Much public focus is being given to a broader role for hospitals in improving the health of their communities. This focus parallels a growing interest in addressing the social determinants of health as well as health care policy reforms designed to increase the efficiency and quality of care while improving health outcomes.

This interest in the community role of hospitals has drawn attention to the federal legal standards and requirements for nonprofit hospitals seeking federal tax exemption. Tax-exempt hospitals are required to provide community benefits. And while financial assistance to patients unable to pay for care is a basic requirement of tax-exemption, IRS guidelines define the concept of community benefit to include a range of community health improvement efforts.

At the same time, the IRS draws a distinction between community health improvement spending–which it automatically considers a community benefit–and certain “community-building” activities where additional information is required in order to be compliant with IRS rules. In addition, community benefit obligations are included in the Affordable Care Act (ACA).

Specifically, the ACA requires nonprofit hospitals periodically to complete a community health needs assessment (CHNA), which means the hospital must conduct a review of health conditions in its community and develop a plan to address concerns. While these requirements are causing hospitals to look more closely at their role in the community, challenges remain. For instance, complex language in the rules can mean hospitals are unclear what activities and expenditures count as a “community benefit.” Hospitals must take additional steps in order to report community building as community health improvement.

These policies can discourage creative approaches. Moreover, transparency rules and competing hospital priorities can also weaken hospital-community partnerships. To encourage more effective partnerships in community investments by nonprofit hospitals:

• The IRS needs to clarify the relationship between community spending and the requirements of the CHNA. 
• There needs to be greater transparency in the implementation strategy phase of the CHNA. 
• The IRS needs to broaden the definition of community health improvement to encourage innovation and upstream investment by hospitals.

Download "Hospitals as Community Hubs: Integrating Community Benefit Spending, Community Health Needs Assessment, and Community Health Improvement" »

Downloads

• Download "Hospitals as Community Hubs: Integrating Community Benefit Spending, Community Health Needs Assessment, and Community Health Improvement"

Event Information

China’s meteoric rise lifted its economy but damaged its environment, and it has new aspirations to leadership on the global stage. Africa has enormous natural capital and is hungry for development. How can they collaborate? Their interests may intersect within a model of development that invests in natural capital instead of prizing only extraction.

On July 11th, the Brookings Tsinghua-Center, in collaboration with GreenPoint Group and School of Public Policy and Management at Tsinghua University, hosted the panel Sustainability within the China-Africa Relationship: Governance, Investment, and Natural Capital. The panel was moderated by SMPP Associate Professor and IMPA director Zheng Zhenqing, and featured Mr. Peter Seligmann, chairman and CEO of Conservation International; Professor Qi Ye, director of the Brookings Tsinghua-Center; Honorable Minister Anyaa Vohiri of the Environmental Protection Agency of Liberia; Professor Pang Xun, expert on official direct assistance and the politics of aid; and Mr. Rule Jimmy Opelo, Permanent Deputy Secretary of the Ministry of Environment, Wildlife and Tourism of Botswana.

Professor and Dean of School of Public Policy and Management Xue Lan gave the opening remarks, highlighting that both China and Africa face the challenge of balancing development and sustainability. Minister Vohiri then presented on the challenges and great potential of Africa's vast, untapped renewable energy resources before Professor Zheng opened the panel. Framing China and Africa as global partners with the common aspiration of growing sustainable, the panelists discussed the need for developing economies to recognize that the health of their environment is inseparable from the health of their economies.

Questions concerning the UN’s Sustainable Development Goals and Millennium Development goals presented conservation as a global issue requiring global governance. Mr. Seligmann forwarded the idea that sustainable development as enlightened self-interest has entered mainstream thought, asserting that the challenge now lies in crafting region-specific policies and plans of implementation. The importance of cooperation surfaced as a common theme. Mr. Opelo examined the possibilities of South-South cooperation, and Professor Qi provided a history for the emergence of natural capital as a concept before underlining the need for government to collaborate with civil society and the private sector.

The highlighted benefits of Sino-African cooperation ranged from the greater political freedom afforded to aid recipient countries when there is donor competition to Africa's potential "leapfrog" development to a green economy if it obtains sufficient investment. Professor Qi spoke of the lessons provided by China’s evolution from a parochial developing country into the world’s leader in sustainable development. Professor Pang emphasized the benefits both to China and to African countries when the influence of conditional aid from the United States is diluted by Chinese competition. Minister Vohiri and Mr. Opelo discussed the challenges of balancing conservation enforcement with the provision of basic needs, concluding that China's capital and knowledge could help Africa develop its economy in a sustainable direction. The panelists closed by addressing questions from the audience that problematical transparency problems with China's current model of development in Africa, the sustainability of green energy subsidies, the threats of mining and poaching, and Africa's role in addressing a global environmental crisis to which it largely did not contribute.

Xue Lan gave the opening remarks

Minister Vohiri delivered keynote remarks

Transcript

• Transcript (.pdf)

Event Materials

• Sustainability within the ChinaAfrica relationship governance investment and natural capital

On the invitation of House Speaker Paul Ryan, who stated that “[t]he friendship between the United States and India is a pillar of stability in an important region of the world,” Indian Prime Minister Narendra Modi will be addressing a joint meeting of the U.S. Congress on June 8. There have been five Indian prime ministers who’ve given such remarks: Jawaharlal Nehru (1949, to separate House and Senate gatherings), Rajiv Gandhi (1985), P.V. Narashima Rao (1994), Atal Bihari Vajpayee (2000) and Manmohan Singh (2005). Their speeches were reflective of the contemporary global context and the state of the U.S.-India relationship, but they did share some themes as well. Modi will likely emphasize that he is transforming India (as these other prime ministers asserted as well) and want to highlight the change he is bringing, but his speech might also echo some of these past themes. Below is a look back at what India’s prime ministers have said to Congress—a past glimpse that is also instructive in terms of how much the U.S.-India relationship has changed.

On October 13, 1949, two years of India’s independence (and a few days after the communists had taken over China), Jawaharlal Nehru addressed back-to-back meetings of the House and Senate. Declaring that “Nehru puts India on freedom’s side,” The New York Times noted in a front-page story that "Pandit Nehru expressed pride for India's past, hope for her future, but acute awareness of her present economic difficulties."

On June 13, 1985, Rajiv Gandhi, Nehru’s grandson who had won a major electoral victory the previous year, became the first Indian premier to address a joint meeting of Congress. In an above-the-fold story featuring a photo of a smiling Gandhi, Vice President George H.W. Bush and House Speaker Tip O’ Neill, The New York Times particularly remarked on the 40-year-old prime minister’s youthfulness and remarks on Afghanistan.

On May 18, 1994, a few years after the collapse of the Soviet Union and after having introduced a wave of economic reforms, P.V. Narasimha Rao addressed Congress. Ten days before that The New York Times featured a story on his finance minister Manmohan Singh and the reforms the two leaders were undertaking. Reflecting the relative disinterest in India in the U.S. at the time, the Times did not, however, cover Rao’s speech.

On September 14, 2000, Atal Bihari Vajpayee, India’s first prime minister from the Bharatiya Janata Party (BJP) addressed the U.S. Congress. His two years in power till then had seen India conduct nuclear tests, a crisis with Pakistan seen as a turning point in U.S.-India relations because the U.S. called out Pakistan for its actions, and a U.S. presidential visit to India after two decades. A jovial photo of the prime minister and President Clinton made the front page a couple of days later, but the speech itself did not get coverage in the newspaper of record.

On July 19, 2005, Manmohan Singh, who’d just reached a civil nuclear agreement with President Bush, addressed Congress. His visit—and that agreement—received front-page coverage, but the speech itself was not covered separately.

In his speech, Prime Minister Modi will likely stress the challenge that terrorism poses globally and regionally, and highlight U.S.-India the counter-terrorism cooperation. The last three Indian premiers have addressed this challenge as well.

President Obama reiterated U.S. support for Indian membership of the Nuclear Suppliers Group and encouraged other members to welcome Indian into the group. The U.S. and India have come a long way on a subject that has come up in every prime minister’s speech since Rajiv Gandhi.

Every prime minister has outlined their economic policy objectives and achievements—more recent ones, have highlighted the opportunity India represents. While this was the focus of Modi’s speech to the U.S.-India Business Council, expect this to be a subject he covers in his remarks to Congress as well.

Indian prime ministers have seen the U.S. as a crucial source of technology, and often made the case for technological assistance or transfers or collaboration.

There has also been the linkage between democracy and development in various ways: highlighting the development task India is undertaking in a democratic context, stressing that democracies are better placed over the long-run to innovate and develop equitably, and suggesting that the U.S. has an interest in helping India’s democratic experiment—now democratic engine—succeed.

Whether to address concerns in Congress, note the similarities between India and the U.S., or stress India’s multi-cultural, multi-ethnic, multi-lingual and multi-religious nature, each prime minister has talked about diversity, equality and freedom.

In their speeches, each of the prime ministers have noted the contributions of the growing numbers of Indian-Americans and non-resident Indians in the United States. Modi has made the diaspora a key focus; expect him to emphasize its role.

A week before his speech to Congress, Vajpayee famously asserted that “India and the USA are natural allies.” He’s not the only one to have noted the “natural” character of the relationship, though there’s been different reasoning behind that assertion or hope.

INTRODUCTION

Elections that follow dramatic downfalls of authoritarian regimes present policymakers with difficult choices. They are an opportunity to establish a sound basis for democratization, putting in place institutions and strengthening actors that help guarantee free and fair elections. Yet such elections are part of a high-stakes conflict over the future that takes place in a context of enormous uncertainty, as new actors emerge, old elites remake themselves, and the public engages in politics in new and unpredictable ways.

Assisting elections in the Arab world today is made more challenging by two factors that have thus far distinguished the region from others. First, transitions are made more difficult by extraordinarily strong demands to uproot the old regime. Fears that former regime elements will undermine ongoing revolutions along with demands for justice after decades of wrongdoing invariably create pressures to exclude former elites. In other regions, reformers within autocratic regimes, like Boris Yeltsin and South Africa’s F.W. DeKlerk, split from hardliners to spearhead reforms, muting demands for excluding old regime allies writ large. In the Middle East, however, old regime elites have been unable to credibly commit to reforms, partly given decades-long histories of empty promises and oppositions that remain largely determined to accept nothing less than Ben Ali-like departures. Room for compromise is difficult to find.

Second, for an international community hoping to support Arab transitions, widespread distrust of outside forces compounds these problems. Such distrust is inevitable in all post-colonial states; however, skepticism is particularly high in the Arab world, especially toward the United States. Cynicism about American intentions has been fed by U.S. support for Israel, its continued backing of Arab autocrats for nearly two decades after the Cold War, and, more recently, its unwillingness to take stronger stands against Mubarak, Asad, and others early on in the uprisings. Even if transitioning elites believe international expertise can help smooth the election process and enhance faith in the outcomes, they find it difficult to embrace in the context of heightened nationalism and a strong desire to assert sovereignty.

In light of these challenges, this paper explores how the international community can best engage in “founding” elections in the Arab world. Examining Egypt and Tunisia, the first two Arab states to hold elections, it focuses on challenges in leveling the playing field, managing electoral processes, and creating just and sustainable outcomes. These cases are undoubtedly unique in many ways and – as in any transition – remain in flux. Nevertheless, examining their early experience yields insights into how international actors can best approach those cases that may follow (e.g., Libya, Syria, and Yemen).

Most notably, these cases suggest that the democracy promotion community should approach first elections differently than it does subsequent ones. It should prioritize different goals and activities, in some cases even leaving off the agenda well-intentioned and generally constructive programs in order to focus on more urgent activities critical to strengthening electoral processes. Recognizing the enormous fear and uncertainty with which democrats approach first elections, international actors should resist the understandable urge to seek immediate, permanent democratic arrangements and “favorable” electoral outcomes. They should also encourage revolutionary forces to resist understandable, but counterproductive, urges to exclude allies of the former regime from new democratic processes. Rather, democracy promoters should suggest interim measures, encourage tolerance toward “unfavorable” results, and, in so doing, support democrats as they make their way through a long, imperfect process.

Downloads

• Download Paper in English
• Download Paper in Arabic

There's been a lot of talk of Pittsburgh's "new economy" as a key reason for the city's star turn as host of this week's G-20 summit, but little has been said about the region's "next economy" -- what comes after the current slump.

It's beginning to be created under our noses.

Though seemingly abstract, the G-20's big-picture decisions -- on dialing down the extraordinary fiscal and monetary steps taken in the past year, building a new regulatory architecture for global finance, and starting the process towards a more balanced global economy and sustainable future -- have big implications for metropolitan areas.

Pittsburgh's stake in the G-20 deliberations goes beyond filling up local hotels and restaurants or hiring additional police -- and even beyond showcasing the region's resilience to the recession.

The fact is that Pittsburgh already is a global metropolis, with deep and growing ties to many of the G-20 countries because of its position as a supplier to the global steel industry (and still a maker of some types of steel), its burgeoning involvement in clean-energy sectors and its established position as a global center of education and health care.

Bayer, the German pharmaceutical conglomerate, has its U.S. headquarters in Pittsburgh, employing some 2,700 workers, including 1,200 at local medical-device manufacturer Medrad. Gamesa, the Spanish wind-energy giant, opened its first North American plant in Ebensburg, about 75 miles east of Pittsburgh. All told, more than 300 international firms from 26 different countries operate in the region, employing tens of thousands of people.

Pittsburgh's goods and services exports make up more than 14 percent of the region's gross metropolitan product, with the lion's share of goods headed to Canada, China, Japan and major economies in Europe -- all G-20 partners.

Given Pittsburgh's global status, the G-20 discussions have substantial implications for the future of the region's $100 billion economy.

The big question, at this summit and others in the future, is how to rebalance the global economy. The Great Recession followed a period of excessive consumption in the United States as Americans spent more on homes and consumer goods than they produced.

The fix is easy to state, but difficult to engineer. As Larry Summers, the head of the White House National Economic Council, said recently, "The rebuilt American economy must be more export-oriented and less consumption-oriented."

This rebalancing will require major and sustained action on currency values and trade policy in the United States as well as in large export economies like China, Germany and Japan (which will need to consume more). As this occurs, U.S. metro areas like Pittsburgh could benefit substantially given their unique assets and special niches.

While this won't quite be a 21st-century version of the equation "what Pittsburgh makes, the world takes," the combination of a more export-oriented trade policy and higher costs for carbon emissions (also to be discussed at the G-20 summit) present the region's economy with both opportunities and threats.

On the plus side, Pittsburgh could export more to the rest of the world and its steel-industry suppliers could benefit from increased exports by U.S. steelmakers. Higher prices for gasoline and jet fuel could mean that manufacturers and retailers in the United States would move away from far-flung networks of global suppliers and rely more on U.S. companies.

There is a potential downside for Pittsburgh, as well: for instance, as steelmakers in Germany and other countries export less and face higher costs of using U.S.-based suppliers, they might rely less on machinery and repair services from Pittsburgh.

To help ensure that the benefits of a rebalanced U.S. economy and a new climate regime outweigh the costs to the Pittsburgh area, local corporate, labor, political, university and civic leaders need a sharp regional business plan to guide the economic policies and innovation investments that they and the federal and state governments make in the Pittsburgh area.

Pittsburgh will have to continue to reclaim polluted industrial "brown fields" for post-industrial use -- an example for cities around the country and world.

Pittsburgh also will need to figure out how to draw more international traffic to its metropolitan airport, which currently offers only one direct flight to Europe.

The upshot: It is time for U.S. metropolitan regions to become more globally fluent and for national leaders to connect their big-picture policies to the fortunes of the urban areas that drive their economies. Only in this way can the United States, and Pittsburgh, move to the next stage of their economic evolution.

Strong Growth and Changing Composition 

External financial flows to sub-Saharan Africa (defined as the sum of gross private capital flows, official development assistance (ODA), and remittances to the region) have not only grown rapidly since 1990, but their composition has also changed significantly. The volume of external flows to the region increased from $20 billion in 1990 to above $120 billion in 2012. Most of this increase in external flows to sub-Saharan Africa can be attributed to the increase in private capital flows and the growth of remittances, especially since 2005 (see Figure 1).

Figure 1. Sub-Saharan Africa: External Flows (1990-2012, in USD billions)

As also displayed in Figure 1, in 1990 the composition of external flows to sub-Saharan Africa was about 62 percent ODA, 31 percent gross inflows from the private sector, and about 7 percent remittances. However, by 2012, ODA accounted for about 22 percent of external flows to Africa, a share comparable to that of remittances (24 percent) and less than half the share of gross private capital flows (54 percent). Also notably, in 1990, FDI flows were greater than ODA flows in only two countries (Liberia and Nigeria) in sub-Saharan Africa excluding South Africa, but 22 years later, 17 countries received more FDI than ODA in 2012—suggesting that sub-Saharan African countries are increasingly becoming less aid dependent (see Figure 2).

Figure 2. Sub-Saharan Africa: Number of Countries Where FDI is Greater than ODA (1990-2012)

But to what extent have these changes in the scale and composition of external flows to sub-Saharan Africa equally benefited countries in the region? Did the rising tide lift all boats? Is aid really dying? Are all countries attracting private capital flows and benefiting from remittances to the same degree? Finally, how does external finance compare with domestic finance? 

The False Demise of ODA

A closer look at the data indicates that, clearly, ODA is not dead, though its role is changing. For instance, middle-income countries (MICs) are experiencing the sharpest decline in ODA as a share of total external flows to the region, while aid flows account for more than half of external flows in fragile as well as low-income countries (LICs) and resource-poor landlocked countries (see Figure 3 and Appendix).

Download the full paper »

Capitalism has provided unprecedented wealth and prosperity around the world, but a growing community is raising concerns about whether the promise of the capitalist system to achieve a more shared and durable prosperity can be achieved without systemic changes in the way for-profit corporations are governed and managed. The change in public opinion has become evident among workers, consumers, and investors, as well as through new policies enacted by elected officials of both parties: more than ever before, the public supports businesses that demonstrate positive social change and sustainable development. These new attitudes have begun to take root in corporations themselves, with a growing community of investors, business leaders, and entrepreneurs expressing a fiduciary duty to create value not only for shareholders but for society. However, businesses and investors seeking to harness these opportunities face significant institutional and normative barriers to achieving their goals.

In a new paper, the co-founders of non-profit B Lab, Andrew Kassoy, Bart Houlahan, and Jay Coen Gilbert, write about this overarching culture shift, the importance of and impediments to effective impact governance and impact management to make this shift meaningful and lasting, and how a rapidly growing community of responsible businesses has overcome these barriers, is maximizing its social impact, and is creating pathways for others to follow. The impact and growth of the B Corp movement will be maximized not only through increased adoption by business leaders, but also through the unique roles played by research institutions, the media, policy-makers, investors, and the general public. With enough support, this movement may soon transform shareholder capitalism into stakeholder capitalism, in which businesses can more easily live up to their potential to create a more shared and durable prosperity for all. 

This paper is published as part of the Center for Effective Public Management’s Initiative on 21st Century Capitalism. It is one of more than a dozen papers written by academics and practitioners about the changing role of the corporation and the importance of improving corporate governance. The authors of this paper are the co-founders of B Lab, a nonprofit organization that oversees the certification of B Corporations, and a major subject of this paper. The perspectives put forth in this paper are solely those of the authors, based on their professional expertise in this area.

Downloads

• Download the paper

Downloads

• Download the policy recommendations
• The potential and limitations of impact bonds: Lessons from the first five years of experience worldwide (PDF)

BPEA co-editor Justin Wolfers describes new research that found: people dropped out of the labor force before the recession started; there are better ways to forecast unemployment; homebuyer expectations helped inflate the bubble; the U.S. is not actually as politically polarized as most people think; central banks’ recent experiments with capital controls haven’t delivered results; and the U.S. is making inroads fighting poverty.

Video

• U.S. Not Actually as Politically Polarized as Most Think
• Poverty Has Fallen Much More than Previously Thought
• New Unemployment Model Can Outperform Forecasters
• Perceptions Matter: Homebuyer Expectations Helped Inflate Bubble
• Central Banks’ Recent Experiments with Capital Controls Haven’t Delivered Results

During debates in Congress and in the legal battles testing its constitutionality, critics of the Bipartisan Campaign Reform Act of 2002 imagined a host of unanticipated and debilitating consequences. The law's ban on party soft money and the regulation of electioneering advertising would, they warned, produce a parade of horribles: A decline in political speech protected by the First Amendment, the demise of political parties, and the dominance of interest groups in federal election campaigns.

The forecast that attracted the most believers — among politicians, journalists, political consultants, election-law attorneys and scholars — was the claim that Democrats would be unable to compete against Republicans under the new rules, primarily because the Democrats' relative ability to raise funds would be severely crippled. One year ago, Seth Gitell in The Atlantic Monthly summarized this view and went so far as to call the new law "The Democratic Party Suicide Bill." Gitell quoted a leading Democratic Party attorney, who expressed his private view of the law as "a fascist monstrosity." He continued, "It is grossly offensive ... and on a fundamental level it's horrible public policy, because it emasculates the parties to the benefit of narrow-focus special-interest groups. And it's a disaster for the Democrats. Other than that, it's great."

The core argument was straightforward. Democratic Party committees were more dependent on soft money — unlimited contributions from corporations, unions and individuals — than were the Republicans. While they managed to match Republicans in soft-money contributions, they trailed badly in federally limited hard-money contributions. Hence, the abolition of soft money would put the Democrats at a severe disadvantage in presidential and Congressional elections.

In addition, the argument went, by increasing the amount an individual could give to a candidate from $1,000 to $2,000, the law would provide a big financial boost to President Bush, who would double the $100 million he raised in 2000 and vastly outspend his Democratic challenger. Finally, the ban on soft money would weaken the Democratic Party's get-out-the-vote efforts, particularly in minority communities, while the regulation of "issue ads" would remove a potent electoral weapon from the arsenal of labor unions, the party's most critical supporter.

After 18 months of experience under the law, the fundraising patterns in this year's election suggest that these concerns were greatly exaggerated. Money is flowing freely in the campaign, and many voices are being heard. The political parties have adapted well to an all-hard-money world and have suffered no decline in total revenues. And interest groups are playing a secondary role to that of the candidates and parties.

The financial position of the Democratic party is strikingly improved from what was imagined a year ago. Sen. John Kerry (D-Mass.), who opted out of public funding before the Iowa caucuses, will raise more than $200 million before he accepts his party's nomination in Boston. The unusual unity and energy in Democrats' ranks have fueled an extraordinary flood of small donations to the Kerry campaign, mainly over the Internet. These have been complemented by a series of successful events courting $1,000 and $2,000 donors.

Indeed, since Kerry emerged as the prospective nominee in March, he has raised more than twice as much as Bush and has matched the Bush campaign's unprecedented media buys in battleground states, while also profiting from tens of millions of dollars in broadcast ads run by independent groups that are operating largely outside the strictures of federal election law.

The Democratic national party committees have adjusted to the ban on soft money much more successfully than insiders had thought possible. Instead of relying on large soft-money gifts for half of their funding, Democrats have shown a renewed commitment to small donors and have relied on grassroots supporters to fill their campaign coffers. After the 2000 election, the Democratic National Committee had 400,000 direct-mail donors; today the committee has more than 1.5 million, and hundreds of thousands more who contribute over the Internet.

By the end of June, the three Democratic committees had already raised $230 million in hard money alone, compared to $227 million in hard and soft money combined at this point in the 2000 election cycle. They have demonstrated their ability to replace the soft money they received in previous elections with new contributions from individual donors.

Democrats are also showing financial momentum as the election nears, and thus have been gradually reducing the Republican financial advantage in both receipts and cash on hand. In 2003, Democrats trailed Republicans by a large margin, raising only $95 million, compared to $206 million for the GOP. But in the first quarter of this year, Democrats began to close the gap, raising $50 million, compared to $82 million for Republicans. In the most recent quarter, they narrowed the gap even further, raising $85 million, compared to the Republicans' $96 million.

Democrats are now certain to have ample funds for the fall campaigns. Although they had less than $20 million in the bank (minus debts) at the beginning of this year, they have now banked $92 million. In the past three months, Democrats actually beat Republicans in generating cash — $47 million, compared to $31 million for the GOP.

The party, therefore, has the means to finance a strong coordinated and/or independent-spending campaign on behalf of the presidential ticket, while Congressional committees have the resources they need to play in every competitive Senate and House race, thanks in part to the fundraising support they have received from Members of Congress.

Moreover, FEC reports through June confirm that Democratic candidates in those competitive Senate and House races are more than holding their own in fundraising. They will be aided by a number of Democratic-leaning groups that have committed substantial resources to identify and turn out Democratic voters on Election Day.

Democrats are highly motivated to defeat Bush and regain control of one or both houses of Congress. BCRA has not frustrated these efforts. Democrats are financially competitive with Republicans, which means the outcome will not be determined by a disparity of resources. Put simply, the doomsday scenario conjured up by critics of the new campaign finance law has not come to pass.

Tomorrow, President Obama unveils his last budget, and we’re sure to see plenty of proposals for spending on education and skills. In the past, the Administration has focused on investments in early childhood education, community colleges, and infrastructure and research. From a budgetary standpoint, the problem with these investments is how to capture their benefits as well as their costs.

First step: find out what works. The Obama Administration has been emphatic about the need for solid evidence in deciding what to fund. The good news is that we now have quite a lot of it, showing that investing in human capital from early education through college can make a difference. Not all programs are successful, of course, and we are still learning what works and what doesn’t. But we know enough to conclude that investing in a variety of health, education, and mobility programs can positively affect education, employment, and earnings in adulthood.

For example:

1. Young, low-income children whose families move to better neighborhoods using housing vouchers see a 31 percent increase in earnings;

2. Quality early childhood and school reform programs can raise lifetime income per child by an average of about $200,000, for at an upfront cost of about $20,000;

3. Boosting college completion rates, for instance via the Accelerated Study in Associate Programs (ASAP) in the City University of New York, leads to higher earnings.

If such estimates are correct (and we recognize there are uncertainties), policymakers are probably underinvesting in such programs because they are looking at the short-term costs but not at longer-term benefits and budget savings.

First, the CBO’s standard practice is to use a 10-year budget window, which means long-range effects are often ignored. Second, although the CBO does try to take into account behavioral responses, such as increased take-up rates of a program, or improved productivity and earnings, it often lacks the research needed to make such estimates. Third, the usual assumption is that the rate of return on public investments in human capital is less than that for private investment. This is now questionable, especially given low interest rates.

A hot topic in budget politics right now is so-called “dynamic scoring.” This means incorporating macroeconomic effects, such as an increase in the labor force or productivity gains, into cost estimates. In 2015, the House adopted a rule requiring such scoring, when practicable, for major legislation. But appropriations bills are excluded, and quantitative analyses are restricted to the existing 10-year budget window.

The interest in dynamic scoring is currently strongest among politicians pushing major tax bills, on the grounds that tax cuts could boost growth. But the principles behind dynamic scoring apply equally to improvements in productivity that could result from proposals to subsidize college education, for example—as proposed by both Senator Sanders and Secretary Clinton. Of course, it is tough to estimate the value of these potential benefits. But it is worth asking whether current budget rules lead to myopia in our assessments of what such investments might accomplish, and thus to an over-statement of their “true” cost.

The recent outbreak of hostilities between Israel and Hamas is a serious setback to ongoing Turkish-Israeli normalization efforts. Israel launched Operation Protective Edge, its third operation against Hamas since leaving Gaza in 2005, in response to rockets and missiles fired by Hamas from Gaza into Israel. As in Israel’s two previous Gaza campaigns, Operation Cast Lead (2008-09) and Operation Pillar of Defense (2012), Turkey quickly condemned Israel’s actions, yet offered to mediate, together with Qatar, between Israel and Hamas.

After Turkish Prime Minister Recep Tayyip Erdogan, in the midst of his presidential campaign, equated Israeli policy towards Gaza to a “systematic genocide” and accused Israel of surpassing “Hitler in barbarism,” Israel accepted an Egyptian cease-fire proposal. Israeli Foreign Minister Avigdor Lieberman accused Turkey and Qatar of “sabotaging the cease-fire proposal,” and Israeli Prime Minister Benjamin Netanyahu complained to U.S. Secretary of State John Kerry about Erdogan’s statements.

Turkish leaders’ harsh rhetoric sparked violent demonstrations in front of Israel’s embassy in Ankara and its consulate in Istanbul, lead the Israeli government to evacuate diplomats’ families, and issue a travel warning advising against travel to Turkey, which prompted numerous cancellations of tourist travel. On Sunday, Netanyahu refrained from declaring Turkish-Israeli reconciliation dead, but accused Erdogan of anti-Semitism more aligned with Tehran then the West.

These heightened Israeli-Turkish tensions come just as the two countries were negotiating a compensation deal for families of victims of the May 31, 2010 Mavi Marmara incident. The deal was intended to facilitate a long-awaited normalization between the two countries, more than a year after Israel’s official apology. The draft stipulated an estimated $21 million in Israeli compensation, the reinstatement of each country’s ambassador, and the reestablishment of a senior-level bilateral dialogue. However, a series of issues has prevented the deal’s finalization, including: Turkish domestic political considerations about the timing (related to March 2014 municipal elections and August 2014 presidential elections) and Israeli demands for Turkish commitments to block future lawsuits related to the Marmara incident.

With the ongoing Gaza conflict, prospects for normalization have again faded at least in the short term, and policymakers on both sides seem to have accepted a limited relationship. Erdogan even declared publicly that as long as he’s in power, there is no chance “to have any positive engagement with Israel”, dismissing any prospect for normalization. Israeli-Turkish animosity runs deep, not only among leaders, but at the grassroots level as well. While it may be difficult to look beyond the short term, a focus on the broader regional picture suggests four reasons why the two countries would benefit from restoring ties.

• First, they share strategic interests. Turkey and Israel see eye to eye on many issues: preventing a nuclear Iran; concerns over spillover from the Syrian civil war; and finally, the rise of the Islamic State of Iraq and the Levant (ISIS/ISIL) and security and stability in Iraq. A resumed dialogue and renewed intelligence sharing can pave the way for more concrete cooperation between Turkey and Israel on all these regional issues, with development of a joint approach toward Syria topping the agenda.
• Second, regional environment may be beyond their control, the bilateral relationship is not. Normalization can eliminate one factor of instability in an unstable region.
• Third, Washington sees greater cooperation and cohesiveness in the U.S.-Turkey-Israel triangle as essential. President Obama has sought to restore a dialogue between Ankara and Jerusalem, including efforts to “extract” an Israeli apology and Turkish acceptance. Senior U.S. officials remain active in trying to improve the Turkish-Israeli relationship.
• Fourth, normalization may convey benefits in the economic sphere, with possible cooperation on natural gas, tourism, and enhanced trade. Gas in particular is viewed as a possible game-changer. In 2013, bilateral trade first crossed the $5 billion mark, and data from the first six months of 2014 indicates a continued rise. A political thaw can help accelerate these joint business opportunities. 

Nevertheless, at this stage it is clear that serious U.S. involvement is required for Turkish-Israeli rapprochement to succeed, even in a limited fashion. At present, there are far greater challenges for U.S. foreign policy in the region. The question now is whether the relationship between two of America’s closest regional allies reflects a new “normal,” or whether the leaders of both countries – and the U.S. – can also muster the political will to reconnect the US-Turkey-Israel triangle along more productive lines.

Check back to Brookings.edu for Dan Arbell’s upcoming analysis paper: The U.S.-Turkey-Israel Triangle.