The difference between medicine and poison lies in the dose. This truth speaks directly to government reform. As Washington prepares to launch an efficiency crusade, we must remember that efficiency, wrongly dosed, can sicken the very system it means to improve….
Just as our bodies maintain seemingly inefficient back-up systems (like two kidneys), and financial systems keep seemingly inefficient capital reserves, governments need built-in redundancies and safety margins to function effectively during crises.
The forgotten French engineer Jules Dupuit understood this problem. In the early 1800s, before the term “scientist” existed, engineers were the high priests of social arithmetic. As Paris’s chief engineer in 1850, he faced a practical issue: how could public projects be efficient while maximising social benefits?
The paradox of efficiency is that it cannot exist without inefficiency. Those apparent redundancies and slack in the system aren’t waste; they make efficient operation possible in the first place.
Consider three recent catastrophes born of ignoring this principle. The “efficient” distribution of risk across financial markets helped to trigger the 2008 global meltdown by sacrificing basic system safety for short-term gains. Before the 2014 Ebola outbreak, “efficient” cost-benefit analyses suggested no rush for vaccine development, leaving us vulnerable to catastrophic risk. And during Covid-19, supply chains optimised for cost-efficiency cracked and crumbled, failing to flex with surging demands.
His answer came not through cost-cutting but by understanding how people valued and used the services…. Like the dramatic pauses in Beethoven’s Fifth Symphony, what appears inefficient on paper — variable tolling, excess capacity, multiple transit modes — might be precisely what gives public systems their natural rhythm.

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