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Healthcare costs have ballooned for much the same reason as university tuition. There are 2 university administrators for every professor vs 10 hospital admini

by nsnick 9y ago

Healthcare costs have ballooned for much the same reason as university tuition. There are 2 university administrators for every professor vs 10 hospital administrators for every doctor. http://www.chronicle.com/interactives/administrative_bloat http://www.chronicle.com/interactives/administrative_bloat https://hbr.org/2013/09/the-downside-of-health-care-job-growth https://hbr.org/2013/09/the-downside-of-health-care-job-grow...

rayiner 9y ago
And most of the people in the Army don't have a rifle in their hands, and most of the people at Google don't write software. By itself those ratios don't tell you anything.
- existencebox 9y ago
  The ratio itself isn't the problem, it's the assertion that we need a growing amount of administrative vs. procedural employees. We can talk in hand wavy abstractions all day long, but for every additional person you have to pay who isn't _writing software_, you need to now pay that much more for your marginal cost of obtaining the software. In almost every other modern domain I can think of as well, efficiency is moving in the other direction. (I think, if I'm trying to be formal here, some aspects of this would seem to be described in 'Baumol's cost disease') If we're talking anecdotes, from what I've seen of administration in healthcare and military (family is in that business) and at bigCo (my business) we could likely handle a far more lean ratio of knowledge to support workers, but that often goes against leadership incentives/risk tolerance for less conventional strategic decisions. (although I think we're seeing vestiges in this through the pushes for e.g. devops and dev/test merges)
- ssambros 9y ago
  In the Army, yes. But "every Marine is a rifleman".
ghostly_s 9y ago
To state the data you've cited in another way, there are 10 non-clinical workers for every 7 clinical roles. I'm guessing you don't personally know anyone in a healthcare administrative role, but these people are certainly not sitting around all day looking for something to do. They are hiring so many of them because the arcane administerial requirements of our healthcare system are only growing.

by nsnick 9y ago

rayiner 9y ago

And most of the people in the Army don't have a rifle in their hands, and most of the people at Google don't write software. By itself those ratios don't tell you anything.

existencebox 9y ago
The ratio itself isn't the problem, it's the assertion that we need a growing amount of administrative vs. procedural employees. We can talk in hand wavy abstractions all day long, but for every additional person you have to pay who isn't _writing software_, you need to now pay that much more for your marginal cost of obtaining the software. In almost every other modern domain I can think of as well, efficiency is moving in the other direction. (I think, if I'm trying to be formal here, some aspects of this would seem to be described in 'Baumol's cost disease') If we're talking anecdotes, from what I've seen of administration in healthcare and military (family is in that business) and at bigCo (my business) we could likely handle a far more lean ratio of knowledge to support workers, but that often goes against leadership incentives/risk tolerance for less conventional strategic decisions. (although I think we're seeing vestiges in this through the pushes for e.g. devops and dev/test merges)
ssambros 9y ago
In the Army, yes. But "every Marine is a rifleman".

ghostly_s 9y ago

To state the data you've cited in another way, there are 10 non-clinical workers for every 7 clinical roles. I'm guessing you don't personally know anyone in a healthcare administrative role, but these people are certainly not sitting around all day looking for something to do. They are hiring so many of them because the arcane administerial requirements of our healthcare system are only growing.