Event Information

An American Enterprise Institute-Brookings/USC Schaeffer Initiative Event
 

For most of the last five decades, the most-discussed finding by the Medicare trustees has been the insolvency date, when Medicare’s trust fund would no longer be able to pay all of the program’s costs. Last year’s report projected that the hospital insurance trust fund would be depleted by 2030 – just 14 years from now. The report also predicted a more immediate and controversial event: the Independent Payment Advisory Board (IPAB), famously nicknamed “death panels,” would be required to submit proposals to reduce Medicare spending in 2018, with the reductions taking place in 2019. Do we remain on this path to automatic Medicare cuts next year?

The American Enterprise Institute and the Schaeffer Initiative for Innovation in Health Policy, a collaboration between the USC Leonard D. Schaeffer Center for Health Policy & Economics and the Brookings Institution, hosted a discussion of the new 2016 trustees report on June 23. Medicare’s Chief Actuary Paul Spitalnic summarized the key findings followed by a panel of experts who discussed the potential consequences of the report for policy actions that might be taken to improve the program’s fiscal condition. You can join the conversation at #MedicareReport.

Video

• Introduction and keynote address
• Panel discussion

Audio

• The 2016 Medicare Trustees Report: One year closer to IPAB cuts?

Event Materials

• AEI TR16 final
• 20160623_medicaretrusteesreport_transcript

Last October, 200 students from Colombia's Servicio Nacional de Aprendizaje (SENA) worked the floor of the campus coliseum at Universidad del Norte in Barranquilla. They were among 900 youth volunteer leaders from nearly 40 nations who had traveled the globe to join the second World Summit for Youth Volunteering, convened by Partners of the Americas and the International Association for Volunteer Effort (IAVE) on the 10th anniversary of the United Nations International Year of Volunteers.

As a developing country, Colombia’s increased civil society participation through volunteering is focused on extending poverty-reduction efforts to levels that the government cannot achieve on its own. Volunteers represent a powerful demographic for a new "service generation" by providing a dual benefit. First, volunteering provides critical services in areas such as education and asset development, which are needed to reduce extreme poverty; second, it connects a new generation with like-minded individuals across the world, which provides young people the professional and leadership skills needed to further access to employment opportunities including entrepreneurship.

For SENA, one of the world's largest educational institutions with more than four million students across Colombia, the opportunity was clear: engage talented and often under resourced youth in Colombia — one of the most economically unequal countries in the world– with innovative global volunteer leaders. According to research from Brookings and the Center for Social Development at Washington University, these types of global volunteering connections have the potential to enhance skills development while increasing social capital networks.

Extreme poverty, along with armed conflict, is one of the highest priorities of the Colombian government. Coincidentally, during the same week as the World Summit, the Colombian armed forces eliminated the Revolutionary Armed Forces of Colombia (FARC) leader Alfonso Cano while President Santos created a new national superagency to combat extreme poverty. The strategic focus on poverty reduction includes a strong role for civil society as a partner with the government in meeting the U.N. Millennium Development Goals and other development commitments. Civil society plays an essential role in overcoming internal conflict. And the youth services generation is among some of the most effective in civil society in working to help their country tackle poverty.

Colombia is certainly not the only country where youth have taken the lead through service to combat poverty. Attendees at the summit heard from Australian humanitarian Hugh Evans, who at 14 began his work to create the Global Poverty Project. In 2006, Evans became one of the pivotal leaders behind the successful Make Poverty History campaign, leading a team across Australia to lobby the country’s government to increase its foreign aid commitment to 0.7 percent of gross national income.

Whether or not SENA’s youth will be able to capitalize on their new connections with global service leaders to combat extreme poverty in Colombia is left to be seen. But the SENA volunteers and their international counterparts are more motivated to do so after gaining access to resources and social capital networks with other inspiring young leaders. That is a cause for celebration as the United Nations releases its State of the World Volunteering report in New York in December at a special session of the U.N. General Assembly.

Jennifer S. Vey, a fellow with the Centennial Scholar Initiative, discusses the current economic, social, and political situation in Baltimore a year after the riots.

“1/5 people in Baltimore lives in a neighborhood of extreme poverty, and yet these communities are located in a relatively affluent metro area, in a city with many vibrant and growing neighborhoods,” Vey says. In this podcast, Vey describes the current state of Baltimore and urges the start of discussions about the abject poverty facing many cities in the United States.

Also in this episode: stay tuned for our presidential election update with John Hudak. Also, Vanda Felbab-Brown discusses global drug policy and the upcoming United Nations General Assembly special session on drug policy.

Show Notes

"The Third Rail"

One year after: Observations on the rise of innovation districts

Confronting Suburban Poverty in America

Subscribe to the Brookings Cafeteria on iTunes, listen in all the usual places, and send feedback email to BCP@Brookings.edu.

Editors’ Note: How do states manage their armed forces, domestic politics, and foreign affairs? Stephen Cohen, senior fellow with the India Project at Brookings, has studied this and a range of other issues in Southeast Asia since the 1960s. In a new book, titled “The South Asia Papers: A Critical Anthology of Writings,” Cohen reflects on more than a half-century of scholarship on India, describing the dramatic changes he has personally witnessed in the field of research. The following is an excerpt from the book’s preface.

[In the 1960s, questions about how states manage their armed forces] were not only unasked in the South Asian context by scholars; they were also frowned on by the Indian government. This made preparation both interesting and difficult. It was interesting because a burgeoning literature on civil–military relations in non-Western states could be applied to India. Most of it dealt with two themes: the “man on horseback,” or how the military came to power in a large number of new states, and how the military could assist in the developmental process. No one had asked these questions of India, although the first was relevant to Pakistan, then still governed by the Pakistani army in the form of Field Marshal Ayub Khan.

***

During my first and second trips [in the 1960s] my research was as a historian, albeit one interested in the army’s social, cultural, and policy dimensions. I discovered, by accident, that this was part of the movement toward the “new military history.” Over the years I have thus interacted with those historians who were interested in Indian military history, including several of my own students. 

While the standard of historians in India was high in places like the University of Calcutta, military history was a minor field, just as it was in the West. Military historians are often dismissed as the “drums and trumpets” crowd, interested in battles, regiments, and hardware, but not much else. My own self-tutoring in military history uncovered something quite different: a number of scholars, especially sociologists, had written on the social and cultural impact of armed forces, a literature largely ignored by the historians. While none of this group was interested in India, the connection between one of the world’s most complicated and subtle societies, the state’s use of force, and the emergence of a democratic India was self-evident. 

***

A new generation of scholars and experts, many of them Indians (some trained in the United States) and Indian Americans who have done research in India, have it right: this is a complex civilizational-state with expanding power, and its rise is dependent on its domestic stability, its policies toward neighbors (notably Pakistan), the rise of China, and the policies of the United States. 

The literature that predicts a conflict between the rising powers (India and China), and between them and America the “hegemon,” is misguided: the existence of nuclear weapons by all three states, plus Pakistan, ensures that barring insanity, any rivalries between rising and established states will be channeled into “ordinary” diplomatic posturing, ruthless economic competition, and the clash of soft power. In this competition, India has some liabilities and many advantages, and the structure of the emerging world suggests a closer relationship between the United States and India, without ruling out much closer ties between China and India. 

There remain some questions: Can the present Indian leadership show magnanimity in dealing with Pakistan, and does it have the foresight to look ahead to new challenges, notably environmental and energy issues that require new skills and new international arrangements? Importantly, some of the best work on answering these questions is being done in India itself, and the work of Kanti Bajpai, Amitabh Mattoo, Harsh Pant, C. Raja Mohan, Rajesh Basrur, and others reveals the maturity of Indian thinking on strategic issues. It has not come too soon, as the challenges that India will face are growing, and those of Pakistan are even more daunting.

Publish What You Fund’s 2016 Aid Transparency Index is out. And as a result, today we can assess whether major donors met the commitments they made five years ago at Busan to make aid transparent by the end of 2015. The index is also a window into the state of foreign aid transparency and how the U.S.—the world’s largest bilateral donor—stacks up.

On the positive side, the index found that ten donors of varied types and sizes, accounting for 25 percent of total aid, have met the commitment to aid transparency. And more than half of the 46 organizations included in the 2016 index now publish data to the International Aid Transparency Initiative (IATI) registry at least quarterly.

At the same time, the index’s assessments show more than half of the organizations still fall into the lowest three categories, scoring below 60 percent in terms of the transparency of their information.

Continuing its leadership on transparency, the Millennium Challenge Corporation comes in second overall in the index, meeting its Busan commitment and once again demonstrating that the institutional commitment to publishing and using its data continues.

Otherwise, at first glance, U.S. progress seems disappointing. The five other U.S. donors included in the 2016 index are all in the “fair” category. Seen through a five-year lens, however, these same five U.S. donors were either in the “poor” or “very poor” categories in the 2011 index. So, all agencies have moved up, and three of them—U.S. Agency for International Development (USAID), Department of the Treasury, and the U.S. President's Emergency Plan for AIDS Relief—are on the cusp of “good.”

In the two biggest U.S. agencies that administer foreign assistance, USAID and the State Department, the commitment is being institutionalized and implemented through more systematic efforts to revamp their outdated information systems. Both have reviewed the gaps in their data reporting systems and developed a path forward. USAID’s Cost Management Plan identifies specific steps to be taken and is well under way. The State Department Foreign Assistance Data Review (FADR) involves further reviews that need to be executed promptly in order to lead to action. Both are signs of a heightened commitment to data transparency and both require continued agency leadership and staff implementation.

The Department of Defense, which slid backwards in the last three assessments (and began at the "very poor" category in 2011), has for the first time moved into the "fair" category.  It is still the lowest performing U.S. agency in the index, but it is now publishing 12 new IATI fields. It is moving in the right direction, but significant work remains to be done.

The third U.S. National Action Plan (NAP) announced last fall—the strongest issued by the U.S. to date—calls for improvements to quality and comprehensiveness of U.S. data and commits the U.S. to doing more to raise awareness, accessibility, and demand for foreign assistance data. This gives all U.S. agencies the imperative to do much more to make their aid information transparent and usable.  

The overall challenge has been laid out in the third NAP:

• Almost all of the U.S. agencies need to improve the breadth and depth of the information they are publishing to meet IATI standards. Far too often, basic information—such as titles—are either not published or are not useful.
• The Millennium Challenge Corporation should continue its leadership role, especially on data use. All agencies should be promoting the use of data among their own staff and by external stakeholders, especially at country level. Feedback will go a long way toward helping them improve the quality of the data they are publishing and thereby help them meet the IATI standards.
• USAID must finish the work on its Cost Management Plan, including putting IATI in the planned Development Information Solution. Additionally, more progress needs to be made on the follow-up to the Aid Transparency Country Pilot Assessment to meet the needs of partners.   
• The State Department needs to follow through on including IATI in the new integrated solution mapped out in its data review.

The leadership of all foreign affairs agencies needs to work harder to make the business case for compiling, publishing, and using data on foreign aid programs. Open data, particularly when it is comparable, timely, accessible, and comprehensive, is an extremely valuable management asset.  Agency leadership should be its champion. So far, we have not seen enough.

U.S. progress on aid transparency was slow to start. It is still not where it needs to be. But with a modest but concerted push, three additional agencies will be in the “good” category and that is a story we can start to be proud of.   

We look forward to continued progress and to the day when all U.S. foreign aid meets transparency standards—a day I believe will be an important one for the cause of greater development, better governance, democratic participation, and reduced poverty worldwide.

Spring has sprung and once again Publish What You Fund has issued its Aid Transparency Index (ATI). Once again most of the multilateral development banks (MDBs) receive high grades rated as very good. And once again I ask whether those grades are well deserved? At the heart of my question is whether aid agencies are disclosing sufficient information during the critical implementation stage of a project.

Last year we reviewed the practices of 8 aid agencies, 7 of which consistently receive the highest accolades in the ATI. What was evident from our review was the serious asymmetry of the type of aid data released to the public. A major target at Busan in 2011 when donors made commitments to aid transparency and in the establishment of the ATI has been the reporting of aid flows and the projects approved by each agency. There has been growing emphasis since then on reporting information on the results of those projects. But there has been very limited progress in the release of information during project implementation.

The importance of such information should be obvious. It is during project implementation that the various stakeholders need to monitor project progress, report on issues requiring attention, and make changes to ensure achievement of the desired results. It is insufficient to only disclose who wins a contract; consideration should be given to publishing the contracts, reporting on its execution, and disclosing amendments to the contracts. And it is not enough to simply publish the resettlement action plan for a project; how that plan is being implemented must be reported. Real time reporting is the key to being able to adapt and make changes as projects evolve.

It is very evident that the International Aid Transparency Initiative (IATI) and the ATI have had a major positive impact on raising the level of transparency of aid agencies. Discussions with various agencies illustrate how they are keen to getting higher scores each year, carefully analyzing the indicators to guide their actions. However, with only a limited focus and weighting of reporting on project implementation in the ATI, there is no incentive to fill this important gap. 

In its 2016 report, Publish What You Fund has indicated that it will be reviewing its indicators later this year and intends to raise the bar. It would be timely to include information on project implementation in those revisions. One challenge is how to develop indicators that are similarly relevant across a wide variety of aid agencies. Implementation information is most critical for agencies that finance longer-term projects, especially infrastructure, such as the MDBs.  One option is to consider a set of indicators to better “incentivize” the relevant agencies and refer to these as ATI+.

The MDB’s, in their major disclosure reforms since 2010, adopted a principle that “deliberative” information would not be disclosed in order to foster candid and open dialogue within the organization and between the organization and the client country. As per the World Bank’s policy, “The Bank, like any institution or group, needs space to consider and debate, away from public scrutiny.” This excludes emails, notes, and other exchanges either internally or with member countries.

As a result, the project supervision reports, which managements use to monitor projects under execution and are generally published twice a year, were divided between disclosed versus undisclosed sections. The undisclosed sections would offer space for reporting on confidential project concerns including potential corruption. Our review of the disclosed reports suggests that most aid agencies’ task managers tend to take a cautious approach, placing most information in the undisclosed sections. Stakeholders outside the MDB, such as local civil society groups, then, often only see truncated information.

While the adoption of the “deliberative” principle is understandable, its application places a serious responsibility on management to ensure that this is applied with considerable restraint. The MDBs should review the application of this principle and assess the type of information released during implementation.

It is indeed time to raise the bar on transparency and to focus on the most critical information required to ensure results. This is not the moment for complacency with high grades.

How has the Joint Comprehensive Plan of Action (JCPOA)—signed between the P5+1 and Iran one year ago—played out in practice? Several Brookings scholars, many of whom participated prominently in debates last year surrounding official congressional review, offered their views.

Borders and fences, amnesty and enforcement, earned legalization and guest workers—such is the shorthand in debating immigration today.

Yet, we talk little about refugees.

It may be because refugees comprise only about 10 percent of annual immigration to America. It may also be because their entry to the United States is rarely debated. Accommodating refugees represents the best ideals of this nation.

Fleeing war, famine, religious or ethnic persecution, and, in some cases, former American foreign-policy engagement, refugees are the epitome of Emma Lazarus' words, engraved on the Statue of Liberty, of the "tired, poor, and huddled masses yearning to be free."

A replica of said statue is set to be returned to its place on the beach at Alki this spring. And it's appropriate, as the Puget Sound region increasingly accommodates many fleeing the worst life has to offer.

From 1983 to 2004, the Seattle region ranked No. 5 nationally in the resettlement of refugees, behind the big immigrant gateways of New York, Los Angeles and Orange County in California, and Chicago. However, Seattle's total foreign-born ranking is only 23rd, as refugees there comprise much more of the immigrant population than most other places around the country.

The region's refugee population is probably more important to the growth of the region than in other places. And it has been growing over the past 20 years.

Of the some 50,000 refugees resettled in Seattle over that period, fully one-third are from Southeast Asia—including Vietnam, Cambodia and Laos—and 42 percent come from the remnants of the USSR.

Other sizable populations come from the former Yugoslavia, Somalia and Ethiopia.

Metropolitan Seattle—along with Minneapolis-St. Paul, Atlanta, Sacramento and Portland—has progressively resettled more refugees over time.

Now, one in five U.S. refugees is initially placed in one of these metropolitan areas, up from only 9 percent in the 1980s and 13 percent in the 1990s.

And these refugees are different than in the past.

Because of changes in the conflicts beleaguering our planet, refugees admitted to the United States in recent years increasingly hail from African countries confronting civil conflict.

Like earlier waves, these newest refugees are determined to pursue, but unprepared for, life and work in the United States and need assistance as they settle into new communities and become active members of local schools, workplaces and neighborhoods.

Like other foreign-born migrants, Seattle's refugees have been quickly plugging into the economic life of the region, from the bustling International District downtown to the polyglot scene that is the Crossroads Mall in Bellevue.

Seattle's healthy local labor market has helped foster their adjustment as many refugees have found foothold jobs in hotels, restaurants, shops, health services, food production and preparation. Perhaps not long term, but these jobs are key steps on the road to economic independence and upward mobility. In any event, they are a far cry from the situations refugees left behind.

Local service agencies and assistance organizations, religious and ethnically based, play a strong role in the resettlement process.

These groups do the local work of connecting refugees to employers, housing, health care and language training and otherwise aid their progress toward self-sufficiency. And they are careful to do it in a linguistically and culturally appropriate way.

And other partners exist.

The Seattle Police Department reaches out to refugee and immigrant communities to deal with the potential downfalls of being a stranger in a strange land, specifically addressing gang and drug problems and launching efforts to prevent violence against refugees and immigrants.

The state Office of the Superintendent of Public Instruction has a multiyear program to target schools with large numbers of immigrant and refugee families that aims to improve schooling outcomes for high-school students and increase graduation rates. Involving parents is key to that success, as is the specialized training that tutors receive.

Programs like these—involving few tax dollars but reaping considerable economic rewards for all the region—are in the best interest of Seattle's residents, whether they are refugee newcomers or families that have lived in the region for generations.

Though Seattle fights about highways and stadiums, transit and buses, the entire Puget Sound should proclaim itself in the vanguard on this issue, a beacon, like the statue, of what is right.

Event Information

To build on its longstanding interest in the evolving transatlantic relationship and to address the serious differences that have emerged between America and Europe after the September 11 terrorist attacks and throughout the ongoing war on terrorism, Brookings announces the launch of its new Center on the United States and Europe. The center offers a forum for research, high-level dialogue, and public debate on issues affecting U.S.-Europe relations.

At the inaugural conference to launch the new center, experts discussed the theme "The United States and Europe: One Year after the War in Iraq." Panelists at this special event included Javier Solana, Robert Kagan, Charles Grant, Klaus Scharioth, Andrew Moravcsik, Martin Indyk, Ulrike Guerot, Pascale Andreani, Cesare Merlini, Reuel Marc Gerecht, Gilles Andreani and others.

Transcript

• Transcript (.pdf)

Event Materials

• cuse20040421