But another advantage, and one that I have not stressed before, is empowerment. Under the current system, those charged with achieving social and environmental goals are mostly employed either by government or by non-governmental organizations. The contrast between the performance of the two groups is compelling.
"Ask yourself," wrote John Fund of the Wall Street Journal more than a decade ago, "If you had a financial windfall and wanted to help the poor, would you even think about giving time or a check to the government?" I think we'd all answer with a resounding "no". We'd much rather give to charity or a non-governmental organization. We know they will be more motivated and make better use of their limited funds. Part of the explanation, I believe, is that they are empowered to make important decisions, in ways that government employees increasingly are not. Consider the proliferation of narrow targets with which UK Government attempts to shape its National Health Service. A recent one is the stipulation that doctors must give after-hours care in the form of appointments that last ten minutes, and only ten minutes:
[UK Prime Minister] Gordon Brown believes in pre-booked, ten-minute appointments and will not pay us the extended hours money if we do seven and a half minute appointments. I’m not prepared to fudge, or lie (some practices are, he said sanctimoniously) so my late evening surgery is now booked at ten-minute intervals. I will see twelve patients rather than the usual sixteen. I will enjoy having that little extra leeway. I may even be able to use some of the time to catch up on paperwork. NHS Blog DoctorIt's not just the inefficiency that this sort of directive generates, or the gaming of the system that will occur. It's also the resentment that such micro-management will inevitably breed. Applied with ever more abandon, such micro-goals take away the intelligence from any form of decision-making. They imply and generate a low level of trust, and reinforce a command-and-control hierarchy.
The contrast with a Social Policy Bond regime targeting broad social and environmental goals is stark. In the health sector we need only agree on and target broad indicators encompassing length and quality of life - not a simple matter, but one that would clarify exactly what government's role should be and one, moreover, that would empower and motivate health experts to go about achieving them in the most efficient ways they can. The obvious disenchantment that NHS Blog Doctor feels along with others whose autonomy is eroded by misguided application of narrow targets would be a thing of the past.