WASHINGTON — Veterans Affairs Secretary Eric Shinseki insisted today that he’s “mad as hell” about the wait list scandal and reported deaths of dozens of veterans seeking care, but his undersecretary suggested that VA employees who cooked the books might not even lose their jobs.

Senate Veterans Affairs Committee Chairman Bernie Sanders (I-Vt.) stressed that he wanted to save a hearing on the scandal for a later date, and instead declared the hearing should be about “what is going well and what is not going well” in VA healthcare.

In the second panel of the hearing, Sanders asked the leaders of major veterans organizations one by one if their members were, for the most part, satisfied with VA healthcare. The trending answer was yes — once veterans got through the gantlet of trying to get an appointment.

“There is no question to my mind that VA healthcare has problems, serious problems. But it is not the case that the rest of healthcare in America is just wonderful — everybody walks in, gets immediate care, gets great care, at no cost. It’s all affordable,” said Sanders, who is a proponent of universal healthcare. “That’s not the world we live in.”

Sen. Patty Murray (D-Wash.), the past chairwoman of the committee, stressed that the “recent allegations are not new issues.”

“They are deep, system-wide problems and they grow more concerning every day,” Murray said. “…The GAO reported on VA’s failures with wait times at least as far back as the year 2000. Last Congress, we did a great deal of work around wait times, particularly from mental healthcare. The inspector general looked at these problems in 2005, 2007 and again in 2012. Each time they found schedulers across the country were not following VA policy. They also found in 2012 that VA has no reliable or accurate way of knowing if they are providing timely access to mental healthcare.”

“The lack of transparency and the lack of accountability is inexcusable and cannot continue on. The practices of intimidation and cover-ups has to change, starting today, giving bonuses to hospital directors for running a system that places priority on gaming the system and keeping their numbers down, rather than provide care to veterans has to come to an end,” she continued. “But, Mr. Secretary, it can’t end with just dealing with a few bad actors or putting a handful of your employees on leave. It has to go much further and lead to system-wide change.”

Shinseki said “veterans should feel safe in using VA healthcare.”

“Any allegation, any adverse incidents like this, makes me as — makes me mad as hell. I could use stronger language here, Mr. Chairman, but in deference to the committee, I won’t,” he said.

“If any allegations are true, they’re completely unacceptable to me, to veterans, and, I will tell you, the vast majority of dedicated VHA employees who come to work every day to do their best by those veterans. If any are substantiated by the inspector general, we will act.”

To rectify the crisis, the secretary said, “VA will continue to aggressively develop and sustain reliable systems and train employees to detect and prevent healthcare incidents before they happen.”

When Sanders asked Shinseki if he was aware of VA employees “cooking the books” — shifting veterans onto secret waiting lists to make their stats for appointment times look better — Shinseki replied, “I’m not aware other than a number of isolated cases where there is evidence of that.”

He told Ranking Member Richard Burr (R-N.C.) that last Friday he put on administrative leave an employee in Fort Collins, Colo., revealed to have written an email on ways to “game the system.”

The secretary also said that a December report from the Cheyenne Medical Center and Fort Collins clinic — which found the “medical center’s business office training included teaching them to make the desired date the actual appointment, and if the clinic needed to cancel appointments, they were instructed to change the desired date to within 14 days of the new appointment” — just came to his attention “recently.”

Murray noted that an undersecretary warned her at a 2012 hearing that “gaming is so prevalent, as soon as new directives are put out, they’re torn apart to find out how to get around the requirement.”

“And the standard practice at the V.A. seems to be to hide the truth in order to look good. That has got to change once and for all,” she said. “And I want to know how you’re going to get your medical directors and your network leaders to tell you, whether it’s through this survey or in the future, when they have a problem and will work with you to address it, rather than pursuing these secret lists and playing games with these wait times.”

“Senator, if there’s anything that gets me angrier than just hearing allegations is to hear you tell me that we have folks that can’t be truthful because they think the system doesn’t allow it,” Shinseki retorted.

“This review will not work if those people who are telling you the information do not tell you the truth,” Murray noted of the VA’s plan to survey employees in its investigation.