This book shows that many of our institutions have both visible, socially-respected goals, but also hidden goals nobody likes to acknowledge. Example: Health C

This book shows that many of our institutions have both visible, socially-respected goals, but also hidden goals nobody likes to acknowledge. Example: Health Care Visible goal: Improve Health Hidden goal: Show how much we care ("kiss the booboo") This explains why much of health care is devoted to high-cost high-visibility interventions (like bypass surgery) and much less to lifestyle interventions (like diet/exercise). It also explains why many obvious changes that would improve the stated goal keep failing to be adopted - they hamper the hidden goals. Software example: Why do people keep estimating development task size assuming nothing goes wrong? And why do their managers not hold them responsible for continually slipping the schedules? Visible goal: Accurate estimates Hidden goal: Brag about how fast we are If accurate estimates were the only goal, then when schedules slip there would be a strong feedback loop to improve future estimates. My experience has been the opposite - the slip is blamed on something "no one could have foreseen" and everybody keeps estimating as before. To be clear, it's always a mix of the visible and hidden motives. Much of health care is actually about improving health. But acknowledging the hidden motives is vital to understanding how much of society works.