An Opt-out voucher would almost certainly eliminate virtually all of the backlog, and a good many complaints about the ineffective care bordering on malfeasance of medical practice, almost completely. But it would also make about half the employees at VA Health administration redundant or just eliminate any justification for their position at all.
And that is why the civil service unions are up and screaming, which stopped the consideration in the Senate of the bill calling for the Director of Veterans Benefits Administration to have some discretionary power to fire ineffective or incompetent managers, or those who actively engaged in unauthorized activity.
The Current Occupant is even more beholden to the union representatives than the Senate majority, else a simple phone call to Harry Reid would have been enough to pass this enabling legislation so the Director of the VBA could have the authority he needs. So nobody in the White Hut does the right thing.
A couple of days ago a federal nurses union rep. talked to a radio host saying the whole problem could be solved if they would just hire more federal employees and get more money.