In old and new democracies alike, concerns that elections are unfair, corrupt, or fraudulent provoke attempts to change the way that elections are run. The Hidden Costs of Clean Election Reform offers a critical look at the consequences of efforts to improve election quality, specifically those aimed at “reducing fraud and error in the casting and counting of votes” (p. 3). Frederic Schaffer persuasively argues that clean election reforms can cause “hidden costs,” including reduced voter turnout, proliferation of cheating, and voter alienation. Electoral reform can lead to such costs by increasing the legal disenfranchisement of voters, excluding voters through administrative procedures, and causing partisan operatives to change their tactics in a manner that reduces participation, or changes the form or rate of cheating.

The book offers a wealth of qualitative evidence and illustrative examples from around the world, including documentation of unintended consequences of election reforms in countries such as Australia, the Philippines, Taiwan, the United States, and Venezuela. Schaffer sets the foundation for further exploration of this important topic by marshaling an impressive array of evidence, both historical and current, from archives, firsthand accounts of elections, surveys, interviews with political actors, news reports, and observer reports on elections. For scholars and practitioners interested in democracy, election administration, and ways of preventing election fraud, his latest book provides an enormously valuable resource.

The clean election reforms considered by Shaffer include efforts to improve the accuracy of the voter register, reduce vote buying, improve civic education, impose uniform standards for voter identification, computerize various aspects of elections, ensure the secrecy of the ballot, allow election observers, and many others. Most reforms appear positive at first glance. The author argues that different political actors vary in their response to election reforms, and can ultimately reduce the willingness of voters to participate in elections and even cause the proliferation of election fraud. Four of the chapters focus on how the most important actors in electoral reform—lawmakers; election officials and workers; political parties, candidates, and their agents; and civic educators—generate unintended and intended costs to democracy.

In describing why “good reforms sometimes go bad,” Schaffer states that “[p]rocedures that make it easy for eligible people to vote also make it easy for ineligible people to vote. When reforms make it harder for ineligible people to vote, they also make it harder for eligible people to vote” (p. 10). Although this statement may well be accurate, I have a harder time concluding that reducing turnout of some eligible voters is worse than reducing illegal voting (by children, the deceased, and foreigners, or by eligible individuals voting more than once). Both situations are bad, but one has to introduce additional assumptions to reach the conclusion that the cost of reform is greater to democracy than the cost of not attempting reform. Schaffer's goal is to establish that some damage occurs from clean election reform, and in this he clearly succeeds. Yet his book highlights the need to address the other side of the equation before his recommendations can be put into practice.

Schaffer refers to the costs of election reform as “iatrogenic harm.” Iatrogenic refers to unintended harm caused by physicians in the course of treating a patient. His use of this term raises an interesting parallel to medicine. Throughout the book, he warns that the same reform can have different effects in different contexts. This is similar to the idea that an identical medical treatment can have different effects on different patients based on their characteristics. As the author makes clear in the concluding chapter, just like in medicine, it is preferable to understand the effects of a reform before it is implemented. One might argue that this is similar to understanding whether a new drug works, as well as the type and magnitude of any side effects. Just like clinical trials, many of the electoral reforms highlighted by Schaffer can and should be evaluated and “pilot tested” before being implemented (pp. 154–59). Schaffer mentions randomized control trials only in passing, but such studies represent a clear opportunity to evaluate many of the questions raised by his using a transparent method that can test the effects of a specific reform in the country in question before it is adopted permanently.

Yet there is an important difference between iatrogenic harm in medicine and iatrogenic harm resulting from election reform that was implicit but underemphasized in this book. Doctors and patients ostensibly share the goal of improving the patient's health, and the aim of physicians to “do no harm” is clearly a priority. Unlike medicine, politics is competitive, and like sports, as many of the cases in this book demonstrate, political actors seek first and foremost to maximize their chances of victory in a zero-sum game. Clean election reforms change the rules, not the competitive nature of the game, and as Schaffer's evidence underscores, this reaction by political actors should always be anticipated.

The book sets the agenda on this subject, and as such it raises a number of questions that should be explored in future research. One question highlighted but sidestepped by Schaffer is whether the costs of clean election reform are greater than the costs of inaction. For each reform, is the counterfactual really worse for democracy? Reduced voter turnout is the most common “hidden cost” of reform. For example, by reducing vote buying or making the requirements for voter registration uniform, the incentives for some citizens to turn out are lessened (because they are no longer getting paid to do so, because they are paid to stay home, or because they lack the appropriate identification). Yet turnout also declines with reductions in ghost voting, ballot box stuffing, multiple voting, and coerced turnout.

In an ideal world, turnout would be high, election violence would be low, all voters would freely vote their conscience in a climate absent intimidation, corruption would not exist, and elections would be “festive” and “fun” (p. 191). Ideal elections would produce elected politicians who are responsive, accountable to their constituents, and immune to bribery, and who otherwise govern benevolently with the best interests of their country at heart. There are many reasons why few countries attain this ideal, and I suspect that clean election reform is not the ultimate culprit, but rather that it exposes other characteristics of the society that present a challenge to democracy. For example, as in the chapter on civic educators and the Philippines case, clean election reform exposes the many difficulties for democracy generated by economic inequality and classism. Election reform is the proximate cause of reduced voter enthusiasm for elections, but it is not the root cause.

Schaffer has made an important contribution to our understanding of the ways in which even well-intentioned changes in the rules of game can have unintended consequences. The next step is to develop methods of testing the consequences of such reforms in a manner that can be used to weigh the likely consequences of proposed electoral reform against the costs of inaction.