Leaders will head to the G-20 Summit in Los Cabos, Mexico, among renewed serious concern about the world economy. The turmoil that started with the U.S. subprime mortgage crisis has resulted in now almost five years of ongoing instability. The emerging market economies fared much better than the advanced economies and pulled out of the crisis already in 2009, but the slowdown we are now facing in 2012 is again global, demonstrating the interdependence in the world economy. The emerging market economies have stronger underlying trend growth rates, but they remain vulnerable to a downturn in the advanced economies. The center of concern is now squarely on Europe, with a recession threatening most European countries, even those that had reasonably good performances so far. After an encouraging start in 2012, the U.S. economy, while not close to a recession, is also showing signs of a slowdown rather than the hoped for steady acceleration of growth. And the slowdown is spreading across the globe.

At a time like this it would be desirable and necessary that the G-20 show real initiative and cohesion. The essays in this collection look at the challenge from various angles. There is concern that the G-20 is losing its sense of purpose, that cohesion is decreasing rather than increasing, and that policy initiatives are reactive to events rather than proactive. Let us hope that at this moment of great difficulty, the G-20 will succeed in giving the world economy a new sense of direction and confidence. It is much needed.

Download » (PDF)

In 2015 the international community agreed on a set of ambitious sustainable development goals (SDGs) for the global society, to be achieved by 2030. One of the lessons that the implementation of the Millennium Development Goals (MDG s) has highlighted is the importance of a systematic approach to identify and sequence development interventions—policies, programs, and projects—to achieve such goals at a meaningful scale. The Chinese approach to development, which consists of identifying a problem and long-term goal, testing alternative solutions, and then implementing those that are promising in a sustained manner, learning and adapting as one proceeds—Deng Xiaoping’s “crossing the river by feeling the stones”—is an approach that holds promise for successful achievement of the SDGs.

Having observed the Chinese way, then World Bank Group President James Wolfensohn in 2004, together with the Chinese government, convened a major international conference in Shanghai on scaling up successful development interventions, and in 2005 the World Bank Group (WBG ) published the results of the conference, including an assessment of the Chinese approach. (Moreno-Dodson 2005). Some ten years later, the WBG once again is addressing the question of how to support scaling up of successful development interventions, at a time when the challenge and opportunity of scaling up have become a widely recognized issue for many development institutions and experts.

Since traditional private and public service providers frequently do not reach the poorest people in developing countries, social enterprises can play an important role in providing key services to those at the “base of the pyramid.”

In parallel with the recognition that scaling up matters, the development community is now also focusing on social enterprises (SEs), a new set of actors falling between the traditionally recognized public and private sectors. We adopt here the World Bank’s definition of “social enterprises” as a social-mission-led organization that provides sustainable services to Base of the Pyramid (BoP) populations. This is broadly in line with other existing definitions for the sector and reflects the World Bank’s primary interest in social enterprises as a mechanism for supporting service delivery for the poor. Although social enterprises can adopt various organizational forms—business, nongovernmental organizations (NGOs), and community-based organizations are all forms commonly adopted by social enterprises—they differ from private providers principally by combining three features: operating with a social purpose, adhering to business principles, and aiming for financial sustainability. Since traditional private and public service providers frequently do not reach the poorest people in developing countries, social enterprises can play an important role in providing key services to those at the “base of the pyramid.” (Figure 1)

Figure 1. Role of SE sector in public service provision

Social enterprises often start at the initiative of a visionary entrepreneur who sees a significant social need, whether in education, health, sanitation, or microfinance, and who responds by developing an innovative way to address the perceived need, usually by setting up an NGO, or a for-profit enterprise. Social enterprises and their innovations generally start small. When successful, they face an important challenge: how to expand their operations and innovations to meet the social need at a larger scale. 

Development partner organizations—donors, for short—have recognized the contribution that social enterprises can make to find and implement innovative ways to meet the social service needs of people at the base of the pyramid, and they have started to explore how they can support social enterprises in responding to these needs at a meaningful scale. 

The purpose of this paper is to present a menu of approaches for addressing the challenge of scaling up social enterprise innovations, based on a review of the literature on scaling up and on social enterprises. The paper does not aim to offer specific recommendations for entrepreneurs or blueprints and guidelines for the development agencies. The range of settings, problems, and solutions is too wide to permit that. Rather, the paper provides an overview of ways to think about and approach the scaling up of social enterprise innovations. Where possible, the paper also refers to specific tools that can be helpful in implementing the proposed approaches. 

Note that we talk about scaling up social enterprise innovations, not about social enterprises. This is because it is the innovations and how they are scaled up that matter. An innovation may be scaled up by the social enterprise where it originated, by handoff to a public agency for implementation at a larger scale, or by other private enterprises, small or large. 

This paper is structured in three parts: Part I presents a general approach to scaling up development interventions. This helps establish basic definitions and concepts. Part II considers approaches for the scaling up of social enterprise innovations. Part III provides a summary of the main conclusions and lessons from experience. A postscript draws out implications for external aid donors. Examples from actual practice are used to exemplify the approaches and are summarized in Annex boxes.

Downloads

• Download the full paper (PDF)

I had been mulling a rebuttal to my colleague and friend Jon Rauch’s interesting—but wrong—new Brookings paper praising the role of “hacks, machines, big money, and back room deals” in democracy. I thought the indictments of Chris Christie’s associates last week provided a perfect example of the dangers of all of that, and so of why Jon was incorrect. But in yesterday’s L.A. Times, he beat me to it, himself defending the political morality (if not the efficacy) of their actions, and in the process delivering a knockout blow to his own position.

Bridgegate is a perfect example of why we need fewer "hacks, machines, big money, and back room deals" in our politics, not more. There is no justification whatsoever for government officials abusing their powers, stopping emergency vehicles and risking lives, making kids late for school and parents late for their jobs to retaliate against a mayor who withholds an election endorsement. We vote in our democracy to make government work, not break. We expect that officials will serve the public, not their personal interests. This conduct weakens our democracy, not strengthens it.

It is also incorrect that, as Jon suggests, reformers and transparency advocates are, in part, to blame for the gridlock that sometimes afflicts our American government at every level. As my co-authors and I demonstrated at some length in our recent Brookings paper, “Why Critics of Transparency Are Wrong,” and in our follow-up Op-Ed in the Washington Post, reform and transparency efforts are no more responsible for the current dysfunction in our democracy than they were for the gridlock in Fort Lee. Indeed, in both cases, “hacks, machines, big money, and back room deals” are a major cause of the dysfunction. The vicious cycle of special interests, campaign contributions and secrecy too often freeze our system into stasis, both on a grand scale, when special interests block needed legislation, and on a petty scale, as in Fort Lee. The power of megadonors has, for example, made dysfunction within the House Republican Caucus worse, not better.

Others will undoubtedly address Jon’s new paper at length. But one other point is worth noting now. As in foreign policy discussions, I don’t think Jon’s position merits the mantle of political “realism,” as if those who want democracy to be more democratic and less corrupt are fluffy-headed dreamers. It is the reformers who are the true realists. My co-authors and I in our paper stressed the importance of striking realistic, hard-headed balances, e.g. in discussing our non-absolutist approach to transparency; alas, Jon gives that the back of his hand, acknowledging our approach but discarding the substance to criticize our rhetoric as “radiat[ing] uncompromising moralism.” As Bridgegate shows, the reform movement’s “moralism" correctly recognizes the corrupting nature of power, and accordingly advocates reasonable checks and balances. That is what I call realism. So I will race Jon to the trademark office for who really deserves the title of realist!

Editor's Note: In September of this year Visiting Fellow Norman Eisen was featured in the Council on Government Ethics Law (COGEL) members-only magazine, The Guardian. An abbreviated version of his interview is featured below.

Interview conducted by Wesley Bizzell, Assistant General Counsel, Altria Client Services LLC.

Recently, you addressed the Italian Parliament to discuss ethics in government, as that legislative body considers adopting its own code of ethical conduct. In that speech, you noted you believe there are four key concepts at the center of Federal U.S. ethics laws. What are those four concepts and why they are important?

Firstly, I’d like to note the importance of focusing on four concepts. The House of Representatives Ethics manual is 456 pages long; too long to be of any real use in creating an ethics system. Instead, these four principles serve as a foundation upon which different governments can build their own sets of rules based on their own unique needs.

I focused on just four to make a point about priorities. The first is “conflicts”—that is, problems that arise when an individual’s personal interests and parliamentary duties may be at odds with one another. The second is “gifts”. Even if there isn’t an explicit quid-pro-quo style agreement involved, when a political figure accepts a gift from someone with a demonstrated interest in government decision-making, the suspicion of misconduct will always be there. “Revolving door” is the third core concept. When individuals rotate from the private sector to the public sector over and over again, they are naturally going to form relationships that tempt them toward unethical behavior. Finally, “use official resources.” Officials must be careful to use official resources only for official purposes, being particularly careful not to conduct any campaign activity on the taxpayer’s dime. The goal with these four priorities is not only to keep people from behaving unethically, but also to make sure it doesn’t seem like anyone is doing anything unethical either.

In that speech, you said that focusing on these four areas keeps you from losing the forest for the trees when working with ethics codes. Can you elaborate on that?

There’s always a danger for members of the executive branch, because the system of rules and regulations that governs ethical behavior is itself so complex. When it’s imbedded in equally complicated and overlapping sets of statute you risk creating rules so specific that they’re practically useless. The same is true in the legislative branch and I dare say in the federal judicial branch, as well as at the state and local levels. You’re always on the edge of being lost in the minutiae.

In fact, you can often make wrong decisions if you focus in too much on the specifics, because you lose sight of the larger picture that guides the rules. There are always options in ethical dilemmas, and the big picture needs to be kept in focus.

While at the White House serving as Special Counsel to the President for Ethics and Government Reform you oversaw numerous significant changes in the area of open government—including helping craft and implement President Obama’s Open Government Directive; publishing White House visitor logs on the internet; and generally improving the Freedom of Information Act (FOIA) process. What change in the area of open government are you most proud?

I was struck when we began the interview by the list of topics—campaign finance, lobbying, ethics, elections, and FOIA issues—because all of those were part of my portfolio as Special Counsel to the President for Ethics and Government Reform during the first two years of the Obama administration. I would have to say that I’m most proud of my role in the President’s decision to put all of the White House visitor records on the internet.

Remember, in previous administrations, Democratic and Republican alike, plaintiffs had to litigate for years just to get a handful of visitor records. To have all of the visitor records on the internet, categorized into various types, opens access to the White House to an unprecedented degree. There are now over four-and-a-half million visitor records available on the White House website, with more added every month. I think that that is remarkable.

Truthfully, I was torn between that accomplishment and a second one, which is that the President and his staff in the White House have had the longest run in presidential history (knock on wood) without a major ethics scandal or a grand jury investigation, indictment, or conviction. I was tempted to list that second fact as the accomplishment of which I was most proud. But it occurred to me that the death of White House scandal is actually a function of the exceptional level of transparency that the visitor records represent. Transparency helps ensure people don’t have meetings they shouldn’t be having, which keeps them out of trouble. So I’ll offer that second accomplishment as a part of the first one.

In your view, what was the most significant lobbying and ethics reform during your tenure at the White House?

No doubt about it: reversing the revolving door. Craig Holman of Public Citizen, who studies these issues, says we were the first in the world to create a reverse revolving door. I think it is absolutely critical to slow the revolving door in both directions—both coming out of government and going in.

I should also note that the comprehensive nature of the ethics system we put into place in the Obama administration bears a responsibility for the good results. The first rule, of course, of any ethics system is “tone at the top.” The president exemplifies that. He has the highest standards of ethics himself, and as a result everyone around him feels he will be personally let down if they don’t embrace the ethics system. Good results flow from that. Looking back, we can identify certain aspects that have more and less successful, but it’s important to recognize that the positive results are owed to the gestalt. Our transparency and ethics system was one of the most through and transparent that I’ve seen in any government, and the result speak for themselves.

Earlier this month, the College Board released SAT scores for the high school graduating class of 2015. Both math and reading scores declined from 2014, continuing a steady downward trend that has been in place for the past decade. Pundits of contrasting political stripes seized on the scores to bolster their political agendas. Michael Petrilli of the Fordham Foundation argued that falling SAT scores show that high schools need more reform, presumably those his organization supports, in particular, charter schools and accountability.* For Carol Burris of the Network for Public Education, the declining scores were evidence of the failure of polices her organization opposes, namely, Common Core, No Child Left Behind, and accountability.

Petrilli and Burris are both misusing SAT scores. The SAT is not designed to measure national achievement; the score losses from 2014 were miniscule; and most of the declines are probably the result of demographic changes in the SAT population. Let’s examine each of these points in greater detail.

It never was. The SAT was originally meant to measure a student’s aptitude for college independent of that student’s exposure to a particular curriculum. The test’s founders believed that gauging aptitude, rather than achievement, would serve the cause of fairness. A bright student from a high school in rural Nebraska or the mountains of West Virginia, they held, should have the same shot at attending elite universities as a student from an Eastern prep school, despite not having been exposed to the great literature and higher mathematics taught at prep schools. The SAT would measure reasoning and analytical skills, not the mastery of any particular body of knowledge. Its scores would level the playing field in terms of curricular exposure while providing a reasonable estimate of an individual’s probability of success in college.

Note that even in this capacity, the scores never suffice alone; they are only used to make admissions decisions by colleges and universities, including such luminaries as Harvard and Stanford, in combination with a lot of other information—grade point averages, curricular resumes, essays, reference letters, extra-curricular activities—all of which constitute a student’s complete application.

Today’s SAT has moved towards being a content-oriented test, but not entirely. Next year, the College Board will introduce a revised SAT to more closely reflect high school curricula. Even then, SAT scores should not be used to make judgements about U.S. high school performance, whether it’s a single high school, a state’s high schools, or all of the high schools in the country. The SAT sample is self-selected. In 2015, it only included about one-half of the nation’s high school graduates: 1.7 million out of approximately 3.3 million total. And that’s about one-ninth of approximately 16 million high school students.  Generalizing SAT scores to these larger populations violates a basic rule of social science. The College Board issues a warning when it releases SAT scores: “Since the population of test takers is self-selected, using aggregate SAT scores to compare or evaluate teachers, schools, districts, states, or other educational units is not valid, and the College Board strongly discourages such uses.”  

TIME’s coverage of the SAT release included a statement by Andrew Ho of Harvard University, who succinctly makes the point: “I think SAT and ACT are tests with important purposes, but measuring overall national educational progress is not one of them.”

SAT scores changed very little from 2014 to 2015. Reading scores dropped from 497 to 495. Math scores also fell two points, from 513 to 511. Both declines are equal to about 0.017 standard deviations (SD).^[i] To illustrate how small these changes truly are, let’s examine a metric I have used previously in discussing test scores. The average American male is 5’10” in height with a SD of about 3 inches. A 0.017 SD change in height is equal to about 1/20 of an inch (0.051). Do you really think you’d notice a difference in the height of two men standing next to each other if they only differed by 1/20^th of an inch? You wouldn’t. Similarly, the change in SAT scores from 2014 to 2015 is trivial.^[ii]

A more serious concern is the SAT trend over the past decade. Since 2005, reading scores are down 13 points, from 508 to 495, and math scores are down nine points, from 520 to 511. These are equivalent to declines of 0.12 SD for reading and 0.08 SD for math.^[iii] Representing changes that have accumulated over a decade, these losses are still quite small. In the Washington Post, Michael Petrilli asked “why is education reform hitting a brick wall in high school?” He also stated that “you see this in all kinds of evidence.”

You do not see a decline in the best evidence, the National Assessment of Educational Progress (NAEP). Contrary to the SAT, NAEP is designed to monitor national achievement. Its test scores are based on a random sampling design, meaning that the scores can be construed as representative of U.S. students. NAEP administers two different tests to high school age students, the long term trend (LTT NAEP), given to 17-year-olds, and the main NAEP, given to twelfth graders.

Table 1 compares the past ten years’ change in test scores of the SAT with changes in NAEP.^[iv] The long term trend NAEP was not administered in 2005 or 2015, so the closest years it was given are shown. The NAEP tests show high school students making small gains over the past decade. They do not confirm the losses on the SAT.

Table 1. Comparison of changes in SAT, Main NAEP (12^th grade), and LTT NAEP (17-year-olds) scores. Changes expressed as SD units of base year.

 *p<.05

Petrilli raised another concern related to NAEP scores by examining cohort trends in NAEP scores. The trend for the 17-year-old cohort of 2012, for example, can be constructed by using the scores of 13-year-olds in 2008 and 9-year-olds in 2004. By tracking NAEP changes over time in this manner, one can get a rough idea of a particular cohort’s achievement as students grow older and proceed through the school system. Examining three cohorts, Fordham’s analysis shows that the gains between ages 13 and 17 are about half as large as those registered between ages nine and 13. Kids gain more on NAEP when they are younger than when they are older.

There is nothing new here. NAEP scholars have been aware of this phenomenon for a long time. Fordham points to particular elements of education reform that it favors—charter schools, vouchers, and accountability—as the probable cause. It is true that those reforms more likely target elementary and middle schools than high schools. But the research literature on age discrepancies in NAEP gains (which is not cited in the Fordham analysis) renders doubtful the thesis that education policies are responsible for the phenomenon.^[v]

Whether high school age students try as hard as they could on NAEP has been pointed to as one explanation. A 1996 analysis of NAEP answer sheets found that 25-to-30 percent of twelfth graders displayed off-task test behaviors—doodling, leaving items blank—compared to 13 percent of eighth graders and six percent of fourth graders. A 2004 national commission on the twelfth grade NAEP recommended incentives (scholarships, certificates, letters of recognition from the President) to boost high school students’ motivation to do well on NAEP. Why would high school seniors or juniors take NAEP seriously when this low stakes test is taken in the midst of taking SAT or ACT tests for college admission, end of course exams that affect high school GPA, AP tests that can affect placement in college courses, state accountability tests that can lead to their schools being deemed a success or failure, and high school exit exams that must be passed to graduate?^[vi]

Other possible explanations for the phenomenon are: 1) differences in the scales between the ages tested on LTT NAEP (in other words, a one-point gain on the scale between ages nine and 13 may not represent the same amount of learning as a one-point gain between ages 13 and 17); 2) different rates of participation in NAEP among elementary, middle, and high schools;^[vii] and 3) social trends that affect all high school students, not just those in public schools. The third possibility can be explored by analyzing trends for students attending private schools. If Fordham had disaggregated the NAEP data by public and private schools (the scores of Catholic school students are available), it would have found that the pattern among private school students is similar—younger students gain more than older students on NAEP. That similarity casts doubt on the notion that policies governing public schools are responsible for the smaller gains among older students.^[viii]

Writing in the Washington Post, Carol Burris addresses the question of whether demographic changes have influenced the decline in SAT scores. She concludes that they have not, and in particular, she concludes that the growing proportion of students receiving exam fee waivers has probably not affected scores. She bases that conclusion on an analysis of SAT participation disaggregated by level of family income. Burris notes that the percentage of SAT takers has been stable across income groups in recent years. That criterion is not trustworthy. About 39 percent of students in 2015 declined to provide information on family income. The 61 percent that answered the family income question are probably skewed against low-income students who are on fee waivers (the assumption being that they may feel uncomfortable answering a question about family income).^[ix] Don’t forget that the SAT population as a whole is a self-selected sample. A self-selected subsample from a self-selected sample tells us even less than the original sample, which told us almost nothing.

The fee waiver share of SAT takers increased from 21 percent in 2011 to 25 percent in 2015. The simple fact that fee waivers serve low-income families, whose children tend to be lower-scoring SAT takers, is important, but not the whole story here. Students from disadvantaged families have always taken the SAT. But they paid for it themselves. If an additional increment of disadvantaged families take the SAT because they don’t have to pay for it, it is important to consider whether the new entrants to the pool of SAT test takers possess unmeasured characteristics that correlate with achievement—beyond the effect already attributed to socioeconomic status.

Robert Kelchen, an assistant professor of higher education at Seton Hall University, calculated the effect on national SAT scores of just three jurisdictions (Washington, DC, Delaware, and Idaho) adopting policies of mandatory SAT testing paid for by the state. He estimated that these policies explain about 21 percent of the nationwide decline in test scores between 2011 and 2015. He also notes that a more thorough analysis, incorporating fee waivers of other states and districts, would surely boost that figure. Fee waivers in two dozen Texas school districts, for example, are granted to all juniors and seniors in high school. And all students in those districts (including Dallas and Fort Worth) are required to take the SAT beginning in the junior year. Such universal testing policies can increase access and serve the cause of equity, but they will also, at least for a while, lead to a decline in SAT scores.

Here, I offer my own back of the envelope calculation of the relationship of demographic changes with SAT scores. The College Board reports test scores and participation rates for nine racial and ethnic groups.^[x] These data are preferable to family income because a) almost all students answer the race/ethnicity question (only four percent are non-responses versus 39 percent for family income), and b) it seems a safe assumption that students are more likely to know their race or ethnicity compared to their family’s income.

The question tackled in Table 2 is this: how much would the national SAT scores have changed from 2005 to 2015 if the scores of each racial/ethnic group stayed exactly the same as in 2005, but each group’s proportion of the total population were allowed to vary? In other words, the scores are fixed at the 2005 level for each group—no change. The SAT national scores are then recalculated using the 2015 proportions that each group represented in the national population.

Table 2. SAT Scores and Demographic Changes in the SAT Population (2005-2015)

The data suggest that two-thirds to three-quarters of the SAT score decline from 2005 to 2015 is associated with demographic changes in the test-taking population. The analysis is admittedly crude. The relationships are correlational, not causal. The race/ethnicity categories are surely serving as proxies for a bundle of other characteristics affecting SAT scores, some unobserved and others (e.g., family income, parental education, language status, class rank) that are included in the SAT questionnaire but produce data difficult to interpret.

Using an annual decline in SAT scores to indict high schools is bogus. The SAT should not be used to measure national achievement. SAT changes from 2014-2015 are tiny. The downward trend over the past decade represents a larger decline in SAT scores, but one that is still small in magnitude and correlated with changes in the SAT test-taking population.

In contrast to SAT scores, NAEP scores, which are designed to monitor national achievement, report slight gains for 17-year-olds over the past ten years. It is true that LTT NAEP gains are larger among students from ages nine to 13 than from ages 13 to 17, but research has uncovered several plausible explanations for why that occurs. The public should exercise great caution in accepting the findings of test score analyses. Test scores are often misinterpreted to promote political agendas, and much of the alarmist rhetoric provoked by small declines in scores is unjustified.

One cannot help feeling a bit silly taking seriously the policy proposals of a person who seems not to take policy seriously himself. Donald Trump's policy positions have evolved faster over the years than a teenager's moods. He was for a woman's right to choose; now he is against it. He was for a wealth tax to pay off the national debt before proposing a tax plan that would enrich the wealthy and balloon the national debt. He was for universal health care but opposed to any practical way to achieve it.

Based on his previous flexibility, Trump's here-today proposals may well be gone tomorrow. As a sometime-Democrat, sometime-Republican, sometime-independent, who is now the leading candidate for the Republican presidential nomination, Trump has just issued his latest pronouncements on health care policy. So, what the hell, let's give them more respect than he has given his own past policy statements.

Perhaps unsurprisingly, those earlier pronouncements are notable for their detachment from fact and lack of internal logic. The one-time supporter of universal health care now joins other candidates in his newly-embraced party in calling for repeal of the only serious legislative attempt in American history to move toward universal coverage, the Affordable Care Act. Among his stated reasons for repeal, he alleges that the act has "resulted in runaway costs," promoted health care rationing, reduced competition and narrowed choice.

Each of these statements is clearly and demonstrably false. Health care spending per person has grown less rapidly in the six years since the Affordable Care Act was enacted than in any corresponding period in the last four decades. There is now less health care rationing than at any time in living memory, if the term rationing includes denial of care because it is unaffordable. Rationing because of unaffordability is certainly down for the more than 20 million people who are newly insured because of the Affordable Care Act. Hospital re-admissions, a standard indicator of low quality, are down, and the health care exchanges that Trump now says he would abolish, but that resemble the "health marts" he once espoused, have brought more choice to individual shoppers than private employers now offer or ever offered their workers.

Trump's proposed alternative to the Affordable Care Act is even worse than his criticism of it. He would retain the highly popular provision in the act that bars insurance companies from denying people coverage because of preexisting conditions, a practice all too common in the years before the health care law. But he would do away with two other provisions of the Affordable Care Act that are essential to make that reform sustainable: the mandate that people carry insurance and the financial assistance to make that requirement feasible for people of modest means.

Without those last two provisions, barring insurers from using preexisting conditions to jack up premiums or deny coverage would destroy the insurance market. Why? Because without the mandate and the financial aid, people would have powerful financial incentives to wait until they were seriously ill to buy insurance. They could safely do so, confident that some insurer would have to sell them coverage as soon as they became ill. Insurers that set affordable prices would go broke. If insurers set prices high enough to cover costs, few customers could afford them.

In simple terms, Trump's promise to bar insurers from using preexisting conditions to screen customers but simultaneously to scrap the companion provisions that make the bar feasible is either the fraudulent offer of a huckster who takes voters for fools, or clear evidence of stunning ignorance about how insurance works. Take your pick.

Unfortunately, none of the other Republican candidates offers a plan demonstrably superior to Trump's. All begin by calling for repeal and replacement of the Affordable Care Act. But none has yet advanced a well-crafted replacement.

It is not that the Affordable Care Act is perfect legislation. It isn't. But, as the old saying goes, you can't beat something with nothing. And so far as health care reform is concerned, nothing is what the Republican candidates now have on offer.

Editor's note: This piece originally appeared in U.S. News and World Report.

We can be sure that the 2016 presidential candidates, whoever they are, will be in favor of promoting opportunity and cutting poverty. The question is: how? In our contribution to a new volume published today, “Campaign 2016: Eight big issues the presidential candidates should address,” we show that people who clear three hurdles—graduating high school, working full-time, and delaying parenthood until they in a stable, two-parent family—are very much more likely to climb to middle class than fall into poverty:

But what specific policies would help people achieve these three benchmarks of success?  Our paper contains a number of ideas that candidates might want to adopt. Here are a few examples: 

1. To improve high school graduation rates, expand “Small Schools of Choice,” a program in New York City, which replaced large, existing schools with more numerous, smaller schools that had a theme or focus (like STEM or the arts). The program increased graduation rates by about 10 percentage points and also led to higher college enrollment with no increase in costs.

2. To support work, make the Child and Dependent Care Tax Credit (CDCTC) refundable and cap it at $100,000 in household income. Because the credit is currently non-refundable, low-income families receive little or no benefit, while those with incomes above $100,000 receive generous tax deductions. This proposal would make the program more equitable and facilitate low-income parents’ labor force participation, at no additional cost.

3. To strengthen families, make the most effective forms of birth control (IUDs and implants) more widely available at no cost to women, along with good counselling and a choice of all FDA-approved methods. Programs that have done this in selected cities and states have reduced unplanned pregnancies, saved money, and given women better ability to delay parenthood until they and their partners are ready to be parents. Delayed childbearing reduces poverty rates and leads to better prospects for the children in these families.

These are just a few examples of good ideas, based on the evidence, of what a candidate might want to propose and implement if elected. Additional ideas and analysis will be found in our longer paper on this topic.

In their recent blog for Social Mobility Memos, Brad Wilcox, Robert Lerman, and Joseph Price make a convincing case that a stable family structure is an important factor in increased social mobility, higher economic growth, and less poverty over time.

The interesting question is: what lies behind this relationship? Why is a rise (or a smaller decline) in the proportion of married families associated, for example, with higher growth in average family incomes or a decline in poverty? The authors suggest a number of reasons, including the positive effects of marriage for children, less crime, men’s engagement in work, and income pooling. Of these, however, income pooling is by far the most important. Individual earnings have increased very little, if at all, over the past three or four decades, so the only way for families to get ahead was to add a second earner to the household. This is only possible within marriage or some other type of income pooling arrangement like cohabitation. Marriage here is the means: income pooling is the end.

How do we encourage more people to share incomes and expenses? There are no easy answers. Wilcox and his co-authors favor reducing marriage penalties in tax and benefit programs, expanding training and apprenticeship programs, limiting divorces in cases where reconciliation is still possible, and civic efforts to convince young people to follow what I and others have called the “success sequence.” All of these ideas are fine in principle. The question is how much difference they can make in practice. Previous efforts have had at best modest results, as a number of articles in the recent issue of the Brookings-Princeton journal The Future of Children point out.      

Our success sequence, which Wilcox wants to use as the basis for a pro-marriage civic campaign, requires teens and young adults to complete their education, get established in a job, and to delay childbearing until after they are married. The message is the right one.

The problem is that many young adults are having children before marriage. Why? Early marriage is not compatible, in their view, with the need for extended education and training. They also want to spend longer finding the best life partner. These are good reasons to delay marriage. But pregnancies and births still occur, with or without marriage. For better or worse, our culture now tolerates, and often glamorizes, multiple relationships, including premarital sex and unwed parenting. This makes bringing back the success sequence difficult.

Our best bet is to help teens and young adults avoid having a child until they have completed their education, found a steady job, and most importantly, a stable partner with whom they want to raise children, and with whom they can pool their income. In many cases this means marriage; but not in all. The bottom line: teens and young adults need more access and better education and counselling on birth control, especially little-used but highly effective forms as the IUD and the implant. Contraception, not marriage, is where we should be focusing our attention.

In this tumultuous election year one wonders whether reasoned debate about education or other policies is still possible. That said, research has a role to play in helping policymakers make good decisions – if not before than after they are in office. So what do we know about the ability of early education to change children’s lives? At the moment, scholars are divided. One camp argues that pre-k doesn’t work, suggesting that it would be a mistake to expand it. Another camp believes that it is one of the most cost-effective things we could do to improve children’s lifetime prospects, especially if they come from disadvantaged homes.

The pre-k advocates cite several earlier demonstrations, such as the Perry Preschool and Abecedarian programs. These have been rigorously evaluated and found to improve children’s long-term success, including less use of special education, increases in high school graduation, reduced crime, and higher earnings. Participants in the Abecedarian program, for example, earned 60 percent more than controls by age 30. Mothers benefit as well since more of them are able to work. The Abecedarian project increased maternal earnings by $90,000 over the course of the mother’s career. Finally, by reducing crime, improving health, and decreasing the need for government assistance, these programs also reduce the burden on taxpayers. According to one estimate, the programs even increase GDP to the tune of $30 to $80 billion (in 2015 dollars) once the children have moved into and through their working lives. A careful summary of all this research can be found in this year’s Economic Report of the President. The Report notes, and I would emphasize, that no one study can do justice to this issue, and not every program has been successful, but the weight of the evidence points strongly to the overall success of high-quality programs. This includes not just the small, very intensive model programs, but importantly the large, publically-funded pre-school programs such as those in Boston, Tulsa, Georgia, North Carolina, and New Jersey. Some estimates put the ratio of benefits to costs at $7 to $1. Very few investments promise such a large return. Pre-k advocates admit that any gains in IQ may fade but that boosts to nonacademic skills such as self-control, motivation, and planning have long-term effects that have been documented in studies of siblings exposed to differing amounts of early education.

The pre-k critics point to findings from rigorous evaluations of the national Head Start program and of a state-wide program in Tennessee. These studies found that any gains from pre-k at the end of the program had faded by the time the children were in elementary school. They argue that the positive results from earlier model programs, such as Perry and Abecedarian, may have been the result of their small scale, their intensity, and the fact that the children involved had few alternative sources of care or early education. Children with more than adequate home environments or good substitute child care do not benefit as much, or at all, from participating in a pre-k program. In my view, this is an argument for targeted programs or for a universal program with a sliding scale fee for those who participate. In the meantime, it is too early to know what the longer-term effects of current programs will be. Despite their current popularity among scholars, one big problem with randomized controlled trials (RCTs) is that it takes a generation to get the answers you need. And, as is the case with Perry and Abecedarian, by the time you get them, they may no longer be relevant to contemporary environments in which mothers are better educated and more children have access to out-of-home care.

In the end, you can’t make public policy with RCTs alone. We need to incorporate lessons from neuroscience about the critical changes to the brain that occur in early childhood and the insights of specialists in child development. We need to consider what happens to non-cognitive skills over the longer term. We need to worry about the plight of working mothers, especially single parents, who cannot work without some form of out-of-home care. Providing that care on the cheap may turn out to be penny wise and pound foolish. (A universal child care program in Quebec funded at $5 a day led to worse behavior among the kids in the program.) Of course we need to continuously improve the effectiveness of pre-k through ongoing evaluation. That means weeding out ineffective programs along with improving curriculum, teacher preparation and pay, and better follow-up in the early grades. Good quality pre-k works; bad-quality does not. For the most disadvantaged children, it may require intervening much earlier than age 3 or 4 as the Abecedarian program did -- with strikingly good results.

Our society is coming apart. Scholars from AEI’s Charles Murray to Harvard’s Robert Putnam agree on that point. Anything that can improve the lives of the next generation should command our attention. The evidence will never be air-tight. But once one adds it all up, investing in high quality pre-k looks like a good bet to me.

Editor's note: This piece originally appeared in Real Clear Markets.

The idea of a universal basic income (UBI) is certainly an intriguing one, and has been gaining traction. Swiss voters just turned it down. But it is still alive in Finland, in the Netherlands, in Alaska, in Oakland, CA, and in parts of Canada. 

Advocates of a UBI include Charles Murray on the right and Anthony Atkinson on the left. This surprising alliance alone makes it interesting, and it is a reasonable response to a growing pool of Americans made jobless by the march of technology and a safety net that is overly complex and bureaucratic. A comprehensive and excellent analysis in The Economist points out that while fears about technological unemployment have previously proved misleading, “the past is not always a good guide to the future.”

Robert Greenstein argues, however, that a UBI would actually hurt the poor by reallocating support up the income scale. His logic is inescapable: either we have to spend additional trillions providing income grants to all Americans or we have to limit assistance to those who need it most. 

One option is to provide unconditional payments along the lines of a UBI, but to phase it out as income rises. Libertarians like this approach since it gets rid of bureaucracies and leaves the poor free to spend the money on whatever they choose, rather than providing specific funds for particular needs. Liberals fear that such unconditional assistance would be unpopular and would be an easy target for elimination in the face of budget pressures. Right now most of our social programs are conditional. With the exception of the aged and the disabled, assistance is tied to work or to the consumption of necessities such as food, housing, or medical care, and our two largest means-tested programs are Food Stamps and the Earned Income Tax Credit.

Liberals have been less willing to openly acknowledge that a little paternalism in social policy may not be such a bad thing. In fact, progressives and libertarians alike are loath to admit that many of the poor and jobless are lacking more than just cash. They may be addicted to drugs or alcohol, suffer from mental health issues, have criminal records, or have difficulty functioning in a complex society. Money may be needed but money by itself does not cure such ills. 

A humane and wealthy society should provide the disadvantaged with adequate services and support. But there is nothing wrong with making assistance conditional on individuals fulfilling some obligation whether it is work, training, getting treatment, or living in a supportive but supervised environment.

In the end, the biggest problem with a universal basic income may not be its costs or its distributive implications, but the flawed assumption that money cures all ills.  

Event Information

Technology unimaginable at the time of the nation’s founding now poses stark challenges to America’s core constitutional principles. Policymakers and legal scholars are closely examining how constitutional law is tested by technological change and how to preserve constitutional principles without hindering progress. In Constitution 3.0: Freedom and Technological Change (Brookings Institution Press, 2011), Governance Studies Senior Fellow Benjamin Wittes and Nonresident Senior Fellow Jeffrey Rosen asked a diverse group of leading scholars to imagine how technological developments plausible by the year 2025 could stress current constitutional law. The resulting essays explore scenarios involving information technology, genetic engineering, security, privacy and beyond.

On December 13, the Governance Studies program at Brookings hosted a Judicial Issues Forum examining the scenarios posed in Constitution 3.0 and the challenge of adapting our constitutional values to the technology of the near future. Wittes and Rosen offered key highlights and insights from the book and was joined by two key contributors, O. Carter Snead and Timothy Wu, who discussed their essays.

After the program, panelists took audience questions.

Video

• Constitution 3.0: Freedom, Technological Change and the Law

Audio

• Constitution 3.0: Freedom, Technological Change and the Law

Transcript

• Uncorrected Transcript (.pdf)

Event Materials

• 20111213_constitution_technology

Downloads

• Table of Contents
• Sample Chapter

• {CD2E3D28-0096-4D03-B2DE-6567EB62AD1E}, 978-0-8157-2212-0, $29.95 Add to Cart
• {9ABF977A-E4A6-41C8-B030-0FD655E07DBF}, 9780815724506, $22.95 Add to Cart

Although we are early in the twenty-first century, breathtaking changes in technology are posing stark challenges to our constitutional values. From free speech to privacy, from liberty and personal autonomy to the right against self-incrimination, basic constitutional principles are under stress from technological advances unimaginable even a few decades ago, let alone during the founding era. In Constitution 3.0, we asked a group of provocative thinkers to imagine the ways in which technological change will challenge our constitutional and legal values in the year 2030.

Will privacy become obsolete, for example, in a world where ubiquitous surveillance is becoming the norm? Imagine that Facebook and Google post live feeds to public and private surveillance cameras, allowing 24/7 tracking of any citizen in the world. How can we protect free speech now that Facebook, Google, and other private intermediaries have more power than any king, president, or Supreme Court justice to decide who can speak and who can be heard? How will advanced brain-scan technology affect the constitutional right against self-incrimination? And on a more elemental level, should people have the right to manipulate their genes and design their own babies? Should we be allowed to patent new forms of life that seem virtually human? And we then asked our contributors to propose ways of translating and preserving constitutional values in the year 2030, in the face of dizzying technological change.

The launch event for the book, held on December 13 at Brookings, provoked a vigorous conversation that mirrored the debates in the book itself. My co-editor Ben Wittes and I invited Tim Wu and Carter Snead to discuss their contributions to Constitution 3.0 and to debate a question the U.S. Supreme Court is now considering: should the police be allowed, without a valid warrant, to secretly put a Global Positioning System device on the bottom of a car of a suspected drug dealer in order to track his movements, 24/7, for a month? The panelists disagreed about the proper outcome: Tim Wu argued that Google and Facebook now have more power over our private data than any police agent or Supreme Court justice, and yet the Constitution, as currently interpreted, restricts private corporations far less rigorously than it constrains the police. Carter Snead insisted that it’s not enough for judges to predict how much privacy people actually expect in the face of new technologies; instead, they need to identify how much privacy we should demand in order to live in a free society rather than a police state. Benjamin Wittes dissented, arguing that Congress, rather than the Courts, should protect the privacy of our geo-locational information, whether collected by GPS devices or stored on cell phones. And I channeled the spirit of the patron saint of Constitution 3.0, Justice Louis Brandeis. Brandeis would have been impatient, I think, with the government’s statements that we have no expectations of privacy in public; instead, Brandeis would have insisted on translating the constitutional Framers’ prohibition on unreasonable searches and seizures into the 21st century. Now that GPS devices and cell phones can reveal far more about our movements, thoughts, and activities outside of the home than old style home break-ins could have revealed in the 18th century, Brandeis might have insisted that long term surveillance is unreasonable without a warrant.

If you watch the webcast, you’ll get a sense of debate among the panelists about who is best equipped to protect constitutional values in the face of new technologies: the Supreme Court, Congress, administrative agencies, private companies like Google and Facebook, political activism groups, or some combination of all of the above. Regardless of where you come out on these issues, I hope you’ll find the project of trying to imagine the constitutional challenges of the next few decades as challenging and rewarding as we did in writing the book.