Evidence of dozens of U.S. veterans dying as they waited months for appointments and treatment are just the tip of the iceberg – and the real number of deaths could be in the thousands – according to a U.S. Marine Corps veteran who closely follows the issue.

Duff said another reason the numbers are likely to soar is because of systemic bureaucracy that grinds the system to a crawl.

“In Albuquerque, New Mexico, veterans were waiting over four months with gangrene, heart disease, brain tumors. I didn’t even know you could wait that long with any of those predicaments. In Harlingen, Texas, in 2010, they decided that men had to come back with three screenings that came out positive before they could get in for a colonoscopy. By that time, it was a Stage Four cancer,” said Duff, who elaborated further on some of the red tape veterans are forced to navigate in Albuquerque.

“It came out that they had eight cardiologists on staff. But only three would work a day, and they would see only two patients per day. I’m not sure if that was two patients per cardiologist or two total. Regardless, the report I read determined that they were seeing in a week what most medical facilities could see in two days,” she said.

Duff said a final death count may prove difficult since many vets ultimately gave up on the VA system and sought care in the private sector. Duff said the most troubling aspect of this story is not just incompetent mismanagement but the blatant deceit perpetrated by VA officials around the nation.

“What disappoints me the most out of this is that it was deliberate. I used to think it was just mismanagement. I’ve been reporting on mismanagement for the past year. Now I realize it was all deliberate and it was all in the name of an almighty dollar,” she said. “I’m so shocked and saddened to know that executives at the highest level were training their employees to hide numbers, training their employees to make it look like veterans were only waiting 14 days.”

Duff added, “They were not realizing the reality nor did they care about the reality that this was going to result in many of these veterans’ deaths. And we’re talking often about our Vietnam era and older. Many of those men are not in a position where they can heal quickly and go without medical care for sustained periods of time.

“It’s tragic that these executives became so removed, so removed from the very veterans they were helping that they never looked in the eyes of these family members or went to one of the funerals or watched the pain and suffering that these men went through.”

Federal spending on veterans’ health care is up significantly in the Obama administration, and the president vowed last week to fight for as much additional money as needed to fix the system. That approach to the problem leaves Duff incensed.

“Oh please. I just want to scream when I hear somebody say, ‘Let’s slap more money onto it,’” Duff said. “They have a $150 billion budget. They requested $160 billion for the next fiscal year. They’ve never been denied anything from the Senate or the House, as far as their budget goes. Thirty-nine percent is going to medical costs. Thirty-nine (percent) of the $150 billion.”

Duff reports that 52 percent of taxpayers dollars spent at the Phoenix VA went to administrative costs, including the purchase of expensive office furniture. Another six million was spent on a sparsely attended national conference in Orlando, Florida.

“They’ve wasted thousands and thousands and millions of dollars,” she said. “The money is simply being mismanaged.”

She is also seething at Senate Democrats for blocking the VA Accountability Act, which easily passed the House and would give the secretary of Veterans’ Affairs. However, GOP attempts to approve the plan in the Senate were blocked by Senate Veterans’ Affairs Committee Chairman Bernie Sanders, D-Vt.

“Sanders has another bill of his own, another $20 billion in a pork-funded bill that he’s trying to get through the Senate. He used two false arguments. His first false argument is we need time to review the bill. It’s a three-page bill, 27 lines, Bernie. How slow do you need to read?”

Duff explained, “The second false argument is that he said this would give a greater opportunity when we change administrations for executives to be fired and that would be unfair. That’s another false argument. The Department of Defense has this authority to fire executives. This was in place in several previous administrations. Secretary (Robert) Gates used it during the Walter Reed scandal in 2007. We have heard of no executives being fired when the administrations changed so that is a false and ridiculous argument.”

She said executives would still have the right to appeal their termination, so punitive firings would be very difficult. Duff said the case of Sharon Helman is the perfect example of why reform is needed.

Helman deliberately submitted false information on the number of veteran suicides. Instead of being fired, she was promoted to director of the Phoenix VA, site of the initial reports of falsified wait lists for veterans.

With all of the promises of reform flowing out of Washington, when will America know if real progress is being made?

“We have over a quarter-million veterans who are appealing their claims. I want to see where they start getting a very solid ratio of when they grant a claim, it’s not being appealed,” Duff said. “That tells me you’re giving a quality assessment to the person who is making the claim. We’re going to see our veteran suicides drop. Right now, 22 vets a day are killing themselves due to mental health issues. Often there is a huge delay of up to three weeks getting in for a mental health exam within the VA. We’ll see that drop.

“We will also see a greater quality in care. I expect that they’ll start serving these veterans and find out how long they’ve been getting care. And I expect the Senate and the House to be monitoring this a hell of a lot closer than they’ve been. Sadly, they’ve all gotten letters from veterans complaining about the VA, but it wasn’t until Phoenix that we heard them do anything about it.”