary Sloan Gibson said he was “disappointed” it took so long to discipline them.

Talk about an understatement.

The VA Accountability Act would go a long way toward addressing this issue. Currently held up in the Senate, this legislation would empower the VA to replace employees who commit wrongdoing in a more timely manner, while simultaneously protecting whistleblowers from retaliation. This bill passed the House of Representatives with votes from both sides of the aisle.

Introducing accountability to the VA is the first of many necessary steps to fixing the still-troubled agency, but those steps need to be taken right away. Two years is too long when veterans’ lives are on the line.

Dan Caldwell, a Marine Corps veteran who served with the 1st Marine Division in Iraq, is vice president of political and legislative action for Concerned Veterans for America.

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