The article talks about the bureaucracy at the VA and also about the intense meddling of veterans' groups. It sounds as though the VA is a fiefdom of veterans' groups, where they dole out jobs and favors. Ugh.
I know very little about the VA or any large bureaucracy--governmental or private. I've always been a first-line worker, never a department manager, and usually worked in small organizations. I have no feel for what happens in a big bureaucracy or for why they grow so large. I'm still a happy hunter-gatherer of sorts, living out my life unaware of the huge states around me. Lucky me... maybe.