> The spreadsheet-using agency is Health New Zealand (HNZ) which was established in 2022 to replace 20 district health boards in the expectation it would be more cost-effective and deliver more consistent services.
Austria did the same with their national health insurance, to reduce costs and organisational overhead. It massively increased costs and organisational overhead.
Sometimes with big policy stuff I wonder how much is the effect of the policy vs the effect of the overall societal inertias and momentums there are. Like regardless of that policy, would costs have massively increased (inflation, financialization of healthcare)? Would organizational overhead have increased? Has it decreased in other industries? The policy might still have made it worse, of course.
It's most likely that technical problems are turned into organization departements. The people making the decisions lack the knowledge and tools to solve them efficiently. They gain nothing from solving the problem itself but they gain from growing the organization in size. The solution is obvious while the path to get there can be very convoluted.
Did the Austrian government or any other social western government ever manage do do anything that lead to a decrease in bureaucratic waste? From my PoV, no matter what they do, no matter their marketing messages, the costs always go up and efficiency goes down.
Interesting, as a German annoyed by having 100+ insurances I always thought Austria is doing the right thing. Do you have a link for that? I am interested in understanding why the costs increased.
I am only talking about the statutory health insurance providers not the private ones. For the private ones you might be correct. The statutory ones, they have a catalogue of services, which they are required to pay for. While there are some minor differences between the providers, they all offer the same benefits essentially.
Austria did the same with their national health insurance, to reduce costs and organisational overhead. It massively increased costs and organisational overhead.