viernes, 22 de febrero de 2008

Entrevista al economista Dani Rodrik


Comparto con ustedes una gran entrevista al economista Dani Rodrik, que encontré en www.webpondo.org. En ella se abordan temas como globalización, políticas industriales, propiedad intellectual, desarrollo económico, instituciones, entre otros.

Se las recomiendo.

A continuación posteo una de las preguntas de la entrevista:

With respect to this same paper1 we are referring to, there was a point that called our attention about it and it’s the fact that you say that the very process of economic development has to do a lot with experimentation and, in that sense, there is some active policy intervention that is necessary. And there are two points with respect to this conclusion which calls our attention. The first one is that you say that there was some kind of more optimal mix in that policy intervention in Asia in terms of “carrots and sticks” (in your terms) and we would like you to explain a bit about that combination. And also, if you are calling for active policy intervention as a consequence of the very process of economic development, what about the imperfections or the potential problems that economists so much worry about in the public sector?

When I talk about experimentation, I have two sorts of experimentation that I have in mind, and I think both are equally important. One, and what you are referring to in the first part of your question, is experimentation in the productive sphere. The other is institutional experimentation. The former is the process of figuring out where your comparative advantage lies, figuring out what you can produce profitably, and this is an activity that’s by and large undertaken by the private sector. This is not an area for the public sector to be doing. But, what I do think is that because this process of experimentation in the productive sphere (what Ricardo Hausmann, my coauthor, and I call “self-discovery”) is a process which is rife with externalities and informational shortcomings, it is also one area where the government potentially has a role to play. And we summarize that role by way of this combination of “carrot and stick” policies. You need the carrot policies so that there is a positive incentive for private entrepreneurs, private investors, to start production and investments in non-traditional activities. That requires a positive inducement. It is not generally going to be undertaken in optimal amounts simply through free market forces, because this is a process which provides tremendous social externalities. The first investor in Colombia that discovered that cut flowers could be profitably exported to the United States, created tremendous social value. And, in fact, this innovation very rapidly dissipated itself to Colombia with many, many more entrepreneurs coming and starting to produce. Economic development is fundamentally a process of this kind where at least early on you need sufficient incentives in place for this investment in new activities to take place. That’s the carrot part of the
policy.

I think the stick part, and I think that’s closely related to the doubts you were raising about the possibilities of useful intervention, the stick part of the policy has to do with ensuring that such incentive policies do not deteriorate into effectively just protecting long. I think generally economists have said that governments cannot do this. I think when economists say that governments cannot do this, they are really, for the most part, really doing amateur political science. Because there is really very little systematic analysis of when and how, or if at all, governments have the capacity to do interventions of this sort.

I think it’s clear that this is not something you can recommend across the board. Typically, you have to look for parts of the government where there is bureaucratic competence, where there is professional expertise with certain amount of autonomy. And I think, where you have those, programs like these can be undertaken. It will never look the same way from one country to another. In some country it might be a public private venture fund; in another country it might be an export processing zone; in a third country it might be tax incentives or investments in new areas. Particularly, this will depend a lot on where the capacity in the system, in the public sector, is really located. But I think it’s just empirically not true that governments cannot do this, or that any attempt to do this is necessarily
doomed to failure.

And I should emphasize one more thing: often people react to such ideas by saying, “the government can never pick winners”. The argument is not that the government has the capacity to pick winners; it is a much weaker argument that says, “the government does not have the capacity to pick winners, often it will pick losers”, but, what we need to do is design institutions that at least give the government the capacity to let go of the losers.

jueves, 21 de febrero de 2008

Gobierno anuncia la iniciativa de crear la Agencia de Calidad de Políticas Públicas (Acpp).

En la sección de Economía y Negocios del mercurio de hoy, sale un artículo sobre esta nueva agencia.

La idea está dentro de las promesas de la campaña de la Presidenta Bachelet:
Hacienda anuncia la creación de una agencia para la calidad de proyectos

Jueves 21 de febrero de 2008
La subsecretaria de Hacienda, María Olivia Recart, dice que la Dipres quedó a cargo para llevar adelante esta iniciativa.Foto:MANUEL HERRERA

La iniciativa fue incluida en la agenda de probidad y debía estar lista hace un año. Ahora se enviará al Congreso recién en 2009.


EDUARDO OLIVARES C.

En la creación de una nueva entidad gubernamental trabajan el Ministerio de Hacienda con el Ministerio Secretaría General de la Presidencia (Segpres).

Se trata de la Agencia de Calidad de Políticas Públicas (Acpp), una de las promesas más remotas de la campaña de la Presidenta Michelle Bachelet. Según anuncia Hacienda, esta idea será finalmente elaborada a través de un proyecto de ley, cuyo envío al Congreso debería postergarse hasta 2009.

"Es un trabajo que ha avanzado bastante bien. Hay unas cuatro o cinco personas que están trabajando en esto", cuenta la subsecretaria de esta cartera, María Olivia Recart (ver entrevista). Aunque hay poca claridad sobre el contenido de la iniciativa, la propia Michelle Bachelet -como candidata- dio las pistas: debía evaluar el gasto, los programas y su pertinencia.

"Para construir una administración pública de excelencia, cada decisión de política pública debe estar adecuadamente respaldada por evidencia que asegure su eficacia", dijo en su programa. Una agencia que aborde ello, dotada de capacidades, facultades y recursos, garantizaría la eficacia y transparencia en la aplicación de los recursos públicos, continuó.

Avances

Hay tres avances que involucraría esta entidad, sostuvo. Primero, las evaluaciones se extenderán a proyectos, programas y políticas públicas.

Segundo, sus resultados incidirán en las decisiones presupuestarias y en las mismas políticas públicas. Y tercero, las metodologías incorporarán sistemas participativos, de modo que los afectados por un programa tengan voz en su diseño.

El lunes 8 de agosto de 2005, la entonces candidata Michelle Bachelet propuso, ante el Congreso, la instauración de esta agencia. Incluso esbozó que el proyecto de ley respectivo estaba listo y se enviaría a tramitación parlamentaria tras asumir en La Moneda. No fue así.

Un segundo intento ocurrió con el Consejo de Probidad. En su tercer paquete de medidas, presentadas en noviembre de 2006, decía que Hacienda trabajaba ya entonces en un proyecto legal al respecto, "con miras a ingresarlo en el primer semestre del año 2007". No hubo tal.

Aparentemente, esta idea fue incluida en el programa de la Presidenta Bachelet por Mario Marcel; pero, como él no se quedó en Hacienda, no fue prioritaria.

Además, la Dirección de Presupuestos ha fortalecido sus propios programas de evaluación y de impacto.

>> Subsecretaria Recart: "Esto no será antes de 2009"

-¿Quién está viendo lo de esta agencia en el Gobierno?

"Hay un comité de dos ministerios: Hacienda y la Secretaría General de la Presidencia (Segpres). Durante 2007 se elaboró un documento inicial de trabajo y hay varias tareas que hacer. El documento debiera ser completado durante este año para evaluar qué se hace hoy, dónde se está haciendo, qué cosas pueden unirse para crear sinergias, qué cosas faltan en las mejores prácticas y qué cosas están siendo implementadas en el mundo en este tipo de agencias. Debiera haber, hacia fines de 2008, alguna propuesta más terminada".

-¿Para convertirse en un proyecto de ley?

"Sí. Mi evaluación personal es que esto no será antes de 2009".

-¿Tendrían que unirse muchas atribuciones que hoy tiene la Dirección de Presupuestos?

"No es sólo la evaluación de programas, porque evaluación de programas hay de distinta naturaleza. Hay una evaluación de programas de control de gestión y hay una evaluación de programas de impacto. La que interesa desde el punto de vista más de políticas públicas de largo plazo es para impacto, y lo que uno debiera tener ahí hoy y ya lo estamos implementando, a modo piloto, es evaluar más programas públicos del Presupuesto".

"Con eso debiéramos tener la línea base. Después de que terminan los programas, uno debiera decir 'esto es lo que ha pasado, y, por lo tanto, aquí la política pública está bien o mal focalizada'. Ese tipo de evaluaciones las hace hoy la Dirección de Presupuestos junto con la del control de gestión, pero hay más evaluaciones: de metas ministeriales -que hace la Segpres- o del Sistema Nacional de Inversión -que hace Mideplan-, y esa mirada en conjunto es la que estamos poniendo hoy para diseñar o ver efectivamente qué es lo que contiene esta Agencia de Calidad de las Políticas Públicas".

-¿Quién está viendo esto aquí? ¿La subsecretaría o la Dirección de Presupuestos?

"La Dirección de Presupuestos".

sábado, 16 de febrero de 2008

Comentarios sobre Obama en The Economist


Barack Obama

But could he deliver?

Feb 14th 2008
From The Economist print edition


It is time for America to evaluate Obama the potential president, not Obama the phenomenon

EPA


THIS has been an extraordinary week for the man who could become America's first black president. Barack Obama has now won all eight of the primaries and caucuses held since Super Tuesday on February 5th, which ended, more or less, in a dead heat with Hillary Clinton. He has won by much larger margins than most people expected, trouncing his rival not just in heavily black states, such as Louisiana, but in ones that are almost completely white, such as Maine. On February 12th he took all three prizes in the “Potomac primary”—Washington, DC, Maryland and, by a socking 29-point margin, Virginia.

Mr Obama now has more pledged delegates than his rival—and he is likely to remain the front-runner for at least another three weeks (see article). Revealingly, Mrs Clinton made her Virginian concession speech from Texas—a state which votes alongside Ohio on March 4th and is already being billed as her last stand. Mr Obama is raising money at the rate of $1m a day, twice as fast as she is; indeed, she has been forced to lend her campaign $5m of her own cash and fire the two people who run her campaign (although her husband has a big say).

Whatever happens, Mr Obama is already that rare thing—a political phenomenon. It is not just that he has managed to survive the Clintons' crude onslaught with grace. He has persuaded huge numbers of people around the world to reconsider politics in an optimistic way. To many Americans, a black man who eschews both racial politics and the conservative-liberal divide is a chance to heal the country's two deepest divisions. To many foreigners, he represents an idealistic version of America—the hope of a more benevolent superpower. Although Mr Obama's slogan “Yes We Can” has been turned into a pop video, the theme of his campaign echoes the Clintons' old tune—“Don't stop thinking about tomorrow”.

Optimism is a powerful emotion, but as that song warned, “tomorrow will soon be here.” That is why the real questioning of Mr Obama should begin now. With the brief exception of those four heady days after the Iowa caucuses, he has never been a front-runner; now he will be more fully scrutinised. The immediate focus will be on the horse race: can he win? But the bigger issue, which has so far occupied too little attention, is this: what would a President Obama, as opposed to Phenomenon Obama, really mean for America and the world?



Yes, you can; but not immediately
Begin with the horse race. Mrs Clinton is in a bad way—and deservedly so. The Clintons have fought a leaden and nasty campaign; at present, the prospect of a “Billary presidency” (even before you take into account the dynastic Bush-Clinton-Bush-Clinton aspect) is hardly enthralling. But Mrs Clinton is tough and smart, and now her rival will be under the media microscope. In debates she trumps Mr Obama on mastery of detail—and the race could well be a long, grinding one, perhaps decided in the end by the 796 “super delegates” from the Democratic Party's establishment. These people have tended to be loyal to the Clintons—though many might defect if polls still showed Mr Obama doing better against John McCain.

Mr McCain, whose lock on the Republican nomination looks stronger than ever following his own triple victory in the Potomac primary, is another part of tomorrow Mr Obama's euphoric supporters might think about. The Republicans are a mess, and the elderly Arizonan senator has plainly failed to stir up his party's supporters in the same way as either of the main Democrats. But Mr McCain is a brave man, with huge experience of international affairs and a much longer record of reaching out to his opponents in politics. Why should independent voters, who have often backed Mr McCain in the past, turn to the less proven man?



Of magnets and magic dust
That question is partly answered by Obama the phenomenon. His immediate effect on international relations could be dramatic: a black president, partly brought up in a Muslim country, would transform America's image. And his youthful optimism could work at home too. After the bitterness of the Bush years, America needs a dose of unity: Mr Obama has a rare ability to deliver it. And the power of charisma should not be underrated, especially in the context of the American presidency which is, constitutionally, quite a weak office. The best presidents are like magnets below a piece of paper, invisibly aligning iron filings into a new pattern of their making. Anyone can get experts to produce policy papers. The trick is to forge consensus to get those policies enacted.

But what policies exactly? Mr Obama's voting record in the Senate is one of the most left-wing of any Democrat. Even if he never voted for the Iraq war, his policy for dealing with that country now seems to amount to little more than pulling out quickly, convening a peace conference, inviting the Iranians and the Syrians along and hoping for the best. On the economy, his plans are more thought out, but he often tells people only that they deserve more money and more opportunities. If one lesson from the wasted Bush years is that needless division is bad, another is that incompetence is perhaps even worse. A man who has never run any public body of any note is a risk, even if his campaign has been a model of discipline.

And the Obama phenomenon would not always be helpful, because it would raise expectations to undue heights. Budgets do not magically cut themselves, even if both parties are in awe of the president; the Middle East will not heal, just because a president's second name is Hussein. Choices will have to be made—and foes created even when there is no intention to do so. Indeed, something like that has already happened in his campaign. The post-racial candidate has ended up relying heavily on black votes (and in some places even highlighting the divide between Latinos and blacks).

None of this is to take away from Mr Obama's achievement—or to imply that he could not rise to the challenges of the job in hand. But there is a sense in which he has hitherto had to jump over a lower bar than his main rivals have. For America's sake (and the world's), that bar should now be raised—or all kinds of brutal disappointment could follow.

jueves, 14 de febrero de 2008

Modern Policy-Making


Les recomiendo leer este documento producido por el National Audit Office del Reino Unido, donde se explica que implica generar políticas públicas modernas que generan value for money y valor público.

Las nueves características de la generación de políticas públicas modernas deben ser:

! Be forward looking (poner el foco en el futuro)
! Be outward looking (poner el foco en el exterior)
! Be innovative and creative (ser innovativas y creativas)
! Use evidence (usar evidencia)
! Be inclusive (ser inclusivas)
! Be joined up (estar transversalmente unidas)
! Evaluate (evaluativas)
! Review (revisadas constantemente)
! Learn lessons (aprender lecciones)

sábado, 9 de febrero de 2008

Si podemos: Un gran video de Obama sobre la esperanza en el cambio que une.



Si podemos

It was a creed written into the founding documents that declared the destiny of a nation.

Yes we can.

It was whispered by slaves and abolitionists as they blazed a trail toward freedom.

Yes we can.

It was sung by immigrants as they struck out from distant shores and pioneers who pushed westward against an unforgiving wilderness.

Yes we can.

It was the call of workers who organized; women who reached for the ballots; a President who chose the moon as our new frontier; and a King who took us to the mountaintop and pointed the way to the Promised Land.

Yes we can to justice and equality.

Yes we can to opportunity and prosperity.

Yes we can heal this nation.

Yes we can repair this world.

Yes we can.

We know the battle ahead will be long, but always remember that no matter what obstacles stand in our way, nothing can stand in the way of the power of millions of voices calling for change.

We have been told we cannot do this by a chorus of cynics...they will only grow louder and more dissonant ........... We've been asked to pause for a reality check. We've been warned against offering the people of this nation false hope.

But in the unlikely story that is America, there has never been anything false about hope.

Now the hopes of the little girl who goes to a crumbling school in Dillon are the same as the dreams of the boy who learns on the streets of LA; we will remember that there is something happening in America; that we are not as divided as our politics suggests; that we are one people; we are one nation; and together, we will begin the next great chapter in the American story with three words that will ring from coast to coast; from sea to shining sea --

Yes. We. Can.



Celebrities featured include: Jesse Dylan, Will.i.am, Common, Scarlett Johansson, Tatyana Ali, John Legend, Herbie Hancock, Kate Walsh, Kareem Abdul Jabbar, Adam Rodriquez, Kelly Hu, Adam Rodriquez, Amber Valetta, Eric Balfour, Aisha Tyler, Nicole Scherzinger and Nick Cannon

Entrevista al economista Eric Finkelstein



Comparto con ustedes una muy buena entrevista al economista Eric Finkelstein sobre la economía de la obesidad, que al parecer revela que la obesidad debe su existencia principalmente al éxito del capitalismo.

The Economics of Obesity: A Q&A With the Author of The Fattening of America
By Melissa Lafsky

We’ve blogged about obesity at length here at Freakonomics. The health economist Eric Finkelstein has been studying the subject for years, and, along with co-author Laurie Zuckerman, has just published a book, The Fattening of America, which analyzes the causes and consequences of obesity in the U.S. Finkelstein agreed to answer our questions about the book.

Q: You state that the factors contributing to the dramatic rise in American (and worldwide) obesity, from air conditioning to restaurant portions to modern medications, are all fundamentally economic issues. What are the most significant ways modern society has made it easier to be obese?

A: Modern society is giving Americans many more incentives to gain weight than to lose it. We are, in fact, victims of our success as a nation. The two most obvious factors are: 1) the abundance of cheap, tasty foods; and 2) the new technologies that allow us to be increasingly more productive at work and at home while burning fewer calories. For example, between 1980 and 2005, the price of food fell 14 percent relative to non-food items, so it is thus not surprising that we are eating more food.

And what kind of foods are we eating? Well, consider the French fry. Fries, if made from scratch, take about 40 minutes to prepare, complete with peeling, slicing, and messy, splattering oil. Frozen French fries? Ready to eat in under 14 minutes. And that’s still a lot of work compared to just stopping at a drive-through on the way home from work. To an economist, then, it is no shocker that the average American now consumes almost 60 pounds of frozen potato products per year, more than triple the amount consumed per person in 1965.

And at the same time, we’re burning less calories. No surprise here. We all know that we are spending more time watching TV, but there are also less obvious culprits that are keeping us ensconced in our chairs. One example is that I recently had an inexpensive printer installed in my office. So now I don’t even have to walk the 100 steps to the community printer down the hall a few times a day.

But technology hasn’t just made our jobs and our lives easier; we can also pop some pills or get out clogged arteries cleaned out with relative ease, thus lowering the health costs of obesity. In fact, research by the Center for Disease Control reveals that today’s obese population has better blood pressure and cholesterol values than normal-weight adults did 30 years ago. As any economist worth his weight will tell you, if the costs of being obese go down, and there are people who like to eat and don’t like to exercise, we are bound to see obesity rates go up.

Q: Is obesity really an “epidemic”? If we were to let the current obesity rates continue unchecked, what would the outcome be?

A: Over the past three decades, the number of obese Americans has more than doubled. But whether or not we call obesity an “epidemic” largely depends on how the word is defined. If one defines an epidemic as the rapid increase in the occurrence of something, then yes, obesity is an epidemic. Of course, we also have an epidemic of flat panel TVs. My family was recently afflicted with one of those. If an epidemic requires the spreading of a disease from person to person in a locality where the disease is not permanently prevalent, as Dictionary.com defines it, then I would say no, obesity does not qualify as an epidemic.

The reality is that no matter how we label it, as long as there is a demand for labor saving devices and cheap, tasty food, there will be a significant obesity problem. The United States has the most advanced economy in the world, so we saw the obesity spike first, but other nations are quickly catching up. Of course, even in this obesity-inducing environment, many people are finding ways to stay thin and, given the large profit motive, companies are working hard to help people do so. As a result, I find it hard to believe that obesity rates could ever reach the dire levels that some have predicted. In fact, recent evidence suggests that obesity rates may be slowing among adults.

Q: From an economic standpoint, should we be diverting so many resources, public and private, to fighting obesity? Would it make more sense to let obesity rates keep rising, and focus instead on treating and preventing the medical conditions (heart disease, diabetes, etc.) to which obesity contributes?

A: This is the $93 billion question. That is how much obesity is costing the nation every year.

When it comes to the private sector, the market should be allowed to freely determine the optimal amount of resources to invest in obesity prevention and treatment. As noted above, there is a huge demand for products and services aimed at reducing rates of obesity. I am not just talking about drugs and devices, I’m also talking about cool new technologies such as Dance Dance Revolution and the Wii, which use technology to re-engineer physical activity back into our lives. I just bought these for my family.

In The Fattening of America, I make the argument that the government should revisit past policies that may have inadvertently helped promote the rise in obesity rates. I point not only to our agricultural subsidy policies for farmers, but also to zoning laws that discourage pedestrian transportation, subsidies to employers for providing health insurance, and even the existence of the Medicare program. All of these in some way blunt the incentives to invest in prevention, be it for obesity or other conditions.

I do want to point out that the government’s primary motivation is not to reduce costs to Medicare and Medicaid. If it were, they could just stop funding these programs altogether. There may be good reasons to invest in preventive care, but there is little evidence to date that document any long-term savings associated with obesity prevention efforts. If the government funds these and they do not work, they only serve to raise our taxes even more.

Q: A recent Dutch study found that it costs more to provide medical care for healthy people than the obese or smokers, who tend to live shorter lives. What do you make of these results? Are they different from, or similar to studies you address in your book?

A: I am familiar with that analysis. It is well known that smokers tend to subsidize non-smokers because the former pay so much in taxes and die before they can collect their due in social security and Medicare benefits. The researchers’ finding that
obese people also cost less is new, and probably not correct for a U.S. population.

It is well established in the U.S. that obese individuals cost more than normal weight individuals at each age of life. I have published several papers showing that result. Recent studies by Fontaine and Flegal also show a relatively small impact of obesity on mortality for BMIs less than 35 (about 70 pounds overweight). As a result, higher age-specific costs and only a slightly shorter life expectancy suggest that the lifetime costs of obesity are indeed positive for most obese adults. The same goes for overweight adults, as they do not seem to have any shorter life expectancy. So I doubt their results for obesity are accurate for the U.S. population.

But let’s suppose they were. Should we give away free Krispy Kreme donuts because obesity saves money? My son would love that, but sorry son, the answer is no. I argue in my book that high costs should motivate employers to address obesity rates, but saving money is not an appropriate reason for government intervention. If it were, then the government should be giving away free cigarettes. Moreover, when it comes to obesity, any effort by the government to encourage people to lose weight, unless it saves more money than it costs, will only raise our taxes even more, regardless of whether or not the measure is effective at getting people to lose weight. Unfortunately, cost-saving obesity interventions have yet to be identified. So until they do, obesity may be taking two significant bites out of the government coffers.

Q: How much should the government really legislate obesity? What programs/efforts would be the most beneficial? Who should they target (e.g., children, low-income adults)?

A: In my book, I talk a lot about my Uncle Al, a smart and successful attorney who also happens, not by accident, to be very overweight. In fact, he’s overweight because instead of spending his time dieting and exercising, he has spent his time building a very successful law firm. I see no reason why the government should get Uncle Al to change his behavior if he does not want to. Even for low-income individuals, any effort to force people to change their behavior will only serve to make them worse off (even if they do become thinner). So no, for adults, I do not think the government can, or even should, legislate obesity away.

In sharp contrast, children are unable to make rational choices, unlike Uncle Al. I think that the government (and parents) have a critical role to minimize the possibility of children growing up to regret the diet and exercise choices they may have made as uninformed youths. Most government interventions are focused on schools, which makes sense given that the food the lunch ladies serve up is too often not that different from the birthday fare my son receives at Chuck E. Cheese. And then, of course, there’s the school vending machines. In my book, we discuss what’s happening in America’s school cafeterias, gymnasiums, and classrooms, and what can be done to help tomorrow’s adults make informed diet and exercise choices.

Q: Can the current obesity trend be summed up as an issue of “personal and immediate benefits” versus “longterm and widespread social costs”? Why or why not?

A: People often like to compare the current obesity “epidemic” with smoking. I think the two are very different. Smokers, by virtue of second-hand smoke, impact non-smokers. As a result, the government has a clear justification for attempting to limit exposure to second-hand smoke (although, in my opinion, some of their policies have gone well beyond resolving market failures).

I see more similarities between obesity and motorcycle helmet laws. If someone wants to ride a motorcycle without a helmet, and take the risk of getting into an accident that would almost surely result in a major trauma, why do we really care? I think the answer is that we don’t want our hard-earned tax dollars to pay for this individual’s “poor” choice. It really boils down to money, and the fact that we live in a society that would not allow this person to bleed out in spite of the fact that he or she knowingly made a choice that made a major injury far more likely. So, to solve this problem, and because those who ride motorcycles are in the minority, we pass mandatory motorcycle helmet laws.

With respect to obesity among adults, I think the issue is one in the same. Nobody wants to pay for my Uncle Al’s excess weight. The primary difference is that with overweight and obese individuals representing two-thirds of the population, passing laws that limit choice, such as we did with the motorcycle helmets, is unlikely to happen any time soon.

Q: Dubner and Levitt recently discussed the unintended consequences that can result from government legislation intended to change behavior or help certain groups — what are the most likely unintended consequences of obesity-prevention legislation?

A: It is very difficult for the government to pass legislation without having unintended consequences. For example, some have suggested that No Child Left Behind may be a factor in rising obesity rates, by helping to eliminate gym class from schools and forcing kids to study harder. Truth or fiction — you get the point. When it comes to obesity legislation, there is no such thing as a free lunch. Getting junky foods out of schools, for example, will not only hurt food companies, but also reduce the revenue for schools to fund other activities. At the end of the day, the choice will be to weigh the costs and benefits to see whether the legislation is better than the status quo.

Q: Is the rise in obesity rates the result of market failures?

A: No. I would say it is just the opposite. The rise in obesity rates is resulting from market forces that are bringing us low-cost products and services that make us more productive at work and at home, and that provide us with highly valued leisure time activities.

For example, consider the microwave. While only 8 percent of American homes had microwaves in 1978, 95 percent currently have them. They make it quick and easy to get food on the table. Then take carbonated beverages. They make up 7 percent of all calories consumed. They would be more expensive without heavy farm subsidies, but not that much more. Also, how many cars today require manually “rolling up” the windows? That term shouldn’t even exist any more. Car windows, along with countless other things, are now automated.

These are a few of the thousands of examples of new products and services that allow us to save a few calories here and there, or consume a few extra calories for not much time or money. In my book, I compare our modern lifestyle to that of the Amish. We could all eschew technology and choose to live like the Amish, but who would want to? That’s a pretty high price to pay to be thin.

In my opinion, obesity is more the result of the success — not the failure — of the market. This is not to say that market failures do not exist, or should not be addressed. My only point is that were we to address them all, obesity rates would still be dramatically higher (although perhaps not quite as high) today than they were a few decades back. But on net, we are still better off.

Q: Is being obese more, less, or equally costly for individuals now than it was twenty years ago?

A: We’ve already discussed how it’s cheaper and easier to be overweight today than it was a few decades back. In addition, thanks to advances in medical technology, the health costs of obesity continue to decline. Among today’s obese population, the prevalence of high cholesterol and high blood pressure are now 21 and 18 percentage points lower, respectively, than they were among obese individuals 30 to 40 years ago. In fact, obese individuals today have better cardiovascular disease risk factor profiles than normal-weight individuals had 30 years ago.

What is driving this surge in improved health profiles for obese individuals? The answer, as you might have guessed, is a dramatic improvement in drugs and devices. Many drugs have been introduced over the past 40 years that effectively treat cholesterol, blood pressure, and other risk factors and diseases that obesity promotes. One million operations were performed in the U.S. last year to unclog clogged arteries. In the past, diet, exercise, and weight loss might have been the primary treatment to help control risk factors resulting from excess weight; today, one has the option of taking a pill or having surgery. Many individuals, including my Uncle Al, feel that diet and exercise are consequently optional.

lunes, 4 de febrero de 2008

Garretón en la Segunda

La gestión

“¡La economía, estúpido!” decía un famoso lema de la campaña presidencial de Bill Clinton, llamando a sus equipos a no distraerse de lo principal. Me gusta por la sensación de urgencia que transmite, no por afán de agredir. Me inspira una consigna local: “¡Es la gestión, ojo, la gestión!”.

Los tribunales de familia, las importantes certificaciones para el comercio exterior de importación y exportación, las posesiones efectivas en el Registro Civil, los recursos públicos para la innovación, los trámites ambientales, la ampliación de las enfermedades beneficiadas con el Plan Auge, los ingentes recursos destinados a regiones, las nuevas regulaciones laborales, el abastecimiento diario de miles de nuevas salas cuna, el crecimiento del presupuesto público para educación... Todas estas son sólo algunas de las medidas y responsabilidades asumidas en estos años por el Estado con sus ciudadanos. Todas ellas representan avances muy importantes, en especial para los más pobres y desamparados. Sumemos, a partir de mediados de año, la reforma previsional que favorecerá a miles de chilenas y chilenos.

Son nuevas tareas que recaen sobre el aparato público. Han sido impulsadas por los gobiernos de los años post dictadura y aprobadas por el Parlamento. Cuando surgen del acuerdo entre oposición y gobernantes, motivan fotos sonrientes con manos entrelazadas. Son bien recibidas por la población. Son logros propios de un país que ha prosperado con el concurso de todos y debe preocuparse de una mejor calidad de vida para todos.

Sin embargo, el hecho de dar forma legal a estas medidas no representa sino el inicio de una tarea. Genera el derecho y mandato de realizar, pero estamos aún muy lejos de su materialización práctica. No nos obnubilemos con abrazos y declaraciones, queda aún lo principal y más difícil por hacer. Estas medidas son verdaderas para la población cuando sus beneficios llegan realmente a ella. Mientras así no ocurre, son sólo un anuncio o una entelequia y, si llegan mal —con errores, retrasos, engorros burocráticos—, la buena nueva se transforma en una irritante frustración. Una nueva ley no es en sí una buena nueva, es sólo el deber de comenzar a hacerla realidad palpable.

Para agregar desafíos, el país se ha hecho más exigente como consumidor o cliente. Se ha acostumbrado a una atención más eficiente, a resolver cosas por internet en tiempo real, a créditos a sola firma, a tecnologías de información para reducir colas y trámites, etc. Aunque el Estado no hubiera aumentado sus responsabilidades, las exigencias de calidad de servicio que le hace la población son muy superiores a las del pasado. Con el agravante que, a poco andar, todos pasamos a considerar un derecho obvio e irreversible cualquier mejora. Las cosas buenas provocan rápido acostumbramiento. No entendemos cómo antes pudimos vivir sin ellas.

El reto no es menor. Mientras las empresas suelen vivir en reorganización para conseguir sus resultados, la estructura pública tiene rigideces inevitables. La dictadura redujo el tamaño del sector público pero no mejoró su calidad. Sólo algunos servicios, como Impuestos Internos, nos prueban que la calidad no es un atributo imposible. Pero la primacía absoluta de procedimientos y normativas sobre resultados lastra el quehacer público. Al igual que la nueva ola fiscalizadora, siempre lista para detectar cabezas políticas a cortar, pero absolutamente indiferente a la responsabilidad funcionaria de gestionar eficientemente. Para muchos funcionarios termina siendo más eficiente no hacer nada que correr el riesgo de fallar en algún procedimiento o quedar a merced de una fiscalización distorsionada.

Pero otra cosa entienden por eficiencia chilenas y chilenos. Quieren que lo prometido y lo anunciado se cumplan, presionando fuertemente la gestión pública. ¡Ojo a la gestión! Una prueba de fuego ad portas será cumplir día a día y un mes tras otro, en residencias de todo el país, las masivas obligaciones que representa hacer realidad material la reforma previsional.

Gobierno Unido o Juntado Transversalmente

En esta columna Geoff Mulgan nos da luces sobre lo que han sido los esfuerzos de armar un gobierno "joined up" ("unido transversalmente" o "anillado") en el Reino Unido.

El proceso de joined up government asume una mirada holística, que apunta más allá de fronteras institucionales hacia los objetivos estratégicos del gobierno y busca establecer la base ética, moral y legal para las políticas públicas. Existen también consideraciones respecto de cual debe ser la gerencia pública y las estructuras organizacionales apropiadas para producir estos objetivos transversales del gobierno que por lo general transcienden los mandatos legales de los ministerios o agencias de gobierno.

Joined up government: past, present and future - Geoff Mulgan (2005)

What's the problem?

The idea of ‘joined up government’ – a term first used by the Prime Minister when he launched the Social Exclusion Unit in 1997 - has become an important aspect of government in the UK. It has influenced how structures are organised; how budgets are allocated; how targets are set; and the day to day work of local agencies and professions.

The main cause of this interest has been the recognition that many of the pressing problems facing government – such as social exclusion, crime, environment, family and competitiveness – do not fit into neat departmental boundaries. However, ‘joining up’ remains in its infancy: the great majority of government is still organised in essentially vertical ‘silos’ not hugely different from 50 years ago, and most of the joining up that has occurred has essentially been about better coordination of existing agencies, rather than radical structural reform.

This paper addresses the background to this debate; the reforms undertaken over the last few years; and possible future directions of reform.

Behind the current concern with joined up or holistic government lie two common problems which face all large organisations – whether they are governments, city administrations, multinational companies or armies:

First, a problem of coordination: how to cajole and encourage an often huge flotilla of agencies, departments, units and professions to point in broadly the same broad direction, and at the very least not to undermine each other’s work.

Second, a problem of organisation and integration: how to align incentives, cultures and structures of authority to fit critical tasks that cut across organisational boundaries.

We coined the phrase ‘joined up government’ to refer to both sets of issues – and indeed to all points on the continuum that runs between them. Although some aspects of it are new – particularly the impact of the Internet – others are very old. They faced all the big imperial bureaucracies whether Roman, Ottoman or Chinese and every military command attempting to coordinate complex forces. In Britain similar problems led to the creation of multi-functional local government in the late 19th century as a joined up alternative to the separate boards for sewage, water, gas and education. In France (echoing ancient China) they prompted the creation of ENA as a tool for forging a ‘joined-up’ administrative elite. In business companies have continually wrestled with the problem of horizontal coordination, and some like Shell, have overcome the substantial managerial challenge of implementing fully fledged matrix structures.

The British approach

Joined up government appears radical now in part because British government opted so firmly for departmentalism during and after its great expansion in the late 19th century. A functional division of labour, with large vertically organised divisions or departments, held together by a relatively small head office, made sense not only for governments but also for large firms and city administrations in an era when communication and the management of knowledge were costly, and best organised within institutions and professions. So government was divided into functions. Separate departments dealt with finance, education, defence, housing, colonies, trade and transport. Often departments developed close relationships with particular professions: health with the doctors, education with teachers, the Home Office with the police, in line with Haldane’s belief that the knowledge base was the best determinant of how organisational boundaries should be defined. Funds were then voted by Parliament for specific ends, with tight monitoring to ensure that they were spent correctly.

This model of dividing government up by functions was often very efficient – for example in getting homes built or developing the NHS. It prevented corruption and waste. It ensured clear lines of accountability. It helped to get things done.

Moreover it was not always overly baronial. The Cabinet, and the principle of collective responsibility, ensured some coherence, and it remains the case that the UK government is often much more joined up than others, particularly those based on coalitions.

Over time, however, the weaknesses of this model have become more apparent. The ‘tubes’ or ‘silos’ down which money flows from government to people and localities have come to be seen as part of the reason why government is bad at solving problems. Many issues have fitted imperfectly if at all into departmental slots. Vertical organisation by its nature skews government efforts away from certain activities, such as prevention – since the benefits of preventive action often come to another department. It tends to make government less sensitive to particular client groups whose needs cut across departmental lines (the elderly are a classic example). At worst it incentivises departments and agencies to dump problems onto each other – like schools dumping unruly children onto the streets where they become a problem for the police, or prisons dumping ex-prisoners into the community without adequate job preparation or housing to become a burden for social security. Over time it reinforces the tendency common to all bureaucracies of devoting more energy to the protection of turf rather than serving the public.

Many reformers in the past have tried to grapple with these problems. Prime Minister Edward Heath created a number of super-ministries (and before him, in the early 1950s, Winston Churchill had appointed ‘overlord’ ministers). The Wilson government created the Joint Approach on Social Policy (JASP). Many governments have set up cross-departmental committees like the one on inner cities under Margaret Thatcher in the late 1980s. Under John Major the Citizens Charter initiative attempted to introduce common principles across all service delivery departments. At a more local level innovations introduced by the Conservative governments of the 1980s and 1990s included the Single Regeneration Budget and City Challenge partnerships; funding for projects that produce more than one service (such as foyers tackling homeless and unemployment); case managers in health and social care and more recently welfare (building on a long history of attempts to build bridges between health and care professionals); and the rise of one-stop shops.

In local government there has been even more experiment. Some have transformed the definition of chief officers’ jobs, and the relationship between senior officials and politicians creating a genuinely corporate tier of decision-making above the functional departments (as in Kirklees); others have transformed the way budgets are organised (as in Lewisham); the way information is gathered and managed to assist prevention (as in Hertfordshire); the way agencies work together to solve common problems (as Milton Keynes did in relation to crime); and the ways in which councillors and officers share vertical and horizontal responsibilities for officers and councillors (as in Coventry).

As a rule, however, although the more local and micro reforms were fairly successful, the higher level attempts at cross-departmental working were not. Super-ministries can simply worsen the information overload at the centre and they require super-ministers to make them work. JASP failed because of the lack of political will, inadequate buy-in by departments, lack of clarity about goals and insufficient attention to the mechanisms for achieving greater integration. It also fell victim to changing political priorities. On their own, interdepartmental committees and task forces have tended to have relatively little effect on behaviour, without substantial investment of time and political capital by the Prime Minister.

Why did joined up government rise up the agenda in the 1990s?

This was the picture that faced the new government in 1997. Many advised that the wisest counsel was to leave existing structures intact. In discussions in the early to mid-1990s the view of most senior figures in Whitehall was that there was little scope for reforming the existing structure of departments, and that most efforts at joining up would be doomed to failure. Yet there were compelling reasons why the new government was sceptical of this conventional wisdom.

The first was that many of the problems that most concerned the new government - poverty, competitiveness, family and environment – were evidently ill-suited to existing structures or tools. The tasks of tackling the problems of run down housing estates, cutting crime or helping industry adapt to global warming demanded organisational forms that were more obviously fit for purpose. Just as important, many of the new ministers and MPs had direct experience from their own constituencies of successful joined up working and couldn’t understand why similar arrangements were impossible at the national level.

The second factor was the clear evidence of the limits of the previous reform agenda. The new public management of the 1980s had successfully encouraged government to be more focused, more organised around targets and performance, and more governed by market forces. However this model – premised on breaking issues down into their component parts – had turned out to be particularly ill-suited to more complex problems, prone to even worse ‘dumping’ of problems across organisational boundaries, poor at knowledge sharing, and ill-suited to the integrative potential of the Internet.

The third factor was a rapidly growing evidence base on the interconnectedness of problems. Social scientists had steadily accumulated evidence on, for example, the extent to which the avoidance of social exclusion is bound up with the balance of risk factors and protective factors in early life; or the extent to which crime is influenced by the economy, family and so on. Faced, for example, with evidence that barely a quarter of health improvements come from health services, ministers wanted to know where else they might direct their attention to get better results.

The fourth factor was rapid progress in technology and organisational techniques – above all the rapid reductions in the costs of horizontal communication and coordination. In the private sector this shift was making networks and projects more important units of activity than traditional structures, as well as making it much easier to organise collaborations, partnerships and joint ventures. Cheaper communications also made it feasible to organise complex systems in different ways – for example setting broad objectives and then monitoring outputs in real time.

The fifth factor was the influence of consumerism: citizens wanted services that better met their needs, and which did not cluster together in ways that fitted traditional departmental structures. Single mothers wanted better links between benefit offices, job centres and the Child Support Agency; small firms wanted a common access point to Business Links, Customs and Excise and DTI grants. As a result it became legitimate to ask how government would be organised if it started from the needs of client groups such as the elderly, young people and small businesses, rather than the interests of existing institutions and professions.

The sixth, less tangible, factor was a broader shift of intellectual attention away from the atomistic models of thinking that dominated the first half of the 20th century towards a greater emphasis on systems thinking, whether in the environment, biology, computing or organisations. As is the nature of intellectual shifts of this kind, the huge sunk investment in older models of thinking meant that the pace of change was bound to be slow. But its direction was unmistakeable.

What works?

These six factors pushed joined up government onto the agenda. However, in themselves they did not give very clear indications as to how government should reshape itself. As a rule government works best:

when there are clearly identified critical tasks;

when authority and resources are distributed in ways that enable these to be carried out;

when there is a clear sense of mission from top to bottom;

and when there is sufficient freedom and flexibility for those working as managers or front-line delivery to get the job done.

Many of the previous joined-up government reforms had not met these conditions. There had not often been a clear enough sense of the critical tasks; authority had often been dissipated rather than distributed; the sense of mission had not been widely shared, and was certainly not strong enough to counter the deep cultures of many departments; and at a local level there had rarely been sufficient autonomy to get things done.

The same considerations also help to explain why there was such frustration with partnership working even amongst its strongest advocates. Literally thousands of ostensibly joined up partnerships had proliferated during the 1980s and 1990s. Although many did good work, too many diverted energy and confused responsibility, in large part because of the way authority and resources were distributed. The key lesson was that if existing structures were left untouched, partnerships could be extremely time-consuming and inefficient.

By the mid-1990s it was evident that lasting change would only be possible if structures were changed, so that all of the main drivers of behaviour within government were better aligned to cross-cutting tasks. That meant achieving change across a range of fronts simultaneously, reforming:

Reforming the way money was allocated – to ensure that more of it was allocated to specific problems, areas, or client groups rather than to functional bureaucracies
Reshaping the way career rewards were organised – rewarding those who acted corporately or collaboratively with promotions, honours and bonuses
Designing targets that would be shared across agencies
Tackling the day to day cultures of the professions
Ensuring that information and knowledge was shared better at all levels
Ensuring clear leadership and responsibility for joined up tasks.

Most important of all it was vital that joined up government was aligned with political realities. That meant strong ‘ownership’ from the top to override vested interests. But it also meant providing kudos for ministers – giving them horizontal as well as vertical responsibilities, enabling them to use these to produce political capital, and promoting those who did them well.

Reforms since 1997

These, then, were the lessons that influenced the agenda of the new government in 1997.1 However rather than taking shape in a single blueprint there was a deliberate decision to experiment with a range of different forms, so that these could be allowed to evolve. These included a wide spectrum of changes which have, overall, been mutually reinforcing. The key ones are these:

Moves to make government more focused on outcomes – with the help of Public Service Agreements, several dozen of which cut across departmental boundaries, and which provide the framework for the allocation of funds and the accountability of ministers and departments

The advent of policy making units like the Social Exclusion Unit (SEU) and Performance and Innovation Unit (PIU) – now the Strategy Unit - in the centre of government to analyse problems and propose solutions free from departmental interests

The advent of joined up delivery units, often as the result of the work of the SEU and PIU – like the Neighbourhood Renewal Unit, the Rough Sleepers Unit, the Children and Young People’s Unit, the e-envoy’s office and the Regional Coordination Unit

The creation of joined up budgets – for Surestart, drugs, conflict prevention and criminal justice – and teams to manage them

The appointment of ministers with crosscutting portfolios – such as Yvette Cooper who had responsibility for Surestart, a programme based in the Department for Education and Employment while being a minister in the Department of Health.

The consolidation of local structures – first through bodies like Youth Offender Teams and more recently with Local Strategic Partnerships acting to bring together multiple partnerships into a single structure

The modernisation of central government’s outreach capacity with the overhaul and enhancement of the regional offices (based on the PIU’s report ‘Reaching Out’)

The creation of new cross-cutting roles – like the office of the e-envoy to coordinate IT and online strategy and exercise a ‘double key’ on spending decisions (based on the PIU’s reports on e-commerce and e.government)

Joined up approaches to key service areas: for example with the appointment of a head of IT, backed by a substantial budget, across all of the departments involved in criminal justice; and moves to integrate some of governments financial transactions with citizens (as signalled in the PIU report on modernising government loans).

The coordination of purchasing through the Office of Government Commerce whose first task was to aggregate government demand

The integration of services – like the life episodes on UK Online which cluster different services together according to user experiences (for example bringing together services relevant to having a baby, or retiring)

The creation of new roles for front-line staff to join up different public services – personal advisers in the New Deal, Connexions and Job Centre Plus – and new approaches to professional development (for example encouraging police to understand the social contexts of crime)

Regular cross-cutting reviews of policy – some through the spending review process and some through bodies like the PIU/SU which has tackled issues as varied as childcare, energy, waste and sport.

New budgets – like the Invest to Save budget, designed to incentivise initiatives that would help other departments (for example supporting joint IT and call centres for the emergency services)

New departments – reshaping traditional structures to solve some of the most acute problems of departmentalitis, such as the creation of the Department of Work and Pensions to take charge of welfare to work, and of the Department for the Environment, Food and Rural Affairs to bring together the various aspects of rural policy.

New approaches to the organisation of knowledge and learning, probably most advanced in the health collaboratives which bring together diagonal slices of responsible practitioners, policy-makers, professionals and others to reflect on lessons. Collaborative models are now being used in other cross-cutting fields (such as crime reduction and regeneration).

Has it worked?

How much has this programme succeeded? And are there any general lessons? The answer to the first question is that there has been a good deal of progress, and it is now generally accepted that horizontal structures are essential to complement vertical ones. The changes listed above are all continuing to make progress, often well away from the glare of publicity.

At a national level more corporate approaches to policy-making and delivery are becoming mainstream. The Strategy Unit, for which I am now directly responsible, has become an accepted part of the Whitehall machinery. The great majority of recommendations from past reviews have been implemented (and are regularly tracked on the SU website) and a telling sign is that nearly half of the Strategy Unit’s work is now initiated by departments rather than by No 10 or the centre.

At a local level local strategic partnerships are becoming stronger, helped by recent government moves to streamline the plethora of different funding streams and initiatives.

However, as is the nature of any evolutionary process, some initiatives have been more successful than others: generally where there have been clear objectives, political commitment and viable joined up structures at lower levels, and where the key drivers of behaviour – money, kudos and career rewards, targets – have been in alignment, progress has been greater.

Some of the progress is covered in the recent National Audit Office report2, and in the recent update on ‘Wiring it Up’, the report prepared by the PIU in 1999 on how to reshape the wiring of central government to better incentivise joined up working3.

Both show that joined up methods have steadily percolated through the system. A great deal has changed in the cultures of working at ground level. New services and roles are being consolidated. Cross-cutting budgets like Surestart and the Criminal Justice reserve are becoming well-established, as are shared targets. The approaches to management of knowledge across organisational boundaries are coming to seen as a benchmark globally. Service integration has also advanced further in some areas, helped by the relative absence of jurisdictional boundaries that are found in federal systems.

There is also undoubtedly a large body of officials and people outside government who are passionately committed to making joined up government work – because they want government to be effective in dealing with problems.

However, many see the current situation as transitional. The old departmental traditions remain very strong. The great majority of budgets and policy processes still organised within old structures. Most ministers still primarily interpret their roles in vertical ways – though in private they will often be the most ardent advocates of change. Professional development has been mainly supported through traditional silos. Some of the work of coordination remains excessively time-consuming because structures have not been reformed.

The future

What will the future bring? Are we at the early stages of a fundamental transformation of government, or will joined-up government turn out to be just another fad? Although governments are necessarily quite conservative institutions the pace of change is unlikely to let up if only because the six factors which I described earlier show no signs of receding.

It is unlikely that government will ever be predominantly organised in horizontal as opposed to vertical structures. If it was there would be as many boundary problems are there are today. Instead the future shape of government is likely to involve a combination of vertical hierarchies, particularly for carrying out long-standing tasks with clear lines of management and accountability, and horizontal structures for determining strategy and carrying out shorter-term tasks. As well as determining strategy and overseeing performance the role of the centre of government will continue to be that of allocating the key resources at its disposal – money, people, political capital, legislative time, knowledge – to both vertical and horizontal parts of the system.

In effect that would mean government evolving further in the direction it is already taking. It would involve:

* More work becoming project based
* More policy making being done in a cross-cutting way, but with the close involvement of practitioners
* More of the budget being tied to outcomes and then allocated across departments and agencies according - to how much they can contribute to outcomes
* More vertical functions being passed out to agencies, leaving behind slimmer, but more integrated central staffs
* A much greater emphasis on shared knowledge management as the glue holding central government together
* An expectation that civil service careers will move across and beyond government
* Use of the integrative power of the Internet to organise access to services according to people’s needs rather than producer convenience
* A much more energetic approach to reshaping business processes that cut across departmental boundaries
* A steadily growing role for local partnerships in integrating the work of both national and local agencies on the ground
* A greater emphasis on professional formation across boundaries
* Structured knowledge management and learning in all major areas of policy

Longer term more radical options may also be feasible. Some have advocated that responsibility for whole systems – like the criminal justice system, transport or children’s services could be organised in an integrated way, potentially with purchaser-provider splits, rather than, as at present, divided between many different agencies and professions each with their own budgets, structures and targets.

My view is that it is right to continue with an evolutionary approach rather than a big bang. However, over time the biggest gains will come from moving beyond the relatively modest joining up of the late 1990s to more fundamental systems redesign.

I have already spelt out many of the reasons for this. One other concerns the motivations of bureaucracies. Contrary to the claims of the public choice school most bureaucracies do not seek to maximise their resources or turf. Instead what they often value just as highly is autonomy, that is to say relatively undisputed jurisdiction. Moves towards joining up that reduce this autonomy for all players are almost certain to be resisted, and are likely to be ineffective. By contrast moves that create new structures and powers, or that give existing agencies greater autonomy to tackle a cross-cutting problem, stand a far higher chance of succeeding.

The barriers remain substantial. Harold Seidman’s ironic words remain a healthy warning to all reformers. The quest for coordination, he wrote, ‘is the 20th century equivalent of the medieval search for the philosopher’s stone … if only we can find the right formula for coordination we can reconcile the irreconcilable.’

There is, of course, no such formula. But this should not be a counsel of despair. Joining up in all its forms has happened, is happening and will happen even more in the future. It may rarely if ever be perfect. But governments that can think and operate in 360 degrees will over time prove better at solving problems and meeting needs than governments that remain trapped in the vertical hierarchies that they have inherited.