Sludge, noun. Thick, soft, wet mud or a similar viscous mixture of liquid and solid component, especially the product of an industrial or refining process. —Oxford English Dictionary Online, 2019
We’ve all had to fight our way through administrative sludge — filling out complicated online forms, mailing in paperwork, standing in line at the motor vehicle registry.
Sludge comes from private and public institutions. It comes from small companies and from large ones. It comes from national governments and from state and local authorities. Lawyers impose sludge. So do courts. So do doctors and hospitals. Banks certainly impose sludge. Although the problem of sludge is worse in some countries than in others, it can be found in every nation on the planet. Sludge is built into the human condition, and we need to start to remove it, piece by piece.
In many cases, sludge imposes economic harm. In other cases, it damages public health. In the worst cases, it kills. Every day, it impairs education; often it deprives people of educational opportunity. It cripples economic growth. It decreases employment and stifles entrepreneurship and innovation. It hurts patients, parents, teachers, doctors, nurses, employees, customers, investors, and developers. It is a pervasive source of inequality.
Sludge can also be an assault on human dignity. If sludge stops you from voting or from getting some kind of license, you might feel as if you do not count. People without much money struggle with sludge. It hurts all of us, but if you are sick, old, disabled, or poor, or if you don’t have a lot of education, sludge is a curse.
Sludge is everywhere in our lives. For a glimpse, consider the following cases:
1. Poor students are entitled to financial aid for college. To obtain that aid, they have to fill out a form. It has dozens of questions, and many students find it challenging to answer some of them. As a result, they decide not to apply for aid at all.
2. To obtain benefits under a healthcare law, people must navigate a complicated website. A lot of them do not understand the questions that they are being asked. Some of them give up.
3. To register a complaint about defective products, consumers are required to go through a time-consuming process. The necessary forms call for detailed information about where the product was originally purchased and how it was used. Some consumers do not have easy access to that information. Others fear that their privacy might be invaded. Many of them decide not to fill out the forms at all.
4. To vote, many citizens of Georgia and other states have to wait in line four hours or more. A number of people cannot spare that time. Some of them do not go to the polls at all. Others leave after an hour.
5. A cellphone company markets some of its products with mail-in rebates. On some products, consumers are entitled to a rebate of $200. The company is well aware that many consumers will be excited about the potential rebate — but then fail to mail in the forms.
Some of these cases are trivial; others are not. All of them involve sludge, and if you have ever tried to get a license from public officials or some kind of permit, you have encountered it. But what, exactly, does the term encompass?
If sludge is understood to consist of frictions that separate people from what they want to get, the concept is not entirely mysterious. Much sludge involves waiting time (in person, on the phone, even online).
Much of it involves reporting burdens (as when people are required to fill out weekly reports, explaining what they have been doing with their lives). Much of it consists of dreary or duplicative application requirements, including time spent online, which might be required if people are seeking to obtain money, medical care, a job, a visa, a permit, or some kind of life-saving help.
Not long ago, I asked a group of students about the healthcare they received at a large university. My question: What could be improved? Two of them singled out the problem of mental health. They said that in order to make an appointment for a mental health issue, they had to make two separate phone calls and fill out some complicated paperwork. They added that the problem of mental illness is stigmatized and that when you are suffering, the last thing you want to do is to find your way through sludge.
One of them reported that after a little frustration, she decided that it just wasn’t worthwhile to try to make an appointment. This story does not have a tragic ending, but all over the world, people with mental health problems have to deal with sludge. Many of them give up.
As part of the response to the coronavirus pandemic, the United States waged a war on sludge. Most people didn’t notice, but it happened.
In a short period, public officials took a series of aggressive steps to reduce administrative barriers that had been imposed on doctors, nurses, hospitals, patients, and beneficiaries of essential public and private services. With respect to sludge, the pandemic concentrated the bureaucratic mind, leading to impressive and brisk reforms. A few examples:
Under the Supplemental Nutrition Assistance Program (formerly known as the Food Stamps Program), would-be beneficiaries have long had to complete in-person interviews before they are approved for benefits. The U.S. Department of Agriculture waived that requirement. It gave states “blanket approval” to give out benefits to people who are entitled to them.
The Internal Revenue Service originally announced that in order to qualify for payments under the Families First Coronavirus Response Act, people would have to file tax returns — even if they are Social Security recipients who typically do not do that. The sludge would have meant that many people would never get money to which they are legally entitled. Under public pressure, and probably seeing the foolishness of the idea, the Department of Treasury reversed course — and said that Social Security recipients would receive the money automatically.
Some of the most aggressive sludge-reduction efforts came from the Department of Health and Human Services. Many paperwork, reporting, and auditing requirements were eliminated. Importantly, dozens of medical services were authorized through telehealth. In the agency’s own words, the government “is allowing telehealth to fulfill many face-to-face visit requirements for clinicians to see their patients in inpatient rehabilitation facilities, hospice, and home health.” In addition, the government allowed Medicare to be used to pay laboratory technicians to travel to people’s homes to collect specimens for testing — thus eliminating the need for people to travel to healthcare facilities for tests (and risk getting sick).
Why did all this happen? One reason is that when public officials (or others) impose sludge, they are making some kind of judgment about whether doing so is a good idea. Sometimes the judgment is intuitive; it is not preceded by numbers. It might be based on a belief that if people are to obtain certain benefits, the least they can do is to show up for an interview to prove that they qualify. Sometimes the judgment is rooted in evidence, offering a basis for deciding how much sludge to impose. But when new circumstances arise, it might become clear that the current amount of sludge is not the right amount of sludge. The harms imposed by sludge are often invisible. In the context of a pandemic, they are there for all to see.
Another reason is subtler and more fundamental. In the midst of the coronavirus pandemic, countless people were scared, confused, overwhelmed, or anxious about their health or their finances. They might have been dealing with young children at home, with sick or elderly friends and relatives, or with both. They might have been sick themselves. Because they were frightened and preoccupied, they did not have a lot of mental bandwidth to manage sludge, whether it came from the government or the private sector. Sludge could defeat them. And it could do so with respect to programs on which their economic situation or their health depended.
For many people, that is true in the best of times, of course — which is one reason that every year is a good year for a war on sludge. The Office of Management and Budget produces an annual report, called the Information Collection Budget of the U.S. government. The ICB quantifies the annual paperwork burden that the U.S. government imposes on its citizens. The 2017 report found that Americans spent 11.4 billion hours on federal paperwork. The number has been growing over time.
The 11.4 billion hours take a significant toll. If we value an hour of work at $27, we are speaking of the equivalent of $307.8 billion — more than quadruple the budget of the Department of Education, about six times the budget of the Department of State, and about ten times the budget of the Department of Energy. Even if we drop the value to minimum wage, the total value of all that wasted time is huge. We have seen enough to know that the monetary figures greatly understate the problem. Sludge can make it difficult or impossible for people to avoid crushing hardship.
People dedicated to consumer protection, economic growth, workers’ rights, environmental protection, sex equality, voting rights, poverty reduction, mental health, immigrants’ rights, visa reform, racial justice, and small businesses and start-ups do not march under colorful banners containing the words “Sludge Reduction Now!” But in light of their own goals, they might want to start doing exactly that.
All over the world, nations should be making an aggressive, across-the-board attack on sludge — for jobs, for education, for voting, for licenses, for permits, for health. Such an effort would call for reductions at the level of program design, including radical simplification of existing requirements and (even better) use of default options to cut learning and compliance costs. Automatic enrollment can drive sludge down to zero and have very large effects for that reason. Where automatic enrollment is not possible or desirable, officials might use an assortment of tools: simplification and plain language; frequent reminders; online, telephone, or in-person help; and welcoming messages to reduce psychological costs.
Both public and private institutions need Sludge Audits — an evidence-based approach to sludge, including an effort to weigh its benefits against its costs and a careful assessment of its distributional effects. Is sludge really helping to reduce fraud? By how much? Are there harmful effects on the elderly, people with disabilities, women, and people of color? What are the compliance costs, in terms of time and money?
Almost everyone approved of the 2020 war on sludge in connection with the pandemic. It saved a lot of lives. In the future, removal of sludge should be a high priority.
Time is the most precious commodity that human beings have. Let’s find ways to give them more of it.
Cass R. Sunstein is Robert Walmsley University Professor at Harvard Law School and Chair of the Technical Advisory Group on Behavioral Insights and Sciences at the World Health Organization. He is the author of How Change Happens, Too Much Information, and other books.
Excerpted from Sludge: What Stops Us from Getting Things Done and What to Do About It by Cass R. Sunstein. Copyright © 2021 Cass R. Sunstein. Reprinted with Permission from The MIT Press
This article is featured in the March/April 2022 issue of The Saturday Evening Post. Subscribe to the magazine for more art, inspiring stories, fiction, humor, and features from our archives.
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