You know the sad thing about the VA "scandal" aside from the fact that no one really gives a shit?

Before it broke the Phx VA was considered one of the best in the nation, after it broke past Phx and into the rest of the VA it turns out it was one of the best in the nation even with all the delays and deaths.

How fucked up is that?

I'm not disagreeing with the article, but you do have to look at the
problem in historical perspective.

The difficulty of firing someone needs to be high. Otherwise you
get what used to be the case. When a different party came to power,
they'd fire all the workers and bring in cronies and party
loyalists. The major qualification became working for the party.
Any actual ability to do the job was an incidental bonus.

As usual, the cure to one problem created a different problem. The
employees are reasonably insulated from party affiliation, but the
bar is set so high that getting rid of the incompetents or worse is
really tough. It's really tricky to set the bar so that it works
but still avoids the original problem. Clearly, they haven't
succeeded.

"The employees are reasonably insulated from party affiliation" - What planet are you from, sir? They belong to a union that belongs to the Democrats on this one.

"No organization can do anything efficiently, or even reasonably, unless workers can be fired."

True, but if workers are fired for the wrong reason, the organization will be even more fouled up, and government managers gain little from firing the right people for the right reasons.

A small business owner can be "fired" by his customers at any time. If he does not provide good service and products at a fair price, he will lose customers, lose money, and eventually go out of business. So he must also be vigilant that his employees are providing good service efficiently, neither alienating customers nor running up excessive costs. Most of them are rather bad at this, but those ones won't be around for long.

But a government bureaucracy does not depend on happy customers. You are forced to deal with them, no matter how bad the service and how inflated the fees. Worse, the successful government manager is the one at the top of a growing department, so inefficiency and excessive cost are _rewarded_ when the legislature tries to make it work acceptably by allocating more money and civil service job slots. A manager that sees that his section does the job it waas created to do well and efficiently will eventually be replaced by one who better serves the organizations real goals
- hiring more workers, consuming more money, and keeping the general population too intimidated to make trouble.

Note that free-market enterprises are usually better, but can rot internally from the same disincentives. A well-managed, successful small business eventually turns into a corporation, with many layers of management that insulate managers from dissatisfied customers and excessive cost. The corporation will run well as long as the original entrepreneur is still controlling things, but sooner or later either he retires or dies, is squeezed out by financiers, or is simply unable to keep up with the scale of the company. Then managers are probably at nearly as much risk of being laid off because another department is hemorrhaging cash as of being fired because of their own screwups. But as long as it still has to succeed in a free market, a corporation can't be as bad as government and survive.

The worst thing, however, is a business with a government-provided monopoly. Public utilities and government contractors can force you to deal with them or pay for them at gun point, but you don't get to vote for anyone in their chain of command.

It is possible to encourage good, or at least not-terrible, service from a government agency if:

1. There is an elected official who is clearly responsible for it, and mostly just for it.
2. Most of the voters have to deal with the agency.

That is, Michigan has long had fairly good service at the DMV, at least as compared to my experiences in other states and stories I've heard. (I don't know if this extends to Detroit, but it's true from Grand Rapids down to the least populous rural counties.) It's not called the "DMV" office, but rather "The Secretary of State" office, and the Secretary of State is elected. Just in case the "customers" miss the connection, they put a large picture of the current SOS in the waiting area of every office. The SOS does have a few other responsibilities such as certifying elections, but DMV functions are most of the job, and almost everyone of voting age has to renew car licenses annually and driver licenses every few years. If that becomes more unpleasant for the majority, that SOS will not be reelected, let alone get a chance of moving up to Senator or Governor.

What I'm left wonder is why this woman hasn't been charged with felony fraud?

Her falsified records lead to her (and others) getting performance bonuses because they appeared to be so...efficient.