Although advancements in medical science have greatly improved overall life expectancy and the ability for many to survive a cancer diagnosis, a recent study predicts that cancer care alone will cost the American health system $157 billion by 2020. It is well known that a major driver of these surmounting costs is the rising cost of chemotherapy and other treatments, in addition to the variation in how these treatments are used across the health care system.  However, there are several ways that providers, payers, and patients can work together to establish a more medically and financially effective cancer care model that also reduce costs and inefficiencies in the system.

Figure 1: Estimates of the national expenditures for cancer care in 2010 and estimated increase in cost in 2020

Source: Journal of the National Cancer Institute

Develop “Clinical Pathways” to Reduce Inappropriate Use
For many cancers, there are multiple drugs that can be equally effective in treating a patient’s condition, but the price of these treatments can differ in cost by tens of thousands of dollars. Currently, oncologists are responsible for purchasing their own chemotherapy drugs, processing and maintaining them in a specialized pharmacy-like set up, and then administering them to their patients. Insurers then reimburse the oncologists for the cost of the drugs plus a margin to defray the price of maintenance and administration. Since oncologists receive a share of their income from the margins on the drugs they prescribe, insurers assert that there is an incentive to prescribe the pricier drugs, even when lower cost options of equal effectiveness exist.

One mechanism for ensuring that the most evidence-based treatment is used in the care of cancer patients is to use a set of “clinical pathways.” These pathways are based on clinical guidelines available to the public, but tailored for a particular set of patients or a type of oncology practice. Many professional societies have contributed to these guidelines and are working on developing more advanced tools to manage a patient’s care. The American Society of Clinical Oncology (ASCO) is developing a system to rate drugs for advanced cancer based on a combination of benefit, side effects and price.

Several health plans and providers are already showing results. A Pennsylvania-based collaboration with the University of Pittsburgh Medical Center and commercial payers achieved savings of more than $1 million in only six months by controlling and reducing the use of Avastin through clinical pathways. A Washington-based health plan also achieved $1 million in cost savings through a partnership with 22 medical oncologists.[i] Most recently, one of the nation’s largest health plans announced a new clinical pathways program that provides oncologists with $350 per patient per month (PMPM) for adhering to specific chemotherapy regimens. The program will be rolled out in July across six states with potential for expansion after its first year.

Develop Appropriate Value-Based Incentives that Improve Care and Reduce Costs
It will also be essential to develop alternative payment models that move away from a volume-based fee-for-service model that only pay oncology practices for traditional face-to-face office visits and parenteral medications. Instead, payers should support the transition to value-based models that reward non-traditional care, such as telephone and e-mail clinician support, patient education, and counseling services with a social worker.

ASCO also released a comprehensive payment reform proposal to transition to an episode-based payment system. The proposal outlines five types of flexible, bundled payments built around (1) taking on new patients; (2) providing treatment during a given month; (3) actively monitoring patients when they are not being actively treated; (4) the progression or recurrence of a patient’s disease that requires significant treatment regimen changes; and (5) a patient’s participation in a clinical trial. Additional recommendations include adding penalties or bonuses of up to 10 percent based on the quality of care provided, and complementing other payment reforms such as primary care medical homes and accountable care organizations (ACOs). A number of potential methods of reforming the oncology payment system have been explored elsewhere, including implementation of the Community Oncology Alliance (COA) Oncology Medical Home.

Replicate value-based models across the private and public sectors. Even with momentum from private insurers, comprehensive change must involve the public sector. When Medicare, the largest health insurer in the country, changes policies, many commercial insurance companies follow suit. Cancer care would be an ideal arena to launch a program like Medicare’s Comprehensive Primary Care Initiative, a multi-payer public sector-private sector collaboration to strengthen primary care.

In many ways, insurers’ decisions to take direct action to minimize variations in care and excessive costs sets the stage for what is to come next in health care reform. Not only does this represent a step toward broad payment reform in oncology, but marks a trend toward exploring new methods of payment in other specialties, and to align those efforts with primary care payment reforms.

To learn more about the Engelberg Center's efforts to reform payment in the field of oncology, join us on July 9th from 10:30 AM to 12:30 PM EST for MEDTalk: Reinventing Patient-Centered Cancer Care.

      

       

Editor’s Note: The National Perspectives on Global Leadership (NPGL) project reports on public perceptions of national leaders’ performance at important international events. This fifth installation of the NPGL Soundings provides insight on the issues facing leaders at the Seoul G-20 Summit and the coverage they received in their respective national media. Read the other commentary »

The week before the Seoul G-20 Summit was one in which the main newspapers read in Washington (The New York Times, The Washington Post and Financial Times) all focused their primary attention on the “currency war,” global imbalances, the debate on quantitative easing (QE 2), the struggle over whether there would be numerate current account targets or only words, and the US-China relationship. As early as Wednesday, November 10, The Washington Post front-page headline read: “Fed move at home trails U.S. to Seoul; Backlash from Europe; Obstacles emerge for key goals at G-20 economic summit.” By Thursday, November 11, things had gotten worse. “Deep fractures hit hopes of breakthrough; governments are unlikely to agree on a strategy to tackle economic imbalances” read the Financial Times headline on Alan Beattie’s article from Seoul. Friday, November 12, The New York Times front-page headline declared: “Obama’s Economic View is Rejected on World Stage; China, Britain and Germany Challenge U.S.; Trade Talks with Seoul Fail, Too.” By Saturday, the Financial Times concluded in its lead editorial: “G-20 show how not to run the world.”

From these reports, headlines and editorials it is clear that conflicts over policy once again dwarfed the progress on other issues and the geopolitical jockeying over the currency and imbalances issues took centre stage, weakening G-20 summits rather than strengthening them. Obama was painted as losing ground, supposedly reflecting lessening U.S. influence and failing to deliver concrete results. China, Germany and Brazil were seen to beat back the U.S. initiative to quantify targets on external imbalances. Given the effort that Korean leaders had put into achieving positive results and “consolidating” G-20 summits, it was, from this optical vantage point, disappointing, to say the least.

How was the Rebalancing Issue Dealt With?

At lower levels of visibility and intensity, however, things looked a bit different and more positive. Howard Schneider and Scott Wilson in Saturday’s edition of The Washington Post (November 13) gave a more balanced view of the outcomes. Their headline read: “G-20 nations agree to agree; Pledge to heed common rules; but economic standards have yet to be set.” They discerned progress toward new terrain that went beyond the agreement among G-20 finance ministers in October at Gyeongju, which other writers missed.

“By agreeing to set economic standards, the G-20 leaders moved into uncharted waters,” they wrote. “The deal rests on the premise that countries will take steps, possibly against their own short-term interests, if their economic policies are at odds with the wider well-being of the world economy. And leaders are committing to take such steps even before there’s an agreement on what criteria would be used to evaluate their policies.”

They continued: “In most general of terms, the statement adopted by the G-20 countries says that if the eventual guidelines identify a problem, this would ‘warrant an assessment of their nature and the root causes’ and should push countries to ‘preventive and corrective actions.’”

The Schneider-Wilson rendering went beyond the words of the communiqué to an understanding of what was going on in official channels over time to push this agenda forward in real policy, rather than declarative terms. As the Saturday, November 13, Financial Times’ editorial put it, “below the headline issues, however, the G-20 grouping is not completely impotent,” listing a number of other issues on which progress was made including International Monetary Fund (IMF) reform which the Financial Times thought might actually feed back into a stronger capacity to deal with “managing the global macroeconomy.”

The Role of President Barack Obama

Without doubt, the easy, simple, big-picture message coming out of Seoul was that Obama and the United States took a drubbing. And this did not help the G-20 either. The seeming inability of the U.S. to lead the other G-20 leaders toward an agreement in Seoul on global imbalances, the criticism of U.S. monetary easing and then, on top of it all, the inability to consummate a US-Korea trade deal, made it seem as if Obama went down swinging.

But again, below the surface of the simple, one got a different picture. Obama himself did not seem shaken or isolated at the Seoul summit by the swirl of forces around him. At his press conference, he spoke clearly and convincingly of the complexity of the task of policy coordination and the time it would take to work out the policies and the politics of adjustment.

“Naturally there’s an instinct to focus on the disagreements, otherwise these summits might not be very exciting,” he said. “In each of these successive summits we’ve made real progress,” he concluded. Tom Gjeltin, from NPR news, on the Gwen Ifyl Weekly News Roundup commented Saturday evening that the G-20 summits are different and that there is a “new pattern of leadership” emerging that is not quite there yet. Obama seems more aware of that and the time it takes for new leadership and new patterns of mutual adjustment to emerge. He may have taken a short-run hit, but he seems to have the vision it takes to connect this moment to the long-run trajectory.

Reflections on the Role of South Korea

From a U.S. vantage point, Seoul was one more stop in Asia as the president moved from India to Indonesia to Korea to Japan. It stood out, perhaps, in higher profile more as the locus of the most downbeat moments in the Asia tour, because of the combination of the apparent lack of decisive progress at the G-20 along with the needless circumstance of two presidents failing to find a path forward on something they both wanted.

From a Korean vantage point, the summit itself was an event of immense importance for Korea’s emergence on the world stage as an industrial democracy that had engineered a massive social and economic transformation in the last 50 years, culminating in being the first non-G8 country to chair the G-20 summit. No one can fault Korea’s efforts to reach significant results. However, the fact is that the Seoul Summit’s achievements, which even in the rebalancing arena were more significant than they appeared to most (see Schneider and Wilson), but included substantial progress on financial regulatory reform, international institutional reform (specifically on the IMF), on development and on global financial safety nets, were seen to be less than hoped for. This was not the legacy the Koreans were looking for, unfortunately.

Conflicts among the major players on what came to be seen as the major issue all but wiped out the serious workmanlike progress in policy channels. The leaders level interactions at G-20 summits has yet to catch up to the highly significant degree of systemic institutionalization of the policy process of the G-20 among ministers of finance, presidents of central banks, G-20 deputies and Sherpas, where the policy work really goes on. On its watch, Korea moved the agenda in the policy track forward in a myriad of significant ways. It will be left to the French and French President Nicolas Sarkozy to see if they can bring the leaders into the positive-sum game arrangements that are going on in the policy channels and raise the game level of leaders to that of G-20 senior officials.

      

       

       

       

       

       

Americans who use defined contribution retirement savings plans (for example, 401(k) or 403(b) plans) or Individual Retirement Accounts will see their retirement security enhanced by two recently announced regulatory initiatives. The first is a series of Treasury Department/IRS proposed regulations that such individuals to use annuity-like guaranteed lifetime income products. The second is a final Department of Labor rule requiring complete fee disclosure to employers sponsoring retirement saving plans. Together, the two initiatives will give current retirement savers and future retirees more flexibility in structuring their retirement incomes, while making it possible to avoid excessive or hidden fees.

Four Treasury/IRS proposals, which were developed under the leadership of our former RSP colleague Mark Iwry, deal with several of the most pressing issues faced by employers and savers that currently reduce the use of annuities. The first proposal would reduce barriers to giving retiring savers the option of annuitizing part of their account balances. Currently, people need to annuitize either the entire balance or none at all. People are naturally wary of annuitizing the entire amount because it leaves them with little in the way of a cash cushion for emergencies. By choosing to annuitize part of the balance, people can retain a lump sum for emergency or other purposes.

A second proposal would remove a technical impediment to using longevity annuities, an annuity that is typically purchased close to retirement but does not begin to pay benefit until the retiree reaches age 85 or a similar age. Longevity annuities enable retirees to manage their money for a set period of time, secure in the knowledge that the longevity annuity will provide income after that, should they live longer than expected.

The third proposal would allow an individual to begin to partially annuitize their savings well before retirement. Starting to annuitize early by buying small pieces of an annuity over twenty or so years allows the saver to avoid having to make a “once and for all” decision and allows the savers to spread out the interest rate risk over time. This option had been subject to a requirement that the saver get a notarized statement from his or her spouse (if any) concerning whether the annuity covers just the saver or both the saver and his or her spouse. The proposal allows this to be handled by the issuing insurer when payments would begin rather than when purchases begin.

The fourth proposal would apply to relatively rare case where the employer has both a retirement savings plan and a traditional defined benefit pension, and would allow an employee to buy a low-cost annuity through the employer’s DB pension.

These four regulatory changes are positive developments. The changes announced today eliminate unintentional barriers to the use of lifetime income products without dictating how individuals should use them. Some may choose to partially annuitize at retirement, some to use longevity annuities to protect them in later years, and some to begin to buy annuities well before retirement. Whatever the choice, the proposals open up new options to future retirees, and should encourage even more market innovations.

At about the same time, the Department of Labor released final regulations requiring providers to disclose all direct and indirect fees to the employer sponsoring a 401(k) plan. The regulations will add needed transparency on fees that will enable increased competition to produce better results for employers and employees.

Despite removing a required template of charges, the new regulations nevertheless give employers a complete and accurate picture of all charges they have to pay, including indirect fees paid by the provider to others. Currently, many indirect fees are not disclosed even though they may reduce the earnings of participants. Endorsed by industry and consumer groups, the disclosures will enable employers who use this information properly to meet their fiduciary responsibility to choose a responsible fee level. What is even more important, the full disclosure will enable employers to structure their 401(k) plan so that individual savers can get the best returns possible, and not be subject to unreasonable fees.

While much more remains to be done to improve retirement savings plan, the steps taken by the proposed Treasury/IRS regulations and the Department of Labor’s final regulations will help savers to improve retirement security.

      

       

       

At the very heart of the American idea is the notion that, unlike in other places, we can start from nothing and through hard work have everything. That nothing we can imagine is beyond our reach. That we will pull up stakes, go anywhere, do anything to make our dreams come true. But what if that's just a myth? What if the truth is something very different? What if we are…stuck?

I. What does it mean to be an American?

Full disclosure: I'm British. Partial defense: I was born on the Fourth of July. I also have made my home here, because I want my teenage sons to feel more American. What does that mean? I don't just mean waving flags and watching football and drinking bad beer. (Okay, yes, the beer is excellent now; otherwise, it would have been a harder migration.) I'm talking about the essence of Americanism. It is a question on which much ink—and blood—has been spent. But I think it can be answered very simply: To be American is to be free to make something of yourself. An everyday phrase that's used to admire another ("She's really made something of herself") or as a proud boast ("I'm a self-made man!"), it also expresses a theological truth. The most important American-manufactured products are Americans themselves. The spirit of self-creation offers a strong and inspiring contrast with English identity, which is based on social class. In my old country, people are supposed to know their place. British people, still constitutionally subjects of Her Majesty Queen Elizabeth, can say things like "Oh, no, that's not for people like me." Infuriating.

Americans do not know their place in society; they make their place. American social structures and hierarchies are open, fluid, and dynamic. Mobility, not nobility. Or at least that's the theory. Here's President Obama, in his second inaugural address: "We are true to our creed when a little girl born into the bleakest poverty knows that she has the same chance to succeed as anybody else because she is an American; she is free, and she is equal, not just in the eyes of God but also in our own."

Politicians of the left in Europe would lament the existence of bleak poverty. Obama instead attacks the idea that a child born to poor parents will inherit their status. "The same chance to succeed as anybody else because she is an American…."

Americanism is a unique and powerful cocktail, blending radical egalitarianism (born equal) with fierce individualism (it's up to you): equal parts Thomas Paine and Horatio Alger. Egalitarian individualism is in America's DNA. In his original draft of the Declaration of Independence, Thomas Jefferson wrote that "men are created equal and independent," a sentiment that remained even though the last two words were ultimately cut. It was a declaration not only of national independence but also of a nation of independents.

The problem lately is not the American Dream in the abstract. It is the growing failure to realize it. Two necessary ingredients of Americanism—meritocracy and momentum—are now sorely lacking.

America is stuck.

Almost everywhere you look—at class structures, Congress, the economy, race gaps, residential mobility, even the roads—progress is slowing. Gridlock has already become a useful term for political inactivity in Washington, D. C. But it goes much deeper than that. American society itself has become stuck, with weak circulation and mobility across class lines. The economy has lost its postwar dynamism. Racial gaps, illuminated by the burning of churches and urban unrest, stubbornly persist.

In a nation where progress was once unquestioned, stasis threatens. Many Americans I talk to sense that things just aren't moving the way they once were. They are right. Right now this prevailing feeling of stuckness, of limited possibilities and uncertain futures, is fueling a growing contempt for institutions, from the banks and Congress to the media and big business, and a wave of antipolitics on both left and right. It is an impotent anger that has yet to take coherent shape. But even if the American people don't know what to do about it, they know that something is profoundly wrong.

II. How stuck are we?

Let's start with the most important symptom: a lack of social mobility. For all the boasts of meritocracy—only in America!—Americans born at the bottom of the ladder are in fact now less likely to rise to the top than those situated similarly in most other nations, and only half as likely as their Canadian counterparts. The proportion of children born on the bottom rung of the ladder who rise to the top as adults in the U.S. is 7.5 percent—lower than in the U.K. (9 percent), Denmark (11.7), and Canada (13.5). Horatio Alger has a funny Canadian accent now.

It is not just poverty that is inherited. Affluent Americans are solidifying their own status and passing it on to their children more than the affluent in other nations and more than they did in the past. Boys born in 1948 to a high-earning father (in the top quarter of wage distribution) had a 33 percent chance of becoming a top earner themselves; for those born in 1980, the chance of staying at the top rose sharply to 44 percent, according to calculations by Manhattan Institute economist Scott Winship. The sons of fathers with really high earnings—in the top 5 percent—are much less likely to tumble down the ladder in the U. S. than in Canada (44 percent versus 59 percent). A "glass floor" prevents even the least talented offspring of the affluent from falling. There is a blockage in the circulation of the American elite as well, a system-wide hardening of the arteries.

Exhibit A in the case against the American political elites: the U. S. tax code. To call it Byzantine is an insult to medieval Roman administrative prowess. There is one good reason for this complexity: The American tax system is a major instrument of social policy, especially in terms of tax credits to lower-income families, health-care subsidies, incentives for retirement savings, and so on. But there are plenty of bad reasons, too—above all, the billions of dollars' worth of breaks and exceptions resulting from lobbying efforts by the very people the tax system favors.

So fragile is the American political ego that we can't go five minutes without congratulating ourselves on the greatness of our system, yet policy choices exacerbate stuckness.

The American system is also a weak reed when it comes to redistribution. You will have read and heard many times that the United States is one of the most unequal nations in the world. That is true, but only after the impact of taxes and benefits is taken into account. What economists call "market inequality," which exists before any government intervention at all, is much lower—in fact it's about the same as in Germany and France. There is a lot going on under the hood here, but the key point is clear enough: America is unequal because American policy moves less money from rich to poor. Inequality is not fate or an act of nature. Inequality is a choice.

These are facts that should shock America into action. For a nation organized principally around the ideas of opportunity and openness, social stickiness of this order amounts to an existential threat. Although political leaders declare their dedication to openness, the hard issues raised by social inertia are receiving insufficient attention in terms of actual policy solutions. Most American politicians remain cheerleaders for the American Dream, merely offering loud encouragement from the sidelines, as if that were their role. So fragile is the American political ego that we can't go five minutes without congratulating ourselves on the greatness of our system, yet policy choices exacerbate stuckness and ensure decline.

In Britain (where stickiness has historically been an accepted social condition), by contrast, the issues of social mobility and class stickiness have risen to the top of the political and policy agenda. In the previous U.K. government (in which I served as director of strategy to Nick Clegg, the deputy prime minister), we devoted whole Cabinet meetings to the problems of intergenerational mobility and the development of a new national strategy. (One result has been a dramatic expansion in pre-K education and care: Every 3- and 4-year-old will soon be entitled to 30 hours a week for free.) Many of the Cabinet members were schooled at the nation's finest private high schools. A few had hereditary titles. But they pored over data and argued over remedies—posh people worrying over intergenerational income quintiles.

Why is social mobility a hotter topic in the old country? Here is my theory: Brits are acutely aware that they live in a class-divided society. Cues and clues of accent, dress, education, and comportment are constantly calibrated. But this awareness increases political pressure to reduce these divisions. In America, by contrast, the myth of classlessness stands in the way of progress. The everyday folksiness of Americans—which, to be clear, I love—serves as a social camouflage for deep economic inequality. Americans tell themselves and one another that they live in a classless land of open opportunity. But it is starting to ring hollow, isn't it?

III. For black Americans, claims of equal opportunity have, of course, been false from the founding.

They remain false today. The chances of being stuck in poverty are far, far greater for black kids. Half of those born on the bottom rung of the income ladder (the bottom fifth) will stay there as adults. Perhaps even more disturbing, seven out of ten black kids raised in middle-income homes (i.e., the middle fifth) will end up lower down as adults. A boy who grows up in Baltimore will earn 28 percent less simply because he grew up in Baltimore: In other words, this supersedes all other factors. Sixty-six percent of black children live in America's poorest neighborhoods, compared with six percent of white children.

Recent events have shone a light on the black experience in dozens of U. S. cities.

Behind the riots and the rage, the statistics tell a simple, damning story. Progress toward equality for black Americans has essentially halted. The average black family has an income that is 59 percent of the average white family's, down from 65 percent in 2000. In the job market, race gaps are immobile, too. In the 1950s, black Americans were twice as likely to be unemployed as whites. And today? Still twice as likely.

From heeding the call "Go west, young man" to loading up the U-Haul in search of a better job, the instinctive restlessness of America has always matched skills to work, people to opportunities, labor to capital.

Race gaps in wealth are perhaps the most striking of all. The average white household is now thirteen times wealthier than the average black one. This is the widest gap in a quarter of a century. The recession hit families of all races, but it resulted in a wealth wipeout for black families. In 2007, the average black family had a net worth of $19,200, almost entirely in housing stock, typically at the cheap, fragile end of the market. By 2010, this had fallen to $16,600. By 2013—by which point white wealth levels had started to recover—it was down to $11,000. In national economic terms, black wealth is now essentially nonexistent.

Half a century after the passing of the Civil Rights Act, the arc of history is no longer bending toward justice. A few years ago, it was reasonable to hope that changing attitudes, increasing education, and a growing economy would surely, if slowly, bring black America and white America closer together. No longer. America is stuck.

IV. The economy is also getting stuck.

Labor productivity growth, measured as growth in output per hour, has averaged 1.6 percent since 1973. Male earning power is flatlining. In 2014, the median full-time male wage was $50,000, down from $53,000 in 1973 (in the dollar equivalent of 2014). Capital is being hoarded rather than invested in the businesses of the future. U. S. corporations have almost $1.5 trillion sitting on their balance sheets, and many are busily buying up their own stock. But capital expenditure lags, hindering the economic recovery.

New-business creation and entrepreneurial activity are declining, too. As economist Robert Litan has shown, the proportion of "baby businesses" (firms less than a year old) has almost halved since the late 1970s, decreasing from 15 percent to 8 percent—the hallmark of "a steady, secular decline in business dynamism." It is significant that this downward trend set in long before the Great Recession hit. There is less movement between jobs as well, another symptom of declining economic vigor.

Americans are settling behind their desks—and also into their neighborhoods. The proportion of American adults moving house each year has decreased by almost half since the postwar years, to around 12 percent. Long-distance moves across state lines have as well. This is partly due to technological advances, which have weakened the link between location and job prospects, and partly to the growth of economic diversity in cities; there are few "one industry" towns today. But it is also due to a less vibrant housing market, slower rates of new business creation, and a lessening in Americans' appetite for disruption, change, and risk.

This geographic settling is at odds with historic American geographic mobility. From heeding the call "Go west, young man" to loading up the U-Haul in search of a better job, the instinctive restlessness of America has always matched skills to work, people to opportunities, labor to capital. Rather than waiting for help from the government, or for the economic tide to turn back in their favor, millions of Americans changed their life prospects by changing their address. Now they are more likely to stay put and wait. Others, especially black Americans, are unable to escape the poor neighborhoods of their childhood. They are, as the title of an influential book by sociologist Patrick Sharkey puts it, Stuck in Place.

There are everyday symptoms of stuckness, too. Take transport. In 2014, Americans collectively spent almost seven billion hours stuck motionless in traffic—that's a couple days each. The roads get more jammed every year. But money for infrastructure improvements is stuck in a failing road fund, and the railophobia of politicians hampers investment in public transport.

Whose job is it to do something about this? The most visible symptom of our disease is the glue slowly hardening in the machinery of national government. The last two Congresses have been the least productive in history by almost any measure chosen, just when we need them to be the most productive. The U. S. political system, with its strong separation among competing centers of power, relies on a spirit of cross-party compromise and trust in order to work. Good luck there.

V. So what is to be done?

As with anything, the first step is to admit the problem. Americans have to stop convincing themselves they live in a society of opportunity. It is a painful admission, of course, especially for the most successful. The most fervent believers in meritocracy are naturally those who have enjoyed success. It is hard to acknowledge the role of good fortune, including the lottery of birth, when describing your own path to greatness.

There is a general reckoning needed. In the golden years following World War II, the economy grew at 4 percent per annum and wages surged. Wealth accumulated. The federal government, at the zenith of its powers, built interstates and the welfare system, sent GIs to college and men to the moon. But here's the thing: Those days are gone, and they're not coming back. Opportunity and growth will no longer be delivered, almost automatically, by a buoyant and largely unchallenged economy. Now it will take work.

The future success of the American idea must now be intentional.

Entrepreneurial, mobile, aspirational: New Americans are true Americans. We need a lot more of them.

There are plenty of ideas for reform that simply require will and a functioning political system. At the heart of them is the determination to think big again and to vigorously engage in public investment. And we need to put money into future generations like our lives depended on it, because they do: Access to affordable, effective contraception dramatically cuts rates of unplanned pregnancy and gives kids a better start in life. Done well, pre-K education closes learning gaps and prepares children for school. More generous income benefits stabilize homes and help kids. Reading programs for new parents improve literacy levels. Strong school principals attract good teachers and raise standards. College coaches help get nontraditional students to and through college. And so on. We are not lacking ideas. We are lacking a necessary sense of political urgency. We are stuck.

But we can move again if we choose.

In addition to a rejuvenation of policy in all these fields, there are two big shifts required for an American twenty-first-century renaissance: becoming open to more immigration and shifting power from Washington to the cities.

VI. America needs another wave of immigration.

This is in part just basic math: We need more young workers to fund the old age of the baby boomers. But there is more to it than that. Immigrants also provide a shot in the arm to American vitality itself. Always have, always will. Immigrants are now twice as likely to start a new business as native-born Americans. Rates of entrepreneurialism are declining among natives but rising among immigrants.

Immigrant children show extraordinary upward-mobility rates, shooting up the income-distribution ladder like rockets, yet by the third or fourth generation, the rates go down, reflecting indigenous norms. Among children born in Los Angeles to poorly educated Chinese immigrants, for example, an astonishing 70 percent complete a four-year-college degree. As the work of my Brookings colleague William Frey shows, immigrants are migrants within the U. S., too, moving on from traditional immigrant cities—New York, Los Angeles—to other towns and cities in search of a better future. Entrepreneurial, mobile, aspirational: New Americans are true Americans. We need a lot more of them.

This makes a mockery of our contemporary political "debates" about immigration reform, which have become intertwined with race and racism. Some Republicans tap directly into white fears of an America growing steadily browner. More than four in ten white seniors say that a growing population of immigrants is a "change for the worse"; half of white boomers believe immigration is "a threat to traditional American customs and values." But immigration delves deeper into the question of American identity than it does even issues of race. Immigrants generate more dynamism and aspiration, but they are also unsettling and challenging. Where this debate ends will therefore tell us a great deal about the trajectory of the nation. An America that closes its doors will be an America that has chosen to settle rather than grow, that has allowed security to trump dynamism.

VII. The second big shift needed to get America unstuck is a revival of city and state governance.

Since the American Dream is part of the national identity, it seems natural to look to the national government to help make it a reality. But cities are now where the American Dream will live or die. America's hundred biggest metros are home to 67 percent of the nation's population and 75 percent of its economy. Americans love the iconography of the small town, even at the movies—but they watch those movies in big cities.

Powerful mayors in those cities have greater room for maneuvering and making an impact than the average U. S. senator. Even smaller cities and towns can be strongly influenced by their mayor.

There are choices to be made. Class divisions are hardening. Upward mobility has a very weak pulse. Race gaps are widening.

The new federalism in part is being born of necessity. National politics is in ruins, and national institutions are weakened by years of short-termism and partisanship. Power, finding a vacuum in D. C., is diffusive. But it may also be that many of the big domestic-policy challenges will be better answered at a subnational level, because that is where many of the levers of change are to be found: education, family planning, housing, desegregation, job creation, transport, and training. Amid the furor over Common Core and federal standards, it is important to remember that for every hundred dollars spent on education, just nine come from the federal government.

We may be witnessing the end of many decades of national-government dominance in domestic policy-making (the New Deal, Social Security, Medicare, welfare reform, Obamacare). The Affordable Care Act is important in itself, but it may also come to have a place in history as the legislative bookend to a long period of national-policy virtuosity.

The case for the new federalism need not be overstated. There will still be plenty of problems for the national government to fix, including, among the most urgent, infrastructure and nuclear waste. The main tools of macroeconomic policy will remain the Federal Reserve and the federal tax code. But the twentieth-century model of big federal social-policy reforms is in decline. Mayors and governors are starting to notice, and because they don't have the luxury of being stuck, they are forced to be entrepreneurs of a new politics simply to survive.

VIII. It is possible for America to recover its earlier dynamism, but it won't be easy.

The big question for Americans is: Do you really want to? Societies, like people, age. They might also settle down, lose some dynamism, trade a little less openness for a little more security, get a bit stuck in their ways. Many of the settled nations of old Europe have largely come to terms with their middle age. They are wary of immigration but enthusiastic about generous welfare systems and income redistribution. Less dynamism, maybe, but more security in exchange.

America, it seems to me, is not made to be a settled society. Such a notion runs counter to the story we tell ourselves about who we are. (That's right, we. We've all come from somewhere else, haven't we? I just got here a bit more recently.) But over time, our narratives become myths, insulating us from the truth. For we are surely stuck, if not settled. And so America needs to decide one way or the other. There are choices to be made. Class divisions are hardening. Upward mobility has a very weak pulse. Race gaps are widening. The worst of all worlds threatens: a European class structure without European welfare systems to dull the pain.

Americans tell themselves and the world that theirs is a society in which each and all can rise, an inspiring contrast to the hereditary cultures from which it sprang. It's one of the reasons I'm here. But have I arrived to raise my children here just in time to be stuck, too? Or will America be America again?

Editor's note: This piece originally appeared in Esquire.

      

As every good teacher knows, education is not just about academics. It is about broadening horizons and discovering passions. (The root of education is the Latin e ducere, meaning “to draw out.”) From this perspective, extra-curricular activities count for a great deal. But as Robert Putnam highlights in his book Our Kids, there are growing class gaps in the availability of music, sports, and other non-classroom activities.

Fewer field trips?

Schools under pressure may also cut back on field trips outside the school walls to parks, zoos, theaters, or museums. In the 2008-09 school year, 9 percent of school administrators reported eliminating field trips, according to the annual surveys by the American Association of School Administrators (AASA). That figure rose through the recession:

Just 12 percent of the administrators surveyed about 2015-16 said they had brought back their field trips to pre-recession levels. Museums around the country report hosting fewer students, from Los Angeles and Sarasota, to Minneapolis, and Columbia, Missouri. None of this is definitive proof of a decline in field trips, since we are relying on a single survey question. But it suggests a downward trend in recent years.

Museums help with science tests

If some children are missing out on field trips, does it matter? They may be nice treats, but do they have any real impact, especially when they take time away from traditional learning? There is some evidence that they do.

Middle school children with the chance to go on a field trip score higher on science tests, according to a 2015 study by Emilyn Ruble Whitesell.

She studied New York City middle schools with teachers in Urban Advantage, a program that gives science teachers additional training and resources—as well as vouchers for visiting museums. In some schools, the Urban Advantage teachers used the field trip vouchers more than others. Whitesell exploits this difference in her study, and finds that attending a school with at least 0.25 trips per student increased 8^th grade scores by 0.026 standard deviations (SD). The odds of a student passing the exam improved by 1.2 percentage points. There were bigger effects for poor students, who saw a 0.043 SD improvement in test scores, and 1.9 percentage point increase in exam pass rates.

Art broadens young minds

Students visiting an art museum show statistically significant increases in critical thinking ability and more open-minded attitudes, according to a randomized evaluation of student visits to the Crystal Bridges Museum in northwest Arkansas. One example: those who visited the museum more often agreed with statements like: “I appreciate hearing views different from my own” and “I think people can have different opinions about the same thing.” The effects are modest. But the intervention (a single day at the museum) is, too. Again, there were larger effects for poor students:

All this needs to be put in perspective. In comparison with the challenge of closing academic gaps and quality teaching, field trips are small beer. But schools create citizens as well as undergraduates and employees. It matters, then, if we have allowed field trips to become a casualty of the great recession.

      

Feminism needs fathers. Unless and until men and women share the responsibilities of parenting equally, gender parity in the labor market will remain out of reach.

As Isabel Sawhill and I argued in our piece on “Men’s Lib” for the New York Times, “The gender revolution has been a one-sided effort. We have not pushed hard enough to put men in traditionally female roles—that is where our priority should lie now.”

Dads on the home front: Paternity leave

An important step towards gender equality is then the provision of paternity leave, or at least forms of parental leave that can be taken up by fathers as well as mothers. Right now the U.S. is one of the few advanced nations with no dedicated leave for fathers:

But there are reasons to be hopeful. More companies are offering paternity leave or, like Amazon, a “leave bank” that parents can share between them. Hillary Clinton is promising to push for paid family leave if she wins in November. Recent studies of California’s paid leave scheme, introduced in 2004, suggest that there are significant benefits for fathers.

The number of fathers taking leave while the mother is in paid work rose by 50 percent, according to an analysis of the American Community Survey by Ann Bartel of Colombia and her colleagues.

Fathers of sons are more likely to take leave than those with daughters, suggesting that parents particularly value father-son bonding. Fathers were also very much more likely to take leave if they worked in occupations with a high share of female workers, indicating that workplace culture is also a big factor.

Men are more likely to take leave when it is exclusively available to them—with a so-called “use it or lose it” design—and when the period of leave is paid. The Quebec Parental Insurance Plan, for instance, which offers fathers three to five weeks at home with a child, resulted in a 250 percent increase father’s participation in parental leave.

Benefits of paternity leave

Of course, there are costs. Paid leave has to be funded: either through payroll taxes (as most Democrats including Senator Kirsten Gillibrand want), taxes on the wealthy (Clinton’s preferred approach), or tax breaks for firms (as Marco Rubio has suggested).

So what are the upsides? Among the potential benefits from paternity leave are:

• A more equal division of labor in terms of parenting and childcare
• More equal sharing of domestic labor, including housework
• Less stress on the family
• Closer father-infant bonding
• Higher pay for mothers (according to a study in Sweden, future income for new mothers rises by 7 percent on average for every month of paternity leave taken by the father)

More than a day

Gender roles have evolved rapidly in recent decades, especially in terms of the place and status of women. But the evolution of our mental models of masculinity, and especially fatherhood, has been slower. Helping fathers to take time to care for their children will help children, families, and women. Fathers need more than a day.

       

Event Information

Earlier this month, the Trans-Pacific Partnership Agreement was signed by its 12 member states in New Zealand, bringing the trade deal one step closer to fruition. The member states must now work on resolving their respective domestic issues tied to TPP. For Japan, one of the major issue areas involving TPP is agriculture.

On February 24, the Center for East Asia Policy Studies hosted Kazuhito Yamashita for a presentation in which he discussed the impact of Japan’s market access commitment on agriculture, the TPP countermeasures that the Japanese government announced for agriculture, and the types of agricultural policy reform that are being considered in Japan.

Transcript

• Transcript of Kazuhito Yamashita Presentation (.pdf)

Event Materials

• Yamashita Brookings presentation for website 022416
• Transcript Kazuhito Yamashita Presentation

       

       

       

       

       

Volunteer, civil society and governmental delegates from 22 nations gathered in Johannesburg this month for the Southern Africa Conference on Volunteer Action for Development. The conference was co-convened by United Nations Volunteers (UNV) and Volunteer and Service Enquiry Southern Africa (VOSESA), in observance of the 10th anniversary of the United Nations International Year of Volunteers (IYV).

Naheed Haque, deputy executive coordinator for United Nations Volunteers, gave tribute to the late Nobel Laureate Wangari Mathai and her Greenbelt tree planting campaign as the “quintessential volunteer movement.” Haque called for a “new development paradigm that puts voluntarism at the center of community-centered sustainable development.” In this paradigm, human happiness and service to others would be key considerations, in addition to economic indicators and development outcomes including health and climate change.  

The international gathering developed strategies to advance three key priorities for the 15 nations in the Southern Africa Development Community (SADC): combating HIV/ AIDS; engaging the social and economic participation of youth; and promoting regional integration and peace. Research data prepared by Civicus provided information on the rise of voluntary service in Africa, as conferees assessed strategies to advance “five pillars” of effective volunteerism: engaging youth, community involvement, international volunteers, corporate leadership and higher education in service.

VOSESA executive director, Helene Perold, noted that despite centuries of migration across the region, the vision for contemporary regional cooperation between southern African countries has largely been in the minds of heads of states with “little currency at the grassroots level.” Furthermore, it has been driven by the imperative of economic integration with a specific focus on trade. Slow progress has now produced critiques within the region that the strategy for integrating southern African countries cannot succeed on the basis of economic cooperation alone. Perold indicated that collective efforts by a wide range of civic, academic, and governmental actors at the Johannesburg conference could inject the importance of social participation within and between countries as a critical component in fostering regional integration and achieving development outcomes. 

This premise of voluntary action’s unique contribution to regional integration was underscored by Emiliana Tembo, director of Gender and Social Affairs for the Common Market of Eastern and Southern Africa (COMESA). Along with measures promoting free movement of labor and capital to step up trade investment, Tembo stressed the importance of “our interconnectedness as people,” citing Bishop Desmond Tutu’s maxim toward the virtues of “Ubuntu – a person who is open and available to others.”

The 19 nation COMESA block is advancing an African free-trade zone movement from the Cape of South Africa, to Cairo Egypt. The “tripartite” regional groupings of SADC, COMESA and the East Africa Community are at the forefront of this pan-African movement expanding trade and development.

Preliminary research shared at the conference by VOSESA researcher Jacob Mwathi Mati noted the effects of cross border youth volunteer exchange programs in southern and eastern Africa. The research indicates positive outcomes including knowledge, learning and “friendship across borders,” engendered by youth exchange service programs in South Africa, Mozambique, Tanzania and Kenya that were sponsored Canada World Youth and South Africa Trust.   

On the final day of the Johannesburg conference, South Africa service initiatives were assessed in field visits by conferees including loveLife, South Africa’s largest HIV prevention campaign. loveLife utilizes youth volunteer service corps reaching up to 500,000 at risk youths in monthly leadership and peer education programs. “Youth service in South Africa is a channel for the energy of youth, (building) social capital and enabling public innovation,” Programme Director Scott Burnett stated. “Over the years our (service) participants have used their small stipends to climb the social ladder through education and micro-enterprise development.”

Nelly Corbel, senior program coordinator of the John D. Gerhart Center for Philanthropy and Civic Engagement at the American University in Cairo, noted that the Egyptian Arab Spring was “the only movement that cleaned-up after the revolution." On February 11^th, the day after the resignation of former Egyptian President Hosni Mubarak, thousands of Egyptian activists  removed debris from Tahrir Square and engaged in a host of other volunteer clean-up and painting projects. In Corbel's words: “Our entire country is like a big flag now,” from the massive display of national voluntarism in clean-up projects, emblematic of the proliferation of youth social innovation aimed at rebuilding a viable civil society.

At the concluding call-to-action session, Johannesburg conferees unanimously adopted a resolution, which was nominated by participating youth leaders from southern Africa states. The declaration, “Creating an Enabling Environment for Volunteer Action in the Region” notes that “volunteering is universal, inclusive and embraces free will, solidarity, dignity and trust… [creating] a powerful basis for unity, common humanity, peace and development.”  The resolution, contains a number of action-oriented recommendations advancing voluntarism as a “powerful means for transformational change and societal development.” Policy recommendations will be advanced by South African nations and other stakeholders at the forthcoming Rio + 20 deliberations and at a special session of the United Nations General Assembly on December 5, the 10^th anniversary of the International Year of the Volunteer.

      

       

Being able to read and write is the most basic foundation of knowledge accumulation and further skill development. Without literacy, there can be no quality education. Presently, 1 in 5 adults is illiterate, two-thirds of whom are women. At the current pace, over 700 million adults worldwide will still not be able to read in 2015. [1] In global education discussions, literacy rates are most often reported for adolescents and adults, an ex post facto measure of the failure of primary school systems to impart basic skills in the most formative schooling years. It is clear that much needs to be done to provide these adolescents and adults with access to successful literacy programs. But we must also ensure that children with access to schooling are not growing up to be illiterate.

Children enrolled and regularly attending school for the first three grades should be able to read basic text. Evidence shows that acquiring this ability to read sets students up for further learning, enabling them to read and comprehend progressively more advanced materials and acquire additional knowledge.

As explained in our earlier policy brief, data from numerous countries show that children in school are failing to acquire the most basic of skills, measured as the ability to read words of connected text. We called for a global paradigm shift that places learning at the center of the global education discourse. This shift requires the major bilateral and multilateral actors to refocus their own efforts on supporting learning in the classroom and measuring progress by increased learning outcomes. There has been some progress here, such as USAID’s goal to improve reading skills for primary school children in its new education strategy and the World Bank’s Education Strategy 2020, Learning for All: investing in people’s knowledge and skills to promote development.

This shift of focus also requires substantial changes on the ground, including encouraging and supporting a culture of literacy and learning at the community level. For example, Gove and Cvelich highlight some main factors contributing to low reading levels, including a lack of support for teachers, limited instructional time, poorly resourced schools, the absence of books in the home and policies regarding the language of instruction. [2] In Mali, a recent survey found that three-quarters of grade 2 students did not have a textbook and no student had supplementary reading books at school. [3] In The Gambia, the vast majority of students who demonstrated a level of reading fluency said that they had books at home. Globally, in both developed and developing economies, a relatively consistent proxy for “parental commitment to education” is the number of books in the home. A 20-year study of 27 countries found that children growing up in homes with many books get three years more schooling than their peers who come from homes without books. [4] There is no one-size-fits-all solution to improving the quality of education in developing countries. However, there is plenty of room for innovation to address some of the biggest barriers to improving reading levels, including availability of appropriate reading materials at school and at home. In disadvantaged communities, where there are relatively few books and even fewer books in local languages and that deal with culturally-relevant topics, innovation is needed to help develop a robust culture of literacy.

One such innovation is Worldreader.org’s iRead pilot in Ghana, which has put hundreds of e-readers into children’s hands. A lot has been written on similar classroom technology in developing countries, which cite examples of supplying hardware to schools without plans for its educational use, promoting technology from a single company, insufficient planning for sustainability, and inadequate investment in time to train teachers and administrators who will be the purveyors of the technology initiatives in the classrooms. [5]

However, the important difference between this e-reader program and similar projects focused on putting computers in classrooms is that e-readers usually operate on the mobile phone system, which has exploded in developing regions over the last few years. In Kenya, more than 80 percent of the population has mobile phone network coverage and more than half of the population has purchased a mobile phone subscription. The GSM compatibility of e-readers allows for downloading of new reading materials wherever there is mobile phone coverage and sufficient funds available to purchase new texts. E-readers also have relatively low levels of energy consumption (a one-hour charge can last more than a week). In addition to gaining the support of community leaders and teachers from the beginning, the pilot began with intense in-service training for teachers in how to use e-readers to complement their existing curricula. While Worldreader.org has not solved all of the challenges posed by technology initiatives in education, it has taken some important steps toward addressing the barriers to project success. [6]

The organization has also tackled specific challenges that are impeding reading success in the early primary grades:

• Additional support for emergent readers. E-readers provide additional support to teachers in teaching children how to read, an important supplement in primary school classrooms in low-income countries where there may be 40 or 50 students per teacher. In such cases, students are required to work independently or in small groups while the teacher is working with other students. The text-to-speech feature on e-readers can read books aloud to the student, exposing her to the written text as she hears it read aloud. Students can also use the downloaded dictionary while reading to look up unfamiliar words and continue to read without adult assistance.
  
• Students and teachers get to choose. While paper books donated by schools, libraries, and individuals from around the world have helped to get written materials into low-resource schools in developing countries, e-books allow students and teachers in developing countries to choose which books they teach and read. Although choices now are restricted by the dominance of English in the e-book market, the potential for the expansion of the digital market represents a step toward greater agency for teachers and students.
  
• Working with local publishers to increase access to books for emergent readers. Children learning to read need access to the types of books that engage their imagination and spark their interest. For children learning to read, this means stories with simple sentences in their local language. Yet, traditionally children’s books are not a good economic bet for publishers, particularly in developing countries. The high cost of printing the books are not recouped since so many families cannot purchase copies for their own household use. However, distributing books in e-reader format will actually allow publishers to reach more customers at a lower cost. To bring more books to the developing world through e-readers and e-books, Worldreader.org seeks to support a self-sustaining reading and publishing culture by working with local publishers to digitize books and materials to support local language curricula.
  
• Portability can increase reading opportunities. Anecdotal reports from classroom teachers in the Ghanaian pilot frequently reference how students would not stop reading, pulling out their e-readers in between lessons, during recess and lunch, and after school with friends, parents and siblings. An International Association for the Evaluation of Educational Achievement study on reading literacy in 32 countries found that the amount of voluntary book reading that students did during out-of-school time was strongly positively related to students’ achievement levels. [7]

While the pilot is still in the early stages, the founders of the project are focused on the essential outcomes. Their USAID-funded impact study seeks to find out whether children are reading more than they were before the program and whether children read better than they were before the program. Measuring program success by understanding the impact on learning outcomes is a critical step for shifting the global education paradigm to one focused on learning.

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[1] UNESCO. (2010). EFA Global Monitoring Report 2010: Reaching the Marginalized. Paris: UNESCO.
[2] Gove, A., and P. Cvelich, (2010). Early Reading: Igniting Education for All. A report by the Early Grades Learning Community of Practice. Research Triangle Park, NC: Research Triangle Institute.
[3] Evans, 2010
[4] M.D.R. Evans, Jonathan Kelley, Joanna Sikora, Donald J. Treiman. “Family scholarly culture and educational success: Books and schooling in 27 nations.” Research in Social Stratification and Mobility, 2010; DOI: 10.1016/j.rssm.2010.01.002
The study controls for education levels, occupations, and socio-economic status of the parents.
[5] For example, Trucano, M. “Worst practice in ICT use in education,” 2010, accessed at http://blogs.worldbank.org/edutech/worst-practice
[6] Some of the core challenges identified by Worldreader.org and others include the upfront costs of e-readers, need for on-going training and support to teachers, students, and communities, buy-in of school systems and local governments to deploy technology and content, insufficient relevant materials in e-book format, and consistent access to electricity and mobile networks.
[7] Elley, W.B. (Ed.). (1994). The IEA Study of Reading Literacy: Achievement and Instruction in Thirty-two School Systems. Oxford: Pergamon Press.

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• Download Paper

      

       

Editors’ Note: In a recent interview with Foreign Policy Interrupted, Tamara Wittes was asked about how the situation in the Middle East has changed since she published her 2008 book Freedom’s Unsteady March. Five years after the Arab uprisings and the start of the Syrian civil war, and a year and a half after the Islamic State captured Mosul (along with the world’s attention), Tamara says that many of the same fundamental dynamics in the Middle East are still at work.

The situation in the region has changed so dramatically since then, but I think that the fundamental insights that informed that book remain true. The underlying drivers of change in the Middle East are still there in terms of the demographic drivers, the economic drivers, the technological drivers that I described in the book; they are all still present.

Although there’s a lot of disorder and a lot of violence, and that leads people on the ground to prioritize security and to search for security in different ways, that doesn’t mean that they’re going to be satisfied. It doesn’t mean that the, “well, at least it’s not ISIS” line is going to suffice for governments in the Middle East for very long.

The underlying drivers of change are still present, the pressure for change is still present, and a lot of those pressures are about the simple fact of individual empowerment. Expectations shifted, and people, individuals, have the ability to act in ways that they didn’t before. States and governments have to accommodate that. It’s affecting politics all over the world, and the Middle East is not immune.

So the question becomes: how are governments going to learn to accommodate that and turn it into a strength? I think that the United States does have a really important role to play there. There were mistakes that the Bush administration made—setting aside his vision of Iraq, which has of course been very thoroughly discussed and assessed. But even in terms of non-military intervention to try to advance reform, the critique I made in the book is that the Bush administration was overly focused on political process and elections in particular. I think that one of the other lessons that has come of recent years is that the United States and other Western countries get very focused on political institutions and think, well, if we set up a judicial system, and we set up a parliament, and a constitution, then the gears in the machine sort of start to turn, the states start to function. Look at the rebuilding efforts in Afghanistan, for example.

But what we see in the Middle East today is that formal institutions aren’t enough. People have to have trust in the institutions, and people and communities have to have sufficient agreement on the basic rules of the game to make those institutions legitimate and authoritative. And that’s what’s missing in a lot of places around the region right now, that there isn’t enough dialogue and debate and ultimately negotiated agreement on the basic rules of the game. So I think that the challenge for the United States and others who care about stability in the Middle East going forward is how to help cultivate platforms for that kind of dialogue, and how to help cultivate the skills and the mechanisms for resolving very fundamental questions about how government should be organized and what should be the role of religion and politics, and what’s the balance between individual rights and collective identity.

These are big, big, questions, and right now, in too many places, they are being fought over violently. But the questions still have to be answered, and so the challenge is helping develop ways to do that, to do it peacefully.

       

       

I came across an interesting chart in yesterday’s Morning Money tipsheet from Politico that struck me as a something that sounded intuitively correct but was, in fact, not. It's worth a comment on this blog, which has served as a forum for discussion of jobs numbers throughout the recovery.

Between last week’s BLS employment report and last night’s State of the Union, we’ve heard a lot about impressive job growth in 2015. For my part, I wrote on this blog last week that the 2.6 million jobs created last year makes 2015 the second best calendar-year for job gains of the current recovery.

The tipsheet’s "Chart of the Day," however, suggested that job growth in 2015 was actually lower-than-average if we adjust for the change in the size of the labor force. This is what was in the tipsheet from Politico:

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CHART OF THE DAY: NOMINAL JOB GROWTH — Via Hamilton Place Strategies: "Adjusting jobs data to account for labor force shifts can help shed some light on voters' economic angst, even as we see good headline statistics. … Though 2015 was a good year in terms of job growth during the current recovery and had higher-than-average job growth as compared to recent recoveries, 2015 actually had lower-than-average job growth if we adjust for the change in the size of the labor force." http://bit.ly/1OnBXSm

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I decided to look at the numbers.

The authors propose that we should "scale" reported job gains by the number of workers, which at first seems to make sense. Surely, an increase in monthly employment of 210,000 cannot mean the same thing when there are already 150 million employed people as when there are just 75 million employed people.

But this intuition is subtly wrong for a simple reason: The age structure of the population may also differ in the two situations I have just described. Suppose when there are 75 million employed people, the population of 20-to-64 year-old people is growing 300,000 every month. Suppose also when there are 150 million employed people, the population of 20-to-64 year-olds is shrinking 100,000 per month. 

Most informed observers would say that job growth of 210,000 a month is much more impressive under the latter assumptions than it is under the first set of assumptions, even though under the latter assumptions the number of employed people is twice as high as it is under the first assumptions.

BLS estimates show that in the seven years from December 2008-December 2015, the average monthly growth in the 16-to-64 year-old (noninstitutionalized) U.S. population was 85,200 per month. That is the lowest average growth rate of the working-age population going back to at least 1960. Here are the numbers:

Once we scale the monthly employment gain by the growth in the working-age population, the growth of jobs in recent years has been more impressive—not less—than suggested by the raw monthly totals. Gains in employer payrolls have far surpassed the growth in the number of working-age Americans over the past five years.

Headline writers have been impressed by recent job gains because the job gains have been impressive.

      

       

       

Community banks play a key role in their local communities by offering traditional banking services to households and lending to nearby small businesses in the commercial, agriculture, and real estate sectors. Because of their close relationship with small businesses, they drive an important segment of economic growth. In fact, compared to all other banks (and to credit unions), small banks devote the greatest share of their assets to small business loans.

In this paper, titled "The community banks: The evolution of the financial sector, Part III," (PDF) Baily and Montalbano examine the evolution of community banks before, through, and after the financial crisis to assess their recovery.

The authors find that despite concerns about the long-term survival of community banks due a decline in the number of banks and increased Dodd-Frank regulations, they continue to recover from the financial crisis and are in fact out-performing the Big Four banks in several key measures.

Although the number of community banks has been steadily declining since before 2003, most of the decline has come from the steep drop in the smallest banking organizations—those with total consolidated assets of less than $100 million. Community banks with total consolidated assets that exceed $300 million have in fact increased in number. Most of the decline in community banks can be attributed to the lack of entry into commercial banking.

In a previous paper, Baily and Montalbano showed that the gap in loans and leases among the Big Four has widened since the financial crisis, but the new research finds that community banks seem to be returning to their pre-crisis pattern, although slowly, with the gap between deposits and loans shrinking since 2011. While total deposits grew gradually after 2011, though at a pace slower than their pre-crisis rate, loans and leases bottomed out in 2011 at $1.219 trillion.

The authors also examine community banks' return on assets (ROA), finding it was lower overall than for the Big Four or for the regionals, and has come back to a level closer to the pre-crisis level than was the case for the larger banks. The level of profitability was slightly lower for community banks in 2003 than it was for the larger banks—about 1.1 percent compared to 1.7 percent for the regional banks—but it did not dip as low, reaching a bottom of about -0.1 percent compared to -0.8 percent for the regional banks.

Baily and Montalbano also find that total assets of the community banks increased 22.5 percent (adjusted for inflation, the increase was 7 percent); the average size of community banks has increased substantially; total bank liabilities grew steadily from 2003-2014; the composition of liabilities in post-crisis years looked largely similar to the composition in the pre-crisis years; and securitization—which plays a relatively small role in the community banking model—has been steadily increasing in the time period both before and after the crisis. 

To read more, download the full paper here.

The paper is the third in a series that examines how the financial sector has evolved over the periods both before and after the financial crisis of 2007-2008. The first paper examines the Big Four banks, and the second takes a closer look at regional banks.

Downloads

• Download "The community banks: The evolution of the financial sector, Part III"

       

       

       

       

Real political change in Turkey has been hard to come by in recent years. Establishment parties in Turkey have, time and again, proven unable to change the political system. Now a new hope for reform has emerged in Turkey from an unlikely source: the Kurds.

During most of the Cold War—and particularly during the 1980s and 1990s—Turkey had, for lack of a better word, a Kemalist consensus: The military played a major role behind the scenes, and those outside the consensus, especially the Islamists and the Kurds, were essentially excluded from politics. 

The first wave of democratization in the post-Cold War era in Turkey came from the Islamists—specifically, from the Justice and Development Party (AKP). In 2002, when the AKP came to power, it decided that accession to the European Union should be its main goal and that effort could serve as tool to undermine the political power of the Turkish military that still lurked behind the scenes. So, incredibly, an Islamist party, the AKP, decided to bring about a post-Kemalist system by pushing for membership in the EU’s essentially liberal, democratic project. This strategy explains why Turkish liberals supported the AKP and could hope that the Islamists would push the system in a liberal direction.

But then something tragic happened. The AKP became the establishment. After the military was essentially defeated as a political force, the AKP ceased to be an anti-establishment party. Rather, it became a party that started to use the privileges of power, and itself began its own networks of patronage clientelism, and became a victim of this entity called the state. The AKP became the state. 

Now we're in a situation where the second wave of democratization may also come from an anti-establishment party, this one mostly representing the Kurds. The most democratic, the most liberal, the most progressive narrative that you hear in Turkish politics today is coming from Selahattin Demirtaş of the pro-Kurdish Peoples’ Democratic Party (HDP)—not the main opposition Republican People’s Party (CHP), not the far-right Nationalist Movement Party (MHP), and not the AKP.

There is reason to think that, in Turkey, only anti-establishment parties can actually improve the system. The old AKP was an anti-establishment party. What gives me hope about the HDP is that, even when it enters the parliament—and even if a miracle happens and it enters a coalition government—it will never become the state. 

By definition, the HDP is a Kurdish political party. The Islamists could become the state, because Turkey is 99 percent Muslim, and people could establish basically a sense of supremacy based on Muslim identity. The Kurds will never be able to represent the majority. They will never be able to become the state. They have vested and permanent interest in the rule of law—indeed their very survival depends on it. Their survival depends on minority rights and on checks and balances. This stark fact gives me hope about the HDP and its agenda.

What’s wrong with the rest of the Turkish opposition?

The real puzzle is the failure of establishment political parties to challenge the system. It would have been wonderful for a center-right party or a center-left party to have taken Turkey to the post-Kemalist phase, to a post-military, pro-E.U., pro-progressive phase. But the mainstream political parties have failed. The establishment of Turkey has failed. The Kemalist order in Turkey has failed.

The agent of change was first the Islamists, and now the agent of change has become the Kurds. 

What is it that creates this mental block of establishment political parties? Why did it take so many years for the CHP to understand that it can become an agent of change, too? In the absence of a left-wing movement in Turkey, there will never be balance. We need a progressive left. We need something that can challenge the strong coalition on the right. The HDP alone cannot be there.

One thing that is not being discussed in Turkey is the possibility of a CHP-HDP coalition, yet this is the most natural coalition. The CHP, if it's a progressive political party, it should be able to get rid of its Kemalist, neo-nationalist baggage and embrace the progress of liberal, democratic agenda of the HDP. 

One reason that the CHP voters and the CHP itself are unable to really embrace the HDP is because the CHP, deep down, is still the party of Atatürk, still the party of Kemalism, still the party of nationalism. And what the Kurds want in Turkey—make no mistake—what the Kurds want in Turkey is autonomy. They want nothing short of autonomy.

The days when you could basically solve the Kurdish question with some cosmetic cultural reforms are over. They want democratic decentralization. And to me, that translates into autonomy. And this is a very difficult step to digest for the CHP. Add to this the fact that the disgruntled CHP voters are voting for the HDP, the fact that people who usually could vote for a central-left progressive party are so disillusioned with the CHP that they're gravitating to the HDP. Therefore, there is also a tactical obstacle, in terms of cooperation between the HDP and the CHP right now. 

But down the line, I think the best reconciliation between Turkish nationalism and Kurdish nationalism would come from a CHP-HDP coalition. Turkish nationalism needs to reconcile itself to the fact that the Kurdish genie is out of the bottle. The good old days of assimilating the Kurds are over. The Kurds want autonomy. They will probably get it, hopefully in a bloodless way.

       

When Süleyman Demirel died last week I asked myself why such a permanent giant of Turkish politics failed to change the country during his 40 years of active politics. Why is it that genuine political change in Turkey proved to be so elusive during the long decades of Demirel's public service? The answer has partly to do with the fact that Demirel was synonymous with the establishment. Establishment parties in Turkey have, time and again, proven unable to change the political system.

During most of the Cold War—and particularly during the 1980s and 1990s—Turkey had, for lack of a better word, a Kemalist consensus, and those outside the consensus, especially the Islamists and the Kurds were essentially excluded from politics.

The first wave of democratization in the post-Cold War era in Turkey came from the Islamists—specifically, from the Justice and Development Party (AKP). In 2002, when the AKP came to power, it decided that accession to the European Union should be its main goal and that that effort could serve as tool to undermine the political power of the Turkish military, which still lurked behind the scenes. So, incredibly, the AKP, an Islamist party, decided to bring about a post-Kemalist system by pushing for membership in the EU's essentially liberal, democratic project. This strategy explains why Turkish liberals supported the AKP and could hope that the Islamists would push the system in a liberal direction.

But then something tragic happened. The AKP became the establishment. After the military was essentially defeated as a political force, the AKP ceased to be an anti-establishment party. Rather, it became a party that started to use the privileges of power, and itself began its own networks of patronage clientelism, and became a victim of this entity called the state. The AKP became the state.

I think similar dynamics were at play in Demirel's political career. Demirel, too, started his career by challenging the establishment but ended up becoming one of the most permanent politicians identified with the state. His ability to change the system vanished the minute he became the system. The real puzzle is the failure of establishment political parties to challenge the system. It would have been wonderful for a center-right party or a center-left party to have taken Turkey to the post-Kemalist phase, to a post-military, pro-EU and progressive phase. But the mainstream political parties have failed. The establishment of Turkey has failed. The Kemalist order in Turkey has failed. And together with that order, Demirel failed.

There is reason to think that, in Turkey, only anti-establishment parties can actually improve the system. The old AKP was an anti-establishment party. Now we're in a situation where the second wave of democratization may also come from an anti-establishment party, this one mostly representing the Kurds. The most democratic, the most liberal, the most progressive narrative heard in Turkish politics today comes from Selahattin Demirtaş, co-leader of the pro-Kurdish Peoples' Democratic Party (HDP) -- not the main opposition Republican People's Party (CHP), not the far-right Nationalist Movement Party (MHP), and not the AKP.

What gives me hope about the HDP is that, even when it enters Parliament—and even if a miracle happens and it enters a coalition government—it will never become the state. By definition, the HDP is a Kurdish political party. The Islamists were able to become the state because Turkey is 99 percent Muslim and people could basically establish a sense of supremacy based on Muslim identity. The Kurds will never be able to represent the majority. They will never be able to become the state. They have vested and permanent interest in the rule of law—indeed their very survival depends on it. Their survival depends on minority rights and on checks and balances. This stark fact gives me hope about the HDP and its agenda.

This piece was originally published by Today's Zaman.

       

       

Editors’ Note: Since President François Hollande’s 2012 election, France has launched an Asia-wide initiative in an attempt to halt declining trade figures and improve its overall leverage with the region, write Philippe Le Corre and Michael O’Hanlon. This piece originally appeared on The National Interest.

On April 26, France’s defense shipbuilding company DCNS secured a victory in winning, against Japan and Germany, a long-awaited $40 billion Australian submarine deal. It may not come as a surprise to anyone who has been following France’s growing interest in the Asia-Pacific for the past five years. Since President François Hollande’s 2012 election, the country has launched an Asia-wide initiative in an attempt to halt declining trade figures and improve its overall leverage with the region.

Visiting New Caledonia last weekend, Prime Minister Manuel Valls immediately decided on the spot to fly to Australia to celebrate the submarine news. Having been at odds in the 1990s over France’s decision to test its nuclear weapon capacities on an isolated Pacific island, Paris and Canberra have begun a close partnership over the last decade, culminating in the decision by Australia’s Prime Minister Malcolm Turnbull, in power since September 2015.

Unlike its Japanese competitor Mitsubishi Heavy Industries (MHI), DCNS promised to build the submarine main parts on Australian soil, creating 2,900 jobs in the Adelaide area. The French also secured support from U.S. defense contractors Lockheed Martin and Raytheon, one of which will eventually build the twelve shortfin Barracuda submarines’ combat systems. Meanwhile, this unexpected victory, in light of the close strategic relationship between Australia and Japan, has shed light on France’s sustained ambitions in the Asia-Pacific region. Thanks to its overseas territories of New Caledonia, Wallis and Futuna, French Polynesia and Clipperton Island, France has the world’s second-largest maritime domain. It is also part of QUAD, the Quadrilateral Defence Coordination Group that also includes the United States, Australia and New Zealand, and which coordinates security efforts in the Pacific, particularly in the maritime domain, by supporting island states to robustly and sustainably manage their natural resources, including fisheries.

France is also attempting to correct an excessive focus on China by developing new ties with India, Japan, South Korea and Southeast Asian countries, which have all received a number of French ministerial visits. France’s overseas territories also include a presence in the southern part of the Indian Ocean, with the islands of Mayotte, Réunion and the Scattered Islands, and French Southern and Antarctic Territories, as well as the northwest region of the Indian Ocean through its permanent military presence in the United Arab Emirates and Djibouti. Altogether these presences encompass one million French citizens. This sets France apart from its fellow EU member states regarding defense and security in the Asia-Pacific, particularly as France is a top supplier of military equipment to several Asian countries including Singapore, Malaysia, India and Australia. Between 2008 and 2012, Asian nations accounted for 28 percent of French defense equipment sales, versus 12 percent during 1998–2002. (More broadly, 70 percent of European containerized merchandise trade transits through the Indian Ocean.)

Despite its unique position, France is also supportive of a joint European Union policy toward the region, especially when it comes to developments in the South China Sea. Last March, with support from Paris, Berlin, London and other members, Federica Mogherini, the EU’s High representative for Foreign Affairs and Security Policy, issued a statement criticizing China’s actions:

“The EU is committed to maintaining a legal order for the seas and oceans based upon the principles of international law, as reflected notably in the United Nations Convention on the Law of the Sea (UNCLOS). This includes the maintenance of maritime safety, security, and cooperation, freedom of navigation and overflight. While not taking a position on claims to land territory and maritime space in the South China Sea, the EU urges all claimants to resolve disputes through peaceful means, to clarify the basis of their claims, and to pursue them in accordance with international law including UNCLOS and its arbitration procedures.”

This does not mean that France is neglecting its “global partnership” with China. In 2014, the two countries celebrated fifty years of diplomatic relations; both governments conduct annual bilateral dialogues on international and security issues. But as a key EU state, a permanent member of the UN Security Council and a significant contributor to the Asia-Pacific’s security, France has launched a multidimensional Asia policy.

All of this should be seen as welcome news by Washington. While there would have been advantages to any of the three worthy bids, a greater French role in the Asia-Pacific should be beneficial. At this crucial historical moment in China's rise and the region's broader blossoming, the United States needs a strong and engaged European partnership to encourage Beijing in the right direction and push back together when that does not occur. Acting in concert with some of the world's other major democracies can add further legitimacy to America's actions to uphold the international order in the Asia-Pacific. To be sure, Japan, South Korea and Australia are key U.S. partners here and will remain so. But each also has its own limitations (and in Japan's case, a great deal of historical baggage in dealing with China).

European states are already heavily involved in economic interactions with China. The submarine decision will help ensure a broader European role that includes a hard-headed perspective on security trends as well.

      

       

       

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 Institution, ExpandNet (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.