I thought this was an excellent, excellent read. This post, about how well-meaning legislation to increase EMR usage had some strong negative unintended consequences, dovetailed with thoughts I've had a lot recently about the concept of "bullshit jobs" (a popular discussion topic on HN). I've wondered what the true source is for these bullshit jobs. After all, corporations voraciously want to increase profits, which should be a strong incentive to eliminate unnecessary jobs.
The conclusion I've come to is that the side effects of government laws and regulations lead to a negative "codependent relationship" between government and companies that exist to implement the complexity required by the regulations. There is no incentive on either side to reduce complexity. To be clear, I am not blanket "anti regulation", and I've seen the benefits of strong (usually simple) regulations - for example, I live in Texas (usually famously anti-regulation), and there is good evidence that old laws restricting home equity loans, due to an old animosity of Texas farmers against bankers, helped uniquely limit the damage of the Great Recession in Texas: https://www.aeaweb.org/research/charts/texas-home-equity-lim....
However, I've also seen the damage and useless work created by well-meaning regulations that create a lot of complexity, and then companies spring up to "tame that complexity". For example, most people in the US are familiar with FSAs, flexible spending accounts. There is a HUGE amount of work that goes into managing FSAs. The rules around what is a qualified expense are complex, and lots of companies have sprung up trying to work around those rules (e.g. companies that will churn out a "medical letter of necessity" for any massage you want). And all FSAs do is let you save taxes on medical expenses. But since FSA money is "use it or lose it", it turns out that 23% of the funds go unused every year! So all this complexity was created to save consumers money, but at the end of the day it ends up being (in aggregate) basically a total wash! All we've gotten is tons of administrators and companies that are paid to manage that total wash.
I don't have a great solution, as again, I don't see incentives on either side to reduce complexity. But more and more "tear down the whole f'ing system" is the only answer I see.