The scale of social innovation required to create public systems like mass schooling and healthcare.
Over time these innovations have become large institutions with their own logic. They are now more self referential. Their internal logic is strong enough that they might get more efficient without getting more effective; they might hit their targets while somehow missing the point. The challenge is to maintain and strengthen the capacity of systems to learn about what they are doing, and to learn what they might do differently.
I describe how incredibly efficient systems can still fail to really serve people. How those outside system can end up feeling like they are not getting the most helpful support and how those inside can feel like they do not have the tools or authority to offer what is most needed. In the end, both can end up feeling trapped.
Education was designed in an age that required punctuality and manual labour, the welfare system was designed at a time with male full employment and stable families, and healthcare has expanded its capacity to treat medical problems but has few tools for enabling wellness more generally. We need new wave of innovation.