As a physician who worked at a Veterans Affairs hospital, I know firsthand why it is and has been a broken system for years. I had my own private practice for 24 years before entering the VA system. Those five years were the most difficult of my medical career.
VA doctors have little incentive to work hard. I normally saw twice or more patients daily than most doctors. It was the only way I knew how to work. Of course, the pay was the same. The union is very powerful in our federal government. Non-physician employees have job security and little incentive to overwork.
Twenty years ago, Category 8 was added to give medical care to veterans of financial means and no service-connected disabilities. I saw these patients, often with 24 to 36 months service time and no deployment, jam the system.
I think a means test for care would help those who desperately need it. It takes an act of Congress to get rid of incompetent directors.
It was always a pleasure seeing World War II vets because they were always grateful for what they received. I could not say that for many vets after that time.