More than a year after a scandal broke over U.S. military veterans enduring extremely long waits to see doctors at clinics run by the Department of Veterans Affairs (VA), things have actually gone from bad to worse.

The number of cases in which appointments took 30 or more days to happen has increased by 67 percent in the past year, despite more money and more staff dedicated to the VA.

Jim Hudson, an Army veteran from California who served on the front lines during the Vietnam War, has spent most of his post-war life advocating for other disabled veterans. But he still has to be his own advocate just to get the healthcare he’s owed by the VA.

Hudson, 66, spent 14 years in the military. He has been diagnosed with post-traumatic stress disorder (PTSD) and other service-related psychiatric issues.

Yet, he still has to wait six months just to see a VA psychiatrist.

“I have PTSD, anxiety, and depressive disorders, and several other issues,” Hudson told Healthline. “I’m on multiple medications. Six months is far too long to wait.”

Mark Trifeletti, a Gulf War veteran from New York, is in the same boat. Trifeletti suffers from chronic pain, and has been waiting more than three months for emergency surgery to fix a device surgically implanted at the base of his spine that was meant to give him some relief.

“I don’t have any idea if or when they’ll come through with the surgery appointment,” he said. “The pain is horrible. VA is still a mess.”

Read More: Vietnam Veterans Still Have PTSD 40 Years After the War »

Wait Times Keep Getting Longer

These veterans’ complaints are all too familiar. For many former service personnel seeking care at VA hospitals and clinics, long delays remain de rigueur — despite the fact that the issue has exploded into the public consciousness.

In 2014, whistleblowers inside the Phoenix VA hospital said staff members there were manipulating reports on wait times to make the facility look better. Some 40 veterans died in Phoenix, reportedly while waiting to see a doctor.

Virtually every major news organization covered the story. Then it snowballed. Within a few months of the Phoenix revelations, more than 100 VA healthcare facilities across the nation had been implicated for the same or similar types of behavior.

Veterans Affairs Secretary Eric Shinseki was forced to resign while President Obama and members of Congress weighed in with outrage. But neither a $16 billion bill passed largely to reduce wait times and fix systemic corruption at the agency, nor the introduction of a new program allowing veterans to seek private care if their wait was too long, have fixed the problem.

Earlier this month, Shinseki’s successor, VA Secretary Robert McDonald, said the number of appointments that had not been completed within 30 days has grown from 300,000 to nearly 500,000. And the Phoenix VA is still a quagmire.

CNN recently reported that the Phoenix VA had 8,000 requests from veterans for care in August for which wait times exceeded 90 days. Veterans with cancer reportedly died waiting for care and medical treatment, while care for almost 1,500 others was delayed because of short staffing and mismanagement.

According to the Washington Post, senior officials at the Phoenix VA did virtually nothing to respond to the severe staffing shortage as recently as April of this year, a full year since the scandal broke.

Read More: Painful Headaches Plaguing Many U.S. War Veterans »

There’s Some Good News

But not all the news is bad for veterans. Efforts by President Obama and Congress to improve the situation at VAs have succeeded on several fronts.

In a Veterans Day speech two weeks ago, the President noted that the veteran disability claims backlog was at 76,000, an 88 percent reduction from its peak in March 2013.

However, what the president did not mention is the fact that while the backlog has been substantially cut, it may have been accomplished by rejecting a larger proportion of claims. Exhibit A: The number of appealed claims is way up. The Los Angeles Times reported this week that the number of appealed disability claims went from 167,412 in September 2005 to 425,480 this October, an all-time high.

Read More: Female Marine Breaks Silence on PTSD Struggles »

Why Are Wait Times so High?

So why can’t the VA get a handle on wait times?

One reason is that far more veterans are coming to the VA for services than ever before. The VA says it has hired more doctors and nurses, but it has also had 3 million more appointments in the latest fiscal year than the previous one.

McDonald says veterans believe that the VA is finally going to put veterans first, so more are coming in.

There have also been a lot of reported snags with the Choice Program, which was designed to allow veterans facing long waits or long drives to receive care from private sector doctors. Congress has taken several steps to strengthen the program, including adjusting driving distances for appointments and opening the program up to more veterans.

But Trifelettie, who turned to the Choice Program for quicker help, said the program has been a disaster for him.

“I can authorize a visit to a doctor with the Choice Program one day, then the next day I call them and they have no authorization,” he said. “Their left hand doesn’t know what their right hand is doing.”

Read More: Brain Scan Can Tell PTSD Apart from Traumatic Brain Injury »

Where Is the Accountability?

Rep. Jeff Miller, chairman of the House Committee on Veterans Affairs, said one of the predominant reasons why things are not changing quickly enough at the VA is the agency’s “pervasive lack of accountability for corrupt and incompetent employees.”

“The VA’s pervasive lack of accountability remains the biggest obstacle to cleaning up the department and improving services for veterans,” Miller (R-Florida) told Healthline. “It’s absolutely baffling why VA leaders are so adamantly against standing up for veterans and taxpayers by firing employees whose incompetence and malfeasance has harmed veterans. One thing is certain, however. VA’s continued tolerance of corruption and fraud within its ranks will only ensure that efforts to reform the department end in failure.” 

Meaningful accountability always seems, frustratingly, just out of reach. Miller noted the example of former Phoenix VA director Sharon Helman, who was widely reported to be one of the architects of the wait time manipulation that harmed veterans. She was subsequently fired, but recently was told she could keep a $9,080 bonus.

On December 9, the House Committee on Veterans Affairs will conduct an oversight hearing to examine the VA’s “continued and pervasive lack of accountability for corrupt and incompetent employees,” according to a Congressional source. McDonald has been invited to this hearing, but VA officials have yet to confirm his attendance.

Meanwhile, Kristie Canegallo, the White House deputy chief of staff for implementation, told reporters a few weeks ago, that “a lot of really important progress has been made with respect to delivering more care for the veterans. But gosh, we've got a lot more work to do."

That is an understatement, said Trifeletti, who doesn’t care why the system remains broken. He just wants to receive the prompt care he earned serving his country.

“I’m this close to leaving the VA for good,” he said. “Nothing ever changes at the VA. They don’t care that I served my country.”