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Cloud computing services over the Internet have the potential to spur a significant increase in government efficiency and decrease technology costs, as well as to create incentives and online platforms for innovation. Adoption of cloud computing technologies could lead to new, efficient ways of governing.

On April 7, the Brookings Institution hosted a policy forum that examines the economic benefits of cloud computing for local, state, and federal government. Federal Chief Information Officer Vivek Kundra delivered a keynote address on the role of the government in developing and promoting cloud computing. Brookings Vice President Darrell West moderated a panel of experts and detailed the findings in his paper, "Saving Money through Cloud Computing," which analyzes its governmental cost-savings potential.

After the program, panelists took audience questions.

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• Cloud Computing a Fiscally Smart Move
• Cloud Computing Saves Money, Makes Government More Open
• Cloud Computing Will Fundamentally Change Government Operations
• Government on Cloud Will Yield Cost-Effective System

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• The Economic Gains of Cloud Computing

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• Uncorrected Transcript (.pdf)

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INTRODUCTION

Later this month, Egyptians will go to the polls, or attempt to, in order to vote in the country’s parliamentary elections. The elections will unlikely be a democratic affair in the Western sense. In fact, opposition candidates, voters, citizen groups—essentially everyone other than government representatives—are fully expecting the elections to be a violent and rigged episode. For easy reference, one can look to the June elections for the Shura Council, or upper house of Parliament, in which the governing National Democratic Party (NDP) managed to land 80 out of a possible 84 seats. Those elections were marked by violence and allegations of rampant violations.

Elections in Egypt are not generally democratic, they do not necessarily reflect the will of the people, and they will invariably usher in a house in which the NDP has an unshakeable majority. More so, the elected body has very little control over the government and none over the president, who, thanks to some creative constitutional amendments in 2007, can dissolve the Parliament at will. Election results are apparently so preordained that many have questioned the wisdom of participating at all. Opposition groups, among them the National Alliance for Change (NAC), led by former International Atomic Energy Agency (IAEA) head and current political reformer Mohamed ElBaradei, have been calling for a boycott. ElBaradei told reporters at a Ramadan Iftar meeting on September 7 that voting “would go against the national will.” Many political analysts and some members of the opposition have echoed the belief that participation in the elections only gives credence to a fundamentally flawed system and perpetuates the state myth of a democratic nation.

The above argument certainly has its merits, but it misses the point. Elections in Egypt are not about who wins seats—that is usually a foregone conclusion. They are about the “how and the what,” in the sense that they are oases of political activity, demand, and dissension in an otherwise arid climate. In that way, every election fought represents losses and gains for the respective participants in ways that invariably influence the following elections. Also, the ballot boxes can yield surprising results—as in the case of the 2005 elections when the Muslim Brotherhood (MB) gained a jawdropping 88 of 454 seats in the elections for the lower house. This outcome certainly would not have come about if the Brotherhood had not participated. To be sure, there are also significant, detrimental changes that happen as a direct consequence of the elections, among them constitutional amendments designed to hobble the opposition’s ability to field candidates and campaign. Still, for opposition parties and movements, boycotting the elections is the equivalent of throwing away the only political participation they have. It would mean relinquishing any visibility or influence and it would mean admitting to their supporters that they are essentially mere window dressings in the democratic façade. Arguably, this is a reason why these elections have only ever been boycotted once, in 1990. The Egyptian political arena is one where contestants scrabble for the smallest patch of ground. The high moral ground simply does not figure into it.

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Editor's note: On March 1, Alice Rivlin testified before the U.S. House of Representatives Committee on Energy and Commerce Subcommittee on Health on the financing and delivery of long-term care in the US. 

Chairman Pitts, Ranking Member Green: I am happy to be back before this Subcommittee, which is never afraid to take on complex issues of great importance to millions of Americans. I have worked on long-term services and supports (LTSS) for a long time and have recently had the privilege of co-chairing the Long-Term Care Initiative at the Bipartisan Policy Center (along with former Senators Bill Frist and Tom Daschle and former Governor and Secretary of Health and Human Services, Tommy Thompson). Our February 2016 report, Initial Recommendations to Improve the Financing of Long-Term Care, appended to my testimony, outlines a set of doable, practical changes in both public and private programs that could improve the availability and affordability of long-term services and supports.

I don’t need to remind this committee that Americans are living longer, and many of us will need help with the ordinary activities of daily living and suffer cognitive impairments that make it dangerous for us to cope alone. The number of people needing LTSS is rising and expected to double in the next 35 years or so.

Responsibility for LTSS is shared among seniors and people with disabilities themselves, family, friends, and volunteer care-givers; communities, state, and federal government. This shared-responsibility system is severely stressed, and will become increasingly unable to cope as the numbers needing care increase. Growing burdens fall on families, often daughters and daughters-in-law, who must manage daily conflicts between earning a living, caring for children, and meeting the needs of elderly or disabled relatives. Growth in Medicaid, the largest payer of long-term services and supports at about $123 billion per year, stresses state and federal budgets as spending for older Americans and individuals with disabilities competes with budgets for education and other investments in young people.

Many efforts to find a comprehensive solution to long-term care financing have failed—evidenced by passage and subsequent repeal of the Community Living Assistance Services and Supports (CLASS) Act and failure of the federal Long-term Care Commission to reach consensus on financing recommendations. Recently, however, a growing consensus has emerged around a set of incremental steps, which, if taken together could greatly improve the availability and affordability of long-term services and supports to America’s most vulnerable populations and take some of the burden off families and Medicaid in a fiscally responsible way. In recent weeks, The Bipartisan Policy Center and The Long-term Care Collaborative have offered similar sets of recommendations, as has LeadingAge, a key provider association.

While policymakers failed to agree on big legislative solutions, amazing progress has been made at the community level in finding new ways of keeping older Americans and people with disabilities out of institutions and in the community where they are happier and less isolated and can be served more effectively and cheaper. There has been an explosion of assisted living facilities, continuing care communities, senior villages, senior centers, senior daycare, and use of home health aides of various sorts. Growth in home and community-based services (HCBS) has been rapid, while the population served by traditional nursing homes has been virtually flat. Medicaid, with the support of both parties in Congress, has moved to increase the availability of home and community-based services.

The group working on the Bipartisan Policy Center’s Long-Term Care Initiative addressed the question: Is there a set of practical policies that could command bipartisan support that would improve the care of older Americans with disabilities, take significant pressure off families and Medicaid, and not break the bank? We came up with four proposals.

Make private long-term care insurance more affordable and available. Long term care ought to be an insurable risk. If more people bought Long-Term Care Insurance (LTCI) in their earning years, there would be less pressure on their savings and family resources and Medicaid when they became disabled. But both demand and supply of LTCI are weak and falling. Potential customers are reluctant to buy because it is costly and the need seems remote and hard to think about. Carriers find it difficult to price a product that will be used far in the future and fear losing money if customers live and use services for a long time. Many insurance companies have stopped offering LTCI.

Our report recommends developing a new type of private insurance product: “retirement long-term care insurance,” which would cover long-term care for a limited period (2-4 years) after a substantial deductible or waiting period and would have coinsurance. The insurance would provide inflation protection, which helps to ensure benefits keep pace with the rising costs of care, and a non-forfeiture benefit, which allows lapsed policyholders to access a limited benefit. Employers would be encouraged to offer such policies as a default option as part of a retirement plan. These policies, if offered through employers and public and private insurance exchanges, could cut premiums in half according estimates done by Milliman, LLC, for the Bipartisan Policy Center and other organizations. Penalty-free withdrawals would be allowed from retirement plans, such as 401(k) plans and IRAs, beginning at age 45, exclusively for the purchase of retirement LTCI.

Design a federal long-term care insurance option for those with catastrophic costs. Part of the reluctance of carriers to offer LTCI relates to the difficulty of predicting costs far in the future and the fact that a few policy holders may have extremely high costs for a very long time. A public program, covering truly catastrophic long-term care spending, could overcome this reluctance and reduce the cost of private LTCI. Catastrophic insurance, combined with retirement LTCI from the private market, could substantially relieve families and Medicaid. The cost of this program should be fully offset so as not to add to the deficit.

Streamline Medicaid home and community-based care options to encourage more effective care in lower-cost settings. While Congress has been proactive in encouraging state Medicaid programs to shift care settings from institutions to home and community-based care, states continue to face a daunting federal waiver process and multiple state options. Securing waivers requires complex negotiations between states and the federal government, and each of the existing state options have disincentives. Home and community-based options should be simplified into a single streamlined state plan amendment process.

Ensure that working people with disabilities in need of long-term services and supports do not lose access to their long-term services and supports as earnings increase. Individuals with modest employment incomes risk losing access to services that permit them to remain on the job. Existing Medicaid “buy-in” programs are often costly. Building on the “Achieving a Better Life Experience,” or “ABLE” Act, states could be given the option to offer a lower-cost, Medicaid buy-in for long-term services and supports designed to “wrap around” private health insurance or Medicare. Under this option, working individuals with disabilities would pay an income-related, sliding-scale premium.

Mr. Chairman and members of the Committee, thank you again for the opportunity to share my thoughts on this issue. It is one of America’s big challenges, but it’s an even bigger opportunity for a constructive bipartisan policy process. I look forward to continued dialogue and will keep you apprised of forthcoming recommendations by BPC’s Long-Term Care Initiative in 2016 and 2017.

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Fee-for-service payments encourage high-volume services rather than high-quality care. Alternative payment models (APMs) aim to realign financing to support high-value services.

The 2 main components of gastroenterologic care, procedures and chronic care management, call for a range of APMs. The first step for gastroenterologists is to identify the most important conditions and opportunities to improve care and reduce waste that do not require financial support.

We describe examples of delivery reforms and emerging APMs to accomplish these care improvements. A bundled payment for an episode of care, in which a provider is given a lump sum payment to cover the cost of services provided during the defined episode, can support better care for a discrete procedure such as a colonoscopy. Improved management of chronic conditions can be supported through a per-member, per-month (PMPM) payment to offer extended services and care coordination.

For complex chronic conditions such as inflammatory bowel disease, in which the gastroenterologist is the principal care coordinator, the PMPM payment could be given to a gastroenterology medical home. For conditions in which the gastroenterologist acts primarily as a consultant for primary care, such as noncomplex gastroesophageal reflux or hepatitis C, a PMPM payment can support effective care coordination in a medical neighborhood delivery model. Each APM can be supplemented with a shared savings component.

Gastroenterologists must engage with and be early leaders of these redesign discussions to be prepared for a time when APMs may be more prevalent and no longer voluntary.

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The Center for Medicare and Medicaid Innovation (CMMI, or “the Innovation Center”) recently announced an initiative called Comprehensive Primary Care Plus (CPC+). It evolved from the Comprehensive Primary Care (CPC) initiative, which began in 2012 and runs through the end of this year. Both initiatives are designed to promote and support primary care physicians in organizing their practices to deliver comprehensive primary care services. Comprehensive Primary Care Plus has some very promising components, but also misses some compelling opportunities to further advance payment for primary care services.

The earlier initiative, CPC, paid qualified primary care practices a monthly fee per Medicare beneficiary to support practices in making changes in the way they deliver care, centered on five comprehensive primary care functions: (1) access and continuity; (2) care management; (3) comprehensiveness and coordination; (4) patient and caregiver engagement; and, (5) planned care and population health. For all other care, regular fee-for-service (FFS) payment continued. The initiative was limited to seven regions where CMMI could reach agreements with key private insurers and the Medicaid program to pursue a parallel approach. The evaluation funded by CMMI found quality improvements and expenditure reductions, but savings did not cover the extra payments to practices.

Comprehensive Primary Care Plus uses the same strategy of conducting the experiment in regions where key payers are pursuing parallel efforts. In these regions, qualifying primary care practices can choose one of two tracks. Track 1 is very similar to CPC. The monthly care management fee per beneficiary remains the same, but an extra $2.50 is paid in advance, subject to refund to the government if a practice does not meet quality and utilization performance thresholds.

The Promise Of CPC+

Track 2, the more interesting part of the initiative, is for practices that are already capable of carrying out the primary care functions and are ready to increase their comprehensiveness. In addition to a higher monthly care management fee ($28), practices receive Comprehensive Primary Care Payments. These include a portion of the expected reimbursements for Evaluation and Management services, paid in advance, and reduced regular fee-for-service payments. Track 2 also includes larger rewards than does Track 1 for meeting performance thresholds.

The combination of larger per beneficiary monthly payments and lower payments for services is the most important part of the initiative. By blending capitation (monthly payments not tied to service volume) and FFS, this approach might achieve the best of both worlds.

Even when FFS payment rates are calibrated correctly (discussed below), the rates are pegged to the average costs across practices. But since a large part of practice cost is fixed, it means that the marginal cost of providing additional services is lower than the average cost, leading to incentives to increase volume under FFS. The lower payments reduce or eliminate these incentives. Fixed costs, which must also be covered, are addressed through the Comprehensive Primary Care Payments. By involving multiple payers, practices are put in a better position to pursue these changes.

An advantage of any program that increases payments to primary care practices is that it can partially compensate for a flaw in the relative value scale behind the Medicare physician fee schedule. This flaw leads to underpayment for primary care services. Although the initial relative value scale implemented in 1992 led to substantial redistribution in favor of evaluation and management services and to physicians who provide the bulk of them, a flawed update process has eroded these gains over the years to a substantial degree.

In response to legislation, the Centers for Medicare and Medicaid Services are working correct these problems, but progress is likely to come slowly. Higher payments for primary care practices through the CPC+ can help slow the degree to which physicians are leaving primary care until more fundamental fixes are made to the fee schedule. Indeed, years of interviews with private insurance executives have convinced us that concern about loss of the primary care physician workforce has been a key motivation for offering higher payment to primary care physicians in practices certified as patient centered medical homes.

Two Downsides

But there are two downsides to the CPC+.

One concerns the lack of incentives for primary care physicians to take steps to reduce costs for services beyond those delivered by their practices. These include referring their patients to efficient specialists and hospitals, as well as limiting hospital admissions. There are rewards in CPC+ for lower overall utilization by attributed beneficiaries and higher quality, but they are very small.

We had hoped that CMMI might have been inspired by the promising initiatives of CareFirst Blue Cross Blue Shield and the Arkansas Health Care Improvement initiative, which includes the Arkansas Medicaid program and Arkansas Blue Cross Blue Shield. Under those programs, primary care physicians are offered substantial bonuses for keeping spending for all services under trend for their panel of patients; there is no downside risk, which is understandable given the small percentage of spending accounted for by primary care. The private and public payers also support the primary care practices with care managers and with data on all of the services used by their patients and on the efficiency of providers they might refer to. These programs appear to be popular with physicians and have had promising early results.

The second downside concerns the inability of physicians participating in CPC+ to participate in accountable care organizations (ACOs). One of CMMI’s challenges in pursuing a wide variety of payment innovations is apportioning responsibility across the programs for beneficiaries who are attributed to multiple payment reforms. As an example, if a beneficiary attributed to an ACO has a knee replacement under one of Medicare’s a bundled payment initiatives, to avoid overpayment of shared savings, gains or losses are credited to the providers involved in the bundled payment and not to the ACO. As a result, ACOs are no longer rewarded for using certain tools to address overall spending, such as steering attributed beneficiaries to efficient providers for an episode of care or encouraging primary care physicians to increase the comprehensiveness of the care they deliver.

Keeping the physician participants in CPC+ out of ACOs altogether seems to be another step to undermine the potential of ACOs in favor of other payment approaches. This is not wise. The Innovation Center has appropriately not established a priority ranking for its various initiatives, but some of its actions have implicitly put ACOs at the bottom of the rankings. Recently, Mostashari, Kocher, and McClellan proposed addressing this issue by adding a CPC+ACO option to this initiative.

In an update to its FAQ published May 27, 2016 (after out blog was put into final form), CMMI eased its restriction somewhat by allowing up to 1,500 of the 5000 practices expected to participate in CPC+ to also participate in Medicare Shared Savings Program (MSSP) ACOs. But the prohibition continues to apply to Next Gen ACOs, the model that has created the most enthusiasm in the field. If demand for these positions in MSSP ACOs exceeds 1,500, a lottery will be held. This change is welcome but does not really address the issue of disadvantaging ACOs in situations where a beneficiary is attributed to two or more payment reform models. CMMI is sending a signal that CPC+, notwithstanding its lack of incentives concerning spending outside of primary care, is a powerful enough reform that diverting practices away from ACOs is not a problem. ACOs are completely dependent on primary care physician membership to function, meaning that any physician practices beyond 1,500 that enroll in CPC+ will reduce the size and the impact of the ACO program. CMMI has never published a priority ranking of reform models, but its actions keep indicating that ACOs are at the bottom.

The Innovation Center should be lauded for continuing to support improved payment models for primary care. Its blending of substantial monthly payments with lower payments per service is promising. But the highest potential rewards come from broadening primary care physicians’ incentives to include the cost and quality of services by other providers. CMMI should pursue this approach.

Editor's note: This piece originally appeared in Health Affairs Blog.

As the nation still struggles with high healthcare costs that consume larger and larger portions of patient budgets as well as government coffers, the search for ways to get costs under control continues. Total healthcare spending in the U.S. now represents almost 18 percent of our entire economy. One promising cost-savings approach is called “reference pricing,” where the insurer establishes a price ceiling on selected services (joint replacement, colonoscopy, lab tests, etc.). Often, this price cap is based on the average of the negotiated prices for providers in its network, and anything above the reference price has to be covered by the insured consumer.

A study published in JAMA Internal Medicine by James Robinson and colleagues analyzed grocery store Safeway’s experience with reference pricing for laboratory services such as such as a lipid panel, comprehensive metabolic panel or prostate-specific antigen test. Safeway’s non-union employees were given information on prices at all laboratories through a mobile digital platform and told what Safeway would cover. Patients who chose a lab charging above the payment limit were required to pay the full difference themselves.

Employers see this type of program as a way to incentivize employees to think through the price of services when making healthcare decisions. Employees enjoy savings when they switch to a provider whose negotiated price is below the reference price, whereas if they choose services above it, they are responsible for the additional cost.

Robinson’s results show substantial savings to both Safeway and to its covered employees from reference pricing. Compared to trends in prices paid by insurance enrollees not subject to the caps of reference pricing, costs paid per test went down almost 32 percent, with a total savings over three years of $2.57 million – patients saved $1.05 million in out-of-pocket costs and Safeway saved $1.7 million.

I wrote an accompanying editorial in JAMA Internal Medicine focusing on different types of consumer-driven approaches to obtain lower prices; I argue that approaches that make the job simpler for consumers are likely to be even more successful. There is some work involved for patients to make reference pricing work, and many may have little awareness of price differences across laboratories, especially differences between those in some physicians’ offices, which tend to be more expensive but also more convenient, and in large commercial laboratories. Safeway helped steer their employees with accessible information: they provided employees with a smartphone app to compare lab prices.

But high-deductible plans like Safeway’s that provide extensive price information to consumers often have only limited impact because of the complexity of shopping for each service involved in a course of treatment -- something close to impossible for inpatient care. In addition, high deductibles are typically met for most hospitalizations (which tend to be the very expensive), so those consumers are less incentivized to comparison shop.

Plans that have limited provider networks relieve the consumer of much complexity and steer them towards providers with lower costs. Rather than review extensive price information, the consumer can focus on whether the provider is in the network. Reference pricing is another approach that simplifies—is the price less than the reference price? What was striking about Robinson’s results is that reference pricing for laboratories was employed in a high-deductible plan, showing that the savings achieved—in excess of 30 percent compared to a control—were beyond what the high deductible had accomplished.

While promising, reference pricing cannot be applied to all medical services: it works best for standardized services and where variation in quality is less of a concern. It also can be applied only to services that are “shoppable,” which is only about one-third of privately-insured spending. Even if reference pricing expanded to a number of other medical services, other cost containment approaches, including other network strategies, are needed to successfully contain health spending and lower costs for non-shoppable medical services.

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

International volunteer service is defined as an organized period of engagement and contribution to society by individuals who volunteer across an international border. There is growing interest in the potential of international service to foster international understanding between peoples and nations and to promote global citizenship and intercultural cooperation. Studies suggest that international service develops skills, mindsets, behaviors and networks that prepare volunteers for living and working in a knowledge-based global economy. Many believe that even short-term experiences abroad can begin to prepare participants for longer-term engagement and future international service.

International service may be growing in prevalence worldwide. In the United States, more than one million Americans reported volunteering abroad in 2008. Despite the scale of international service, its impacts are not well understood. Although there is a growing body of descriptive evidence about the various models and intended outcomes of international service, the overwhelming majority of research is based on case and cross-sectional studies, which do not permit conclusions about the impacts of international service. Scholars and practitioners in the field have called for rigorous research that documents impacts.

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David Caprara, a Brookings nonresident fellow and expert on volunteering, says that John F. Kennedy’s call to service a half-century ago led to the founding of dozens of international aid organizations, and leaves a legacy of programs aimed at improving health, nutrition, education, living standards and peaceful cooperation around the globe.

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Robert Sargent Shriver, Jr. guided the Peace Corps from its inception in 1961 (when it was a nascent vision of service and citizen diplomacy) to establish a renowned track record of success over the past half century, in which more than 200,000 volunteers and trainees have served in 139 countries.

The legacy of Shriver’s leadership with the Peace Corps and later with the Office on Economic Opportunity and Special Olympics has reached and changed millions of lives—of both those empowered and those who served—from impoverished communities across rural and urban America to huts and villages in developing nations throughout the world. Yet one of the greatest gifts he leaves us is the foundation to build on those accomplishments to scale-up service as a direly needed “soft power” alternative to establish international understanding and collaboration in a volatile world. As Sarge put it, so simply but powerfully: “Caring for others is the practice of peace.”

Sarge Shriver’s unquenchable idealism today is being advanced by a new generation of social entrepreneurs such as Dr. Ed O’Neil, founder of OmniMed and chair of the Brookings International Volunteering Project health service policy group. With the help of Peace Corps volunteers and USAID-supported Volunteers for Prosperity, O’Neil has fielded an impressive service initiative in Ugandan villages that has expanded the capacity and reach of local health-service volunteers engaged in malaria prevention and education on basic hygiene. 

Timothy Shriver, who succeeded his parents, Sarge and Eunice, at the helm of the Special Olympics, speaks eloquently on the move of a second generation from politics to building civil society coalitions promoting soft power acts of service and love, one at a time. This impulse is echoed in the Service World policy platform which hundreds of NGOs and faith-based groups, corporations and universities have launched to scale-up the impact of international service initiatives. This ambitious undertaking was first announced by longtime Shriver protégé former Senator Harris Wofford at a Service Nation forum convened on the morning of President Obama’s Cairo speech in which he called for a new wave of global service and interfaith initiatives.

I had the privilege of serving as a national director of the VISTA program inspired by Shriver and  to work alongside Senator Wofford and John Bridgeland, President George W. Bush’s  former White House Freedom Corps director, who have co-chaired the Brookings International Volunteering Project policy team. Along with Tim Shriver, they have ignited the Service World call to action, together with Michelle Nunn of Points of Light Institute, Steve Rosenthal of the Building Bridges Coalition, Kevin Quigley of the National Peace Corps Association and many others.

The Obama administration and Congress would best honor the life and legacy of Sarge Shriver by calling for congressional hearings and fast- tracking agency actions outlined in the Service World platform and naming the global service legislation after him. Coupled with innovative private-sector and federal agency innovations, the legislation would authorize Global Service Fellowships, link volunteer capacity-building to USAID development programs such as  Volunteers for Prosperity, and double the Peace Corps to reach a combined goal of 100,000 global service volunteers annually—a goal first declared by JFK.

Those who promote opportunity and service as vehicles to advance peace and international collaboration will continue to draw inspiration from Sargent Shriver’s indefatigable quest for social justice―from the time he talked then-Senator John F. Kennedy into intervening in the unjust jailing of Martin Luther King, Jr. to his refusal to accept wanton violence and impoverished conditions in any corner of the world.

Information on offering online tributes to the Shriver family and donations in lieu of flowers requested by the family of Sargent Shriver can be found at www.sargentshriver.org .

Today could have been the day when Senate Democrats went nuclear – reining in minority party abuse of the filibuster with a simple majority vote.  That would have been my Super Bowl.  Instead, the Senate is poised to adopt a bipartisan set of modest (many say, meager) changes to the Senate’s cloture rule.   More like the Famous Idaho Potato Bowl, I say.

As many have noted (for starters, Ezra Klein here and Jonathan Bernstein here), the proposed changes to the Senate’s Rule 22 fall far short of what reformers had hoped for.  Much blame has been heaped on Harry Reid, the Democratic leader, and on a few senior Democrats, highlighting their resistance to abandoning the Senate’s sixty-vote threshold for bringing the chamber to a vote.  The reforms are modest, largely finding ways of speeding up the Senate once both parties have agreed on the matter at hand (for instance on the way to advancing a measure to the floor or after cutting off debate on a nomination).  Even if the changes may seem to many like small potatoes, I think there’s more to be gleaned from the Senate’s brush with reform.

First, take a little, give a little.  Today’s rule changes remind us that there is no free lunch when it comes to Senate reform.  That hurdle is built into Rule 22, given its requirement that 67 senators consent to a vote on efforts to reform Rule 22.  In the absence of majority willing to bear the costs of asserting the majority’s right to change its rules, Senate reform is necessarily bipartisan and incremental.  Reforms must secure the consent of the minority, or be packaged with changes judged equally important to the opposition.  (Recall that even when reformers reduced cloture to 60 votes in 1975, they paid a price: 67 votes would still be required to end debate on changing Rule 22.)  Today’s reforms allow a majority to circumvent filibusters of motions to proceed to legislative measures.  In return, the majority pays a price each time: The minority is guaranteed votes on two amendments, whereas previously recent leaders might have precluded all amendments by immediately “filling the tree.”  To be sure, this potentially dilutes the value of the rule change for the majority.   But concessions are dictated by the Senate’s inherited rules.  (And, of course, nothing is that simple when it comes to Senate rules; the majority may yet fill the tree, at least after the disposition of the minority’s amendments.)

Second, I suspect we might be underestimating the importance of a non-debatable motion to proceed for the majority party in a period of partisan polarization.  Judging from the increase in filibusters on the motions to proceed in recent years, minority parties have fought hard to keep bills off the floor that they oppose on policy or political grounds.   So long as the motion to proceed could be filibustered, majority and minority parties shared agenda-setting powers.  Today’s change grants the majority a slightly stronger hand in choosing the chamber agenda.  To be sure, the minority can still filibuster the bill and amendments beyond those newly guaranteed, but the reform undermines the minority’s ability to throw the majority off course.  Take immigration policy, for example.  Filibusters of the motion to proceed have kept the DREAM Act off the Senate floor in recent years.  Minority influence over the Senate’s agenda is diminished with today’s reform.

Third, these are leader-driven reforms, shaped by the unique burdens carried by the majority and (sometimes) minority leaders.  For example, the reforms speed up post-cloture debate on some judicial and executive branch nominations, and allow the chamber to hurry onto cloture votes on motions to proceed to legislative business when the minority offers a modicum of support.  No surprise that these housekeeping changes elicit little enthusiasm.   These changes don’t make it any easier for a majority to break sizable minority opposition.  And they potentially make it harder for rank and file senators to exploit the rules in pursuit of their own policy goals.  But from leaders’ perspectives, the reforms rein in the excesses of rank and file dissent when a bipartisan group is ready to move ahead.  As one Senate Democrat aide confided, “that’s all Reid ever really wanted.”

Finally, this episode highlights the limitation of the Constitutional option and other “reform-by-ruling” strategies.  There appears to have been a majority or near-majority support for securing only very limited reform of Rule 22.  Senators seem unwilling to use the tactic for a major overhaul of the Senate’s cloture rule—in part because of the fear of minority retaliation, in part because the filibuster rule likely serves as the foundation of senators’ power.   To be sure, Harry Reid aggressively used reform-by-ruling in the fall of 2011 to secure smaller changes to Rule 22 (as did Robert Byrd in the 1980s).  But we have to reach back nearly forty years to the 1975 reforms to find a Senate majority willing to go nuclear to impose major changes to Rule 22.  (Even then, reformers proceeded without the support of the majority leader, Mike Mansfield.)  Perhaps senators see the consequences of weakening Rule 22 in a different light when the parties polarize over policy problems and solutions, with senators nervous about curtailing extended debate when the tables turn on their majority.  Regardless, so long as majorities will only form to impose  minor reform by majority vote, those majorities will be forced to live under supermajority rules that daily frustrate their policy and political agendas.

And in the Senate’s world, those frustrating days can last for weeks!

Stephen was still a teenager on the north side of St. Louis when his dad, a police officer, was killed during a robbery in their neighborhood. Despite the trauma, Stephen later joined the police force to continue his dad’s legacy and commitment to safe and inclusive neighborhoods. But even before the fatal shooting of Michael Brown in Ferguson in 2014, Stephen (not his real name) yearned to right local wrongs through broader approaches. “The darkest forces weren’t necessarily the ones getting arrested,” he observed. “So I retired from the police force after 22 years, essentially to chase after a different type of perpetrator.” Wanting to focus on policies at multiple levels of government that “were causing the disparities that fueled increasing crime and violence in St. Louis,” Stephen pivoted to civil rights enforcement, tracking policy violations and innovations at a government agency in the St. Louis region.

I met Stephen in February while in St. Louis for a conference his agency organized on HUD’s recently strengthened Affirmatively Furthering Fair Housing (AFFH ) rule, which increases local accountability in promoting residential integration. He wasn’t a speaker at the event, but hearing his story reinforced the importance of combating the deeply entrenched and often invisible causes of segregation.

Recent events and new academic research, including landmark findings by Raj Chetty and colleagues testifying to the benefits of low-poverty neighborhoods for low-income kids, the updated AFFH rule, and the Supreme Court’s disparate impact decision upholding other tools to fight segregation have brought renewed attention to these challenges. Meanwhile, underlying these developments, poverty has failed to decline since the recession and, as recent Brookings research shows, has become more concentrated in neighborhoods of extreme poverty.

How can regional leaders and practitioners respond to these challenges? I was in St. Louis to discuss one part of the solution—advancing more mixed-income neighborhoods. In the Chicago region, our housing and community development-focused firm, BRicK Partners, is collaborating with the Chicago Metropolitan Agency for Planning (CMAP), the Illinois Housing Development Authority (IHDA), and 10 metropolitan Chicago public housing authorities, with support and leadership from HUD, to develop and operate the Regional Housing Initiative (RHI)

RHI is a small, systemic, and potentially scalable “work around” of a very specific set of programs and policies that contribute inadvertently to regional inequities. A flexible and regional pool of resources working across the many traditional public housing authority (PHA) and municipal jurisdictions in the Chicago region, RHI increases quality rental housing in neighborhoods with good jobs, schools, and transit access and provides more housing options to households on Housing Choice Voucher (HCV) waiting lists. Recognizing that the federal formulas allocating HCVs to each individual PHA are not responsive to population, employment, or poverty trends, RHI partners convert and pool a small portion of their HCVs to provide place-based operating subsidies in support of development activity that advances local and regional priorities. RHI supports both opportunity areas with strong markets and quality amenities as well as revitalization areas where public and private sector partners are planning and investing toward that end. In both cases, the bulk of RHI investments are in the suburbs, where the PHAs are smaller and the rental stock more limited. 

RHI has committed over 550 RHI subsidies to nearly 40 mixed-income and supportive housing developments across Chicagoland, supporting more than 2,200 total apartments, over half of which are in opportunity areas. The pooling and transferring of subsidies has allowed RHI to support proposals that local jurisdictions wouldn’t be able to undertake otherwise.

Although a number of innovative programs around the country provide assistance to households moving to opportunity areas, RHI is unique its focus on increasing the supply of housing in opportunity areas regionwide. Its approach is consistent with lessons learned from Brookings’ work on Confronting Suburban Poverty in America: With CMAP as a strong quarterback, RHI has addressed the shortage of rental housing in the suburbs by working across jurisdictions, developing shared priorities, metrics and selection criteria, and by working with IHDA and other stakeholders to leverage greater private sector investment.

This recipe for success is now being deployed in communities beyond Chicago. Baltimore is preparing to advertise for its first round of developer applicants under the leadership of the Baltimore Metropolitan Council, with regionwide PHAs, the State Housing Finance Agency, and a regional housing counselor lined up as supportive partners. In St. Louis, the regional planning and housing finance organizations both attended the February conference where I met Stephen, signaling the potential for greater collaboration for both these entities and the PHAs.

Like many housing advocates and professionals, my colleagues and I at BRicK Partners derive a lot of satisfaction from supporting communities like Baltimore and St. Louis and individuals like Stephen and his peers with replicable best practices. Given today’s political realities, we don’t expect major changes in the federal formulas and statutes behind some of the regional inequities, but “work arounds” such as RHI can still scale up. Nationwide, just a small percentage of HCVs have been converted for such flexible supply-side solutions, but there is reason to be hopeful that this will change. The Regional Mobility Demonstration proposed in the 2017 budget as well as federal public housing voucher legislation passed by the House of Representatives earlier this year are signs that there is real momentum to advance regional strategies that increase access to opportunity for low income residents and families. 

Ranking U.S. metro areas, or counties, or even countries, by some fixed metric is a straightforward and often useful way to start a deeper dive into a larger body of research. For example, the top 10 counties by share of taxpayers claiming EITC, or the top 10 metro areas by change in prosperity. But what if the phenomenon being measured is more complex, has interacting characteristics that make a top 10 list less useful?

In new research, Brookings Senior Fellow Alan Berube, along with his colleagues at the Metropolitan Policy Program, and John Irons of the Rockefeller Foundation, ask “What makes an economy inclusive?” Inclusive economies, they say, “expand opportunities for more broadly shared prosperity, especially for those facing the greatest barriers to advancing their well-being.” A new Rockefeller Foundation framework identifies five characteristics of inclusive economies: equity, participation, stability, sustainability, and growth.

A typical ranking approach would list the top 10 inclusive economies (or the bottom 10) based on some score derived from data. It turns out, however, that understanding the “trends and relationships that might reveal the ‘big picture’ of what makes an economy inclusive” doesn’t lend itself to typical ranking techniques, and instead requires looking at relationships among the characteristics to ascertain that “big picture.”

Take, for example, equity, defined as: “More opportunities are available to enable upward mobility for more people.” For this analysis, Brookings researchers used 16 discrete indicators—such as the Gini coefficient, median income of less-educated workers as a share of overall median income, and transportation costs as a share of income—to come up with an equity score for each of the 100 largest U.S. metro areas. (Likewise, each of the other four inclusive economy indicators are composites of many discrete indicators, for a total of about 100 across the five.) Looking at equity alone, the top 10 metro areas are:

1. Allentown, PA-NJ
2. Harrisburg, PA
3. Ogden, UT
4. Scranton, PA
5. Des Moines, IA
6. Salt Lake City, UT
7. Wichita, KS
8. Grand Rapids, MI
9. Pittsburgh, PA
10. Worcester, MA-CT

Top 10 lists can also be fashioned for the other four dimensions in the inclusive economies research, each showing a different mix of U.S. metro areas. For example, the top three metro areas in the growth characteristic are San Jose, CA; Houston, TX; and Austin, TX. For participation: Madison, WI; Harrisburg, PA; and Des Moines. Stability: Madison; Minneapolis, MN-WI; and Provo, UT. And, sustainability: Seattle; Boston; and Portland, OR-WA. In fact, 30 different metropolitan areas are present in the combination of the five inclusive top 10 lists, spanning the country from Oxnard, to Omaha, to Raleigh. The individual top 10 lists for each inclusive economy characteristic look like this:

Because these rankings each impart useful and distinctive information about metro economies, Brookings researchers next combined the data into an overall ranking of the 100 metro areas “based on their average rankings on individual indicators for each of the five inclusive economy characteristics.” Instead of generating a ranking from 1 to 100, the analysis produces a grid-like chart that shows how metro areas fare not only in terms of inclusiveness (top to bottom), but also along a left-to-right spectrum that demonstrates the trade-offs between growth and equity. Here’s a sample from the chart (visit and study the chart here; note that wealth is depicted but by itself is not part of the inclusive economy score):

One thing that stands out when considering this colorful chart against the disaggregated top 10 lists is how unrelated they seem to be. San Jose sits at the upper right position of the chart, suggesting that it ranks as one of the most inclusive metro economies, and yet it ranks only 51st on equity. By contrast, Allentown, PA—on the left of the second row—ranked first in equity, but lower on other measures. However, taken as a whole, both Allentown and San Jose are in the top 20 metro areas overall for inclusiveness. Detroit sits along the bottom row of the inclusiveness chart. Among the five characteristics, it posts its highest rank in growth (37th overall), with much lower ranks in the other categories, even though it ranks 29th for wealth. Las Vegas, NV, is one of the least wealthy metro areas (91st), but ranks 19th in terms of equity.

Berube and Irons point to what they call “a few important insights” about the chart and these data:

• Judged across all five characteristics, the “most” and “least” inclusive metro economies are geographically and economically diverse.
• More equitable metropolitan economies also exhibit higher levels of participation and stability. 
• Growth and equity vary independently across metropolitan areas. 
• Metro areas with similar performance across the five characteristics may not possess the same capacity to improve their performance.

For more detailed discussion, and the complete inclusive economies chart, see “Measuring ‘inclusive economies’ in metropolitan America,’ by John Irons and Alan Berube.

See also “A metro map of inclusive economies,” showing metro areas that are similar to others in these outcomes.

Finally, download detailed information on the composition of the 100 indicators used to measure the five inclusive economies indicators.

ABSTRACT

In recent decades economists have turned their attention to data that asks people how happy or satisfied they are with their lives. Much of the early research concluded that the role of income in determining well-being was limited, and that only income relative to others was related to well-being. In this paper, we review the evidence to assess the importance of absolute and relative income in determining well-being. Our research suggests that absolute income plays a major role in determining well-being and that national comparisons offer little evidence to support theories of relative income. We find that well-being rises with income, whether we compare people in a single country and year, whether we look across countries, or whether we look at economic growth for a given country. Through these comparisons we show that richer people report higher well-being than poorer people; that people in richer countries, on average, experience greater well-being than people in poorer countries; and that economic growth and growth in well-being are clearly related. Moreover, the data show no evidence for a satiation point above which income and well-being are no longer related.

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• The New Stylized Facts About Income and Subjective Well-Being

Editor's Note: At a Zócalo Public Square* event, several experts were asked to weigh in on the following question: How should we most effectively measure happiness? Here is Carol Graham's response-

We must make it a measure that’s meaningful to the average person

Happiness is increasingly in the media. Yet it is an age-old topic of inquiry for psychologists, philosophers, and even the early economists (before the science got dismal). The pursuit of happiness is even written into the Declaration of Independence (and into the title of my latest Brookings book, I might add). Public discussions of happiness rarely define the concept. Yet an increasing number of economists and psychologists are involved in a new science of measuring well-being, a concept that includes happiness but extends well beyond it.

Those of us involved focus on two distinct dimensions: hedonic well-being, a daily experience component; and evaluative well-being, the way in which people think about their lives as a whole, including purpose or meaning. Jeremy Bentham focused on the former and proposed increasing the happiness and contentment of the greatest number of individuals possible in a society as the goal of public policy. Aristotle, meanwhile, thought of happiness as eudemonia, a concept that combined two Greek words: “eu” meaning abundance and “daimon” meaning the power controlling an individual’s destiny. Using distinct questions and methods, we are able to measure both. We can look within and across societies and see how people experience their daily lives and how that varies across activities such as commuting time, work, and leisure time on the one hand, and how they feel about their lives as a whole—including their opportunities and past experiences, on the other. Happiness crosses both dimensions of well-being. If you ask people how happy they felt yesterday, you are capturing their feelings during yesterday’s experiences. If you ask them how happy they are with their lives in general, they are more likely to think of their lives as a whole.

The metrics give us a tool for measuring and evaluating the importance of many non-income components of people’s lives to their overall welfare. The findings are intuitive. Income matters to well-being, and not having enough income is bad for both dimensions. But income matters more to evaluative well-being, as it gives people more ability to choose how to live their lives. More income cannot make them experience each point in the day better. Other things, such as good health and relationships, matter as much if not more to well-being than income. The approach provides useful complements to the income-based metrics that are already in our statistics and in the GDP. Other countries, such as Britain, have already begun to include well-being metrics in their national statistics. There is even a nascent discussion of doing so here.

Perhaps what is most promising about well-being metrics is that they seem to be more compelling for the average man (or woman) on the street than are complex income measures, and they often tell different stories. There are, for example, endless messages about the importance of exercising for health, the drawbacks of smoking, and the expenses related to long commutes. Yet it is likely that they are most often heard by people who already exercise, don’t smoke, and bicycle to work. And exercise does not really enter into the GNP, while cigarette purchases and the gasoline and other expenses related to commuting enter in positively. If you told people that exercising made them happier and that smoking and commuting time made them unhappy (and yes, these are real findings from nationwide surveys), then perhaps they might listen?

Read other responses to this question at zocalopublicsquare.org »

*Zócalo Public Square is a not-for-profit daily ideas exchange that blends digital humanities journalism and live events. 

Many scholars have argued that once “basic needs” have been met, higher income is no longer associated with higher in subjective well-being. We assess the validity of this claim in comparisons of both rich and poor countries, and also of rich and poor people within a country. Analyzing multiple datasets, multiple definitions of “basic needs” and multiple questions about well-being, we find no support for this claim. The relationship between well-being and income is roughly linear-log and does not diminish as incomes rise. If there is a satiation point, we are yet to reach it.

Introduction

In 1974 Richard Easterlin famously posited that increasing average income did not raise average well-being, a claim that became known as the Easterlin Paradox. However, in recent years new and more comprehensive data has allowed for greater testing of Easterlin’s claim. Studies by us and others have pointed to a robust positive relationship between well-being and income across countries and over time (Deaton, 2008; Stevenson and Wolfers, 2008; Sacks, Stevenson, and Wolfers, 2013). Yet, some researchers have argued for a modified version of Easterlin’s hypothesis, acknowledging the existence of a link between income and well-being among those whose basic needs have not been met, but claiming that beyond a certain income threshold, further income is unrelated to well-being.

The existence of such a satiation point is claimed widely, although there has been no formal statistical evidence presented to support this view. For example Diener and Seligman (2004, p. 5) state that “there are only small increases in well-being” above some threshold. While Clark, Frijters and Shields (2008, p. 123) state more starkly that “greater economic prosperity at some point ceases to buy more happiness,” a similar claim is made by Di Tella and MacCulloch (2008, p. 17): “once basic needs have been satisfied, there is full adaptation to further economic growth.” The income level beyond which further income no longer yields greater well-being is typically said to be somewhere between $8,000 and $25,000. Layard (2003, p. 17) argues that “once a country has over $15,000 per head, its level of happiness appears to be independent of its income;” while in subsequent work he argued for a $20,000 threshold (Layard, 2005 p. 32-33). Frey and Stutzer (2002, p. 416) claim that “income provides happiness at low levels of development but once a threshold (around $10,000) is reached, the average income level in a country has little effect on average subjective well-being.”

Many of these claims, of a critical level of GDP beyond which happiness and GDP are no longer linked, come from cursorily examining plots of well-being against the level of per capita GDP. Such graphs show clearly that increasing income yields diminishing marginal gains in subjective well-being. However this relationship need not reach a point of nirvana beyond which further gains in well-being are absent. For instance Deaton (2008) and Stevenson and Wolfers (2008) find that the well-being–income relationship is roughly a linear-log relationship, such that, while each additional dollar of income yields a greater increment to measured happiness for the poor than for the rich, there is no satiation point.

In this paper we provide a sustained examination of whether there is a critical income level beyond which the well-being–income relationship is qualitatively different, a claim referred to as the modified-Easterlin hypothesis. As a statistical claim, we shall test two versions of the hypothesis. The first, a stronger version, is that beyond some level of basic needs, income is uncorrelated with subjective well-being; the second, a weaker version, is that the well-being–income link estimated among the poor differs from that found among the rich.

Claims of satiation have been made for comparisons between rich and poor people within a country, comparisons between rich and poor countries, and comparisons of average well-being in countries over time, as they grow. The time series analysis is complicated by the challenges of compiling comparable data over time and thus we focus in this short paper on the cross-sectional relationships seen within and between countries. Recent work by Sacks, Stevenson, and Wolfers (2013) provide evidence on the time series relationship that is consistent with the findings presented here.

To preview, we find no evidence of a satiation point. The income–well-being link that one finds when examining only the poor, is similar to that found when examining only the rich. We show that this finding is robust across a variety of datasets, for various measures of subjective well-being, at various thresholds, and that it holds in roughly equal measure when making cross-national comparisons between rich and poor countries as when making comparisons between rich and poor people within a country.

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Abstract

We explore the relationship between agency and hedonic and evaluative dimensions of well-being, using data from the Gallup World Poll. We posit that individuals emphasize one well-being dimension over the other, depending on their agency. We test four hypotheses including whether: (i) positive levels of well-being in one dimension coexist with negative ones in another;and (ii) individuals place a different value on agency depending on their positions in the well-being and income distributions. We find that: (i) agency is more important to the evaluative well-being of respondents with more means; (ii) negative levels of hedonic well-being coexist with positive levels of evaluative well-being as people acquire agency; and (iii)both income and agency are less important to well-being at highest levels of the well-being distribution. We hope to contribute insight into one of the most complex and important components of well-being, namely,people’s capacity to pursue fulfilling lives.

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• Download the full paper

“It’s probably the most interesting presidential election I’ve seen in my lifetime,” I said to an American friend the moment I arrived to Washington. My friend was upset. “For you it’s interesting,” he said. “For us it’s painful.”

“What you’ve just said rings a bell,” I said. “This is exactly, word for word, what I keep saying to foreign journalists who come to Israel to write a story.” Covering politics in Israel is like covering a professional wrestling fight: the rivals exchange numerous hits, shout at each other, humiliate each other, disregard every rule, but in most cases the outcome is known in advance.

Covering politics in Israel is like covering a professional wrestling fight...in most cases the outcome is known in advance.

Americans are supposed to play their political game in a cooler way. At least, this is the impression a foreign correspondent get when he lands here, directly from the boiling quarrels of the Middle East. 

I had the opportunity to cover almost all the U.S. presidential campaigns since Jimmy Carter’s victory over Gerald Ford in 1974. I loved it—I loved the town halls and the rallies in remote places, where people are kind and willing to answer every clueless question from a foreign reporter; I loved the access to the candidates, weeks and months before the secret service builds a wall between them and real life; I loved the hectic atmosphere, described so well in the “Making of the President” books by Theodore H. White; I loved to see how little-known candidates like Bill Clinton or Barack Obama evolve, grow, and flourish; and I enjoyed every chapter: the spins, the buzz, the role played by big money.

The election campaign seems to be different this time: It looks different; it sounds different. The key word is anger—anger dominated the selection process in both parties. Angry voters elected angry candidates. If a candidate was not angry enough—e. g. Jeb Bush—the voters judged him unfit for the job.

The election campaign seems to be different this time: It looks different; it sounds different. The key word is anger.

An accidental tourist like me pauses here for a long list of questions: how do we quantify anger? Is it limited to the ballots or can it evaporate at some point and turn into violent acts, as Donald Trump has insinuated time and again? Is it a reflection of the bitterness of specific, limited constituencies or is it something much more widespread, an outrage of a generation or a class of Americans who feel that they were betrayed by the political and business elite, by the establishment? How to explain the Trump phenomenon, the Sanders phenomenon? 

The obvious answer is the economic collapse of 2008: the people who fell victim to the 2008 crisis, who lost a home or a job or had to give up college for their children are now in revolt. Why now and not earlier? Because four years ago they were struggling to survive; they were busy. Politicizing emotions is a long process; sometimes it takes years.

Tip O'Neill, speaker of the house in the second half of the previous century, taught us that all politics is local. There is a lot of truth in it even today, but is it the whole truth? In the flat world of 2016, local politics are executed in a global way. All politics are local and global at the same time. Political actions spread from country to country like the Zika virus, using social media as carriers.

The young Sanders supporters I met in Brooklyn, during the last Democratic debate, were not much different from the young Israelis I met in Tel Aviv in the summer of 2011, when hundreds of thousands of Israelis took to the streets. Those Israelis complained about similar things: high prices, loss of employment security, difficulty getting a decent job, and the ever-growing gap between expectations and reality. They were promised to live in the land of opportunity; the opportunity was not there—not for them.

Politicizing emotions is a long process; sometimes it takes years.

They complained bitterly about the banks and the major corporations. They became so big that the government has no choice but to subsidize them when they lose money. And the people who run them get huge salaries and bonuses on the expense of the shareholders and the general public. Israel used to be a social democratic society, with a strong middle class and a relatively narrow gap between rich and poor. Now the rich are very rich and get richer, and the less fortunate are left behind.

The protest was fueled by social media: another similarity between Tel Aviv and the young voters in Brooklyn and elsewhere. The brazenness, the bluntness, the rudeness of the social media culture affected the political discourse. It became less cordial and more personal. 

Israelis were not alone. The Arab Spring predated the Israeli Summer. Greece and Spain followed. Occupy Wall Street, a smaller, more radical protest movement, appeared on the streets of major American cities in the fall of 2011. It was inspired by the protests in the Arab countries and in Spain. The demonstrators faded away after a while, but they left their mark: political agendas have changed dramatically, governments fell, conventions were shuttered. It remains to be seen if and how they will contribute to social justice and equality.

In Israel, the demand for social justice captured a prominent place on the national agenda; several activists in the protest movement were elected to the Knesset; the rhetoric has changed, priorities didn't. Not really. Most Israelis were not prepared for a revolution, not even a moderate revolution, Bernie Sanders-style. 

I have no way to know what lies ahead for the American society. What I can see so far is a unique electoral season, characterized by unusual, almost bizarre candidates, their qualification for the job questionable, and a long, destructive battle over votes. For many Americans it is painful. People in other countries can only wonder: is it the best America is able to produce? 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Almost two years ago, I alerted readers to a contest, sponsored by the Bill and Melinda Gates Foundation through the Global Development Network, to develop new ideas to improve the impact of development cooperation. The Next Horizons Essay contest 2014 received 1,470 submissions from 142 countries, from which 13 winners were selected.

Four of the winners took part in a roundtable at the Brookings Institution yesterday. Here’s a quick synopsis of the main takeaways.

There is a lot of experimentation happening in the delivery of aid, and most aid agencies are thinking hard about how to position themselves to contribute more to the sustainable development goals. In part, this is because these agencies are mission-driven to improve impact. The current system of aid replenishments of multilateral institutions forces them to compete with each other by persuading donors that they are best deserving of the scarce aid budgets being allocated. Even bilateral aid agencies find themselves under budgetary stress, asked to justify the impact of their lending compared to a counterfactual of channeling the money through a multilateral agency or of contributing to an appeal from the United Nations for humanitarian assistance or climate financing.

Stephen Mwangi Macharia talked about using development assistance to promote social impact investing. He noted the problems of sustainability, dependence, and ownership that can arise in traditional aid relationships and argued that social entrepreneurs can avoid such pitfalls. The question then becomes how donors can best help build the market infrastructure to support such efforts. Stephen’s idea: develop a social impact network initiative to build entrepreneurs’ capacity to develop “bankable” projects and to have a database to help match entrepreneurs and funders. 

There is certainly a lot of interest in social impact investing. According to the Global Impact Investing Network, around $60 billion are already under management (although mostly in developed countries) and the market is growing rapidly. Some questioned the role of aid donors however, noting that they could reduce incentives for others (universities, non-profits, etc.) who charge a fee for business development, awareness raising, and other market services. Others questioned the risk tolerance of donors for impact investing and a culture in many countries where business is viewed suspiciously when it tries to intentionally generate positive social and environmental impacts. As an aside, Judith Rodin, president of the Rockefeller Foundation, has noted that the development of impact investing was one of the accomplishments that she was most proud of.

Ray Kennedy suggested that vertical funds, because of better governance and a sharper focus, should be a preferred channel for development assistance. Interestingly, his argument was not based on advocacy for a particular sector, but on the improved adaptability of these institutions. His evidence provided several examples of how vertical funds changed in response to changing global conditions, and, he argued, such change is a highly desirable virtue in our rapidly changing times.

Of course, the recommendation to favor vertical funds did not go unchallenged. There was a lively discussion about the comparative advantage of different institutions and the dangers of mission creep by more effective institutions into space left open by less effective institutions. Yet, most agreed that new platforms were being fluidly created to solve new problems, and that a “mixed coalition,” to borrow a phrase from one of the participants, was part of the preferred solution.

Yuen Yuen Ang took on the problem of local ownership directly. It is easy to talk about local ownership, she said, but few agencies do anything about it in their actual operations. Instead, they promote best practice ideas, some of which may fail even the basic test of “do no harm.” Basing her arguments on the complexity of how organizations change, she advocates specific internal reforms: diversify staff experiences and backgrounds beyond economics and finance; carve out time for staff to pursue “non-standard” approaches; and build a bank of examples about “best-fit” approaches that have been shown to work in weak institutional settings.

A lively discussion followed on best-fit versus best-practice approaches and, indeed, on whether there is a trade-off between the two or whether the issue is how to balance both at the same time. There was agreement that best-practice applies to some issues, especially where global standards have developed (debt management or anti-money laundering, perhaps). Best-fit is more useful when judgement and a deep understanding of local conditions are required. Some questioned the role of external donor agencies in such contexts, however.

Dan Honig argued for greater autonomy of field-based staff. Based on an extensive and unique data set, he was able to test the impact of the degree of autonomy on project success. The econometrics show significant impact of autonomy on certain activities and in certain situations. When the context is fluid and unpredictable, as in fragile states for example, or when judgement is required, as in institutional development, then autonomy can help. But when desired outcomes are easily measurable, such as school or road construction, then autonomy makes little difference.

During the discussion, there was agreement that too much of a focus on metrics could be distortionary and, in fluid situations, could be damaging. The theme of donor risk aversion came up again, but this time coupled with the idea that metrics, however false and misleading they might be, provide comfort and cover for bureaucrats. A sympathetic hearing was given to former United States Agency for International Development Administrator Andrew Natsios’ concept of “obsessive measurement disorder.” But, participants also warned of the need to show that the costs of autonomy, in the form of larger field presence and a limited ability to scale up, outweighed the benefits.

It was refreshing to see new evidence and multidisciplinary approaches being brought to bear on development effectiveness. The four themes highlighted in these essays—making markets work for the poor, improving agency governance, local ownership and contextualization, and decentralization and autonomy—resonated with those participants who are, or had been, active in aid agencies. I thank the Global Development Network and the Bill and Melinda Gates Foundation for this initiative, as well as to the winning scholars for injecting new ideas into the discourse.

At a legislative conference in Cambridge, Ohio, Bruce Katz stressed the importance of cities and metro areas to the state's overall prosperity. Acknowledging the decline of Ohio's older industrial cities, Katz noted the area's many assets and argued for a focus on innovation, human capital, infrastructure, and quality communities as means to revitalize the region. 

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Editor’s note: Brookings Senior Fellow Vanda Felbab-Brown is currently on the ground in Afghanistan and sent over a dispatch on what she’s seeing.

President Barack Obama is about to make crucial decisions about the number of U.S. soldiers in Afghanistan in 2016 and possibly after. His decision will be a vital signal to other U.S. allies in Afghanistan and its neighbors. Recent events in Afghanistan, particularly the Taliban's capture of Kunduz, show how too large a reduction in US military and economic support can hollow out the state-building effort and strengthen the Taliban and many other terrorist groups operating in Afghanistan, including those labeling themselves daesh. In such a case, collapse of the government and indeed a collapse of the entire political order the United States has sought to build since 2001 are high. Maintaining support at something close to the current level of effort does not guarantee military or political success or that peace negotiations with the Taliban will eventually produce any satisfactory peace. But it buys us time. On the cusp of a dire situation, Afghan politicians equally need to put aside their self-interested hoarding, plotting, and back-stabbing, which are once again running high, and being put ahead of the national interest.

The Taliban’s recent victory in Kunduz is both highly impactful and different from the previous military efforts and victories of the Taliban over the past several years. For the first time since 2001, the Taliban managed to conquer an entire province and for several days hold its capital. The psychological effect in Afghanistan has been tremendous. For a few days, it looked like the entire provinces of Badakshan, Takhar, and Baghlan would also fall. Many Afghans in those provinces started getting ready to leave or began moving south. If all these northern provinces fell, the chances were high, with whispers and blatant loud talk of political coups intensifying for a number of days, that the Afghan government might fall, and perhaps the entire political system collapse., In short, the dangerous and deleterious political and psychological effects are far bigger than those from the Taliban's push in Musa Qala this year or last year. Particularly detrimental and disheartening was the fact that many Afghan National Army (ANA) and Afghan National Police (ANP) units, led by weak or corrupt commanders, did not fight, and threw down their arms and ran away. Conversely, the boost of morale to the Taliban and the strengthening of its new leader Mullah Akbar Mansour were great. However, the Taliban also discredited itself with its brutality in Kunduz City.

The Taliban operation to take Kuduz was very well-planned and put together over a period of months, perhaps years. Foreign fighters from Central Asia, China, and Pakistan featured prominently among the mix of some 1,000 fighters, adding much heft to local militias that the Taliban mobilized against the militias of the dominant powerbrokers and the United States, as well as the government-sponsored Afghan Local Police. The support of Pakistan's Inter-services Intelligence for the Taliban, which the country has not been able to sever despite a decade of pressure from the United States and more recent engagement from China, significantly augmented the Taliban's capacities.

Kunduz is vital strategic province, with major access roads to various other parts of Afghanistan's north. Those who control the roads—still now the Taliban—also get major revenue from taxing travelers, which is significant along these opium-smuggling routes. It will take time for the Afghan forces to reduce Taliban control and influence along the roads, and large rural areas will be left in the hands of the Taliban for a while. Both in the rural areas and in Kunduz City itself, the Taliban is anchored among local population groups alienated by years of pernicious exclusionary and rapacious politics, which has only intensified since March of this year. Equally, however, many of the local population groups hate the Taliban, have engaged in revenge killings and abuses this week, and are spoiling for more revenge.

Despite the intense drama of the past week, however, Afghanistan has not fallen off the cliff. Takhar and Baghlan have not fallen, nor has all of Badakhshan. The political atmosphere in Kabul is still poisonous, but the various anti-government plots and scheming are dissipating in their intensity and immediacy. On Wednesday, Afghan President Ashraf Ghani reached out to some of those dissatisfied powerbrokers, who have been salivating for a change in political dispensation. The crisis is not over, neither on the battlefield in Kunduz and many other parts of Afghanistan, nor in the Afghan political system. But it is much easier to exhale on Thursday, October 8th.

United States air support was essential in retaking Kunduz and avoiding more of Badakhshan falling into the hands of the Taliban, precipitating a military domino effect in the north and inflaming the political crisis. Despite the terrible and tragic mistake of the U.S. bombing of the Médecins Sans Frontières hospital, maintaining and expanding U.S. air support for the Afghan forces, and allowing for U.S. support beyond in extremis, such as in preventing a similar Taliban offensive, is vital. It is equally important to augment intelligence- assets support. Significant reductions in U.S. assistance, whether that be troops, intelligence, or air support, will greatly increase the chances that another major Taliban success—like that of Kunduz, and perhaps possibly again in Kunduz—will happen again. It would also be accompanied by intensely dangerous political instability.

Equally imperative is that Afghan politicians put aside their self-interested scheming and rally behind the country to enable the government to function, or they will push Afghanistan over the brink into paralysis, intensified insurgency, and outright civil war. In addition to restraining their political and monetary ambitions and their many powerplays in Kabul, they need to recognize that years of abusive, discriminatory, exclusionary governance; extensive corruption; and individual and ethnic patronage and nepotism were the crucial roots of the crisis in Kunduz and elsewhere. These have corroded the Afghan Army and permeate the Afghan Police and anti-Taliban militias. Beyond blaming Pakistan, Afghan politicians and powerbrokers need to take a hard look at their behavior over the recent days and over many years and realize they have much to do to clean their own house to avoid disastrous outcomes for Afghanistan. To satisfy these politicians, many from the north of the country and prominent long-term powerbrokers, President Ghani decided over the past few days to include them more in consultations and power-sharing. Many Afghan people welcome such more inclusive politics, arguing that while the very survival of the country might be at stake, grand governance and anti-corruption ambitions need to be shelved. That may be a necessary bargain, but it is a Faustian one. Not all corruption or nepotism can or will disappear. But unless outright rapacious, exclusionary, and deeply predatory governance is mitigated, the root causes of the insurgency will remain unaddressed and the state-building project will have disappeared into fiefdoms and lasting conflict. At that point, even negotiations with the Taliban will not bring peace.