Military veterans, trying to get medical care or other services, face a maze of subagencies in the Department of Veterans Affairs. And that’s just one of many reasons for making the federal government more efficient, policy experts say.

“The VA has 42 different offices, including 14 specifically related to health,” said Rachel Greszler, research fellow in economics, budget, and entitlements with The Heritage Foundation.

“These things just create a bureaucratic nightmare for veterans who are seeking integrated services, one stop to go to for all of their needs as opposed to 42 different offices, [and the veteran] responsible for taking documentation from one to another,” Greszler added Tuesday during a panel discussion at the think tank’s Capitol Hill headquarters.

Also on the panel were an official from the first administration of President Ronald Reagan, which successfully scaled back the federal bureaucracy, and another from the first administration of George W. Bush, which hit congressional roadblocks in reform attempts.

Now another Republican president, Donald Trump, has repeatedly pledged to “drain the swamp”—meaning in part the entrenched federal bureaucracy.

Trump signed an executive order in March directing the Office of Management and Budget to complete a comprehensive plan for reorganizing the government. OMB Director Mick Mulvaney said the study would seek ways to save tax dollars and require each agency to submit a proposal to modernize and streamline operations.

The Heritage Foundation published two reports this year on reorganizing the government: “An Analysis of Federal Departments and Agencies,” which recommends ways to downsize and reform the executive branch, and “Pathways to Reform and Cross-Cutting Issues,” which evaluates personnel, budget, and regulatory reforms to reduce the bureaucracy.

Most of the more than 100 recommendations will require congressional buy-in, said Greszler, who previously was an economist with the Joint Economic Committee of Congress.

Agencies targeted for elimination by the think tank, the parent organization of The Daily Signal, include the Federal Housing Administration, the Consumer Financial Protection Bureau, the Corporation for Public Broadcasting, and the Export-Import Bank.

The recommendations call for shifting certain functions from one department to another. For example, federal student aid for college would move out of the Department of Education and into the Treasury Department, which has the information to determine eligibility and already distributes the funds.

One major problem is that the Trump administration isn’t taking the quickest approach to reducing the bureaucracy, said Donald Devine, director of the Office of Personnel Management during Reagan’s first term.

“Just send these out to the agencies. Tell them to do it. Or, if you don’t like it, have a good reason why you don’t do it,” Devine said. “If you just turn it over to the careerists at OMB, this will go on for a year, two years. It will come out at the end with some halfway-done thing and will never happen. What we should do is go back and reinvent Cabinet government. Turn it over to the agencies. That’s their job.”

An OMB spokesman didn’t respond by deadline to inquiries from The Daily Signal regarding Devine’s skepticism.

Devine talked about Reagan’s success in cutting 100,000 nondefense employees and moving to a more performance-based system.

“It was a miracle, but it happened,” he said.

The reforms unraveled under his vice president and successor, George H.W. Bush, Devine said. Citing research finding that the government has 60 levels between a Cabinet secretary setting policies and an action being implemented, he said that today it’s nearly impossible to run the government.

“[In the private sector] you can go down even 60 levels and look and say, is that division making a profit or not? If it is, you keep it. If it’s not, you get rid of it,” Devine said. “In the government, you go down those 60 levels and if they’re failing, that means you spend more money on it.”

Bush’s son, George W. Bush, attempted reforms after taking office in 2001, but hit problems with a reluctant Congress, said Robert J. Shea, a former associate director of the Office of Management and Budget.

Shea, during his time in office, proposed a commission to evaluate federal programs similar to that in the Defense Department’s Base Realignment and Closure process, which determines which military bases will close and submits the plan to Congress for an up-or-down vote.

The theory behind that process is that it gets around political turf wars. But Congress is reluctant to give up authority to spend money, Shea said.

Also, during the second Bush administration, Shea established an accountability test to make funding decisions for agencies based on whether the agency’s purpose was clear and whether it was achieving results, which also wasn’t popular with Congress.

“We didn’t make a lot of progress integrating this data into the budget decision-making process,” Shea said. “Policymakers don’t have a huge appetite for listening to evidence when figuring out how to make funding decisions, because a lot of those funding decisions are highly political.”

Entitlements such as Social Security and Medicare will inevitably force a future day of reckoning to reorganize the government, Devine said.

“The entitlements are going to eat up discretionary spending of the federal government, period,” Devine said, adding:

Clearly you can’t even raise the issue, or you’re hating old people or whatever. It’s happening already. Entitlements are growing more and more and they’re going to have to cut these things. … It [will be] a marvelous opportunity to change the nature of government, and it’s going to happen whether Congress wants it, whether the people want it.