By Doing "Government's Work", Are We Making It Easier for The Government and Worse for the People?

At the end of the CHLP session today Akshay (not me) asked something like: "When we do work that the government should be doing, are we making it easier for the government in some ways, and also making it more difficult to hold the government accountable?"

This is a question that only someone who is truly invested in community work can ask. They are worried that the government is going to invest less in that particular problem, that in the long run it becomes harder and complicated because of the reliance on "bespoke" solutions. (The example given was how government relies on the voluntary effort of data by covid19india.org / covid19bharat.org to get COVID related counts and how there is no other system to track these counts)

I do not claim enough experience to answer this question.

But if we break down this question, the concerns we have are:

  1. How sustainable are such bespoke solutions? If we could keep doing it forever, then why should we not do it forever? Should government ever take over?
  2. Are such bespoke solutions less effective than more universal solutions? If yes, are we causing a less than optimal outcome? If no, are we preventing a scale-up of these solutions by the mere fact that it came from outside the government?
  3. Does access to and/or existence of such bespoke solutions make it difficult to demand more universal solutions from the government? (Either by making people reticent or by making the demand look less urgent)

A few counter points are:

  1. But how long should I wait for the government to do the right thing?
  2. Who is at the receiving end of our desire to wait for a universal solution? Who suffers when we wait?
  3. Let's say I don't attempt the bespoke solution. What do I do now? Should I now force the government to build a solution?

The way I avoid these questions are by thinking:

  • The government is a huge, inefficient, highly hierarchical organization with not much capability to build innovative solutions. Therefore, expecting government to come up with a good solution is pointless.
  • I should do things that give me joy, not what brings joy to the world. If bringing joy to the world in certain ways brings me joy, then so be it.
  • The second-order, third-order effects of our actions are very very hard to predict. No matter how much we "calculate", not much is going to come out of the calculations. We have no way to say that any particular action is what is going to help the world. We just do what we want to do and hope that it turns out to be a good thing. Often, there is no way to actually say whether something turned out to be good either.
  • If we are creating value, putting value out into the world, it is more likely than not that we're doing something right. The value will compound in ways we cannot anticipate. Always.

 If you are reading this and you have answers to some of these (existential, sorta) questions, let me know.


Update

I sent this to Tanya and Prashanth. Prashanth tried to add a comment and failed. That comment is:

"This is an important question to "struggle" with especially for those (like me) who are involved in such "solutions" that are often not only outside-the-box, but also as rightly pointed out, being designed outside the "public" system. For an individual like me for whom, working with indiviudals/communities/populations is coming from an ethical imperative and from wishing to move our society towards health equity, there is - I confess - no other way. What do we who do not wish to work within governments for various reasons do? I think what we can do is build coalitions, networks and allies which nudge/push/critically demonstrate the need for public services and systems to do more. And for me, such efforts are ways of showing that more can be done. Another reason to do this is to address the inertia that sometimes develops at middle level institutions (like districts) where the glamour of word/jargon based policy vocabulary is not there and the fatigue of under-resourcedness is a daily reality. So, I believe such efforts can hopefully spur creative thinking within public systems, build allies within the system and who knows...knowing the complexity and unintended effects these things have...some things stick...some things flourish...improve? But, certainly there ought not to be a claim that such accomplishments (if they are such) will automatically result in "systems change"....these are some of my thoughts. "

 

Prashanth also got Werner Soors involved. You can read W's comment below this post. To me, W has more or less arrived at the crux of the dilemma. The struggle is related to the dichotomy created by the ideal government and the real government. But as W points out, it maybe worth trying to become part of the government through becoming part of the people.

Coincidentally, I saw this video by The Ugly Indian today



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I am a general practitioner rooted in the principles of primary healthcare. I am also a deep generalist and hold many other interests. If you want a medical consultation, please book an appointment When I'm not seeing patients, I code software, advise health-tech startups, and write blogs. Follow me by subscribing to my writings