This is an article taken from my 2018 book, Thinkonomics, with Chuck Harrison. I have decided to post it free of charge in response to some of the myths surrounding election campaigns in the UK in 2019.
Most of us will recognise that no system is perfect. Combustion engines in cars don’t just create the energy to power the car, they give off heat energy and produce exhaust fumes which a perfectly designed engine would be able to neutralise and use to power the movement instead. Voting cards on election days are made to be as simple and effective as possible, but there will always be someone who marks the wrong box, or reacts in the wrong way, unintentionally wasting their vote. Even the best made and most expensive TVs heat up, failing to turn all of the electricity it uses into picture quality, whilst many speaker systems fail to cope with the full and infinitely varied spectrum of sound that could come their way, and most can experience vibrations or ‘tinny’ effects when unusual sounds are transmitted. In every day life we are used to these imperfections.
The point I’m getting at is that no system works perfectly. However beautiful or perfect the maths and physics involved, most systems, in reality, cannot be made to a perfect standard. But we get over it. It can be summed up by the sofa analogy: our sofas have holes down the back, and we could lose pound coins down there, but it’s better than not having a sofa. A reasonable amount of waste is accepted and expected. Of course, you could actually just buy a sofa without the hole down the back, and it could still arguably be as comfy… but hey, I’m still proving my point: after all, even analogies can’t be perfect!
The types of system that seem least likely to be perfect are those involving people; people are machines functioning at incredibly complex levels. They each consist of billions of cells and are capable of abstract and irrelevant thoughts, so compared to designing systems containing electricity, metal or plastic, human systems are unimaginably more complex. We are, after all, not just compositions of genetics, but we learn and develop based on our experiences. As a result, no two of us are anywhere near the same, and we can sometimes react to the same stimuli in bizarrely different ways. One person would kill so as not to be tied and tortured, whilst another might consider it a kinky thrill. We are a complicated and varied species, and those designing systems to organise our healthcare, or to run our economy, have a monumental task ahead of them.
That our societies function at all is remarkable, and probably reflective of our intelligence: in general, we realise that despite our differences we must cohabit on Earth. Still, what we have collectively organised in our individual groups is more remarkable. In the UK, for instance, we manage to utilise an advanced form of medical science, funded collectively and improving yearly, to look after one another. We employ people with passions for medicine and caring to do those jobs, so we can live our lives enjoyably yet still endeavour to care for the weakest, oldest, youngest and the most ill. The system isn’t perfect, but that word – remarkable – is appropriate when you consider how far we relatively hairless apes have come.
Yet, despite our progress, we seem to be taking for granted what we have created, and instead focusing on the weaknesses of systems in order to demonise people. We blame the NHS – not its politically motivated lack of funding – when people suffer through lack of care. No system can be perfect, especially not those which suffer through being understaffed and relying on the good nature of the most empathetic and caring people in society, rather than costing us all equally. We might pay chunks of our taxes to keep it running, but the extra unpaid hours that doctors, nurses and volunteers put in to keep the system functioning, and to keep people from suffering, means we aren’t all paying our fair share.
Part of the excuse put forward from Conservative politicians – who are motivated classically by lessening the taxes of the wealthier – is that the NHS is wasteful and so taxes must be cut. Yet, we are asking the wrong questions on public services if we’re more interested in the waste of any system than the output. We can always do things better, but using that as an excuse to limit the input of resources is not doing things better, it’s just doing things cheaper. You don’t make cars run more efficiently by putting less fuel in; you have to redesign the entire system if you’re aiming at efficiency. And when Conservative politicians argued they were getting rid of ‘bureaucrats’ in the NHS, they removed huge swathes of people who were useful for organising care and connecting different sectors.
Those elderly patients who are suffering in the system don’t just require doctors, nurses and carers – who already work long and often unpaid hours just to provide an average service due to understaffing. They also need people to intervene and monitor their care, uphold standards, arrange multi-disciplinary meetings between them, and keep the patient in mind. They need people to balance the books in GP practices and care homes; people to keep the supplies ordered in hospitals; and people to clean the floors and empty the bins. By removing those kinds of people you don’t only make things more dangerous and worse for patients – as you end up spending expensive clinician time on what should be cheaper admin tasks – but you also increase the risk of patients being regularly admitted to hospital, which is the really expensive part of the system.
Of course some of those people are actually bureaucrats – but that is up to managers to deal with and organise, to get the best from people. If they fail, and some bureaucrats continue to exist in the system, we should consider it the same wastage as a warm combustion engine. Large and complicated systems will always involve waste of some sort. If we can’t get rid of it in relatively simple mechanics, we certainly can’t expect to do so in massive organisations focused on human health care. Better to deal with the waste as best we can rather than cut it all out, cutting out half the engine or limiting the fuel in the process.
Yet, arguably, health care is not the biggest instance of ‘back of the sofa’ thinking. I think the welfare state is.
Every week, seemingly without fail, a mainstream TV channel, or a national newspaper, decides it will show us someone who is ‘benefiting’ a little too much from not working but instead being on benefits. It will show us stories of people with 20 children who earn tens of thousands of pounds a year by being on benefits, or it will show us stories of drug addicts who buy drugs with their benefits. The media’s intention is to create an audience from which to profit – selling outrage to any scandal they can find – but its effect is in creating a distrust of the system by focusing on the waste rather than putting it in context.
Let’s start at the beginning. Welfare is a necessary cost to the taxpayer, by any standard of human decency and fairness. Capitalism and modern economics can’t exist without unemployment of some level (you need unemployed people, as they help create growth when they become employed), so someone will always be suffering that indignity. It is entirely unreasonable and irrational to decide we are going to have a capitalist system, then not compensate those that suffer because of it. Capitalism is the best form of economic system available to us, but we’re structuring it wrong if we allow people to demonise/harm the necessary victims. As a result, we do provide ‘benefits’ to people who do not have a steady or sufficient income, and the vast majority of those compensated are exactly who are meant to be benefiting.
However – as with any system – some people will be able to claim benefits in an unfair manner. This is a very small percentage of total benefits paid out, but some people will work illegitimately whilst claiming benefits, whilst others won’t want to work at all. All of which will seem unfair to people who do slave away in day jobs and pay for these benefits from their own wages. Further down the line, some people will have huge numbers of children, and be looked after by the state – which will seem parasitic to your average person who is in a hard-working job – and others will spend benefits on drugs instead of food, which to those same workers will seem to not be the point of benefits.
But, as I mentioned before, whereas these numbers of people might be vocal, louder, and scrutinised far more regularly on TV – a normal job-seeker is boring compared to a family of 15 living in squalor, or a drug addict living in a squat – they are a tiny minority.
However, let’s assume them to be wasting taxpayers’ money. That makes them the relative waste in the system. You can’t feasibly uphold an unemployed person’s dignity by giving them food vouchers for certain shops instead of money, just to spite the drug addict. And you can’t force children into poverty by lessening the benefits of people with children, just to stop people having large amounts of children whilst on benefits.
To build a system which does care about people, foster a sense of belonging and an enthusiasm for hard work, and which works to eradicate child poverty, you need a system of benefits. And no system is perfect, no matter how good the intention, so we should expect there to be waste within that system.
If you want to teach people interesting things about the system, teach them how the alternatives to capitalism are more unfair, but how capitalism requires a certain level of unemployment to function. That would help to change the perception of the unemployed, especially those chronically unemployed. Without them there is no capitalism, which needs a pool of the unemployed to balance growth.
Just as next time you find a £1 coin down the back of the sofa, you won’t look with distrust at your furniture for stealing your hard-earned cash, we shouldn’t look with distrust at the welfare state or the NHS, or any other public service, for that matter. These are truly remarkable systems to be proud of. If – as science suggests – there is no afterlife, you have lived as a member of a species so advanced as to be capable of things that are utterly wonderful to behold. Things that you and other members of your species have fought tooth and nail for, died in pursuit of, and championed, whether popular or not. What better life could you have lived?
And it all starts with understanding why waste exists in any system, whilst not allowing yourself to see it out of context.