And the business school approach emphasizes, you got it, management. The solution to every problem is management. Even bringing in more management to reduce the amount of management. Even better, the corporate metrics and management ethos generates an entire industry (with consultants) to perpetuate the cycle in endless iterations of management fads. Each fad is costly,  yet most have little empirical basis. 

Well worth reading Pasi Sahlberg on education reform, the lessons resonate for health care. 

Lets not forget how much the privatization of home care through the use of quasi-markets has contributed to the growth of management. Out-sourcing the care process to multiple agencies, often for the same person, is complex and time-consuming requiring the growth of, you got it again, management.

As someone notes below, marketization and focus on medical tasks decimated many chapters of the VON and those that survived surrendered  the essence of caring.