Why do some political scandals stick while others fade? The level of media obsession seems to rise and fall as mysteriously as the stock market. On Benghazi, sell. Hold on the IRS audits. On the Department of Veterans Affairs scandal, buy, buy, buy.

In the broader scandal market, fraud or criminality helps. Political intrigue is a plus. Sexual content increases attention but may eventually seem pathetically human and excusable. Conservatives are convinced that the liberal media are harder on Republicans. There is a natural human tendency to attribute good motives to people with whom you agree — and corrupt motives to people with whom you don’t. This is also not unknown in the conservative media.

But I’d contend that the stickiest scandals are the ones that confirm preexisting suspicions — that draw neon outlines on an existing portrait. The Iran-contra affair confirmed a public impression that Ronald Reagan was disengaged. Bill Clinton’s infidelity was further evidence of indiscipline. More recent, the image of Chris Christie as a bully was reinforced by a staff that engaged in malicious bullying.

This is precisely why President Obama’s VA scandal is the most serious and damaging of his presidency. It is the Obama administration in sum and in miniature: incompetent management of a health system, defended by crude media manipulation.

Each of these elements deserves some unpacking. The incompetence comes in the aftermath of HealthCare.gov — the Technicolor failure of technocratic liberalism. Again, the White House is shocked, saddened and angered by the management fiasco of a manager under its direct control. In both cases, a presidential priority was badly mishandled over a period of years, and the president seems to have learned about it on cable news. Obama has defended himself by assuming the role of an outraged bystander — which, when it comes to leadership, is more of a self-indictment than a defense.

1 of 25 Full Screen Autoplay Close Skip Ad × The Right’s 25 most influential, from Townhall.com View Photos The conservative Web site’s latest listing of the most prominent voices on the right, with a few names you may not know. Caption The conservative Web site’s latest listing of the most prominent voices on the right, with a few names you may not know. 1, Rush Limbaugh He can make news, kill legislation and sell books anytime he wants to, Townhall says. The biggest right-wing radio show host in America has spoken to a generation of conservatives. Micah Walter/Reuters Buy Photo Wait 1 second to continue.

Modern liberalism involves centralized, bureaucratic authority and therefore presupposes administrative competence. But the caliber of technocrats chosen by Obama — including former health and human services secretary Kathleen Sebelius and VA Secretary Eric K. Shinseki — throws the entire enterprise into question. Are the best and brightest really this dull?

The more immediate problem for Obama is that the VA scandal comes in the context of a broader health-care debate. The VA health system is unapologetically socialized medicine, in a way that Obamacare (for all its faults) is not. But for the administration, the scandal is an inconvenient public reminder that the centralization of government power in health care has inherent dangers.

The VA scandal is not only the result of weak leadership; it is typical of government-managed systems, which often ration care with waiting lists and lines. The demands on the VA have been increasing, with large numbers of returning veterans, some with complicated injuries, receiving recently expanded benefits. At the same time, the Obama administration has pledged to reduce waiting lists. The results? Alleged double-booking of appointments. Overburdened staff. And the gaming of lists to hide waiting times.

Some liberal economists once referred to the VA system as a model for national health reform. It can’t help the cause of liberalism when the results of rationing, inherent in all government-managed care, are dramatically demonstrated.

In addition, the VA scandal has revealed the naked essence of the White House media management strategy, stripped of adornments such as credibility and sincerity. In a savage fit of accountability, the administration let go a VA health official — who was already scheduled to retire in less than a month. This, presumably, also saved the cost of the cake at his going-away party.

Then White House press secretary Jay Carney insisted, nine times, that the American Legion was pleased with this housecleaning. The American Legion, however, had actually pronounced it “business as usual” and called for the immediate replacement of Shinseki. What could possess Carney to make a claim that could be immediately and completely disproved? It indicates a strategy that has dispensed with persuasion: Pick a minor scapegoat, institute an inconsequential reform, claim broad support, then insist, tomorrow, that the whole matter is old news.

But this approach implies a certain amount of contempt for the journalists who are expected to carry the message. Even the most pliant among them wants some scraps of credibility mixed in their feed.

In a presidency defined by health-care ambitions and debates, the VA scandal is likely to stick — as a summary and a parody.

Read more from Michael Gerson’s archive, follow him on Twitter or subscribe to his updates on Facebook .