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health care in North America
(thelemmy.club)
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It helps that much of this bureaucracy is invisible to the patient. You just go to the doctor and they scan your insurance card. That's it for billing as far as you're concerned.
What happens behind the scenes is a horrible mess that has been in the process of being digitalized for the last decade. But they did put up a nice facade that hides most of this.
By the way, that part about quarterly EDIFACT files to change addresses is actually how it works for health insurances. Of course they regularly screw this up and then everyone else has to deal with the mess... But that's just everyone who tries to bill them. Patients didn't even know it's a thing.