The rise (and rise) of the healthcare administrator
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.<p>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.<p>This is what the free market fundamentalists wont accept: that their precious private enterprise is often terribly bloated and inefficient.<p>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.<p>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.<p>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.<p>Instead every component speak to every other one in a clunky manner. Through faxes, paper forms, which are never standarized.<p>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.<p>The bureaucracy is the equivalent to all the insane amount of glue code you got to write when nobody has agreed upon standard interfaces.