Where's the vision?

I've long stressed the most obvious feature of Social Policy Bonds: their efficiency, which would be measured as the increase in social (or environmental) well-being per pound spent. Under a bond regime, bondholders would have incentives to achieve our social goals as efficiently as they can. Also, I've talked about the stability of the goals that a Social Policy Bond regime could target: there's more consensus about such goals than there is about the means of achieving them, the most efficient of which would anyway change over time. And I've mentioned the transparency of a bond regime, which would target explicit, verifiable goals. All these attributes are beneficial. They allow us to take a long-term approach to dealing with complex social problems that require a wide array of diverse, adaptive approaches to their solution. 

It's also important that the goals we can target with a bond regime are comprehensible and meaningful to ordinary citizens. Taking health, for example, most of us have little idea about the relative merits of certain interventions, and recent events have seen a growing distrust of corporations and governments who, we'd like to believe, are acting with good intentions. My (long) essay on applying the bond principle to a country's health discusses the possible use of Quality Adjusted Life Years as one way of measuring the physical well-being of the population that could be targeted. Such  measures have their technical difficulties but they would be broadly understood by citizens with an interest in health outcomes. This is a benefit in its own right, but also a stimulus to greater public engagement with health policy and, therefore, greater buy-in. 

Sadly, but not unexpectedly, the essay languishes on my website, and current policymaking in the UK at least, continues to be an incoherent and incomprehensible (to outsiders) mix of arguments about funding and structures, and short-term kludges. Where is the vision? The strategy? The buy-in?