In his latest podcast, Russ Roberts interviews Steven Lipstein the CEO of the large hospital that shunted my father around to 8 different units over a two-week period.

What strikes me about Lipstein is how little responsibility he wants to take. Roberts asks him to explain hospital pricing, and Lipstein describes the factors involved but takes no responsibility. When asked about co-ordination of care, Lipstein says that it is important for family remembers to be active, but again he takes no responsibility. Finally, when it comes to health care policy, he endorses the idea of a Federal board, which presumably would relieve him of whatever responsibility he might currently allow himself.

One of the most frustrating experiences you can have is dealing with a bureaucracy where no one has a sense of responsibility. Have you ever tried to deal with an organization in which no one can solve your problem? In which everyone says, “Sorry, that’s the way it is. There’s nothing I can do about it.”

It starts at the top.