The scandal in veterans' health care has centered around facilities in the Phoenix area, where more than 40 patients are alleged to have died as a result of scheduling delays.

Unfortunately, an interim report issued Wednesday by the inspector general of the Department of Veterans Affairs made the point that the VA's problems are nationwide in scope.

While the findings of the IG - the independent watchdog of the Department of Veterans Affairs - didn't take up the question of mortality, it provides a sickening picture of scheduling-record manipulation that resulted in delays far in excess of that reported by staff.

The IG report also provides a powerful indictment of rampant failures of oversight by the agency's leadership, including VA Secretary Eric Shinseki.

For example, a statistical sample of data for 226 veterans provided by the Phoenix VA medical facility cited an average waiting time of 24 days for an initial visit. But the inspector general's review found that the average wait for the first visit was actually 115 days.

Moreover, the IG found that some 1,700 Phoenix-area veterans were placed on so-called "unofficial" waiting lists which gave no assurance when - or if - they would be seen by a physician.

Similar complaints are being investigated at VA facilities across the nation - so far with unsettling results.

"Our reviews at a growing number of VA medical facilities ... have confirmed that inappropriate scheduling practices are systemic," the IG reported.

Consequently, further reviews are under way at other VA hospitals to determine the extent of the problem across the nation. It's a first step toward accountability, but the VA has a long way to go. The IG reported that scheduling problems have been cited periodically since 2005.

Incidentally, site visits by the IG staff are not being announced in advance "to reduce the risk of destruction of evidence, manipulation of data and coaching staff on how to respond to our interview questions," acting IG Richard J. Griffin wrote. "To date, we have ongoing or scheduled work at 42 VA medical facilities and have identified instances of manipulation of VA data that distort the legitimacy of reported waiting times."

In short, it is a general breakdown of the VA's mission. And the IG added ominously, those investigatory efforts are being coordinated, as warranted, with the Department of Justice when criminal intent is suspected.

Included in the report is a list of elaborate scheduling techniques used by VA officials to obscure patient backlogs and extended waiting periods.

If as much ingenuity had been used in actually getting veterans the care they needed in a timely manner, the scandal might have been averted - and lives might have been saved.

Prompt scheduling is necessary for patient health. But the mere appearance of timely scheduling can help employees get good job reviews and better compensation.

Health care is a promise made by the federal government to those who have served in the military, and to those who are considering enlisting. That fundamental promise obviously has been broken - and systemic practices have been used to cover up that appalling fact.

The veterans of our armed forces need - and have earned - high-quality health care.

And the Department of Veterans Affairs needs a thorough overhaul - starting at the top.