So the US averages a ratio of 10:1 administrative employees[0] per doctor. As a random comparison, Sweden maintains roughly a 1:1 ratio [1].

Ironically, the link below is a Swedish article about how the Swedish admin-to-doctor ratio is bloated and problematic.

[0] https://hbr.org/2013/09/the-downside-of-health-care-job-grow...

[1] (in Swedish, Doctors vs. Admin) http://www.lakartidningen.se/Aktuellt/Nyheter/2018/05/Admini...

Much less. Having lived multiple places I got to day the heavy bureaucracy of the US system is apparently immediately when you interact with it.

Some of it has to do with common law. Common law means a lot of stuff always has to be spelled out over and over again while in civil law things default to the law if not spelled out. Hence you don’t need the same amount of disclaimers e.g.