[pieceofthepuzzle]

I’m well aware the regulations, and live with them every day. The growth of administrators is in part secondary to the growth in regulations, but the growth in administrators also fuels the growth of more regulations (this is how they justify their existence). You have to break the cycle. You do that two ways. One is to alter federal law, and reduce regulations, which is what you are addressing. The other is to introduce into the system pressure to reduce administrative costs. At some point the only way to decrease the number of administrators is to put the at war with each other over who is going to survive while the money that can legally go to administrators is markedly cut back. It’s absolutely necessary.

[Rockingham]

The logic of trying to gain efficiency by squeezing administrative costs is one of the arguments for the government running health care. The supposed gains in efficiency are illusory though because, when the malign effects of unnecessary regulations are factored out, many administrative costs are in fact associated with the quality of patient care.

A few years ago, when I had a major surgical procedure at a major university hospital, I was impressed with the cheerfulness of the employees and their attention to my care. I learned that this was due to the relentless focus of the hospital administrator and his team on the quality of patient care. I am confident though that accounting rules would book their salary and benefits as mere "administrative costs."