The net result is the organization fails its mission even as it adds employees and expands its budget and regulatory powers. One of the most painfully visible symptoms of profound failure is the way our systems now thwart and frustrate sincere, hard-working people who labor within them. If you work within any of the institutions at the heart of our system--healthcare, education, governance, the armed forces, insurance, finance, and so on--or know people who work in these fields, you know most people are honest and hard-working, and trying to do a good job.