Preview Thursday: Untangling the USA: The Cost of Complexity and What Can Be Done About It

The following is a preview of Untangling the USA: The Cost of Complexity and What Can Be Done About It by Etienne Deffarges.

Tom Brady and the “tuck rule.”

“Nobody knew health care could be so complicated.”

“The financial world has become way too complicated and very secretive.”

What could Tom Brady, Donald Trump, and Michael Lewis possibly have in common?


Complexity. Lewis has analyzed it; Trump has discovered it; Brady has benefited from it. And the USA is entangled in it.

Complex systems are an inevitable part of business and socio-economic structures. We reach a breaking point, however, when social and organizational structures become cumbersome and unintelligible. Entire new systems need to be constructed just to manage this complexity, with questionable or negative value to society at large.

The result is high costs (literally trillions of dollars), poor results, deepening social inequality, and the erosion of public trust. Wholesale changes must be contemplated. This is particularly true in the U.S.A today, where complexity is piled upon complexity in a number of critical sectors, such as health care, energy, finance, and government.

Etienne Deffarges takes a common sense, broad-based, and analytical approach to some of the most complicated issues facing the U.S. today. He examines the costs of complexity through a wide-angle lens, provides analysis of the root causes involved, and explains what is necessary to both improve results and lower costs.

The ever-increasing level of complexity in the U.S. is compared to that in other developed economies. History is referenced as a guide to show that, in many areas, America’s success has relied on simple and elegant solutions. These contrasting paths are used to propose alternative approaches and new solutions. Beyond analyzing how incredibly complex socio-economic systems have emerged in recent years in the U.S., Deffarges steps back, reflects on the fundamental values of this country, and offers a number of actionable proposals to improve the lives of all American citizens.

In his writing, Deffarges focuses in six core areas of American society and institutions:
  1. Health care
  2. Energy
  3. Finance
  4. Taxes
  5. Government
  6. Social programs

So how did we get to the current state of affairs, where we are literally surrounded by complexity in pretty much all aspects of our lives? It was a complex path as well . . . full of incremental changes, one on top of each other.

Deffarges looks at five major causes for the intrusion of complexity in our society, spanning over 70 years:
  1. Our recent history and politics
  2. The increased role of finance in our economy
  3. The combination of globalization forces and outsized CEO pay packages
  4. Our education system and its “college for all” mentality
  5. America’s insulation relative to the rest of the world


Etienne Deffarges has lived in San Francisco since 1985 and became a U.S. citizen in 1993. He has counseled, created, and invested in countless organizations during his professional life as a management consultant, business executive and entrepreneur. As a senior partner with Booz Allen Hamilton and global managing partner with Accenture, he advised businesses and governments all over the world, and orchestrated billion-dollar deals.

In 2004, Etienne helped start health care IT Accretive Health (now R1 RCM), growing it from the proverbial "blank sheet of paper" to a 2010 IPO valuing the company at $1.2 billion.

An active angel investor and start-up advisor, he serves on boards in aerospace, automotive, construction, energy, food, and health care.
His book, Untangling the U.S.A: The Cost of Complexity and What Can Be Done About It, includes endorsements and forwards from former Senate Majority Leader Tom Daschle (D-SD), and former Secretary of State George Shultz.