Janice Stein is a highly regarded political scientist at the University of Toronto who specializes in international conflict and security issues. Why, then, has she written the 2001 Massey Lectures on “the cult of efficiency,” a subject more likely to be addressed by an economist, perhaps, or a sociologist?
The answer may lie in the anecdote she tells at the beginning of the first lecture: Stein’s 85-year-old mother was hospitalized after breaking her hip. Seven days after her surgery, the hospital’s discharge co-ordinator buttonholed Stein in the hallway and asked with some impatience when the patient would be leaving. “Your mother is now a negative statistic for this unit,” she blurted out. “Every additional day that she remains in hospital, she drives our efficiency ratings down.”
None of us would like to think of our ailing mother as a negative statistic. The episode got Stein thinking about the mantra of efficiency that now governs the public sectors – the hospitals, the schools, the water supply, the border security – of all the Western post-industrial states, including Canada. Inefficiency, she postulates, has become the paramount transgression of our age, replacing earlier sins such as dishonesty, unfairness, and injustice. Such a shift in values is bringing about profound changes in our notion of the state and our sense of responsibility to each other. These are the issues she explores in these lectures, with an academic’s thoroughness, a journalist’s skepticism, and a citizen’s concern.
Stein defines efficiency as “the best possible use of scarce resources to achieve a valued end” and does not deny its importance. But the neo-con bottom-liners go off the rails, she believes, when they see efficiency, or cost-effectiveness, as an end in itself, divorced from its impact on content, quality, or morale. They have turned efficiency into a cult, “a system of religious worship that engenders almost blind loyalty in its members.”
Stein herself sets about asking the questions the cultists never entertain: Efficient at what? Efficient for whom? What does “quality” health care actually mean? These are not really answerable questions, but they are crucial to the ongoing public dialogue that is pre-empted when we raise efficiency to cult status.
Efficiency only makes sense in the context of effectiveness, but effectiveness, it turns out, is a devilishly difficult value to pin down. Neverending controversies over teaching methods in our classrooms attest to this. Stein notes that in the U.S., they’ve gone from more homework to less, a return to basics, phonics, whole language, back to phonics, core curriculums, widespread course choice, back to core curriculums … and student performance on standardized tests has not materially improved.
In the struggle to gauge effectiveness, there is a new public hunger for accountability, and this, in turn, is creating a whole new role for governments. In the past, when states ran and managed all monolithic public programs in-house, it was not in their interest to report to the public about the effectiveness of those programs. But now, in the new “efficient” climate of contracting out public services, governments are developing evaluation and monitoring skills they never needed before. (Perhaps not soon enough in the case of Ontario and the Walkerton water crisis, but still.)
If all this seems somewhat abstract, Stein brings the arguments into sharp focus with her postscript, written after the world-shaking shocks of Sept. 11. Now, instead of worrying about accountability in the health-care system or efficiency in our classrooms, she is talking about security: “There is no more difficult conflict,” she writes, “than that between the security of all and the rights of the individual in society.” She notes, with some amusement, that the two sides seem to have flipped since the terrorist attacks. The efficiency cultists who generally want the state to pull back and slim down are now calling for aggressive state intervention in society to root out the enemy within. At the same time, the defenders of the state who vociferously support public education and medicare are now urging restraint on the powers a fearful public might hand over to the government.
The Cult of Efficiency is full of hard ideas, so it’s not an easy read; it would have been easier with less abstraction and more examples. When Stein does illustrate her arguments with examples, they are well chosen and resonant.
Here’s Stein’s example of efficiency cultism that will always stick in my memory: Forty years ago, General Curtis LeMay told President Kennedy that the U.S. had an 18:1 superiority over the Soviet Union in nuclear warheads, so it was time to launch an all-out missile attack. “At most,” he said, “the United States would lose only three cities.” Kennedy’s inefficient response? “Even one city is too much.”