The rise (and rise) of the healthcare administrator

Parasites always expand as far as possible without actually killing the host.

I'm an administrator and I'm here to help.

There is actually a symbiosis between the government administrators creating more and more regulations, and the healthcare administrators who implement them. There are also self-reinforcing effects in licensing professions, which demand more qualifications, feeding the vocational training industry. Same in finance, with Dodd-Frank, AML and KYC (all justified by fake 'wars on terror' and 'war on drugs').

It is an infestation of the western world. Social democracy is a self-reinforcing doom loop of bureaucrats and welfare recipients voting for more bureaucracy and handouts. Overheads and taxes expand to crush productivity, but not quite enough to kill it. Whatever happened to small government and small bureaucracies?

Time to invent some antiadminotics, but then they will eventually develop resistance.

Anti-administrator sentiment doesn't seem limited to healthcare, here's an interesting article focused on the same theme in academia:

https://www.theguardian.com/higher-education-network/2018/ju...

Also, the comments on that article provide some insight into the administrator's point of view.

I think this is a trend in most big organizations. In my company we also have a host of business analysts, project managers, architects and line managers. Then you have some random people who pop up with big titles where you don't even know what they are doing. They spend endless hours reporting to each other, evaluating options and making sure that the few people who do something stay under control.

A lot of projects have more management than people who actually implement something.

Spent a lot of time in Heath tech. Main driver for administration is costs imposed by insurance schemes, even (especially) in public systems.

Insurance causes hyperinflation in drug prices and services. It's just a giant pool of money that nobody owns and everyone wrestles for, except instead of competing on price and service quality, they use lawfare and bureaucracy to impose costs and disincentives on each other.

Administration bloat has a few causes, some as a result of the effect above, and some from political factors.

The solution? Automation. If you want to get rid of the administrative bureaucratic layer, develop technologies, products, and platforms that decimate it.

It's a shame the data stops in 2010 - I bet we're seeing an even larger boom due to HITECH. Technology has not solved many problems in healthcare. Medical coders for example, are still a thing, even though everything is tracked electronically, there is still a game to putting codes on claims for higher chance of reimbursement.

Unsaid: the continually rising cost goes hand-in-hand with the extra drag.

This probably should be studied, though we'll also have to study improvements in health care along with the extra headcount.

Isn't this the same thing with colleges? Most of the rise in tuition costs goes to administration rather then education.

It’s an iron law of bureaucracy that the nominal purpose of the organization is always secondary to the unstated primary purpose of persisting and growing itself. a particular amusing example is that the British Colonial Office was at its largest size after Britain had lost her colonies.

This story is another particular case.

Reading the denials of these people about the problem reminds me of the emperors new clothes. They don’t see what is plain to see for anyone with half an open mind.

This insane growth of bureaucrats is particular to the US health care system. While it grows in socialized medicine as well it does not do so at the same insane rate.

This is what the free market fundamentalists wont accept: that their precious private enterprise is often terribly bloated and inefficient.

I live in a country with socialized medicine and I’ve lived in others with universal health care. The most free market oriented I’ve experienced was the American one and it was by far the most bureaucratic.

In software development terminology I think it is easy to describe the issue. You got several components you want to talk to each other. In software engineering that means some central group of people create common interfaces for the components to speak to each other.

That is essentially the function of government. It is what creates the common interfaces. Except in the US this doesn’t happen because somebody is going to scream “socialism” from the top of his lunges.

Instead every component speak to every other one in a clunky manner. Through faxes, paper forms, which are never standarized.

That is what I notice most about the US. There are so often no standards for anything. People just wait for the magic of the market to create one, except that never happens and you end up with half a dozen competing and incompatible standards.

The bureaucracy is the equivalent to all the insane amount of glue code you got to write when nobody has agreed upon standard interfaces.

How does this compare with the situation in other developed countries?