The difference is between trained investigators from the Department of Justice whose job it is to ferret out waste, fraud and abuse — lying to them can trigger criminal penalties — and V.I.S.N. office workers who ask a few questions of clinic staff members who may be afraid to speak the truth out of fear of retribution.

Here’s another idea: I would much prefer to have Debra A. Draper, the director of the Health Care Government Accountability Office, conduct an anonymous electronic survey of primary care providers, nurses and clerks at every V.A. hospital and clinic across the nation to find out what they think the real new and returning patient waiting times are. Then her team should give the hospital administrators a one-week amnesty period to report their own version of the waiting times. If the numbers match, then you have reliable data. If they don’t, then send the inspector general out to audit them. If the hospital administrators have fudged their data, fire them and prosecute them to the maximum extent under the law.

A full accounting is necessary in the narrow sense to punish those who engaged in improper or illegal conduct. In a larger sense, the accounting is needed because the V.A. must determine the magnitude of its problem in order to design a solution.

It is apparent to me that the scheduling scandal is a symptom of a much more serious disease — a mismatch between the V.A.’s mission and its resources. Today’s V.A. health care system in general does a very good job at providing chronic care, and it excels at things like blood pressure and diabetes control. It has an excellent computerized records system that is second to none in transferring clinical information from facility to facility across the nation.

Where it breaks down badly, especially out West and in other sparsely populated parts of the country, is in the provision of urgent and emergency care where the distance to any suitable hospital, let alone a V.A. hospital, can be great. We should think about giving veterans in these situations something like a Vetacare card, which could be used for urgent or emergency care, or both, and subsequent hospitalization if needed. This would allow for more immediate treatment, and the V.A. could be billed directly.