There's a naive tendency to believe that whatever a government agency's mission is supposed to be, is really the mission that its people pursue. That's seldom the case for long.
Science fiction writer Jerry Pournelle, observing such things, has formulated what he calls the Iron Law of Bureaucracy: In every organization there are two kinds of people: those committed to the mission of the organization, and those committed to the organization itself. While the mission-committed people pursue the mission, the organization-committed people take over the organization. Then the mission-committed people tend to become discouraged and leave.
As a result, the strongest priority of most bureaucracies is the welfare of the bureaucracy and the bureaucrats it employs, not whatever the bureaucracy is actually supposed to be doing. That's worth remembering, whenever someone says they've found something else that we should "choose to do together."
This is not unique to government, but a rule for all organizations. However, in a private-sector, organizations that devolve in this way get slaughtered (except of course for crony favors and bailouts, but that is another topic). Accountability never ever comes to government organizations.
Update: One other observation -- in criticizing Obamacare in advance of its implementation, I never mentioned computer systems problems. And I always assumed that if you threw enough money and mandates at the problem, the number of uninsured (not to be confused with the number of people with access to quality care) would be reduced. So all the current triumphalism around Obamacare are about issues that were in fact never raised in advance as criticisms.
One issue that was raised time and again was the information and incentives issues that make it almost impossible to government health care to deliver quality care at a reasonable price. And the heart of the VA disaster is all an incentives issue. And it will not get solved. In part because the incentives issues are endemic to monopoly government services (see: public high schools). But the government is not even trying to solve the incentives issue.