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Ducks1944: I suspect that this came about this way.

Auditing or monitoring case loads showed that there was a long wait time for vets to be given appointments. So, rather than insist that the managers crack down and solve the problem (something which may have been thwarted by the union members anyway), Congress decided to throw money at the problem. As an incentive to reduce wait times, Congress offered bonuses.

Seeing an opportunity to make some extra money, or realizing that they could not possibly make the union workers be more productive, the managers came up with a scheme which would create secret waiting lists. This way, it would seem that great progress was being made to reduce waiting times, at least on paper! The people who were put on the lists thought they were going to get appointments, so they simply waited and suffered, or died. Also, the managers were able to disable the computer codes which tracked the case loads so that those who were put on the lists wouldn't show up.

Let's personalize this though. What if some of the people on the waiting lists were survivors of:

The Bataan Death March
Omaha Beach at Normandy
The Battle of the Bulge
Guadalcanal, Iwo Jima, Peleliu, Saipan, Okinawa
The withdrawal at the Chosin Reservoir
Agent Orange, The Tet Offensive
The wars in Iraq and Afghanistan.

The managers decided that it was simply someone who would have to "wait." And so they waited, continued suffering, and some died.

I wonder if the cadets at West Point understood on an unspoken level the essence of the Obama Administrtion VA scandal. The scandal meant that if the enemy didn't make them suffer and die, then the United States would finish the job.

One is reminded of the central theme of, The Best and Brightest, about the Vietnam War in which the whiz kids installed in the White House by Jack Kennedy went on to manage the Vietnam War to failure.

The author, the late David Halberstam, whom I would characterize as a member of a vanishing breed of reasonable liberals, demonstrated with painstaking research but lively and readable writing the self-defeating management techniques of "the best and brightest" like Secretary of Defense Robert McNamara who was one of the "whiz kids" who went on to be president of Ford Motor Company post-World War II and then into the Kennedy administration.

Halberstam describes McNamara's quantification of the business of making automobiles a top down approach in which he tried to control the minutest functions of the vast Ford Motor Company through data collection and analysis. The remote facilities of the Ford Motor Company felt pressure quite naturally and, quite naturally, they began to Doctor the reports that were sent back to Detroit in order to maintain their jobs and even gain promotion and bonuses. The very controls which were put in place to streamline and gain efficiency resulted in the company's subordinates simply cooking the books.

Halberstam argues that McNamara replicated the process in Vietnam. We all know what happened in Vietnam and the metaphor for the whole business of self deception which occurred up and down the ranks in that war was the "body count." So notoriously had not been discredited as a viable management tool that the Pentagon, at least publicly, abandoned it in subsequent actions.

The parallel to what is happening today in the Veterans Administration is obvious and we should not be surprised that, if people of the candlepower possessed by Robert McNamara could be fooled, so could management in the Veterans Administration be fooled, or just as likely, be happy not to really know.

There are lessons to be learned from this and the first lesson is not to try harder to micromanage a huge and far-flung operation. The lesson is to go back to our founding fathers and set in place separation of powers and checks and balances which cause the machine to operate as its own gyroscope keeping the operation upright (in both senses of the word). That means we should privatize and set competing forces in motion.