Why government doesn’t work anymore, but it can again

By Martin Stewart-Weeks

Tuesday July 12, 2016

Why doesn’t government work anymore? It’s a ridiculous question, right? Unless you are unlucky enough to live in Somalia or Libya, the question seems absurd. Of course government works. Just look around.

Public transport systems work (more or less), most of the time criminals are apprehended and sent to prisons, most of which are run pretty well (more or less), people get checked across borders, passports get issued, pensions and benefits are mostly paid to the right people, at the right amount and at the right time. Birth certificates are issued, courts hear cases, schools teach, complex health systems look after sick people and occasionally surprise themselves by investing in keeping people out of hospital in the first place.

“Dashed expectations seem to define the fate of modern democracy … political gridlock, inequality, reactionary nationalism, and rising authoritarianism.”

Of course government works, and it’s never been busier doing all that work faster, better and cheaper.

Millions of clever and dedicated people work very hard to make all this happen methodically and predictably. Millions more of us are the direct, sometimes unwitting and too often ungrateful beneficiaries.

So why is it that in so many apparently functioning states everything seems to be working but nothing gets done? Or, to put it another way, there’s lots going on but nothing seems to be happening.

Sophisticated failed states

Government no longer working is the paradoxical conclusion from the director of the Carnegie Foundation in Europe, Jan Techau. In a recent Financial Times op-ed piece, Techau describes a malaise whose symptoms include lack of clear, bold thinking, a failure to take measured risks, compounded by the failure to counter the triumph of spin over substance in pursuit of difficult change and complex reform.

As long as this dilemma remains unresolved, the result is paralysis. Over time, as disappointments have accumulated, growing numbers of voters have begun to voice their frustrations. Political elites, however, are disposed to protect the status quo, so opportunities for painless change are routinely missed. The result is the slow migration of discontent from the fringes to the centre.

In other words, Donald Trump (my conclusion, not his).

Techau calls it sophisticated failed state syndrome, characterised by a reinforcing and intensifying cycle of suspicion and cynicism. Citizens complain their politicians won’t take the big decisions for change in the face of risk and complexity. Politicians shy away from big decisions for change in the face of risk and complexity because they don’t think citizens will let them or, better still, reward them. The problem, according to EU President Jean-Claude Juncker, is that politicians can’t, or have forgotten how to, take risks, be bold and still get re-elected.

And elections, of course, are perfect times to see these dilemmas in especially stark terms. They are times when the hyper energy and concentrated attention to governing and the business of politics drive a mixture of hope and frustration.

Australia has just seen the longest election campaign for a while. And there was the usual response, a kind of visceral joy in the recurring manifestation of one of our greatest and most bedrock freedoms — the exercise of open and contested democratic elections — tinged with varying degrees of disappointment, even anger, at what can sometimes feel like a more or less well-meaning charade cleverly, even cynically scripted to within an inch of its superficial and stilted life.

The truth is much more complex than that, of course. Even though we don’t like to admit it, real questions and big choices are being traded about things that really matter to all of us. But for all that, it can still feel like a lot of sound and fury, signifying not very much.

But for some, and in a different context, this sense that there is something bigger and deeper wrong with the way we play this game is conceived in more dramatic terms: Liberal democracy is in trouble.

The great wave of democratization that spread across the developing world at the end of the Cold War has long since crested. Today, it is the undertow of dashed expectations that seems to define the fate of modern democracy: political gridlock, economic stagnation, increasing inequality, fraying social contracts, reactionary nationalism, and rising authoritarianism.

Staying busy in a Clayton’s gridlock

Techau’s paradox reflects an important distinction between doing things (which most reasonably functional governments do all the time) and doing the things that need to be done (which too many governments appears to be finding harder, if not impossible).

For example, every day, the Australian public health system does a lot of things. In 2013-14, there were nearly 10 million hospitalisations in public and private hospitals, 60% of which were in the public system. In 2012-13, over a third of Australians visited a GP more than six times. Plenty of things get done every day in and across the health system in Australia.

But a recent story focusing on “healthcare waste” reinforces the distinction between doing lots of things while simultaneously managing to avoid getting things done.

Improving health efficiency, claims the Health Safety and Quality Commission, could save 15% of the $150 billion national health budget through a series of “falling off a log” reforms “with no reduction in actual outcomes.”

Over servicing (the story estimates 600,000 “highly avoidable” hospital admissions every year in Australia), lack of competition, a fairer approach to the cost of prosthetics and a 20% surge in the number of medical specialists in Australia (now outnumbering general practitioners) are all in the frame. Rationalising the $21 billion per year Medicare Benefits Schedule could save $500 million annually.

The problem, according to the head of insurance firm Bupa, who is quoted in the article, is the absence of “turbo charged” and consolidated health care reform. But the story notes “the Coalition and previous Labor government commissioned a variety of reviews into aspects of the health system but very limited structural reforms have been made.” In recent years, Australia has seen 6 separate reviews of the healthcare system, but the call now is for another one, this time by the Productivity Commission, into how the public and private systems could collaborate more effectively.

Add to this kind of analysis new calls for much greater integration of social care and health, wrapping more flexible and modular services around individuals and families in their local communities and you get a sense of the work that needs to get done, but isn’t. The system seems to be working perfectly well, but things aren’t getting done.

Another example is in the human services area.

There is surely no shortage of things being done here. As the digital transformation Minister recently noted, the federal Department of Human Services in the last financial year paid out $165 billion, took 57 million phone calls and served 4 million people through their shop fronts offices.  There were 115 million visits to the DHS website, 124 million transactions went through online accounts and 61 million through mobile apps.

Progress as hostage

Two approaches currently in favour, the work of policy simplification, which is not simple at all of course, together with a much closer alignment of the policy and delivery, could ensure a smoother and more efficient benefits and support system. However, they remain hostage to poor political and bureaucratic structures and culture, inertia and timidity, or some combination of all three.

Techau’s Financial Times piece boils down to this: the busier governments become being reasonably competent doing the work they have to do, they less able they seem to be to wrangle the political, institutional and cultural factors necessary to get on with the work that needs to be done.

The next instalment will look more closely at the contradictions of government and how they make it harder for tough, necessary and ultimately unavoidable reforms to be acknowledged and executed.

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