The thing is he'd find a lot of the "unnecessary overhead" is necessary to deal with the payers in the system. You need a massive billing organization to make sure insurance actually pays you. You need a massive compliance organization to make sure Medicare pays you (and that you don't kill your patients and get sued)

If you reformed the whole system you could trim a lot of hospital overhead, but it's a systemic problem. More overhead and waste is happening in the insurance companies which is what needs to be cleaned out first, then you can start dealing with providers' overhead that exists to serve the rest of the system

I was wondering the same thing. I see the difference in my primary care doctor who does not take insurance. So much less overhead, same salary, and better patient outcomes. There is a multiplier effect, as you add people at some point you might need an office manager and then more nurses to keep up quota but for every new dollar of revenue you make the margin goes down.

You wonder how much of a hospital is true emergencies vs scheduled care. While ERs are indeed busy, how many of those should actually go to a primary care doctor instead. Even then I would imagine your schedule appointments are the bulk of the volume at a hospital.