> Mostly what has happened is administrators now have data used to push docs to see more and more patients (and spend fewer and fewer with any one of them), all the while the paperwork stacks up. Somehow they never quite seemed to go away.
Under capitalism, old companies (like hospitals) don't really tend to adapt in response to market forces by actually changing anything as drastic as the shape/relative scale of their internal bureaucracy.
It looks like that happens from a 10,000ft view, but what's really happening is that old companies are just dying, having been outcompeted by new small companies that "grew up in" the market environment where the changes were "the new normal." And then, eventually, the new, small companies acquire the big old dying companies for their brand value—so the resulting merged company has the appearance of the big old company having managed to turn over a new leaf.
When a company is only slightly relatively unfit (due to e.g. serving a market with inelastic demand, like medical care), it can take decades for their relative unfitness to deplete their resources to the point that they'd seek to be acquired. The current heavily-bureaucratic hospitals might be actively dying right now—it'll just take them another 50 years to become all-the-way dead.
Under capitalism, old companies (like hospitals) don't really tend to adapt in response to market forces by actually changing anything as drastic as the shape/relative scale of their internal bureaucracy.
It looks like that happens from a 10,000ft view, but what's really happening is that old companies are just dying, having been outcompeted by new small companies that "grew up in" the market environment where the changes were "the new normal." And then, eventually, the new, small companies acquire the big old dying companies for their brand value—so the resulting merged company has the appearance of the big old company having managed to turn over a new leaf.
When a company is only slightly relatively unfit (due to e.g. serving a market with inelastic demand, like medical care), it can take decades for their relative unfitness to deplete their resources to the point that they'd seek to be acquired. The current heavily-bureaucratic hospitals might be actively dying right now—it'll just take them another 50 years to become all-the-way dead.