Systems and Symptoms in Public Services

I got my start in civic tech working with the City of San Francisco. I was a Google employee at the time, and San Francisco had just started their Civic Bridge program, which worked with volunteers from Bay Area companies to solve technical problems. I was put on a team of three Googlers, working full-time and on-site for a month on what eventually became San Francisco’s affordable housing website. 

When we arrived, the Mayor’s Office of Housing and Community Development (MOHCD)  asked us to help them visually redesign their existing website. Instead, leveraging the training from the Civic Bridge program, we dug deeper – looking at the service as a whole, understanding the various touchpoints, the different people that would use this information. We talked to community-based organizations and people applying for affordable housing. We went to lottery raffles (before they were electronic, when they were in-person events with numbers rolling in a barrel), followed applications from start to finish, and iterated on scrappy prototypes. We held trainings on agile development, brought MOHCD staff with us to research interviews, and helped them understand how to redesign the service. 

There’s an argument to make here that the most needed export from tech companies into government is talent and experience in modern methods of working, and not the technology itself. But to get there, I first want to address a core problem we had in the Civic Bridge work. 

We were addressing a symptom, and not the system. 

All we could do for MOHCD was try to make it easier for their clients to find information and apply for the incredibly limited supply of affordable housing. We could empower community-based organizations, we could support multiple languages, we could make the application easier to understand for applicants – but we couldn’t fix the real problem. The shortage of housing and the spiking rent prices in the San Francisco area were completely out of our reach, and we saw thousands of people apply for only a handful of available units. Even as we set MOHCD up for success with their new website, we felt disillusioned at how much this would actually address the larger system that keeps people unhoused. Even if more people could now successfully apply for affordable housing, that didn’t increase the number of people who would actually receive affordable housing. 

I’m reminded of this experience now because of a new podcast series by 99% Invisible’s Katie Mingle called According to Need. Their incredible work chronicles the end-to-end system of affordable housing in San Francisco’s neighbor, Alameda County. From the experience of the unhoused, to the front-line public servants supporting them, to the higher level policy makers, it traces the entire journey not only of the people seeking support, but of the service itself. (If you haven’t listened to it yet, go subscribe!) I’m reminded by their work of how excited I first was to be working on a problem that really mattered to people that I had long wanted to help. And I am also reminded of how unsettling it was to more fully understand how deeply rooted the problem truly is. 

Navigating the Symptoms vs Systems Tension  

I have not gotten better at chess (yet), but one thing I know is if you’re quibbling over how much it costs to let people see the law or how many clicks it takes to apply to healthcare that’s checkmate baby, you’re no longer talking about making people free

— Rebecca Williams (@internetrebecca) December 1, 2020

Since those early days of the Civic Bridge program, I’ve shifted my career wholesale towards civic tech – towards improving public services using modern techniques, tools, and skills. But even now, after four years working in the U.S. Digital Service, that constant question remains: are we spending our efforts on the right problems? While at USDS, I had the honor and privilege of working on problems I felt were important, such as the U.S. immigration system. But even when working on something I cared about deeply, this question of symptom vs system came up constantly. We were making it easier for immigrants to apply and for immigration officers to process applications, but we knew that the deepest changes would have to come from policy and legal changes. 

So how do we navigate this? As people committed to working on public problems, how do we reconcile the tension between having access to work on websites and internal tools, versus wanting to address the larger processes that keep people in need? Is it worth it to spend our time making benefits applications easier, or should we use our labor to address the deeper roots? In my experience, I have had much more ability to address apparent symptoms, but I wonder if those problems will simply keep coming back if we don’t make some much larger changes. 

Finding and understanding root causes is, of course, an act of discovery in and of itself. In some cases, you have to personally go through the process to understand the roots of these big problems. In other cases, you can learn much about the systems by taking the time to listen to people who have done this hard work. Activists, organizers, and researchers that have done the hard work have tons to say about systemic injustices and issues – we should do ourselves a favor and learn as much as we can from them. For some large and historic problems, we already know the answer, and it’s just a matter of finding the right place to apply leverage and getting to work. 

In many cases, though, that answer is unclear and often inaccessible. Navigating this tension is a personal debate, and ends up involving moral choices about how you want to spend your time and efforts. In lieu of a simple solution, the best we can do is to constantly ask ourselves these questions, to ask them of each other, and to continually deepen our own individual and collective understanding of the systems we’re trying to fix. 

Personally, I believe that treating symptoms is still a valuable and necessary component. These issues – complicated application processes, inaccessible services, lagging timeframes, and the like – cause real pain and friction, and any work to address them will make the lives of real people better. It can also help uncover or further highlight root causes. If a particular public service is designed and implemented well, but its users are still suffering, that’s a good sign that the roots are deeper down. Some may argue that it’s counterproductive to address the symptoms because it might reduce the attention given to root causes. I don’t personally subscribe to the argument that we should keep services so bad that it gets attention, but I do believe in holding these systems accountable, and so any work that can be done towards both ends is a win in my book. Put another way, we have a responsibility to always ensure that even if we're working on a symptom, to look at how it affects the whole system and to make sure we're not complicit in worsening or perpetuating it. 

Working on the Inside vs the Outside 

Right alongside this debate of symptom vs system comes another equally difficult and equally discussed debate: even if you do find an opportunity to address a systemic problem, can you effectively work towards change if you’re working inside the system itself? As sung in Hamilton, “If there's a fire you're trying to douse, you can’t put it out from inside the house.” I’ve had long conversations with friends on this topic, talking about major federal programs like SNAP benefits and Veteran health care – programs that do a ton of good for people in need, but that could be addressed in much bigger ways by advocating for larger policy changes such as universal health care. 

In scenarios like these, the work of pushing for more comprehensive solutions is best done outside of government. Mutual aid groups, advocacy organizations, local action planning, and even political campaigns are all effective ways to move the needle on large changes. When looking for impactful opportunities to make change, it can seem almost trite to work on anything other than these pushes for large-scale change.  

However, working in this way often takes a very long time, and it can be difficult to trace efforts to outcomes. On the other hand, we can make direct progress and alleviate pain on what we have now by working inside of government and directly fixing these broken processes. Working inside of government gives incredible access to make changes to processes that haunt people looking for support, which in turn can have immediate impacts on their lives and livelihood. 

Thankfully, we’re not strapped to a mutually exclusive decision here. As a community, and even as individuals, we can and should work on both sides of this divide. While working within the systems, we can make significant changes that will directly help people. And we can simultaneously push for large-scale reforms that will drastically change the entire landscape. In fact, in may cases these two are directly intertwined. For example, if we want to expand Medicare to cover orders of magnitude more people, we will have to address the underlying software applications that make it so difficult today. Working on one directly supports the other in cases like this. 

Addressing the Root of Roots 

One key reason I got sucked in by 99% Invisible’s work is because the storytelling format they’re using is such a clever way of walking people through what I see as service design and research. Service design and research all about understanding the people, constraints, and needs of an entire system – seeing it for its branches as well as its roots. When we take the time to see the whole journey from end to end, as Katie Mingle did for her series, we can separate symptoms from systems, understand the tension, address the whole picture effectively. 

Of the many skill sets needed in government, service design is one which I think is direly needed at the policy table. When we create new policies in an effort to support people in need, we must do the hard work of talking to them, of following the trail, and of understanding current lived experiences and needs. If we want to get better at solving root problems in public services, the root for that is best addressed by bringing more service design and research into government. 

We need to hire service designers into government, into in-house teams that analyze and address policy problems. We need to train policymakers on key research skills, such as user research, journey mapping, design thinking and service blueprinting. And for people in decision making roles, we need to demand that this level of research is done thoroughly and consistently – for without it, how can we know that we’re truly solving root problems? 

If you have thoughts on this piece or want to chat, I’d love to hear from you at mlerner@hks.harvard.edu.