Administrative costs in health care are a silent epidemic. Our inefficiency is costly to patients, providers, insurers, and government.
In many ways, our health care system mirrors our tax code — especially in its financing and health insurance facets. These can be made so complex and have been made so complex in the health care system in the United States that many decision makers in health care — patients, physicians, hospitals, employers and so on — need in-house or external consultants to find their way through the maze.
and:
Consulting firms help physicians bill private and public insurers or help patients submit claims to insurers after an illness. Legions of insurance brokers help prospective clients through the maze of the nongroup or small-group health insurance market. Large employee-benefit consulting firms, helping large companies, establish what amount, in effect, to analogues of the health-insurance exchanges in the Affordable Care Act, and many more consultants of many stripes are involved.
Medicynical Note: Yes the U.S. has the number 1 health care system in the world–it’s the most inefficient by far.
Medicynic 
For a good read on the performance of the world’s health systems go here: http://goo.gl/AZPn5
If it’s any consolation the US performs ever so slightly better than Australia in terms of access to care….
http://www.aheblog.com
I’m not sure where you got the info, the BMJ article was behind a paywall. But the Commonwealth Fund’s evaluation of health care in 2007 concluded that “Among the six nations studied—Australia, Canada, Germany, New Zealand, the United Kingdom, and the United States—the U.S. ranks last, as it did in the 2006 and 2004 editions of Mirror, Mirror. Most troubling, the U.S. fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last on dimensions of access, patient safety, efficiency, and equity. ”
http://www.commonwealthfund.org/Publications/Fund-Reports/2007/May/Mirror–Mirror-on-the-Wall–An-International-Update-on-the-Comparative-Performance-of-American-Healt.aspx