Example: Health Care

Visible goal: Improve Health

Hidden goal: Show how much we care ("kiss the booboo")

This explains why much of health care is devoted to high-cost high-visibility interventions (like bypass surgery) and much less to lifestyle interventions (like diet/exercise).

It also explains why many obvious changes that would improve the stated goal keep failing to be adopted - they hamper the hidden goals.

Software example: Why do people keep estimating development task size assuming nothing goes wrong? And why do their managers not hold them responsible for continually slipping the schedules?

Visible goal: Accurate estimates

Hidden goal: Brag about how fast we are

If accurate estimates were the only goal, then when schedules slip there would be a strong feedback loop to improve future estimates. My experience has been the opposite - the slip is blamed on something "no one could have foreseen" and everybody keeps estimating as before.

To be clear, it's always a mix of the visible and hidden motives. Much of health care is actually about improving health. But acknowledging the hidden motives is vital to understanding how much of society works.