Like a concave mirror, American bureaucracy reflects American pathologies and causes them to converge. American culture tends to hold administrative work (and service work generally) in low regard, if not in outright contempt, and the administrators in turn despise those they are supposed to serve, using the office rulebook not as a blueprint for getting things done but as an excuse for the opposite. If you have ever had the experience of, say, registering a car in person, it is obvious enough that the procedures and requirements involved have nothing to do with providing any benefit at all to owners of vehicles but rather are optimized for the convenience of the bureaucrats. Like about one-third of local police activity, it is tax-collection masquerading as a public-safety project. This is by no means limited to the public sector: Go to your doctor’s office and you’ll notice that he collects your health information by handing you a pencil, but collects his payment with one of the world’s most sophisticated arrays of information technology. This is not eccentricity — it is an internal value hierarchy made visible.
Better bureaucracies come from better administrative cultures, but they also come from such relatively easy things as giving bureaucracies less to do and restricting their activities to those areas in which they have real competence. The failure of the Affordable Care Act — and it is a failure on its own terms — is in part evidence of that.
And behind the failure of bureaucracy is the failure of legislation. The great political crisis of our times is not Donald Trump’s soggy nationalism or Alexandria Ocasio-Cortez’s callow socialism, but the abdication of Congress, an institution that has substituted self-importance for self-respect.