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Care home pharmacists redeployed, despite COVID-19 palliative care increase

Exclusive: Pharmacy staff in care homes are being redeployed to cover other roles during the COVID-19 pandemic, even though demands on care homes are increasing rapidly, The Pharmaceutical Journal has learnt.

To read the whole article click on the headline




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En Banc: Federal Circuit Provides Guidance on Application of On-Sale Bar to Contract Manufacturers

Pharmaceutical and biotech companies breathed a sigh of relief Monday when the Federal Circuit unanimously ruled in a precedential opinion that the mere sale of manufacturing services to create embodiments of a patented product is not a “commercial sale” of the invention that triggers the on-sale bar of 35 U.S.C. § 102(b) (pre-AIA).[1]  The en banc opinion...… Continue Reading




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Supply chain headache? Hundreds of millions of syringes will be needed to vaccinate U.S.

The world's largest manufacturer says there's not enough capacity to quickly ramp up production to those levels.




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No specialist needed: Fujifilm cuts coronavirus test to 75 minutes




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Genome-wide association study of angioedema induced by angiotensin-converting enzyme inhibitor and angiotensin receptor blocker treatment




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Urban sprawl overspreads Earth at an unprecedented speed




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Five courses on Ganymede




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A questionnaire study on the impact on oral health-related quality of life by conventional rehabilitation of edentulous patient




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Associations of interruptions to leisure-time sedentary behaviour with symptoms of depression and anxiety




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The Folly and Vanity of The Project to Redesign New Delhi, The Wire

Six years ago, the then editor of the Hindustan Times invited me to write a fortnightly column. I agreed, on condition that there would be no censorship. While occasionally some changes to my text were made without my consent, there was no attempt to get me to rewrite my column or change its arguments. Until [...]




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Biomedical ethics 2.0: redefining the meaning of disease, patient and treatment




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'Sanctions or threats can't take us to Geneva. We were there for a new approach. The world, the region needed this... Terror is a real threat'

At this Idea Exchange, Iranian Ambassador Gholamreza Ansari says Tehran achieved what it wanted to in the Geneva nuclear deal.




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Mixed emotions for Mercedes drivers in Hungary

Mercedes drivers Nico Rosberg and Michael Schumacher were left with mixed emotions after enduring contrasting fortunes in Saturday's qualifying session




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Mercedes understands pit lane tyre incident

Ross Brawn says that his Mercedes team understands why Nico Rosberg's wheel came off in the pit lane during the Hungarian Grand Prix




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Mercedes hopes rest with Spa weather

Michael Schumacher will find himself in unfamiliar territory at the back of the grid after his ten place grid demotion means his Mercedes will line up sandwiched between the HRT cars




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Mercedes buoyed by double points haul

Both Nico Rosberg and Michael Schumacher confessed themselves happy with their points scoring finishes after the team-mates finished sixth and seventh respectively at the Belgian Grand Prix




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Mixed fortunes for Mercedes drivers

Mercedes drivers Michael Schumacher and Nico Rosberg suffered mixed fortunes in the Korean Grand Prix




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Horner calls on FIA to rein in Mercedes

Red Bull boss Christian Horner has called on the FIA to rein in Mercedes' advantage over the rest of the field after admitting Renault had a 100bhp deficit to the world champions at the season-opening Australian Grand Prix




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Damage limitation for Mercedes

Mercedes drivers Nico Rosberg and Michael Schumacher admitted there was not much more they could have done after a frustrating German Grand Prix saw them finish in 8th and 9th respectively on home soil




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Can we take the politics out of the federal minimum wage?


At 77 years of age, the federal minimum wage deserves a respite from the day-to-day combat of political life. Today, protestors around the country are demanding a $15 minimum. But few observers think this level is economically desirable: even fewer think that it is likely.

Democrats want a higher minimum, and say so loudly. Republicans of a free-market persuasion mostly do not—but tend to stay silent because they know that swing voters look positively at raising the wages of low-earners.

The minimum wage is lagging…

Congressional political stalemate has meant the U.S. wage floor has lagged behind median earnings. In contrast wage growth in other OECD countries has performed much better, as this graph produced by the Hamilton Project shows:

Advanced nations have de-politicized minimum wage decisions

The federal minimum wage is an established piece of the U.S. policy furniture—and one that is quite dated. It now makes sense to consider taking some of the power and responsibility for setting the wage rate out of the hands of politicians—just as interest rates are set by the Federal Reserve.

This is not a novel proposal in international terms. In most advanced economies, minimum wage decisions are not purely political. Out of 66 countries studied by Tito Boeri in 2009, 24 delegate the determination the minimum wage level to a tripartite body; 26 countries set the minimum wage after taking advice following formal consultation between the Government and representatives of employers and workers; and just 16 countries (including the U.S.) set the minimum wage through a simple legislative vote.

Over in the U.K., the Conservative Prime Minister David Cameron just jacked up the national minimum wage by 3% up to £6.70, with barely a squeak of protest from employers or the right wing of his own party. Why? Because, like his two predecessors, he simply followed the advice of the Low Pay Commission, which is comprised of nine commissioners—three each from trade unions, employer organizations and academia.

Two options for taking the political heat out of the U.S. minimum wage

Can the U.S. follow suit? And if it can, what might the new system look like? Two options at least are worth considering.

1. A Federal Minimum Wage Advisory Board. This could be made up (like the U.K. version) of nine members: three representatives of employer organizations, three from labor organizations, and three independent labor economists. The Board would recommend a rate for the national minimum wage each year, which would then be enacted by Congress in the usual manner. The Board would have a strong incentive to set a rate likely to be adopted by Congress, in order to establish and maintain its reputation: there is, after all, little point in sitting on a Board that is ignored. The Board’s recommendation would not be binding and would not become the legal ‘default’ level. But because the advice is likely to be sensible, Congress would likely be inclined to follow it.

2. Wage Indexation. An alternative—favored by my Brookings colleague Gary Burtless—would be to simultaneously raise the minimum wage and introduce automatic indexing, lifting the minimum wage at the same rate as either consumer prices or the median wage—preferably the latter. In effect, this would do for the minimum wage what President Nixon did for Social Security. Congress would have the power to suspend a rise—perhaps if unemployment reached a certain threshold—but the default position would be to link changes in the minimum wage to changes in the median wage or in the broader consumer economy.

Policy commitment devices in action

These are both examples of what I have called policy commitment devices—in a new paper, Ulysses Goes to Washington—that help to overcome political myopia in order to support longer-term policy objectives. In the first case, taking advice from an independent commission, the commitment is somewhat less binding, although as James Madison knew, ‘the counsels and checks of friends’ can carry plenty of weight. Indexation would be a tighter form of binding, since inaction on the part of politicians would lead to an uprating of minimum wage, rather than the current stasis.

For both sides, there are political attractions to sub-contracting some decision-making power over the minimum wage. By accepting the advice of an independent body or allowing indexation to do its silent work, Republicans can keep their business donors and right-wing critics at bay; Democrats can do the same for unions and the political left. Sometimes the most powerful thing politicians can do is give some power away. The minimum wage is now perhaps a case in point.

Image Source: © Brian Snyder / Reuters
      
 
 




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Rosberg invites Vettel to Mercedes debrief

Nico Rosberg has officially invited Sebastian Vettel to Mercedes' debrief in Malaysia following the pair's tetchy exchange after the Australian Grand Prix




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Plenty more to come from Mercedes - Hamilton

Lewis Hamilton says Mercedes still has work to do to perfect its set-up despite a hugely impressive start to the 2015 season on Friday in Australia




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Hamilton: Work needed to convert pole to win

Lewis Hamilton says he still has a lot of work to do to convert his dominant pole into a victory at the season-opening Australian Grand Prix




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Vettel's victory a 'wake-up call' for Mercedes

Mercedes boss Toto Wolff says Sebastian Vettel's win for Ferrari in Malaysia has set alarm bells ringing for the reigning world champion




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Hamilton '99.6%' done on new Mercedes £27m deal

Lewis Hamilton is closing on a new Mercedes deal reportedly worth £27 million a year and he expects it to be closed this week




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Ferrari still has work to do to catch Mercedes - Kimi

Kimi Raikkonen says Ferrari still has work to do to be consistently competitive with Mercedes but is confident it has taken a big chunk out of Mercedes lead following Sebastian Vettel's victory in Malaysia




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Mercedes has come good - Rosberg

Nico Rosberg believes his podium at the British Grand Prix was proof the team had bounced back from its disastrous weekend two weeks ago in Valencia




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Mercedes dominates opening practice session

Mercedes started the 2015 season as they finished 2014, holding a significant advantage over the rest of the field during the first practice session for the Australian Grand Prix




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Hamilton beats Rosberg to dominant Mercedes victory

Lewis Hamilton got his title defence off to a flying start with victory over Mercedes team-mate Nico Rosberg at the season-opening Australian Grand Prix




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Vettel beats Mercedes for first Ferrari win

Sebastian Vettel took his first Ferrari victory at the Malaysian Grand Prix and the first for the team in 35 races after beating Mercedes in a battle of tyre degradation and strategy in the heat of Sepang




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The Economic Gains of Cloud Computing: An Address by Federal Chief Information Officer Vivek Kundra

Event Information

April 7, 2010
9:00 AM - 11:00 AM EDT

Falk Auditorium
The Brookings Institution
1775 Massachusetts Ave., NW
Washington, DC

Register for the Event

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.

Video

Audio

Transcript

Event Materials

     
 
 




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Technology and the Federal Government: Recommendations for the Innovation Advisory Board


Our former Brookings colleague Rebecca Blank, now at the Commerce Department, is today leading the first meeting of the Obama Administration’s Innovation Advisory Board, looking at the innovative capacity and economic competitiveness of the United States.

I applaud the effort.  Nothing is more important to America’s longterm competitiveness than emphasizing innovation.  As the council looks to the private sector and global markets, I urge it to examine how the U.S. government can lead innovation and contribute to economic growth.  The best place to look is new and emerging digital technologies that can make government more accessible, accountable, responsive and efficient for the people who use government services every day.

Here are some of the recommendations I made in a recent paper I wrote with colleagues here at Brookings as part of our “Growth Through Innovation” initiative:

  • Save money and gain efficiency by moving federal IT functions “to the cloud,” i.e., using advances in cloud computing to put software, hardware, services and data storage through remote file servers.

  • Continue to prioritize the Obama administration’s existing efforts to put unparalleled amounts of data online at Data.gov and other federal sites, making it easier and cheaper for citizens and businesses to access the information they need.

  • Use social media networks to deliver information to the public and to solicit feedback to improve government performance.

  • Integrate ideas and operations with state and local organizations, where much of government innovation is taking place today. 

  • Apply the methods of private-sector business planning to the public sector to produce region-specific business plans that are low cost and high impact.

These improvements in government services innovations in the digital age can help spur innovation and support a robust business climate.  And, as a sorely needed side benefit, they can also serve to eliminate some of the current distrust and even contempt for government that has brought public approval of the performance of the federal government to near historic lows.  



Authors

Image Source: © Mario Anzuoni / Reuters
     
 
 




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New Federal Government CIO is Key to Improving Government Performance


The appointment of new federal chief information officer Steven VanRoekel comes at a challenging time for President Barack Obama. The national economy continues to be weak. Congress plans to cut trillions from the federal budget. And in the time leading up to the 2012 election, American voters remain cynical about the ability of the government to address important policy problems in an effective manner.

In an era of deficit reduction and public cynicism, the tasks facing federal officials are to determine how to do more with less and persuade voters the government can become smarter and more effective. There are going to be fewer dollars for virtually every federal program so it is important to figure how ways to innovate and perform more efficiently.

Former CIO Vivek Kundra sought to do this through encouraging agencies to move software applications to the cloud, consolidating federal data centers, improving transparency, and improving the information technology procurement process. It is important to continue this progress even as agencies are forced to downsize their operations.

As shown in the private sector, government administrators should use technology to cut costs, improve worker productivity, and streamline operations. This is not just a matter of using technology in more innovative ways, but changing the operations and culture of the public sector. Public officials must improve its data mining activities to identify fraud and abuse in Medicare, Medicaid, the Defense Department, and other domestic programs.

New software gives managers better tools to evaluate how money is being spent and whether it is fulfilling intended goals. If it is not, programs need to be modified or eliminated. The most important weapon in Mr. VanRoekel’s arsenal may be the scalpel as he goes through the federal government’s $80 billion IT budget.

Authors

Image Source: © Hyungwon Kang / Reuters
      
 
 




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Analyzing the Federal Government's Use of the Cloud


Since 2009 the federal government started the process of replacing local computers with cloud platforms. A recent report from the Congressional Research Service (CRS) provides an interesting view into the progress of these investments. It reveals the benefits that public agencies gain when using cloud services and the barriers they face when making the transition.

Advantages of Cloud Computing

Cloud computers are superior to locally-run data centers for a variety of reasons. The CRS report identifies six specific cloud benefits:

  • Cost- Cloud computer platforms use resources more efficiently than local servers. An organization that uses local Information Technology (IT) must invest in the infrastructure to support computer systems at times of peak demand. However, most times companies or government agencies require only a fraction of that computing power. Cloud computing allows organizations to pay for all of the resources they need and avoid costly investments in rarely used local IT systems.
  • Energy Efficiency- Cloud computing data centers benefit from economies of scale to run more efficiently than local servers. In some cases this can result in huge energy savings. For a large cloud computing center it also makes economic sense to invest in green energy sources like wind or solar for power.
  • Availability- Cloud computing systems make it easy for any device with an Internet connection to access files or software. However, if a facility temporarily loses Internet access the files on cloud system are inaccessible. Alternatively, a locally administered IT system could function without Internet connectivity.
  • Agility- Cloud systems can make it easier to upgrade operating systems and applications. The available computing power also means that memory intensive software packages are cost effective.
  • Security- Cloud providing companies also have the financial resources to purchase the tools necessary to ensure that networks remain safe.
  • Reliability- Cloud systems can save data onto multiple servers. If a single server goes down due to a cyberattack or another issue, the data is available on another server.

Government Investments in the Cloud

Determining the exact size of government cloud computing expenditures is difficult. Government spending on IT has increased every year from 2001 to 2013 when it reached a peak of $81 billion. In the three subsequent years it has decreased. Cloud computing expenditures likely represent a tiny fraction of that total. Market research firms have estimated that the federal government spends between $1.4 billion and $7 billion on cloud computers annually.

Trends in Total Federal Investment in Information Technology


Source: Congressional Research Service

Challenges for Migrating to the Cloud

The federal government has encountered several barriers in its plan to shift more functions to cloud platforms:

  • High Federal Security Requirements- The government faces new advanced persistent threats routinely. System-wide security updates are necessary more often than for private sector organizations. The short update cycle provides a unique challenge to cloud providers.
  • Adopting New Technologies- Government agencies have ingrained cultures that are slow to change. This shift from locally-based servers to the cloud can be slow and tedious for this reason.
  • Ancillary Technologies- Cloud technologies are known for their flexibility. However, government agencies may lack the necessary IT infrastructure or speedy Internet connections that leverage the maximum potential of the cloud.
  • Technical Know How- Cloud platforms require specialized knowledge to administer. Many government agencies lack the necessary experts to oversee a migration to the cloud.
  • IT Expenditure- Migration to the cloud can involve expensive initial costs. Additional funding is necessary to facilitate the shift to the cloud.

The Future of the Government Cloud

An analysis of the costs and benefits of cloud migration uncover a few specific barriers that the federal government must overcome to earn the full value from new technologies. First, lawmakers must be willing to spend more now to save money later. Cloud systems are cheaper to run than local administered servers but the initial transition costs are high. Current funding levels, which are trending down, are too low to finance such a change. Privacy and security are also major challenges. Government servers host troves of data that Americans expect to remain private. Converting these systems to the cloud will require the government’s full confidence that cloud systems are at least as secure. New legislation is likely necessary to achieve the complimentary goals of privacy and security.

More TechTank posts available here

Authors

Image Source: © Donna Carson / Reuters
      
 
 




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The economics of federal tax policy

Abstract The federal government faces increasing revenue needs driven by the aging of the population and emerging challenges. But the United States collects less revenue than it typically has in the past and less revenue than other governments do today. In addition, how the government raises revenue—not just how much it raises—has critical implications for…

       




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More than price transparency is needed to empower consumers to shop effectively for lower health care costs


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.

Authors

Publication: JAMA
       




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Congressional Master Class: The Senate Filibuster, Congress and the Federal Reserve


In this podcast, congressional expert Sarah Binder explains why the Senate filibuster is a historical mistake. She talks about her research on Congress’s relationship with the Federal Reserve and addresses whether Congress is more polarized today than it has been in the past. Binder, a senior fellow in Governance Studies, is also a professor of political science at George Washington University and contributor to the Monkey Cage blog.

 

SUBSCRIBE TO THE PODCAST ON ITUNES »

Show notes:

• The Federal Reserve: Balancing Multiple Mandates (testimony by Alice Rivlin)
Boom! What the Senate Will Be Like When the Nuclear Dust Settles
Beyond the Horse Race to Lead the Fed
Droning on: Thoughts on the Rand Paul “Talking Filibuster”
• Advice and Dissent: The Struggle to Shape the Federal Judiciary
The History of the Filibuster

* In the image, Senator Henry Clay speaks about the Compromise of 1850 in the Old Senate Chamber. Daniel Webster is seated to the left of Clay and John C. Calhoun to the left of the Speaker's chair. (engraving by Robert Whitechurch, ca. 1880, Library of Congress)

Authors

      
 
 




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Rebuilding or redefining Syria?

Syria’s tenuous ceasefire brokered by Russia, Turkey, and Iran has rekindled hopes for ending the horrific violence in the country while reviving interest in various initiatives for reconstruction. The latter include the United Nation’s National Agenda for the Future of Syria, an ambitious undertaking with participation from the regime and opposition groups, assessments from the […]

      
 
 




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The market makers: Local innovation and federal evolution for impact investing


Announcements of new federal regulations on the use of program-related investments (PRIs) and the launch of a groundbreaking fund in Chicago are the latest signals that impact investing, once a marginal philanthropic and policy tool, is moving into the mainstream. They are also illustrative of two important and complementary paths to institutional change: fast-moving, collaborative local leadership creating innovative new instruments to meet funding demands; federal regulators updating policy to pave the way for change at scale.

Impact investing, referring to “investment strategies that generate financial returns while intentionally improving social and environmental conditions,” provides an important tier of higher-risk capital to fund socially beneficial projects with revenue-generating potential: affordable housing, early childhood and workforce development programs, and social enterprises. It is estimated that there are over $60 billion of impact investments globally and interest is growing—an annual JP Morgan study of impact investors from 2015 reports that the number of impact investing deals increased 13 percent between 2013 and 2014 following a 20 percent increase in the previous year.

Traditionally, foundations have split their impact investments into two pots, one for mission-related investments, designed to generate market-rate returns and maintain and grow the value of the endowment, and the other for program-related investments. PRIs can include loans, guarantees, or equity investments that advance a charitable purpose without expectation of market returns. PRIs are an attractive use of a foundation’s endowment as they allow foundations to recycle their limited grant funds and they count towards a foundation’s charitable distribution requirement of 5 percent of assets. However they have been underutilized to date due to perceived hurdles around their use–in fact among the thousands of foundations in the United States, currently only a few hundred make PRIs.

But this is changing, spurred on by both entrepreneurial local action and federal leadership. On April 21, the White House announced that the U.S. Department of the Treasury and Internal Revenue Service had finalized regulations that are expected to make it easier for private foundations to put their assets to work in innovative ways. While there is still room for improvement, by clarifying rules and signaling mainstream acceptance of impact investing practices these changes should lower the barriers to entry for some institutional investors.

This federal leadership is welcome, but is not by itself enough to meet the growing demand for capital investment in the civic sector. Local innovation, spurred by new philanthropic collaborations, can be transformative. On April 25 in Chicago, the Chicago Community Trust, the Calvert Foundation, and the John D. and Catherine T. MacArthur Foundation launched Benefit Chicago, a $100 million impact investment fund that aims to catalyze a new market by making it easier for individuals and institutions to put their dollars to work locally and help meet the estimated $100-400 million capital needs of the civic sector over the next five years.

A Next Street report found that the potential supply of patient capital from foundations and investors in the Chicago region was more than enough to meet the demand – if there were ways to more easily connect the two. Benefit Chicago addresses this market gap by making it possible for individuals to invest directly through a brokerage or a donor-advised fund and for the many foundations without dedicated impact investing programs to put their endowments to work at scale. All of the transactional details of deal flow, underwriting, and evaluation of results are handled by the intermediary, which should lead to greater efficiency and a significant increase in the size of the impact investing market in Chicago.

In the last few years, a new form of impact investing has made measurement of social return to investments even more concrete. Social impact bonds (SIBs), also known as pay for success (PFS) financing, are a way for private investors (including foundations) to provide capital to support social services with the promise of a return on their investment from a government agency if some agreed-upon social outcomes are achieved. These PFS transactions range from funding to support high-quality early childhood education programs in Chicago to reduction in chronic individual homelessness in the state of Massachusetts. Both the IRS and the Chicago announcements are bound to contribute to the growth of the impact bond market which to date represents a small segment of the impact investing market.

These examples illustrate a rare and wonderful convergence of leadership at the federal and local levels around an idea that makes sense. Beyond simply broadening the number of ways that foundations can deploy funds, growing the pool of impact investments can have a powerful market-making effect. Impact investments unlock other tiers of capital, reducing risk for private investors and making possible new types of deals with longer time horizons and lower expected market return.

In the near future, these federal and local moves together might radically change the philanthropic landscape. If every major city had a fund like Benefit Chicago, and all local investors had a simple on-ramp to impact investing, the pool of capital to help local organizations meet local needs could grow exponentially. This in turn could considerably improve funding for programs—like access to quality social services and affordable housing—that show impact over the long term.

Impact investing can be a bright spot in an otherwise somber fiscal environment if localities keep innovating and higher levels of government evolve to support, incentivize, and smooth its growth. These announcements from Washington and Chicago are examples of the multilevel leadership and creative institutional change we need to ensure that we tap every source of philanthropic capital, to feel some abundance in an era where scarcity is the dominant narrative.

Editor's Note: Alaina Harkness is a fellow at Brookings while on leave from the John D. and Catherine T. MacArthur Foundation, which is a donor to the Brookings Institution. The findings, interpretations and conclusions posted in this piece are solely those of the authors and not determined by any donation.

Image Source: © Jeff Haynes / Reuters
     
 
 




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Webinar: How federal job vacancies hinder the government’s response to COVID-19

Vacant positions and high turnover across the federal bureaucracy have been a perpetual problem since President Trump was sworn into office. Upper-level Trump administration officials (“the A Team”) have experienced a turnover rate of 85 percent — much higher than any other administration in the past 40 years. The struggle to recruit and retain qualified…

       




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The Federal Housing Policy Dilemma for Older Communities

Often the biggest challenge for older cities and close-in suburbs is not a lack of affordable housing but a need to grow, hold, and attract middle-income households and to foster mixed-income neighborhoods. This creates a policy dilemma: While federal policymakers target limited federal housing assistance to persons with the greatest needs, doing so can create concentrations of poverty within already challenged cities and suburbs. This approach also can set limits that hinder efforts to create the middle-income and mixed-income areas needed for revitalization in older communities.

The metro program hosts and participates in a variety of public forums. To view a complete list of these events, please visit the metro program's Research and Commentary page which provides copies of major speeches, PowerPoint presentations, event transcripts, and event summaries.

Downloads

Publication: Capitol Hill Briefing
     
 
 




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Covid-19 is a wake-up call for India’s cities, where radical improvements in sanitation and planning are needed

      




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The federal government’s coronavirus response—Public health timeline

By now, it is obvious to everyone seeking to understand the United States’ response to the novel coronavirus (officially SARS-CoV-2) that there were massive failures of judgment and inaction in January, February, and even March of this year. While mistakes are inevitable in the face of such a massive and rapidly evolving domestic and global…

       




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Trade Policy Review 2016: Russian Federation

Each Trade Policy Review consists of three parts: a report by the government under review, a report written independently by the WTO Secretariat, and the concluding remarks by the chair of the Trade Policy Review Body. A highlights section provides an overview of key trade facts. 15 to 20 new review titles are published each […]

      
 
 




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"The Vital Center": A Federal-State Compact to Renew the Great Lakes Region

Brookings John Austin provided Great Lakes regional economic context for a forum of Ohio and Pennsylvania business and civic leaders convened by Congressmen Jason Altmire (PA), and Tim Ryan (OH) to develop strategies for growing the bi-state regional economy.

 

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Webinar: How federal job vacancies hinder the government’s response to COVID-19

Vacant positions and high turnover across the federal bureaucracy have been a perpetual problem since President Trump was sworn into office. Upper-level Trump administration officials (“the A Team”) have experienced a turnover rate of 85 percent — much higher than any other administration in the past 40 years. The struggle to recruit and retain qualified…

       




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20180808 New Yorker Bruce Riedel

       




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The SECURE Act: a good start but far more is needed

In December, while public attention focused on impeachment, the most extensive retirement legislation in more than a decade was passed and signed into law. Spearheaded by House Ways and Means Chairman Richard Neal (D-MA), the SECURE Act of 2019 was three years in the making and designed to raise the level and security of retirement…

       




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Trump, the Administrative Presidency, and Federalism

How Trump has used the federal government to promote conservative policies The presidency of Donald Trump has been unique in many respects—most obviously his flamboyant personal style and disregard for conventional niceties and factual information. But one area hasn’t received as much attention as it deserves: Trump’s use of the “administrative presidency,” including executive orders…

       




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U.S. Public Diplomacy For Cuba: Why It's Needed and How to Do It

INTRODUCTION

U.S. public diplomacy with Cuba — or the United States engaging with Cuban public opinion — is an intriguing subject. The principal reason for this is because it has never been tried. There was no attempt before the 1959 Revolution because the United States had no need to convince the Cuban government and people of why the United States mattered to them. In almost every aspect of life it was impossible to conceive of Cuba without the United States. Fidel Castro’s Revolution changed that. And since the Revolution, the Castro regime has carefully molded the United States as the arch enemy of the Cuban people. Successive U.S. administrations have made little effort to banish that impression while U.S. public diplomacy has been largely aimed at the Cuban-American exile community.

The public diplomacy challenge for the United States with Cuba is exciting but also formidable. The Cuban Government has had many years experience of controlling access to information and shackling freedom of expression. The public diplomacy messages that the United States will send will be distorted and blocked. Nevertheless there are growing signs that Cubans on the island are accessing new technologies so information does get through, particularly to residents of the major cities. Expansion of people-to-people exchanges and a lifting of the travel ban on ordinary Americans would greatly assist any public diplomacy campaign. But public diplomacy can start without this and the Cuban government’s capacity to block messages is no argument for not transmitting them.

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Authors

  • Paul Hare