>>A - 58% of billions is a drop in the bucket?

The latest OECD report last month put most of the world at about 3% of healthcare spending on admin and the US about 8%. I'm not familiar with your 58% paper- but I've seen 25-27% in for-profit US hospitals, so I wonder whether yours includes at least 40% of their time physicians have to spend (waste) on admin rather than providing care. Ironically, as more physicians get sick of admin and accept salaried positions to isolate themselves from it- the more admin costs will rise, because everybody else wants to be paid by the hour. That's usually what happens when physicians delegate to lower-paid groups: you suddenly discover the docs were doing it effectively for free and now it needs 3 salaried admin people.

It's true that some administrators are doing very nicely thank you: https://www.nytimes.com/2014/05/18/sunday-review/doctors-salaries-are-not-the-big-cost.html?_r=1

But my reference to drop in the bucket was in response to this:

>>>We need to start jailing hospital administrators who hire people like Michelle Obama as political payoffs.
>>>That's no less a theft than someone sticking a gun in your face.

You could do that, and the facility's non-medical spending would reduce by a fraction of a %.

The easiest way to reduce admin costs closer to the rest of the world? Experts point to private insurance that turns revenue cycle management into a *huge* admin chore, more than enough to explain why healthcare admin costs more in the US. As an example- it's calculated that reducing US healthcare admin % to the Canadian level would have saved $158B in 2011. Which sounds a lot, and while waiting for better comparative post-ACA figures...

Lets not risk straining at gnats! Per-capita healthcare spend in the US now tops US$10,000 compared to US$3328 in NZ. Even if you could magically eliminate 8% admin costs in the US overnight- that would only reduce the per capita cost to $9200. So while it's important to eliminate admin costs- there's at least another elephant or two in the room. ;-)