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Experts weigh in (part 2): What is the future of al-Qaida and the Islamic State?


Will McCants: As we begin another year in the so-called Long War, it’s a good time to reflect on where we are in the fight against al-Qaida and its bête noire, the Islamic State. Both organizations have benefited from the chaos unleashed by the Arab Spring uprisings but they have taken different paths. Will those paths converge again or will the two organizations continue to remain at odds? Who has the best strategy at the moment? And what political changes might happen in the coming year that will reconfigure their rivalry for leadership of the global jihad?

To answer these questions, I’ve asked some of the leading experts on the two organizations to weigh in. First was Barak Mendelsohn, who contrasts al-Qaida’s resilience and emphasis on Sunni oppression with the Islamic State’s focus on building a utopian order and restoring the caliphate.

Next is Clint Watts, a Fox fellow at the Foreign Policy Research Institute. He offers ways to avoid the flawed assumptions that have led to mistaken counterterrorism forecasts in recent years. 


Clint Watts: Two years ago today, counterterrorism forecasts focused on a “resurgent” al-Qaida. Debates over whether al-Qaida was again winning the war on terror ensued just a week before the Islamic State invaded Mosul. While Washington’s al-Qaida debates steamed away in 2013, Ayman al-Zawahiri’s al-Qaida suffered unprecedented internal setbacks from a disobedient, rogue affiliate formerly known as al-Qaida in Iraq (AQI). With terror predictions two years ago so far off the mark, should we even attempt to anticipate what the next two years of al-Qaida and ISIS will bring?

Rather than prognosticate about how more than a dozen extremist groups operating on four continents might commit violence in the future, analysts might instead examine flawed assumptions that resulted in the strategic surprise known as the Islamic State. Here are insights from last decade’s jihadi shifts we should consider when making forecasts on al-Qaida and the Islamic State’s future in the coming decade. 

Loyalty is fleeting, self-interest is forever. Analysts that missed the Islamic State’s rise assumed that those who pledged allegiance to al-Qaida would remain loyal indefinitely. But loyalties change despite the oaths that bind them. Abu Bakr al-Baghdadi and the Islamic State’s leaders used technicalities to slip their commitments to al-Qaida. Boko Haram has rapidly gone from al-Qaida wannabe to Islamic State devotee. 

In short, jihadi pledges of loyalty should not be seen as binding or enduring, but instead temporary. When a group’s fortunes wane or leaders change, allegiance will rapidly shift to whatever strain of jihad proves most advantageous to the group or its leader. Prestige, money, manpower—these drive pledges of allegiance, not ideology. 

Al-Qaida and the Islamic State do not think solely about destroying the United States and its Western allies. Although global jihadi groups always call for attacks on the West, they don’t always deliver. Either they can’t or they have other priorities, like attacking closer to home. So jihadi propaganda alone does not tell us much about how the group is going to behave in the future. 

Zawahiri, for example, has publicly called on al-Qaida’s affiliates to carry out attacks on the West. But privately, he has instructed his affiliate in Syria to hold off. And for most of its history, the Islamic State focused on attacking the near enemy in the Middle East rather than the far enemy overseas, despite repeatedly vowing to hit the United States. Both groups will take advantage of any easy opportunity to strike the United States. However, continuing to frame future forecasts through an America-centric lens will yield analysis that’s off the mark and of questionable utility.

[J]ihadi propaganda alone does not tell us much about how the group is going to behave in the future.

Al-Qaida and the Islamic State don’t control all of the actions of their affiliates. News headlines lead casual readers to believe al-Qaida and the Islamic State command and control vast networks operating under a unified strategic plan. But a year ago, the Charlie Hebdo attack in Paris caught al-Qaida in the Arabian Peninsula (AQAP) completely by surprise—despite one of the attackers attributing the assault to the group. Al-Qaeda in the Islamic Maghreb's (AQIM) recent spate of attacks in Mali and Burkina Faso were likely conducted independently of al-Qaida’s central leadership. While the Islamic State has clearly mobilized its network and inspired others to execute a broad range of international attacks, the group’s central leadership in Iraq and Syria closely manages only a small subset of these plots. 

At no time since the birth of al-Qaida have jihadi affiliates and networks operated with such independence. Since Osama bin Laden’s death, al-Qaida affiliates in Yemen, the Sahel, Somalia, and Syria all aggressively sought to form states—a strategy bin Laden advised against. Target selections and the rapid pace of plots by militants in both networks suggest local dynamics rather than a cohesive, global grand strategy drive today’s jihad. Accurately anticipating the competition and cooperation of such a wide array of terrorist affiliates with overlapping allegiances to both groups will require examination by teams of analysts with a range of expertise rather than single pundits. 

At no time since the birth of al-Qaida have jihadi affiliates and networks operated with such independence.

Both groups and their affiliates will be increasingly enticed to align with state sponsors and other non-jihadi, non-state actors. The more money al-Qaida and the Islamic State have, the more leverage they have over their affiliates. But when the money dries up—as it did in al-Qaida’s case and will in the Islamic State’s—the affiliates will look elsewhere to sustain themselves. Distant affiliates will seek new suitors or create new enterprises. 

Inevitably, some of the affiliates will look to states that are willing to fund them in proxy wars against their mutual adversaries. Iran, despite fighting the Islamic State in Syria, might be enticed to support Islamic State terrorism inside Saudi Arabia’s borders. Saudi Arabia could easily use AQAP as an ally against the Iranian backed Houthi in Yemen. African nations may find it easier to pay off jihadi groups threatening their countries than face persistent destabilizing attacks in their cities. When money becomes scarce, the affiliates of al-Qaida and the Islamic State will have fewer qualms about taking money from their ideological enemies if they share common short-term interests. 

If you want to predict the future direction of the Islamic State and al-Qaida, avoid the flawed assumptions noted above. Instead, I offer these three notes: 

  1. First, look to regional terrorism forecasts illuminating local nuances routinely overlooked in big global assessments of al-Qaida and the Islamic State. Depending on the region, either the Islamic State or al-Qaida may reign supreme and their ascendance will be driven more by local than global forces. 
  2. Second, watch the migration of surviving foreign fighters from the Islamic State’s decline in Iraq and Syria. Their refuge will be our future trouble spot. 
  3. Third, don’t try to anticipate too far into the future. Since bin Laden’s death, the terrorist landscape has become more diffuse, a half dozen affiliates have risen and fallen, and the Arab Spring went from great hope for democracies to protracted quagmires across the Middle East. 

Today’s terrorism picture remains complex, volatile, and muddled. There’s no reason to believe tomorrow’s will be anything different.

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Experts Weigh In (part 3): What is the future of al-Qaida and the Islamic State?


Will McCants: As we continue onwards in the so-called Long War, it’s a good time to reflect on where we are in the fight against al-Qaida and its bête noire, the Islamic State. Both organizations have benefited from the chaos unleashed by the Arab Spring uprisings but they have taken different paths. Will those paths converge again or will the two organizations continue to remain at odds? Who has the best strategy at the moment? And what political changes might happen in the coming year that will reconfigure their rivalry for leadership of the global jihad?

To answer these questions, I’ve asked some of the leading experts on the two organizations to weigh in. First was Barak Mendelsohn, who analyzed the factors that explain the resilience and weaknesses of both groups. Then Clint Watts offered ways to avoid the flawed assumptions that have led to mistaken counterterrorism forecasts in recent years. 

Next up is Charles Lister, a resident fellow at the Middle East Institute, to examine the respective courses each group has charted to date and whether that's likely to change. 


Charles Lister: The world of international jihad has had a turbulent few years, and only now is the dust beginning to settle. The emergence of the Islamic State as an independent transnational jihadi rival to al-Qaida sparked a competitive dynamic. That has heightened the threat of attacks in the West and intensified the need for both movements to demonstrate their value on local battlefields. Having spent trillions of dollars pushing back al-Qaida in Afghanistan and Pakistan and al-Qaida in Iraq, the jihadi threat we face today far eclipses that seen in 2000 and 2001.

As has been the case for some time, al-Qaida is no longer a grand transnational movement, but rather a loose network of semi-independent armed groups dispersed around the world. Although al-Qaida’s central leadership appears to be increasingly cut off from the world, frequently taking many weeks to respond publicly to significant events, its word remains strong within its affiliates. For example, a secret letter from al-Qaida leader Ayman al-Zawahiri to his Syrian affiliate the Nusra Front in early 2015 promptly caused the group to cease plotting attacks abroad.

Seeking rapid and visible results, ISIS worries little about taking the time to win popular acceptance and instead controls territory through force.

While the eruption of the Arab Spring in 2010 challenged al-Qaida’s insistence that only violent jihad can secure political change, the subsequent repression and resulting instability provided an opportunity. What followed was a period of extraordinary strategic review. Beginning with Ansar al-Sharia in Yemen (in 2010 and 2011) and then with al-Qaida in the Islamic Maghreb (AQIM), Ansar al-Din, and the Movement for Unity and Jihad in West Africa (MUJAO) in Mali (2012), al-Qaida began developing a new strategy focused on slowly nurturing unstable and vulnerable societies into hosts for an al-Qaida Islamic state. Although a premature imposition of harsh Shariah norms caused projects in Yemen and Mali to fail, al-Qaida’s activities in Syria and Yemen today look to have perfected the new “long game” approach.

In Syria and Yemen, al-Qaida has taken advantage of weak states suffering from acute socio-political instability in order to embed itself within popular revolutionary movements. Through a consciously managed process of “controlled pragmatism,” al-Qaida has successfully integrated its fighters into broader dynamics that, with additional manipulation, look all but intractable. Through a temporary renunciation of Islamic hudud (fixed punishments in the Quran and Hadith) and an overt insistence on multilateral populist action, al-Qaida has begun socializing entire communities into accepting its role within their revolutionary societies. With durable roots in these operational zones—“safe bases,” as Zawahiri calls them—al-Qaida hopes one day to proclaim durable Islamic emirates as individual components of an eventual caliphate.

Breadth versus depth

The Islamic State (or ISIS), on the other hand, has emerged as al-Qaida’s obstreperous and brutally rebellious younger sibling. Seeking rapid and visible results, ISIS worries little about taking the time to win popular acceptance and instead controls territory through force and psychological intimidation. As a militarily capable and administratively accomplished organization, ISIS has acquired a strong stranglehold over parts of Iraq and Syria—like Raqqa, Deir el-Zour, and Mosul—but its roots are shallow at best elsewhere in both countries. With effective and representative local partners, the U.S.-led coalition can and will eventually take back much of ISIS’s territory, but evidence thus far suggests progress will be slow.

Meanwhile, ISIS has developed invaluable strategic depth elsewhere in the world, through its acquisition of affiliates—or additional “states” for its Caliphate—in Yemen, Libya, Algeria, Egypt, Afghanistan, Pakistan, Nigeria, and Russia. Although it will struggle to expand much beyond its current geographical reach, the growing importance of ISIS in Libya, Egypt, and Afghanistan-Pakistan in particular will allow the movement to survive pressures it faces in Syria and Iraq. 

As that pressure heightens, ISIS will seek to delegate some level of power to its international affiliates, while actively encouraging retaliatory attacks—both centrally directed and more broadly inspired—against high-profile Western targets. Instability breeds opportunity for groups like ISIS, so we should also expect it to exploit the fact that refugee flows from Syria towards Europe in 2016 look set to dramatically eclipse those seen in 2015.

Instability breeds opportunity for groups like ISIS.

Charting a new course?

That the world now faces threats from two major transnational jihadist movements employing discernibly different strategies makes today’s counterterrorism challenge much more difficult. The dramatic expansion of ISIS and its captivation of the world’s media attention has encouraged a U.S.-led obsession with an organization that has minimal roots into conflict-ridden societies. Meanwhile the West has become distracted from its long-time enemy al-Qaida, which has now grown deep roots in places like Syria and Yemen. Al-Qaida has not disappeared, and neither has it been defeated. We continue this policy imbalance at our peril.

In recent discussions with Islamist sources in Syria, I’ve heard that al-Qaida may be further adapting its long-game strategy. The Nusra Front has been engaged in six weeks of on/off secret talks with at least eight moderate Islamist rebel groups, after proposing a grand merger with any interested party in early January. Although talks briefly came to a close in mid-January over the troublesome issue of the Nusra Front’s allegiance to al-Qaida, the group’s leader Abu Mohammed al-Jolani now placed those ties as an issue on the table for negotiation. 

Al-Qaida has not disappeared, and neither has it been defeated.

The fact that this sensitive subject is now reportedly open for discussion is a significant indicator of how far the Nusra Front is willing to stretch its jihadist mores for the sake of integration in Syrian revolutionary dynamics. However, the al-Nusra Front's leader, Abu Mohammed al-Jolani, is a long-time Al-Qaeda loyalist and doesn't fit the profile of someone willing to break a religious oath purely for the sake of an opportunistic power play. It is therefore interesting that this secret debate inside Syria comes amid whispers within Salafi-jihadi and pro-al-Qaida circles that Zawahiri is considering “releasing” his affiliates from their loyalty pledges in order to transform al-Qaida into an organic network of locally-inspired movements—led by and loosely tied together by an overarching strategic idea.

Whether al-Qaida and its affiliates ultimately evolve along this path or not, the threat they pose to local, regional, and international security is clear. When compounded by ISIS’s determination to continue expanding and to conduct more frequent and more deadly attacks abroad, jihadist militancy looks well-placed to pose an ever present danger for many years to come. 

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American attitudes on refugees from the Middle East


Event Information

June 13, 2016
2:00 PM - 3:30 PM EDT

The Brookings Institution
Falk Auditorium
1775 Massachusetts Ave., N.W.
Washington, DC 20036

Register for the Event

On June 13, Brookings launched a new public opinion survey focusing on American attitudes toward refugees from the Middle East and from Syria in particular.



With violence in the Middle East and the associated refugee crisis continuing unabated, these issues remain prominent in Washington policy debates. It is therefore increasingly important for U.S. policymakers, political candidates, and voters to understand the American public’s attitudes toward the conflicts in the Middle East and the refugees fleeing those crises.

On June 13, Brookings launched a new public opinion survey focusing on American attitudes toward refugees from the Middle East and from Syria in particular. Conducted by Nonresident Senior Fellow Shibley Telhami, the poll looks at a range of questions, from whether Americans feel the United States has a moral obligation to take in refugees to whether these refugees pose a threat to national security. The national poll takes into account an expanded set of demographic variables and includes an over-sized sample of millennials.  

Telhami was joined in discussion by POLITICO Magazine and Boston Globe contributor Indira Lakshmanan. William McCants, senior fellow and director of the Project on U.S. Relations with the Islamic World at Brookings, provided introductory remarks and moderated the discussion.

This event launched the Brookings Refugees Forum, which will take place on June 14 and 15.

Join the conversation on Twitter using #RefugeeCrisis.


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Why a Trump presidency could spell big trouble for Taiwan


Presumptive Republican presidential nominee Donald Trump’s idea to withdraw American forces from Asia—letting allies like Japan and South Korea fend for themselves, including possibly by acquiring nuclear weapons—is fundamentally unsound, as I’ve written in a Wall Street Journal op-ed.

Among the many dangers of preemptively pulling American forces out of Japan and South Korea, including an increased risk of war between Japan and China and a serious blow to the Nuclear Non-Proliferation Treaty, such a move would heighten the threat of war between China and Taiwan. The possibility that the United States would dismantle its Asia security framework could unsettle Taiwan enough that it would pursue a nuclear deterrent against China, as it has considered doing in the past—despite China indicating that such an act itself could be a pathway to war. And without bases in Japan, the United States could not as easily deter China from potential military attacks on Taiwan. 

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President Obama’s role in African security and development


Event Information

July 19, 2016
10:00 AM - 11:30 AM EDT

Falk Auditorium
Brookings Institution
1775 Massachusetts Avenue NW
Washington, DC 20036

Register for the Event

Barack Obama’s presidency has witnessed widespread change throughout Africa. His four trips there, spanning seven countries, reflect his belief in the continent’s potential and importance. African countries face many challenges that span issues of trade, investment, and development, as well as security and stability. With President Obama’s second term coming to an end, it is important to begin to reflect on his legacy and how his administration has helped frame the future of Africa.

On July 19, the Center for 21st Century Security and Intelligence at Brookings hosted a discussion on Africa policy. Matthew Carotenuto, professor at St. Lawrence University and author of “Obama and Kenya: Contested Histories and the Politics of Belonging” (Ohio University Press, 2016) discussed his research in the region. He was joined by Sarah Margon, the Washington director of Human Rights Watch. Brookings Senior Fellow Michael O'Hanlon partook in and moderated the discussion.

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Charting a New Course for the World Bank: Three Options for its New President


Since its 50th anniversary in 1994, the World Bank has been led by four presidents: Lewis Preston until his untimely death in 1995; then James Wolfensohn, who gave the institution new energy, purpose and legitimacy; followed by Paul Wolfowitz, whose fractious management tossed the World Bank into deep crisis; and most recently, Robert Zoellick, who will be remembered for having stabilized the bank and provided effective leadership during its remarkably swift and strong response to the global financial crisis.

Throughout these years of ups and downs in the bank’s leadership, standing and lending, the overall trend of its global role was downhill. While it remains one of the world’s largest multilateral development finance institutions, its position relative to other multilateral financing mechanisms is now much less prominent. Other multilateral institutions have taken over key roles. For example, the European Union agencies and the regional development banks have rapidly expanded their portfolios, and new “vertical funds” such as the Global Fund for AIDS, Tuberculosis and Malaria have become major funding vehicles. At the same time, according to a 2011 OECD Development Assistance Committee report multilateral aid has declined as a share of total aid. Meanwhile, non-governmental aid flows have dramatically increased, including those from major foundations like the Bill and Melinda Gates Foundation, but also from new internet-based channels bundling small individual donations, such as Global Giving. The World Bank— which 20 years ago was still the biggest and most powerful global development agency and hence a ready target for criticism— today is just one of the many institutions that offer for development to the poor and emerging market economies.

Against this backdrop, the World Bank, its members and Dr. Kim face three options in its long-term trajectory over the next 10 to 20 years: 1) the bank can continue on its current path of gradual decline; 2) it might be radically scaled back and eventually eliminated, as other aid channels take over; or 3) it can dramatically reinvent itself as a global finance institution that bundles resources for growing global needs.

There is no doubt in this author’s mind that the World Bank should remain a key part of the global governance architecture, but that requires that the new president forge an ambitious long-term vision for the bank – something that has been lacking for the last 30 years – and then reform the institution and build the authorizing environment that will make it possible to achieve the vision.

Option 1: “Business as Usual” = Continued Gradual Decline

The first option, reflecting the business-as-usual approach that characterized most of the Zoellick years of leadership will mean that the bank will gradually continue to lose in scope, funding and relevance. Its scope will be reduced since the emerging market economies find the institution insufficiently responsive to their needs. They have seen the regional development banks take on increasing importance, as reflected in the substantially greater capital increases in recent years for some of these institutions than for the World Bank in relative terms (and in the case of the Asian Development Bank, even in absolute terms). And emerging market economies have set up their own thriving regional development banks without participation of the industrial countries, such as the Caja Andina de Fomento (CAF) in Latin America and the Eurasian Development Bank in the former Soviet Union. This trend will be reinforced with the creation of a “South Bank” or “BRIC Bank”, an initiative that is currently well underway.

At the same time, the World Bank’s soft loan window, the International Development Association (IDA), will face less support from industrial countries going through deep fiscal crises, heightened competition from other concessional funds, and a perception of reduced need, as many of the large and formerly poor developing countries graduate to middle-income status. It is significant that for the last IDA replenishment much of the increase in resources was due to its growing reliance on advance repayments made by some of its members and commitments against future repayments, thus in effect mortgaging its future financial capacity. The World Bank’s status as a knowledge leader in development will also continue to be challenged with the rise of research from developing countries and growing think tank capacity, as well as a proliferation of private and official agencies doling out advice and technical assistance.

As a result, under this option, over the next 10 to 20 years the World Bank will likely become no more than a shadow of the preeminent global institution it once was. It will linger on but will not be able to contribute substantially to address any of the major global financial, economic or social challenges in the future.
 
Option 2: “The Perfect Storm” = Breaking Up the World Bank

In 1998, the U.S. Congress established a commission to review and advise on the role of the international financial institutions. In 2000, the commission, led by Professor Allan Meltzer, released its recommendations, which included far-reaching changes for the International Monetary Fund and the World Bank, most of them designed to reduce the scope and financial capacities of these institutions in line with the conservative leanings of the majority of the commission’s members. For the World Bank, the “Meltzer Report” called for much of its loan business and financial assets to be devolved to the regional development banks, in effect ending the life of the institution as we know it. The report garnered some attention when it was first issued, but did not have much impact in the way the institution was run in the following 10 years.

In 2010, the U.S. Senate Foreign Relations Committee released a report on the international financial institutions, which called on them to aim toward “succeeding in their development and economic missions and thereby putting them out of business”. However, it did not recommend a drastic restructuring of the multilateral development banks, and instead argued strongly against any dilution of the U.S. veto right, its lock on leadership selection, and its voting share at the IMF and World Bank. While not dramatic in its short-term impact, these recommendations were likely a strong factor in the subsequent decisions made by the Obama administration to oppose a substantial increase in contributions by emerging markets during the latest round of capital increase at the World Bank to push for an American to replace Robert Zoellick as World Bank president. These actions reinforced for emerging market countries that the World Bank would not change sufficiently and quickly enough to serve their interests, and thus helped create the momentum for setting up a new “South Bank.”

While there seems to be no imminent risk of a break-up of the World Bank along the lines recommended by the Meltzer Report, the combination of fiscal austerity and conservative governments in key industrial countries, compounded by a declining interest of the emerging market countries in sustaining the institution’s future, could create the perfect storm for the bank. Specifically, as governments face constrained fiscal resources, confront the increasing fragmentation of the multilateral aid architecture, and take steps to consolidate their own aid agencies, they might conclude that it would be more efficient and fiscally prudent to rationalize the international development system. There is a obvious overlap on the ground in the day-to-day business of the World Bank and that of the regional development banks. This is a reality which is being fostered by the growing decentralization of the World Bank into regional hubs; in fact, a recent evaluation by the World Bank’s Independent Evaluation Group concluded that “[r]ather than functioning as a global institution, the bank is at risk of evolving into six regional banks”. With the growing financial strength, institutional capacity and dynamism, and the apparently greater legitimacy of regional development banks among their regional members, shareholders might eventually decide that consolidation of the World Bank’s operations with those of the regional development banks, in favor of the latter, is the preferred approach.

There are lots of reasons to think that this drastic step would be difficult to take politically, financially and administratively, and therefore the inertia common to the international governance architecture will also prevail in this case. However, the new World Bank president would be well advised to be prepared for the possibility of a “perfect storm” under which the idea of eviscerating the World Bank could gain some traction,. The more the bank is seen to fade away, as postulated under Option 1 above, the greater is the likelihood that Option 2 would be given serious consideration.

Option 3: “A Different World Bank” = Creating a Stronger Global Institution for the Coming Decades

Despite all the criticism and the decline in its relative role as a development finance institution in recent decades, the World Bank is still one of the strongest and most effective development institutions in a world. According to a recent independent ranking of the principal multilateral and bilateral aid institutions by the Brookings Institution and the Center for Global Development “IDA consistently ranks among the best aid agencies in each dimension of quality”.

A third, radically different option from the first two, would build on this strength and ensure that the world has an institution 10 to 20 years from now which helps the global community and individual countries to respond effectively to the many global challenges which the world will undoubtedly face: continued poverty, hunger, conflict and fragility, major infrastructure and energy needs, education and health challenges, and global warming and environmental challenges. On top of this, global financial crises will likely recur and require institutions like the World Bank to help countries provide safety nets and the structural foundations of long-term growth, as the bank has amply demonstrated since 2008. With this as a broad mandate, how could the World Bank respond under new dynamic?

First, it would change its organizational and operating modalities to take a leaf out of the book of the vertical funds, which have been so successful in tackling major development challenges in a focused and scaled-up manner. This means substantially rebalancing the internal matrix between the regional and country departments on the one hand and the technical departments on the other hand. According to the same evaluation cited above, the World Bank has tipped too far toward short-term country priorities and has failed to adequately reflect the need for long-term, dedicated sectoral engagement. The World Bank needs to fortify its reputation as an institution that can muster the strongest technical expertise, fielding team with broad global experience and with first rate regional and country perspective. This does not imply that the World Bank would abandon its engagement at the country level, but it means that it would systematically support the pursuit of long-term sectoral and sub-sectoral strategies at the country level, linked to regional and global initiatives, and involving private-public partnership to assure that development challenges are addressed at scale and in a sustained manner.

Second, recognizing that all countries have unmet needs for which they need long-term finance and best practice in areas such as infrastructure, energy, climate change and environment, the World Bank could become a truly global development institution by opening up its funding windows to all countries, not just an arbitrarily defined subset of developing countries. This would require substantially revising the current graduation rules and possibly the financial instruments. This would mean that the World Bank becomes the global equivalent of the European Investment Bank (EIB) and of the German Kreditanstalt fuer Wiederaufbau (KfW)—development banks that have successfully supported the infrastructure development of the more advanced countries.

Third, the World Bank would focus its own knowledge management activities and support for research and development in developing countries much more on a search for effective and scalable solutions, linked closely to its operational engagement which would be specifically designed to support the scaling up of tested innovations, along the lines pioneered by the Bill and Melinda Gates Foundation.

Fourth, for those countries with strong project management capacities, the World Bank would dramatically simplify its lending processes, following the example of the EIB. This would make it a much more efficient operational institution, making it a more attractive partner to its borrowing member countries, especially the emerging market economies.

Fifth, the membership of the World Bank would fix some fundamental problems with its financial structure and governance. It would invite the emerging market economies to make significantly larger contributions to its capital base in line with their much-enhanced economic and financial capacities. It would revamp the bank’s voting and voice rules to reflect the changed global economic weights and financial contributions of emerging markets. The bank would also explore, based on the experience of the vertical funds, tapping the resources of non-official partners, such as foundations and the private sector as part of its capital and contribution base. Of course, this would bring with it further significant changes in the governance of the World Bank. And the bank would move swiftly to a transparent selection of its leadership on the basis of merit without reference to nationality.

Conclusion: The New World Bank President Needs to Work with the G-20 Leaders to Chart a Course Forward
 
The new president will have to make a choice between these three options. Undoubtedly, the easiest choice is “business-as-usual”, perhaps embellished with some marginal changes that reflect the perspective and new insights that an outsider will bring. There is no doubt that the forces of institutional and political inertia tend to prevent dramatic change. However, it is also possible that Dr. Kim, with his background in a relatively narrow sectoral area may recognize the need for a more vertical approach in the bank’s organizational and operational model. Therefore, he may be more inclined than others to explore Option 3.

If he pursues Option 3, Dr. Kim will need a lot of help. The best place to look for help might be the G-20 leadership. One could hope that at least some of the leaders of the G-20 understand that Options 1 and 2 are not in the interest of their countries and the international community. Hopefully, they would be willing to push their peers to contemplate some radical changes in the multilateral development architecture. This might involve the setting up of a high-level commission as recently recommended by this author, which would review the future of the World Bank as part of a broader approach to rationalize the multilateral system in the interest of greater efficiency and effectiveness. But in setting up such a commission, the G-20 should state a clear objective, namely that the World Bank, perhaps the strongest existing global development institution, should not be gutted or gradually starved out of existence. Instead, it needs to be remade into a focused, effective and truly global institution. If Dr. Kim embraces this vision and develops actionable ideas for the commission and the G-20 leaders to consider and support, then he may bring the right medicine for an ailing giant.

Image Source: © Issei Kato / Reuters
     
 
 




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The G-20 Los Cabos Summit 2012: Bolstering the World Economy Amid Growing Fears of Recession


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)

Image Source: Andrea Comas / Reuters
     
 
 




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Implementing the SDGs, the Addis Agenda, and Paris COP21 needs a theory of change to address the “missing middle.” Scaling up is the answer.


So we’ve almost reached the end of the year 2015, which could go down in the history of global sustainable development efforts as one of the more significant years, with the trifecta of the approval of the Sustainable Development Goals (SDGs), the agreement on the Addis Agenda on Financing for Development (FfD) and the (shortly to be completed) Paris COP21 Climate Summit. Yet, all will depend on how the agreements with their ambitious targets are implemented on the ground.

Effective implementation will require a theory of change—a way to think about how we are to get from “here” in 2015 to “there” in 2030. The key problem is what has very appropriately been called by some “the missing middle,” i.e., the gap between the top-down global targets on the one hand and the bottom-up development initiatives, projects, and programs that are supported by governments, aid agencies, foundations, and social entrepreneurs.

One way to begin to close this gap is to aim for scaled-up global efforts in specific areas, as is pledged in the Addis Agenda, including efforts to fight global hunger and malnutrition, international tax cooperation and international cooperation to strengthen capacities of municipalities and other local authorities, investments and international coopera­tion to allow all children to complete free, equitable, inclusive and quality early childhood, primary and secondary education, and concessional and non-concessional financing.

Another way is to develop country-specific national targets and plans consistent with the SDG, Addis, and COP21 targets, as is currently being done with the assistance of the United Nations Development Program’s MAPS program. This can provide broad guidance on policy priorities and resource mobilization strategies to be pursued at the national level and can help national and international actors to prioritize their interventions in areas where a country’s needs are greatest.

However, calling for expanded global efforts in particular priority areas and defining national targets and plans is not enough. Individual development actors have to link their specific projects and programs with the national SDG, Addis, and COP21 targets. They systematically have to pursue a scaling-up strategy in their areas of engagement, i.e., to develop and pursue pathways from individual time-bound interventions to impact at a scale in a way that will help achieve the global and national targets. A recent paper I co-authored with Larry Cooley summarizes two complementary approaches of how one might design and implement such scaling-up pathways. The main point, however, is that only the pursuit of such scaling-up pathways constitutes a meaningful theory of change that offers hope for effective implementation of the new global sustainable development targets.

Fortunately, over the last decade, development analysts and agencies have increasingly focused on the question of how to scale up impact of successful development interventions. Leading the charge, the World Bank in 2004, under its president Jim Wolfensohn, organized a high-level international conference in Shanghai in cooperation with the Chinese authorities on the topic of scaling up development impact and published the associated analytical work. However, with changes in the leadership at the World Bank, the initiative passed to others in the mid-2000s, including the Brookings InstitutionExpandNet (a group of academics working with the World Health Organization), Management Systems International (MSI), and Stanford University. They developed analytical frameworks for systematically assessing scalability of development initiatives and innovations, analyzed the experience with more or less successful scaling-up initiatives, including in fragile and conflict-affected states, and established networks that bring together development experts and practitioners to share knowledge.

By now, many international development agencies (including GIZ, JICA, USAID, African Development Bank, IFAD and UNDP), foundations (including the Bill & Melinda Gates Foundation and Rockefeller Foundation) and leading development NGOs (including Heifer International, Save the Children and the World Resources Institute), among others, have focused on how best to scale up development impact, while the OECD recently introduced a prize for the most successful scaling-up development initiatives. The International Fund for Agricultural Development (IFAD) is perhaps the most advanced among the agencies, having developed a systematic operational approach to the innovation-learning-scaling-up cycle. In a collaborative effort with the Brookings Institution, IFAD reviewed its operational practices and experience and then prepared operational design and evaluation guidelines, which can serve as a good example for other development agencies. The World Bank, while yet to develop a systematic institution-wide approach to the scaling-up agenda, is exploring in specific areas how best to pursue scaled-up impact, such as in the areas of mother and child health, social enterprise innovation, and the “science of delivery.”

Now that the international community has agreed on the SDGs and the Addis Agenda, and is closing in on an agreement in Paris on how to respond to climate change, it is the right time to bridge the “missing middle” by linking the sustainable development and climate targets with effective scaling-up methodologies and practices among the development actors. In practical terms, this requires the following steps:

  • Developing shared definitions, analytical frameworks, and operational approaches to scaling up among development experts;
  • Developing sectoral and sub-sectoral strategies at country level that link short- and medium-term programs and interventions through scaling-up pathways with the longer-term SDG and climate targets;
  • Introducing effective operational policies and practices in the development agencies in country strategies, project design, and monitoring and evaluation;
  • Developing multi-stakeholder partnerships around key development interventions with the shared goal of pursuing well-identified scaling-up pathways focused on the achievement of the SDGs and climate targets;
  • Developing incentive schemes based on the growing experience with “challenge funds” that focus not only on innovation, but also on scaling up, such as the recently established Global Innovation Fund; and
  • Further building up expert and institutional networks to share experience and approaches, such as the Community of Practice on Scaling Up, recently set up by MSI and the Results for Development Institute.
      
 
 




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Web Chat: Climate Change and the Presidential Election

As the nation’s economy continues a slow and difficult recovery, climate change has so far received little attention on the presidential campaign trail. With the world’s carbon footprint soaring and America approaching an energy crossroads, however, the next president will be forced to make critical decisions regarding clean energy and the future of fossil fuels…

       




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US-China trade talks end without a deal: Why both sides feel they have the leverage

       




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Why Bridgegate proves we need fewer hacks, machines, and back room deals, not more


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!

Authors

Image Source: © Andrew Kelly / Reuters
      




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Climate change brings disasters on steroids

Editor’s Note: Nonresident Senior Fellow Jane McAdam says that climate change-related displacement is happening now and band aid solutions to natural disasters are simply not enough. The time is now to be proactive, because the cost of inaction will be much higher. This article was originally published in The Sydney Morning Herald and on smh.com.au.…

      
 
 




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As the venture capital game gets bigger, the Midwest keeps missing out

Those working to accelerate economic growth in the Heartland must face some stark realities. The Great Lakes region continues to export wealth to coastal economies, even as investment leaders try to equalize growth between the coasts and the Heartland. The region sees only a tiny fraction of venture capital (VC) deals, despite producing one quarter…

       




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What do Midwest working-class voters want and need?

If Donald Trump ends up facing off against Joe Biden in 2020, it will be portrayed as a fight for the hearts and souls of white working-class voters in Pennsylvania, Wisconsin, and my home state of Michigan. But what do these workers want and need? The President and his allies on the right offer a…

       




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COVID-19 is turning the Midwest’s long legacy of segregation deadly

The COVID-19 pandemic is unmasking a lot of ugly economic and social truths across the Midwest, especially in my home state of Michigan. The appearance of a good economy in the Midwest following the Great Recession (which hit the region very hard) was a bit of an illusion. Prior to the arrival of the coronavirus,…

       




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American workers’ safety net is broken. The COVID-19 crisis is a chance to fix it.

The COVID-19 pandemic is forcing some major adjustments to many aspects of our daily lives that will likely remain long after the crisis recedes: virtual learning, telework, and fewer hugs and handshakes, just to name a few. But in addition, let’s hope the crisis also drives a permanent overhaul of the nation’s woefully inadequate worker…

       




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The presidential candidates’ views on energy and climate

This election cycle, what will separate Democrats from Republicans on energy policy and their approach to climate change? Republicans tend to be fairly strong supporters of the fossil fuel industry, and to various degrees deny that climate change is occurring. Democratic candidates emphasize the importance of further expanding the share of renewable energy at the…

       




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Brookings experts on the implications of COVID-19 for the Middle East and North Africa

The novel coronavirus was first identified in January 2020, having caused people to become ill in Wuhan, China. Since then, it has rapidly spread across the world, causing widespread fear and uncertainty. At the time of writing, close to 500,000 cases and 20,000 deaths had been confirmed globally; these numbers continue to rise at an…

       




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Are COVID-19 restrictions inflaming religious tensions?

The novel coronavirus that causes the disease known as COVID-19 is sweeping across the Middle East and reigniting religious tensions, as governments tighten the reins on long-held practices in the name of fighting the pandemic. There is no doubt that the restrictions, including the closure of Shia shrines in Iraq and Iran and the cancelation…

       




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Federal fiscal aid to cities and states must be massive and immediate

And why “relief” and “bailout” are two very different things There is a glaring shortfall in the ongoing negotiations between Congress and the White House to design the next emergency relief package to stave off a coronavirus-triggered economic crisis: Relief to close the massive resource gap confronting state and local governments as they tackle safety…

       




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Webinar: COVID-19 and the economy

With more than 1,000 deaths, 3 million and counting unemployed, and no definite end in sight, the coronavirus has upended nearly every aspect of American life. In the last two weeks, the Federal Reserve and Congress scrambled to pass policies to mitigate what will be a very deep recession. Americans across the country are asking—…

       




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How cities and states are responding to COVID-19

As Congress passes multi-trillion dollar support packages in response to the economic and physical shocks of the coronavirus pandemic, what are state and local governments doing to respond? What kinds of economic and other assistance do they need? What will be the enduring impact of this crisis on workers and certain industries? On this episode,…

       




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COVID-19 outbreak highlights critical gaps in school emergency preparedness

The COVID-19 epidemic sweeping the globe has affected millions of students, whose school closures have more often than not caught them, their teachers, and families by surprise. For some, it means missing class altogether, while others are trialing online learning—often facing difficulties with online connections, as well as motivational and psychosocial well-being challenges. These problems…

       




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Poll shows American views on Muslims and the Middle East are deeply polarized

A recent public opinion survey conducted by Brookings non-resident senior fellow Shibley Telhami sparked headlines focused on its conclusion that American views of Muslims and Islam have become favorable. However, the survey offered another important finding that is particularly relevant in this political season: evidence that the cleavages between supporters of Hillary Clinton and Donald Trump, respectively, on Muslims, Islam, and the Israeli-Palestinians peace process are much deeper than on most other issues.

      
 
 




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The Islamic State threat to the Middle East

Politicians and analysts in Europe and the United States understandably focus on the threat the Islamic State poses to the West, and the debate is fierce over whether the group’s recent attacks are a desperate gasp of a declining organization or proof of its growing menace. Such a focus, however, obscures the far greater threat […]

      
 
 




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Campaign 2016: Ideas for reducing poverty and improving economic mobility


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.

Authors

Image Source: © Darren Hauck / Reuters
     
 
 




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Paid leave will be a hot issue in the 2016 campaign


The U.S. is the only advanced country without a paid leave policy, enabling workers to take time off to care for a new baby or other family member. At least two Presidential candidates, Hillary Clinton and Marco Rubio, have been talking about it, making it likely that it will get attention in 2016.

The idea has broad appeal now that most two-parent families and almost all one-parent families struggle with balancing work and family. Polls show that it is favored by 81 percent of the public—94 percent of Democrats, 80 percent of Independents and 65 percent of Republicans. Three states, California, New Jersey, and Rhode Island, have each enacted policies that could become models for other states or for the nation.

Paid leave promotes inclusive growth

Overall, paid leave is good for workers, good for children, and possibly even good for employers because of its role in helping to retain workers. It is also a policy that encourages inclusive growth. Studies of European systems suggest that paid leave increases female labor force participation and that the lack of it in the U.S. may be one reason for the decline in female labor force participation since 2000 and the growing female participation gap between the U.S. and other countries, adversely affecting our absolute and relative growth. The policy would make growth more inclusive because it would disproportionately benefit lower-wage workers.

The devil is in the design

The major issues in designing a paid leave policy are:

  1. Eligibility, and especially the extent of work experience required to qualify (often a year);
  2. the amount of leave allowed (Clinton suggests three months; Rubio four weeks);
  3. the wage replacement rate (often two-thirds of regular wages up to a cap), and
  4. financing.

Legislation proposed by Rep. Rosa DeLauro (D-CT) and Sen. Kirsten Gillibrand (D-NY) calls for a 0.2 percent payroll tax on employers and employees. Most states have made paid leave a part of their temporary disability systems. Senator Rubio proposes to finance it through a new tax credit for employers. 

Getting it right on eligibility, length of leave, and size of benefit

My own view is that a significant period of work experience should be required for eligibility to encourage stable employment before the birth of a child. This would not only encourage work but also insure that the subsidy was an earned benefit and not welfare by another name (but see below on financing).   

Leave periods need to be long enough to enable parents to bond with a child during the child’s first year of life but not so long that they lead to skill depreciation and to parents dropping out of the labor force. Three months seems like a good first step although it is far less generous than what many European countries provide (an average of 14 months across the OECD). That said, the Europeans may have gone too far. While there is little evidence that a leave as long as 6 months would have adverse effects on employment, when Canada extended their leave from six months to a year, the proportion of women returning to work declined.

A replacement rate of two-thirds up to a cap also seems reasonable although a higher replacement rate is one way to encourage more parents to take the leave. Among other things, more generous policies would have positive effects on the health and well-being of children. They might also encourage more fathers to take leave.  

How to pay for it

On financing, social insurance is the appropriate way to share the putative burden between employers and employees and avoid the stigma and unpopularity of social welfare. It would, in essence, change the default for employees (who are otherwise unlikely to save for purposes of taking leave). Some may worry that imposing any new costs on employers will lead to fewer employment opportunities. However, many economists believe that the employer portion of the tax is largely borne by workers in the form of lower wages. Moreover, in a study of 253 employers in California, over 90 percent reported either positive or no negative effects on profitability, turnover, and employee morale. Reductions in turnover, in particular, are noteworthy since turnover is a major expense for most employers. 

Will paid leave cause discrimination against women?

Another worry is discrimination against women. Here there is some cause for concern unless efforts are made to insure that leave is equally available to, and also used by, both men and women. This concern has led some countries to establish a use-it-or-lose-it set aside for fathers. In the province of Quebec, the proportion of fathers taking leave after implementation of such a policy increased from 21 to 75 percent and even after the leave period was over, men continued to share more equally in the care of their children.

Will Congress enact a national paid leave policy in the next few years? That’s doubtful in our current political environment but states may continue to take the lead. In the meantime, it can’t hurt if the major candidates are talking about the issue on the campaign trail.       

     
 
 




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The District’s proposed law shows the wrong way to provide paid leave


The issue of paid leave is heating up in 2016. At least two presidential candidates — Democrat Hillary Clinton and Republican Sen. Marco Rubio (Fla.) — have proposed new federal policies. Several states and large cities have begun providing paid leave to workers when they are ill or have to care for a newborn child or other family member.

This forward movement on paid-leave policy makes sense. The United States is the only advanced country without a paid-leave policy. While some private and public employers already provide paid leave to their workers, the workers least likely to get paid leave are low-wage and low-income workers who need it most. They also cannot afford to take unpaid leave, which the federal government mandates for larger companies.

Paid leave is good for the health and development of children; it supports work, enabling employees to remain attached to the labor force when they must take leave; and it can lower costly worker turnover for employers. Given the economic and social benefits it provides and given that the private market will not generate as much as needed, public policies should ensure that such leave is available to all.

But it is important to do so efficiently, so as not to burden employers with high costs that could lead them to substantially lower wages or create fewer jobs.

States and cities that require employers to provide paid sick days mandate just a small number, usually three to seven days. Family or temporary disability leaves that must be longer are usually financed through small increases in payroll taxes paid by workers and employers, rather than by employer mandates or general revenue.

Policy choices could limit costs while expanding benefits. For instance, states should limit eligibility to workers with experience, such as a year, and it might make sense to increase the benefit with years of accrued service to encourage labor force attachment. Some states provide four to six weeks of family leave, though somewhat larger amounts of time may be warranted, especially for the care of newborns, where three months seems reasonable.

Paid leave need not mean full replacement of existing wages. Replacing two-thirds of weekly earnings up to a set limit is reasonable. The caps and partial wage replacement give workers some incentive to limit their use of paid leave without imposing large financial burdens on those who need it most.

While many states and localities have made sensible choices in these areas, some have not. For instance, the D.C. Council has proposed paid-leave legislation for all but federal workers that violates virtually all of these rules. It would require up to 16 weeks of temporary disability leave and up to 16 weeks of paid family leave; almost all workers would be eligible for coverage, without major experience requirements; and the proposed law would require 100 percent replacement of wages up to $1,000 per week, and 50 percent coverage up to $3,000. It would be financed through a progressive payroll tax on employers only, which would increase to 1 percent for higher-paid employees.

Our analysis suggests that this level of leave would be badly underfunded by the proposed tax, perhaps by as much as two-thirds. Economists believe that payroll taxes on employers are mostly paid through lower worker wages, so the higher taxes needed to fully fund such generous leave would burden workers. The costly policy might cause employers to discriminate against women.

The disruptions and burdens of such lengthy leaves could cause employers to hire fewer workers or shift operations elsewhere over time. This is particularly true here, considering that the D.C. Council already has imposed costly burdens on employers, such as high minimum wages (rising to $11.50 per hour this year), paid sick leave (although smaller amounts than now proposed) and restrictions on screening candidates. The minimum wage in Arlington is $7.25 with no other mandates. Employers will be tempted to move operations across the river or to replace workers with technology wherever possible.

Cities, states and the federal government should provide paid sick and family leave for all workers. But it can and should be done in a fiscally responsible manner that does not place undue burdens on the workers themselves or on their employers.


Editor's note: this piece originally appeared in The Washington Post

Publication: The Washington Post
Image Source: © Charles Platiau / Reuters
     
 
 




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End of life planning: An idea whose time has come?


Far too many people reach their advanced years without planning for how they want their lives to end. The result too often is needless suffering, reduced dignity and autonomy, and agonizing decisions for family members.

Addressing these end-of-life issues is difficult. Most of us don’t want to confront them for ourselves or our family members. And until recently, many people resisted the idea of reimbursing doctors for end-of-life counselling sessions. In 2009, Sarah Palin labelled such sessions as the first step in establishing “death panels.” Although no such thing was contemplated when Representative Earl Blumenauer (D- Oregon) proposed such reimbursement, the majority of the public believed that death panels and euthanasia were just around the corner. Even the Obama Administration subsequently backed away from efforts to allow such reimbursement.

Fortunately, this is now history. In the past year or two the tenor of the debate has shifted toward greater acceptance of the need to deal openly with these issues. At least three developments illustrate the shift.

First, talk of “death panels” has receded, and new regulations, approved in late 2015 to take effect in January of this year, now allow Medicare reimbursement for end of life counselling. The comment period leading up to this decision was, according to most accounts, relatively free of the divisive rhetoric characterizing earlier debates. Both the American Medical Association and the American Hospital Association have signaled their support.

Second, physicians are increasingly recognizing that the objective of extending life must be balanced against the expressed priorities of their patients which often include the quality and not just the length of remaining life. Atal Gwande’s best-selling book, Being Mortal, beautifully illustrates the challenges for both doctors and patients. With well-grounded and persuasive logic, Gwande speaks of the need to de-medicalize death and dying.

The third development is perhaps the most surprising. It is a bold proposal advanced by Governor Jeb Bush before he bowed out of the Presidential race, suggesting that eligibility for Medicare be conditioned on having an advanced directive. His interest in these issues goes back to the time when as governor of Florida he became embroiled in a dispute about the removal of a feeding tube from a comatose Terry Schiavo. Ms. Schiavo’s husband and parents were at odds about what to do, her husband favoring removal and her parents wishing to sustain life. In the end, although the Governor sided with the parents, the courts decided in favor of the husband and allowed her to die. If an advanced directive had existed, the family disagreement along with a long and contentious court battle could have been avoided.

The point of such directives is not to pressure people into choosing one option over another but simply to insure that they consider their own preferences while they are still able. Making this a requirement for receipt of Medicare would almost surely encourage more people to think seriously about the type of care they would like toward the end of life and to talk with both their doctors and their family about these views. However, for many others, it would be a step too far and might reverse the new openness to advanced planning. A softer version nudging Medicare applicants to address these issues might be more acceptable. They would be asked to review several advance directive protocols, to choose one (or substitute their own). If they felt strongly that such planning was inappropriate, they could opt out of the process entirely and still receive their benefits.

Advanced care planning should not be linked only to Medicare. We should encourage people to make these decisions earlier in their lives and provide opportunities for them to revisit their initial decisions. This could be accomplished by implementing a similar nudge-like process for Medicaid recipients and those covered by private insurance.

Right now too few people are well informed about their end-of-life options, have talked to their doctors or their family members, or have created the necessary documents. Only about half of all of those who have reached the age of 60 have an advanced directive such as a living will or a power of attorney specifying their wishes. Individual preferences will naturally vary. Some will want every possible treatment to forestall death even if it comes with some suffering and only a small hope of recovery; others will want to avoid this by being allowed to die sooner or in greater comfort. Research suggests that when given a choice, most people will choose comfort care over extended life.

In the absence of advance planning, the choice of how one dies is often left to doctors, hospitals, and relatives whose wishes may or may not represent the preferences of the individual in their care. For example, most people would prefer to die at home but the majority do not. Physicians are committed to saving lives and relatives often feel guilty about letting a loved one “go.”

The costs of prolonging life when there is little point in doing so can be high. The average Medicare patient in their last year of life costs the government $33,000 with spending in that final year accounting for 25 percent of all Medicare spending. Granted no one knows in advance which year is “their last” so these data exaggerate the savings that better advance planning might yield, but even if it is 10% that represents over $50 billion a year. Dr. Ezekiel Emanuel, an expert in this area, notes that hospice care can reduce costs by 10 to 20 percent for cancer patients but warns that little or no savings have accompanied palliative care for heart failure or emphysema patients, for example. This could reflect the late use of palliative care in such cases or the fact that palliative care is more expensive than assumed.

In the end, Dr. Emanuel concludes, and I heartily agree, that a call for better advance planning should not be based primarily on its potential cost savings but rather on the respect it affords the individual to die in dignity and in accordance with their own preferences.


Editor's note: This piece originally appeared in Inside Sources.

Publication: Inside Sources
     
 
 




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In Daniel Patrick Moynihan Prize speech, Ron Haskins and Isabel Sawhill stress importance of evidence-based policy


Senior Fellows Ron Haskins and Isabel Sawhill are the first joint recipients of the Daniel Patrick Moynihan Prize from the American Academy of Political and Social Science (AAPSS). The prize is awarded each year to a leading policymaker, social scientist, or public intellectual whose career focuses on advancing the public good through social science. It was named after the late senator from New York and renowned sociologist Daniel Patrick Moynihan. The pair accepted the award May 12 at a ceremony in Washington, DC. 

In their joint lecture delivered at the ceremony, Haskins and Sawhill emphasized the importance of evidence-based public policy, highlighting Sawhill’s latest work in her book, Generation Unbound (Brookings, 2014). Watch their entire speech here:

“Marriage is disappearing and more and more babies are born outside marriage,” Sawhill said during the lecture. “Right now, the proportion born outside of marriage is about 40 percent. It’s higher than that among African Americans and lower than that among the well-educated. But it’s no longer an issue that just affects the poor or minority groups.”

Download Sawhill's slides » | Download Ron Haskins' slides »

The power of evidence-based policy is finally being recognized, Haskins added. “One of the prime motivating factors of the current evidence-based movement,” he said, “is the understanding, now widespread, that most social programs either have not been well evaluated or they don’t work.” Haskins continued:

Perhaps the most important social function of social science is to find and test programs that will reduce the nation’s social problems. The exploding movement of evidence-based policy and the many roots the movement is now planting, offer the best chance of fulfilling this vital mission of social science, of achieving, in other words, exactly the outcomes Moynihan had hoped for.

He pointed toward the executive branch, state governments, and non-profits implementing policies that could make substantial progress against the nation’s social problems.

Richard Reeves, a senior fellow at Brookings and co-director, with Haskins, of the Center on Children and Families (CCF), acknowledged Haskins and Sawhill’s “powerful and unique intellectual partnership” and their world-class work on families, poverty, opportunity, evidence, parenting, work, and education.

Haskins and Sawhill were the first to be awarded jointly by the AAPSS, which recognizes their 15-year collaboration at Brookings and the Center on Children and Families, which they established. In addition to their work at CCF, the two co-wrote Creating an Opportunity Society (Brookings 2009) and serve as co-editors of The Future of Children, a policy journal that tackles issues that have an impact on children and families.

Haskins and Sawhill join the ranks of both current and past Brookings scholars who have received the Moynihan Prize, including Alice Rivlin (recipient of the inaugural prize), Rebecca Blank, and William Julius Wilson along with other distinguished scholars and public servants.

Want to learn more about the award’s namesake? Read Governance Studies Senior Fellow and historian Steve Hess’s account of Daniel Patrick Moynihan’s time in the Nixon White House in his book The Professor and the President (Brookings, 2014).

Authors

  • James King
      
 
 




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