Shinseki got his job as a result of activities as a Democrat Party operative

VA chief Shinseki has a lot to explain: Our view

Barry Coates, a 44-year-old Army veteran, visited VA hospitals and clinics in South Carolina seven times starting in 2010, complaining of severe stomach pain and rectal bleeding and practically begging for a routine cancer screening test.

When Coates finally got the colonoscopy, more than a year after his first visit, it was too late. Doctors found a huge tumor and diagnosed him with late-stage colon cancer, which has since spread to his liver and lungs. "I stand before you terminally ill," Coates told a House hearing last month, adding, "Someone should be held accountable."

So far, no one has been, although that might be about to change.

At a hearing on Thursday, senators from both parties expressed outrage over a string of reports from across the country of treatment delays, deaths of patients waiting for care, coverups and alleged document destruction at a VA facility in Phoenix. Veterans Affairs Secretary Eric Shinseki declared himself "mad as hell."

VETERANS AFFAIRS : We can, and must, do better

More than anger is needed, however. It's action to identify and fix what appear to be longstanding, systemic problems. Reports and investigations going back years show a VA system overwhelmed by a surge of veterans needing care, often unable to give them timely treatment and plagued by some workers cooking the books to hide unacceptable delays. Among the most disturbing reports:

• The deaths of 23 veterans were linked to delayed cancer screenings dating back four years at 13 facilities in nine states. Six veterans died after delays at a single hospital in Columbia, S.C.
• Veterans in Fort Collins, Colo., waited months to be seen, and clerks were taughthow to falsify appointment records to make it appear the small staff of doctors was meeting performance goals. Similar games were played at a VA center in Cheyenne, Wyo.
• At the VA hospital in Phoenix, a retired doctor charged that some patients facing lengthy waits for appointments were omitted from electronic files and placed on a "secret" paper waiting list. Forty died, he said, but it is unclear whether their deaths were linked to the delays. This month, a high-ranking physician at the Phoenix hospital told The Arizona Republic that there was an attempt to destroy evidence of the waiting list manipulations.

For VA leaders — including Shinseki, who has been on the job since 2009 — these problems should come as no shock. In April 2010, an internal VA inquiry found systematic "gaming strategies" at regional clinics to hide delays. The report cited about two dozen gaming techniques, some involving falsifying records.

There is no evidence of effective follow-up.

Bipartisan concern over Shinseki's leadership is increasing, and one major veterans group has called for his ouster. Firing at this point mightbe premature, but the VA chief has a lot to explain.

At Thursday's hearing, Shinseki said he's awaiting results from an investigation of the Phoenix VA and his own nationwide audit. To save his job, he'll need to act more decisively than he has if the needless parade of negligence and death is to be stopped.