Bureaucracy in Healthcare

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Charles Mason
August 1, 2025

Red tape in the U.S. makes it more challenging to obtain funding for patient care. Healthcare costs $496 billion and 8 percent to 34 percent of that amount is allocated to administration. Half of it is wasteful when compared to Canada’s efficient system. Due to numerous rules, insurance paperwork and technological needs, a doctor requires ten administrators. A more efficient market, less government intervention and greater individual responsibility can all help make things run more smoothly and prioritize patients and doctors.

Data Showing Issues

Between 1975 and 2010, the number of doctors increased by 150 percent while the number of healthcare administrators rose by 3200 percent. There are between 2 and 10 million more administrators than doctors: CEOs, billing clerks, compliance officers and others who work in IT. More than 30 percent of the 16 million private healthcare personnel are administrators. There are 4.8 administrators for every doctor. Complicated rules and insurance limits make it more difficult for patients and providers to access the care they need, resulting in financial and time burdens.

Doctors and Patients

Doctors and patients were upset with the bureaucracy. Doctors spend 19 hours a week on paperwork and 54 percent of them experience burnout. Twenty-five percent of patients are unable to access care due to issues with their insurance paperwork or bills. The system is expensive and ranks 37th in the world for health performance, which hurts poor families the most. Doctors and patients are less accountable when they prioritize paperwork over patient health. To improve public service, the system needs to be changed.

Removing Rules?

To be more efficient, we need to eliminate laws that are no longer necessary or effective. Quality reports and pre-approvals cost more but don’t add any benefit. The National Quality Forum’s plan to eliminate redundant reporting appears promising. Doctors, patients and business leaders may be able to identify and eliminate unnecessary rules that hinder responsibility and innovation. Doctors can focus on patient care and reduce costs if unnecessary administrative tasks do not burden them.

Without government help, Tech Smart operates more efficiently. AI can handle scheduling, billing and electronic health records (EHRs), which saves doctors 60 hours a week. Keeping good records reduces mistakes and paperwork. Patients receive resources, not bureaucrats, due to frequent audits and private funding. Tax breaks for hospitals that adopt efficient technology will accelerate this change by utilizing market-based solutions to enhance patient care and treatment.

Work Together

To provide adequate care, doctors and administrators must work together. CareMore’s Academy teaches doctors how to run a company, develop trust and work as a team. Patients come first when doctors make rules. Hospitals that work together have better patient outcomes and reduced burnout. Setting aside 10 percent of administrative costs for training doctors in finance and operations connects policy to practice. It promotes fairness and responsibility without a hierarchical structure.

Care-Based Values

Unlike fee-for-service, which complicates administration, value-based care prioritizes results over numbers. Tests for Medicare save money and get better results. Private insurers might be able to charge more easily and help more people if they were given financial incentives or exemptions from specific rules. This market-based approach makes healthcare fairer and more efficient by promoting competition for excellence and avoiding excessive centralization.

Canada’s single-payer system reduces administrative costs but it also hinders the emergence of new ideas. It gives more power to a few people, makes it harder for others to compete and puts off non-emergency surgery for 25 weeks. Changes to the state that make billing easier and keep private alternatives are better. Cost reductions and patient outcomes can guide these systems to hold people accountable without the need for government control. This helps healthcare fulfill the requirements of the community.

The Patient Experience

The documentation for patients is a mess and 73 percent of them are required to perform at least one administrative task each year. One-third of people put off getting care because it’s hard. Online billing and insurance are examples of private solutions that will make travel easier. When billing statements are clear, consistent and transparent, patients may make informed choices. Subsidies for private patient navigators could help individuals who are already struggling without the need for government involvement.

Fixing Problems

Changes are necessary to ensure the safety of millions of government jobs. Efficiency shouldn’t come at the expense of quality of care. People argue about centralized systems but value-based care, technology and deregulation are all possible. Using real-world data and feedback from doctors, patients and business leaders, we can enhance the system for the benefit of everyone.

Moving Forward

Having up to ten administrators for each doctor has an impact on the efficiency, fairness and accountability of the healthcare system. We can restore the system for patients by removing restrictions, leveraging technology, fostering teamwork, employing value-based therapy and making things easier for them. These realistic and fair alternatives deliver better care at lower prices because they hold people accountable and function well in the market. Bigger is not always better.

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Author: Charles Mason, Ph.D., is a graduate of Walden University in Public Policy and Administration specializing in Criminal Justice. He is also a graduate of Barry University with an MPA and a graduate of Vincennes University with a Bachelor of Science in Homeland Security and Public Safety. He has over 30 years of experience in security, local law enforcement, state corrections and military service. He is currently the president of Mason Academy. He can be reached at [email protected]. Twitter: https://twitter.com/DRCharlesMason

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