Why good ideas aren’t always enough

Back in 2007, the Gates Foundation and several partners tried something new. At the time, pneumonia was killing hundreds of thousands of kids in poor countries every year. The science to make a vaccine already existed, but pharmaceutical companies weren’t developing it for African strains of the virus because there was no obvious market to sell to.

So we made the companies a deal: If you build it, we’ll buy it. That promise, known as an Advance Market Commitment, led to the creation of affordable pneumonia vaccines that have saved an estimated 700,000 lives.

I was excited to see this story cited in Abundance, a recent book by Ezra Klein and Derek Thompson about why America struggles to build things and how we can do better. Their argument is that progress and innovation rely not just on good ideas but on systems—economic, political, and regulatory—that help those ideas spread and succeed. Today, those systems too often do the opposite. And good ideas end up slowed down or stonewalled instead.

Abundance is organized into five sections: Grow, Build, Govern, Invent, and Deploy. Each one examines a different bottleneck that gets in the way of getting stuff done.

The Grow section looks at how zoning and land-use rules have made housing scarce and expensive. Build focuses on the reasons it’s so hard to build the infrastructure the U.S. needs, especially for energy and transportation. Govern digs into why government has lost the capacity to make decisions and execute projects. Invent explores what drives scientific breakthroughs. And Deploy, where Klein and Thompson write about the pneumonia vaccines, examines what it will take to get more innovations from the lab into the real world. (An incentive structure like the Advanced Market Commitment is one of many potential solutions.)

I’ve spent a lot of time over the past two decades thinking about these problems. When I was running Microsoft, it was relatively easy to scale a good idea; if we built a better product, customers usually adopted it. But since I began working at the foundation full time, I’ve seen how the bottlenecks discussed in Abundance impede progress in global health—whether we’re trying to improve seeds, design better toilets, or eradicate polio. Sometimes the science itself is hard. But often, the logistics and execution are even harder.

That’s true in climate, too. Breakthrough Energy, which I helped launch in 2015, has backed hundreds of startups working on clean technologies. But getting those technologies to market is incredibly difficult—especially when it requires building new physical infrastructure. One of the biggest barriers to clean energy in the U.S. is the permitting process for long-distance transmission lines. Without them, we can’t upgrade our outdated grid to make it more affordable and reliable. But building them is slow and expensive.

Klein and Thompson dig into why this is. One of their recurring arguments is about government capacity. There was a time, especially in the mid-20th century, when government could make decisions and act on them—building highways, launching space programs, and approving major projects with clear timelines. Today, authority is spread across so many agencies and jurisdictions that even simple projects get stuck in limbo. And when they do move forward, there's a second problem: cost. America now spends exponentially more on infrastructure than other wealthy countries.

It's one thing to talk about these dynamics in the abstract. But Klein and Thompson show how they shape real-life outcomes in less obvious ways.

Take homelessness. A lot of people think mental illness or substance use are the main drivers. But the data tells a different story. While rates of addiction and mental illness are higher in West Virginia, California has much higher rates of homelessness—because housing costs are much higher. When you make it nearly impossible to build inexpensive housing through zoning rules, minimum lot sizes, or limits on shared bathrooms, then only expensive housing is built. The result is a shortage of everything else.

Abundance is tough on both sides of the aisle. The authors note how Republicans often rail against regulation while blocking government investments or gutting the institutions needed to do permitting well.

Klein and Thompson are liberals, though, and that’s who their primary message is for. They argue that Democrats—who tend to believe in government’s power to do good—have added layers of process and regulation that make it way too complex to actually get things done. But progress isn’t made by simply funding projects. It’s made by finishing them. And if you’re going to ask government to take on big challenges, you have to make sure it can deliver.

And we know it can. Our government is incredibly effective at building infrastructure and accelerating innovation when it wants to. Operation Warp Speed's development of COVID vaccines in record time is a perfect example. Democrats and Republicans alike should be competing to make this kind of thing happen more, not less.

Abundance doesn’t have all the answers. But in my view, Klein and Thompson are asking the right questions. I’m glad the book has already sparked some real debate, and I hope the conversation continues.