It’s been more than six months since CNN and then the Arizona Republic began reporting about veterans dying while they were waiting for medical services—in some cases, on secret lists that clinics were maintaining to hide the long delays from authorities in the Department of Veterans Affairs. It’s not clear how many of these people died because they were waiting for care. An initial examination of 17 deaths, in Phoenix, suggested that none were the product of delays. Then again, it's not clear how much such nuance should matter. People who really need medical care shouldn’t have to wait for it, especially when those people have served their country. Everybody in Washington seems angry. For a change, they should be.

But angry at whom? It's hard to be sure right now. Conservatives say this story is proof that big government bureaucracies are prone to failure—and that Obama has failed to create the "21st Century V.A." he promised as a candidate. Both claims seem credible but, even together, they also seem incomplete. The process for getting veterans into the government's health system—and then getting them seen by VA medical professionals—has a long history of problems, dating back decades. And while the Obama Administration obviously hasn't solved them, it's presided over significant improvements in these and other areas of veterans services—at a time when the need for care from wounded veterans is growing.

Some of the best reporting on the scandal has come from Jordan Carney and Stacy Kaper of National Journal. As their stories point out, the struggle to make sure veterans get the assistance and care they need dates at least as far back as the presidency of John F. Kennedy. There have been ups and downs, frequently set off by surges in demand. In the 1990s, for example, federal lawmakers changed eligibility guidelines, so that all veterans—not just those with service-related disabilities or low incomes—were eligible to get medical services at government-run veterans’ clinics. That flooded the system and caused delays.

In 2001, the General Accounting Office issued a report warning that wait times for medical services at VA clinics were excessive—and dangerous. Since that time, wars in Afghanistan and Iraq have created a whole new generation of veterans. Advances in battlefield medicine have allowed more fighters to survive serious injuries, but that has also meant more returning home with wounds and disabilities, both physical and mental. Even though the total number of veterans has been declining, as the World War II generation passes on, the number of veterans seeking care has been increasing—placing further strains on the system. As my colleague Alec MacGillis has noted, the lawmakers screamingly most loudly right now seem blissfully unaware that the need for VA services is a direct by-product of wars they supported even more enthusiastically.

But demand alone doesn’t explain the VA's problems. Antiquated, sclerotic bureacracies are also part of the story. Veterans who wish to use VA health services must first apply. They also must get determinations about what kinds of disabilities they have—and how they got them. Those determinations are important: Veterans who lost limbs in battle, for example, get priority for services over those who served stateside without injury. The application files are still on paper, creating a huge backlog. The process also inflates wait times for actual medical services, since the disability determinations frequently require tests and checkups at VA medical facilities.