Government Without the Drama and Tumult

(Bloomberg Opinion) -- Many social problems seem impossibly daunting, simply because they are so large. Poverty, immigration, cancer deaths, gun violence, climate change – in light of the magnitude of those problems, most imaginable reforms seem pretty small.

In their book “Switch: How to Change Things When Change Is Hard,” Chip Heath and Dan Heath argue that the best response to big challenges is often to “shrink the change.” Instead of trying to solve a problem, dent it.

If you do that, you will accomplish some good, and help real people in the process. And you might spur much more, because success breeds more of the same.

In the midst of its nation’s tumult and anxiety over Brexit, the U.K.’s Behavioural Insights Team has enjoyed a lot of quiet successes, not least because it has been shrinking the change. BIT’s latest annual report should be an inspiration to governments all over the world -- and to citizens who are unsure whether public officials can get together and achieve anything.

Consider a few examples.

1. About half of the population of the U.K. will get cancer in their lifetime. For many people, survival depends on early diagnosis. Doctors are allowed to use an urgent cancer referral process, which can get patients to a specialist within two weeks. But a lot of doctors just don’t take advantage of that process.

To increase referrals, BIT, a global public-service company connected with the U.K. government, sent personalized letters to doctors whose referral rates were below the U.K. average. The letters simply informed them of that fact.

The result? A significant increase in referrals by those doctors. That means an improvement in survival rates – and also major economic savings, because earlier cancer treatment is a lot cheaper.

 2. Childhood obesity is now a problem in many nations. In the U.K., about 20 percent of children are overweight or obese by the age of 11. There’s no magic bullet for the problem, but some steps, such as restrictions on the promotion of unhealthy food, are likely to help.

BIT has helped to develop a childhood obesity plan that relies on proven strategies. The U.K.’s sugar tax is designed to promote reformulation of products. Even before the tax went into effect in 2018, popular brands cut the sugar content of soft drinks by 11 percent – removing 10,000 tons of sugar from the market.

3. Many consumers stick with their current energy provider even though they could save money if they switched. BIT worked with the U.K. energy regulator to send personalized messages to 150,000 customers, telling them how much they could save by switching, and informing them about the best available alternatives. Within just 30 days, the letters tripled switching rates.

4. In the U.K., as elsewhere, cyber attacks are a serious threat. They often begin with phishing attacks, in the form of seemingly real emails designed to elicit responses that expose computer systems to attacks.

Working with the Metropolitan Police Service, BIT designed several forms of preventative training, including simple rules of thumb for how to avoid phishing attacks. BIT followed up by sending mock phishing attacks to the officers who had been trained – and compared their responses with those of officers who had not been trained.

 The training worked. It dramatically reduced the number of officers who clicked on the link and submitted relevant information. 

Originally limited to the U.K., BIT is now operating in 31 nations. In Moldova, it identified a way to encourage tuberculosis patients to take their daily medication – and succeeded in nearly doubling adherence rates. In Indonesia, it worked to increase tax compliance -- and with one small communication, informing taxpayers that early filing avoids potential problems, it succeeded in bringing in the equivalent of nearly $2 million.

In Australia, BIT helped simplify the form that teachers must use to obtain placements in rural areas, where they are badly needed. The simplified forms, along with timely prompts, tripled the number of teachers who applied for rural placements.

BIT is making progress on other problems as well, including air quality, road safety, domestic violence, voter turnout and sex equality in hiring.

In many of these cases, it is working to reduce “sludge” – administrative burdens that make it hard for people to achieve their goals. In other cases, it is working to get people’s attention (for example, through simple reminders), with an understanding that all of us have limited mental bandwidth. If the goal is to promote health and safety, getting people’s attention may be half the battle.

When it comes to government, citizens find it natural to focus on the most dramatic questions – indictments, investigations, shutdowns, Brexit, border walls. Amid the tumult, the release of BIT’s report demonstrates that creative people in the public sector are working hard, every day, to improve people’s lives, sometimes by denting the most daunting problems.

BIT’s secret? It shrinks the change.

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

Cass R. Sunstein is a Bloomberg Opinion columnist. He is the author of “The Cost-Benefit Revolution” and a co-author of “Nudge: Improving Decisions About Health, Wealth and Happiness.”

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