[sailfast]

Mostly speaking based on my hearing first-hand from those working there to some of the technology horror stories / treatment backlog issues. There are also some fairly comprehensive issues with specific hospitals that I recall from the news, but maybe that's media spin.

My point is not that interacting with folks at the VA is bad (generally folks try to do their best) but that at a certain point if a single organization runs a specific function incentives get turned around to the point where you lose the ball somehow, and there's no pressure to improve. This seems to have happened to a certain extent at the VA and I see the pattern happen a lot across large institutions, generally. ESPECIALLY if they are not in a competitive environment.