zlacker

This problem is far broader than health care. Doesn't matter whether your actual "product" is hospital wards, sheet steel, romance novels, or mowed lawns - if your sector of the economy is not structured to have draconian penalties for bloated management/bureaucracy/overhead, then it will quickly develop ever-worsening bloat. Because it's always quicker & easier to scale up the desks & paperwork. And guess who makes the decisions about where to allocate resources?

>>bell-c+(OP)
Seems like large tech companies never have a shortage of management.

Between the matrix style organizational structure and the many layers (project manager, program manager, director, VP, senior VP, BU president, etc…), I would love to know what, if anything, the higher levels actually DO.

>>BobbyT+we2
> I would love to know what, if anything, the higher levels actually DO.

In many org's, they mostly compete with other higher-levels for status.

And the biggest signifiers of status are usually (1) how many lower-level managers ultimately report to you, and (2) how many layers those lower-level managers span.

>>bell-c+Mz3
Shouldn't it be the margin on whatever product your division works on? How does bloat fly in a "capitalist" economy?