A recent blog suggested that CMS’ efforts to standardize assessment data was based on a goal of “….creating a functional measurement tool that could be used throughout the industry.” In fact, CMS has been working since 2005 to meet the Congressional directive to standardize assessment information at hospital discharge, and post-acute care (PAC) admission and discharge for payment and quality reporting purposes (Deficit Reduction Act of 2005). The CARE tool was developed as part of the national Post-Acute Care Payment Reform Demonstration (PAC PRD). The conceptual domains and items were selected with the input of the wide range of stakeholder communities working with PAC populations. Clinicians from acute hospitals and each of the four PAC settings, including long term care hospitals (LTCHs), inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), and home health agencies (HHAs) identified items to test in four areas: medical status, functional status, cognitive status, and some social support factors. Input was given by physicians, nurses, physical therapists, occupational therapists, speech and language pathologists, social workers and case managers working in each of the different levels of care. Initial item selection was based on a review of existing assessment items, including those in the three Federally-mandated instruments, (the IRF-PAI, MDS 2.0, and OASIS-B which were in effect at this time) and the input of each of the scientific communities working in these areas.

Developers of proprietary systems such as the UDS-MR©, Inter-RAI ©, and AM-PAC ©, as well as public domain items tested in clinical trials such as the PROMIS items, were all reviewed as part of this process. The selected items needed to be in the public domain so the measures could be modified as science advanced practice.

Over 200 providers participated nationwide to submit over 53,000 CARE assessments over the course of the PAC PRD. Participating clinicians also provided feedback during training and exit interviews. In general, positive feedback was provided on most items. Feedback showed that almost all items were commonly collected on existing instruments in hospitals and PAC providers, although some of the information may have been informally noted in charts rather than provided in the structured form of the CARE items.

The items were tested for reliability so they could be applied consistently across populations and settings. Most of the items were previously tested and found reliable in at least one of the five levels of care. Two types of reliability tests were conducted on the final CARE tool item set used in the PAC PRD. The results showed that most items when applied to the other four settings were at least as reliable as the existing Federal assessment items (Kappa scores of 0.6 or better) ensuring their reliable use in future quality measures or payment models would reach consistent results. Complete reports on item reliability and PAC PRD results can be found here.

Data standardization is critical to allow providers to exchange information as they follow the patient. The Deficit Reduction Act of 2005 directed CMS to use standardized assessment items at acute hospital discharge and PAC admission and discharge to allow for empirical comparisons of key questions arising out of changing incentives in the Medicare payment policies. The standardized CARE items are consensus-based versions of the items already collected by clinicians. These and additional items being incorporated into CMS’ assessment item library represent the “best in class.” The team developing the CARE item set represented the leading experts in each of the areas – Dr. Margaret Stineman of the University of Pennsylvania, developer of the function-related groups associated with the proprietary FIM©, Dr. Deborah Saliba, UCLA, lead developer of the MDS 3.0, and Dr. Chris Murtaugh of the Visiting Nurse Service of New York. Team members included Drs. Anne Deutsch and Trudy Mallinson of the Rehabilitation Institute of Chicago. Input was also given by Dr. David Hittle, of the University of Colorado who has worked closely with the OASIS tool, Dr. Samuel Markello, formerly of the UDS-MR©, and Dr. Patrick Murray of Case Western University.

The blog suggested that, “the early reviews of the CARE tool have been poor.” While this clearly is not true, it is worth pointing out that the author owns one of the key proprietary assessment instruments. The CARE items have been evaluated for reliability and they meet the national standards; they allow providers and others the opportunity to download the e-specification of the items without charge and to have the clinicians trained for free under CMS’ regular assessment training initiatives. CMS is currently developing quality measures using the “best in class” assessment items which all meet scientific standards. The quality measure development process already requires CMS to submit measures for endorsement by the National Quality Forum. The “loophole” identified by the UDS-MR© author is non-existent. The Measures Application Partnership is part of the existing NQF process included in the IMPACT legislation. Further, use of uniform data elements across settings, such as those used in the currently collected pressure ulcer measure, allows for exchangeability and improves communication across the system, finally creating a “data follows the person” system.

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Over the past year, much attention has been given to the growing production of shale oil and the challenge that these unconventional sources of energy pose to traditional producers in the Gulf. As the world’s leading exporter of liquefied natural gas (LNG), Qatar faces related concerns – mounting competition from new LNG exporters and more competitive pricing in key Asian gas markets. How will this global gas boom unfold? How can Doha develop a robust response to growing volatility in gas pricing and demand?

In a new Brookings Doha Center Analysis Paper, Naser al-Tamimi examines Qatar’s position on the global gas stage and assesses the prospects of new competitors. He argues that new LNG production and exports – from Australia, the United States, and other countries – present a challenge to Qatar’s dominant status in global gas markets, particularly in the Asia-Pacific region. At the same time, diversification and slowing growth in this region’s major economies, such as China, South Korea, and Japan, may reduce LNG demand across the board.

Read "Navigating uncertainty: Qatar’s response to the global gas boom"

Ultimately, Tamimi argues that Qatar’s pricing mechanisms and export revenues will come under significant pressure as a result of these developments, posing a potential challenge to Qatari finances. He contends that an effective response from Qatari officials must emphasize greater exports to the Middle East/North Africa region, greater contract flexibility to attract new buyers, and cooperation with other GCC members to improve Gulf bargaining power in key regional markets.

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Over the past few years, higher education has been a frequent casualty of the violent conflicts sweeping the Middle East. Campuses have been bombed in Syria, Gaza and now Yemen; occupied or closed in Libya and Iraq; and been the subject of severe police crackdowns across the region. What institutional measures can both regional entities and international bodies take to protect institutions of higher learning in the Arab world? Beyond this, how can strategies of protection be incorporated into programs of reconstruction and development for this much-maligned sector?

Read "Houses of wisdom matter: The responsibility to protect and rebuild higher education in the Arab world"

Sultan Barakat and Sansom Milton, in a new Brookings Doha Center Policy Briefing, contend that higher education is often an unrecognized casualty of these conflicts, with priority given to more pressing humanitarian needs. They assert that the protection and rebuilding of such institutions across the Middle East forms a crucial response to present concerns, helping to shelter and develop strategically vital youth populations. Crucially, they hold that an action plan for higher education in the Arab world cannot end at rebuilding shattered classrooms or rescuing individual scholars.

Ultimately, Barakat and Milton argue for a regional approach to defending and advancing higher education, as a key tool to combat violent extremism, address economic challenges, and encourage social stability. A strategy of “building back better” would allow higher education to serve as an engine for regional revitalization, living up to the historical example set by the region’s centuries-old institutions of higher learning.

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In many policy-related situations, the states can be useful laboratories to determine the most appropriate federal actions. Variations across states in health care programs, earned income credit rules, minimum wages, and other policies have helped inform debates about federal interventions.

In this paper, we reverse that approach. Many state and local governments currently face difficulties financing future pension obligations for their workers. The federal government, however, faced similar circumstances in the 1980s and successfully implemented a substantial reform. We examine the situation the federal government faced and how it responded to the funding challenge. We present key aspects of the situation facing state governments currently and draw comparisons between them and the federal situation in the 1980s. Our overarching conclusion is that states experiencing distress today about the cost and funding of its pension plans could benefit from following an approach similar to the federal government’s resolution of its pension problems in the 1980s.

The federal government retained the existing Civil Service Retirement System (CSRS) for existing employees and created a new Federal Employees’ Retirement System (FERS) for new employees. FERS combined a less generous defined benefit plan than CSRS, mandatory enrollment in Social Security, and a new defined contribution plan with extensive employer matching. Although we do not wish to imply that a “one size fits all” solution applies to the very diverse situations that different states face, we nonetheless conclude that the elements of durable, effective, and just reforms for state pension plans will likely include the major elements of the federal reform listed above.

Section II discusses the federal experience with pension reform. Section III discusses the status and recent developments regarding state and local pensions. Section IV discusses the similarities in the two situations and how policy changes structured along the lines of the federal reform could help state and local governments and their employees.

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In her February 25 Brookings report, Dr. Dale Farran questions the scientific case for endorsing widespread policy in preschool education. Indeed, she argues that enthusiasm for public preschool and its promise is “premature.” Her argument is founded on three points—that the data on impact is mixed, that we do not have scientific direction with respect to the key quality constructs, and that our measurement of these constructs lack empirical validity. There is a grain of truth in each of these statements. Yet, a closer look reveals that when the data are focused on high quality preschools, the weight of the evidence for effectiveness is compelling. The early childhood science is at least evidence informed on the skill sets that will promote later school and life success and valid measures exist for many of the important outcomes. While there is always more to be learned, the bulk of the scientific community contends that high quality preschool programs will play a role in preparing young children for success in school and beyond.

There is no doubt that the literature looking for relationships between preschool access and school readiness outcomes in literacy, mathematics, and other domains are mixed.  Both the Head Start Impact Study and recent findings from Farran’s own Tennessee pre-k study (Lipsey et al., 2015) indicate that preschool of less than high quality produce only modest short-term gains. 

The data do not look bleak, however, when we look across preschool outcomes in the aggregate. And when high quality programs are investigated, whether in well-controlled studies of intensive models (e.g., Perry and Abecedarian) or in studies of strong public programs in Boston (Weiland & Yoshikawa, 2013), Cincinnati (Karoly & Auger, 2016), New Jersey (Barnett et al., 2013), North Carolina (Peisner-Feinberg et al., 2015), and Tulsa (Hill et al., 2015), the results are downright promising  (Yoshikawa et al., 2013; Minervino. 2014). Society reaps benefits from fostering early skill development, as children participating in high quality preschool programs had lower rates of grade retention, less need for special education, decreased antisocial behavior, and greater productivity as adults (Reynolds & Temple, 2015; Cunha & Heckman, 2006). In 2014, over 1,200 scientists who work in the area of early education signed the ECE Consensus Letter for Researchers, attesting to the mountains of data in support of the role of preschool education in improving child outcomes in social development, language, pre-literacy, and mathematics.

Though Farran’s brief reviews only data from the United States, a growing literature suggests that preschool education has long and lasting and causal effects on outcomes around the globe (Atinc & Gustafsson-Wright, 2013). For example, an impact evaluation of a preschool program in Mozambique found that the program increased on-time enrollment into primary school among beneficiaries by 22 percent relative to the children in the control group. Enrolled children also experienced a 6 percent increase in fine motor development, and an 87 percent increase in cognitive development. More importantly, this is not just a story of “everything is bleak in the developing world so the program is bound to have an impact.”

With compelling data in the United States and across the globe, one might ask why there is such a great divide between Farran’s interpretation and that of the wider academic community? One reason appears to be that Farran discounts any data that did not emerge from random assignment longitudinal studies. While correlational studies are not the gold standard, they are informative. Surely practitioners and policymakers would not dismiss data on parenting practices because children were not randomly assigned to parents. Further, in the area of preschool education, there is no difference in findings between randomized trials and other methodologies with respect to targeted cognitive, achievement-related outcomes when other study and program features are taken into account (Duncan & Magnuson, 2013; Camilli et al., 2010). 

Farran also discounts many of the randomized trials because she says they do not tell us enough about cause and effect. She writes of the famous Abecedarian and Perry Preschool studies:

The primary difficulty with this approach as a basis for designing interventions is that there is no way to identify what specifically changed about children’s abilities that enabled them to perform better in school or to link those changes to any particular set of active ingredients in the treatment. Neither Perry nor Abecedarian explicitly describes beyond the broadest level the “treatment” that brought about their positive effects.

But the children did improve, and at some level—while it would be wonderful to isolate the exact recipe for preschool success—we need not deny children the benefits of preschool while scientists probe for the precise combinations of active ingredients that yield the best results. Consider an analogy: the impact of storybook reading on children. While numerous studies document that reading storybooks with children in a joint way improves vocabulary and early literacy, we have yet to isolate the exact causal factors that matter in book reading. Perhaps it is the cuddling that occurs between child and parent; perhaps this crucial unstudied variable is the key that has not yet been turned. But no one would argue that we should stop book reading as a way to foster young children’s interest in reading. So it is with preschool. A quality preschool can heighten young children’s desire to attend school and prepare them for learning—even if all the ingredients in the magic sauce have not yet been identified.

In short, the evidence does provide models of high quality preschool that effectively prepare children for entrée into school and that change a child’s trajectory toward success. Not knowing the exact mechanisms by which preschool exerts its impact is secondary to the fact that poor children need good preschools now and we know how to provide them.

Farran raises the very important point that a narrow focus on only reading and math outcomes would be misplaced in our quest to build high quality preschool curricula. We could not agree more. She goes on to write, however, that “premature as well is the presumption that solid research exists to guide the content and structure of pre-K programs.”

Here we beg to differ. There are thousands of studies that speak to the skill sets children need to achieve success in the changing world. Reading and math are among these skills—collectively bundled under what Golinkoff and Hirsh-Pasek (2016) call “content skills.” But there is overwhelming evidence that children need to master skills that move beyond just reading and math. Content knowledge has, at its base, language and executive function skills. Language is the medium of instruction and executive function skills empower children with the ability to control their impulses and attend. Flexibility and working memory (Galinsky, 2010; Blair, 2016), also part of executive function, enable children to shift gears and remember what they have been told. But even language and executive function are not enough. Children must be prepared to participate alongside others (collaboration), to question when they are unclear (critical thinking) (Kuhn, 1999), and to have the persistence needed to stick with difficult problems—grit (Duckworth et al., 2007). These skills have been tested, are predictive of later achievement, have been shown to be malleable and to relate to academic, social, and learning outcomes in school.

Farran argues that we cannot provide high quality preschool because we lack strong measures of quality. Again, there is some truth in her assertion, but it seems to us somewhat confused. Farran mixes together policy benchmarks, measures of classroom practice, and child outcome measures. All are useful, but for different purposes. The first is meant to set a floor across many domains including health and safety. The second is designed for providing feedback on classroom practice. The last allows us to assess children’s wellbeing and progress. Well-designed continuous improvement systems for pre-K have detailed standards for learning and teaching that align with assessments of classroom practice and systems operation as well as with child assessments. Together with program standards these can provide a clear vision of high quality. They set high expectations for children’s learning and development and for pedagogy. Our ability to specify all of this exceeds our ability to measure it with reasonable investments of time and money. Nevertheless, classroom observation measures and child assessments as elements of a continuous improvement system help inform teachers and administrators about where they are and what steps they need to take next (Hall et al., 2012; Sylva et al., 2006; Williford et al., 2013). None of us would argue that this is easy, or that any single measure of classroom quality or child development is sufficient. Providing guidance for the improvement of learning and teaching is hard work and domain specific, but it is not futile.

Farran closes her report by suggesting that “[the] proposition that expanding pre-K will improve later achievement for children from low-income families is premature.” Perhaps instead it is Farran’s prognosis that is overly pessimistic. Research to date indicates that sustained access to high quality preschool does alter the trajectory of low-income children who are otherwise not exposed to early math and to age-appropriate books. In several now classic studies, the effects of a quality preschool education has far reaching consequences linked to not only reading and math, but to fewer incarcerations, teen pregnancies, and higher employment well into adulthood. As economists have shown, high quality early learning programs save money for society—a finding that has been replicated in different programs across the globe—in the United States, Canada, the U.K., and Mozambique.

Do we need to know more about what constitutes high quality and how to harness this reliably? Absolutely. But science offers evidence-based and evidence-informed advice on what has worked and what should work when brought to scale. We have an obligation to use the best science to serve our struggling children. Recent surveys indicate that a majority of the American public—Republican and Democrat—agrees that all children deserve a chance to reach their fullest potential. Let the science progress and let us use what we know at this point in time to meet the promise that all children should have a fighting chance to succeed. Better to light a candle than curse the darkness.

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.

Technical change is advancing at a breakneck speed while the institutions that govern innovative activity slog forward trying to keep pace. The lag has created a need for reform in the governance of innovation. Reformers who focus primarily on the social benefits of innovation propose to unmoor the innovative forces of the market. Conversely, those who deal mostly with innovation’s social costs wish to constrain it by introducing regulations in advance of technological developments. In this paper, Walter Valdivia and David Guston argue for a different approach to reform the governance of innovation that they call "Responsible Innovation" because it seeks to imbue in the actors of the innovation system a more robust sense of individual and collective responsibility.

Responsible innovation appreciates the power of free markets in organizing innovation and realizing social expectations but is self-conscious about the social costs that markets do not internalize. At the same time, the actions it recommends do not seek to slow down innovation because they do not constrain the set of options for researchers and businesses, they expand it. Responsible innovation is not a doctrine of regulation and much less an instantiation of the precautionary principle. Innovation and society can evolve down several paths and the path forward is to some extent open to collective choice. The aim of a responsible governance of innovation is to make that choice more consonant with democratic principles.

Valdivia and Guston illustrate how responsible innovation can be implemented with three practical initiatives: 

1. Industry: Incorporating values and motivations to innovation decisions that go beyond the profit motive could help industry take on a long-view of those decisions and better manage its own costs associated with liability and regulation, while reducing the social cost of negative externalities. Consequently, responsible innovation should be an integral part of corporate social responsibility, considering that the latter has already become part of the language of business, from the classroom to the board room, and that is effectively shaping, in some quarters, corporate policies and decisions.
2. Universities and National Laboratories: Centers for Responsible Innovation, fashioned after the institutional reform of Internal Review Boards to protect human subjects in research and the Offices of Technology Transfer created to commercialize academic research, could organize existing responsible innovation efforts at university and laboratory campuses. These Centers would formalize the consideration of impacts of research proposals on legal and regulatory frameworks, economic opportunity and inequality, sustainable development and the environment, as well as ethical questions beyond the integrity of research subjects.
3. Federal Government: Federal policy should improve its protections and support of scientific research while providing mechanisms of public accountability for research funding agencies and their contractors. Demanding a return on investment for every research grant is a misguided approach that devalues research and undermines trust between Congress and the scientific community. At the same time, scientific institutions and their advocates should improve public engagement and demonstrate their willingness and ability to be responsive to societal concerns and expectations about the public research agenda. Second, if scientific research is a public good, by definition, markets are not effective commercializing it. New mechanisms to develop practical applications from federal research with little market appeal should be introduced to counterbalance the emphasis the current technology transfer system places on research ready for the market. Third, federal innovation policy needs to be better coordinated with other federal policy, including tax, industrial, and trade policy as well as regulatory regimes. It should also improve coordination with initiatives at the local and state level to improve the outcomes of innovation for each region, state, and metro area.

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Editor's Note: This past week's vote in the United Kingdom to leave the European Union reveals huge frustration among British voters with economic, immigration, national self-identity, and the whole "European project." Trade between Britain and continental Europe could be notched back a bit as tariffs; London's role as a financial capital of the world may be compromised somewhat. But after acknowledging such real, if finite, concerns, writes Michael O'Hanlon, we should take a deep breath and relax. This piece was originally published by USA Today.

There's no denying it: this past week's vote in the United Kingdom to leave the European Union is very big news. It reveals huge frustration among British voters with economic globalization, immigration, national self-identity and the whole "European project." And there will be costs. Trade between Britain and continental Europe could be notched back a bit as tariffs return; London's role as a financial capital of the world may be compromised somewhat.

But after acknowledging such real, if finite, concerns, we should take a deep breath and relax. Silly headlines like that appearing in the June 25 NY Times about a looming end to the post-World War II order are not only premature, they are basically wrong.

Start with that order. The United States and United Kingdom worked together to win World War II, of course, without the UK being part of any European Union or even a European Community. (The European Community or EC was organized for European economic cooperation that began in the 1970s; it did not create open borders within Europe the way the European Union later did.) Indeed, we collectively won the Cold War without the European Union, which was not created until 1993. Western Europe had already re-established itself as a modern economic powerhouse before the creation of the EU, recovering spectacularly from the unbelievable wartime devastation that occurred in the 1940s. The United States helped a great deal with that process through the Marshall Plan and other mechanisms—none of which depended on EU bureaucracies or open borders.

Look at it another way. The UK is an important country. But with 1% of world population and 3% of world GDP, it does not drive the modern global economy. The stakes here are real, but again, they are finite.

Moreover, the tanking of shocked stock markets right after the Brexit vote should not confuse us about the state of economic fundamentals. To be sure, lots of people will have to work hard to negotiate new terms for Britain's future association with Europe. But the UK and the European Union's remaining 27 members will have powerful incentives to keep trade relatively free and financial markets quite integrated. Think of the models of Norway and Switzerland—also not EU members, but important and interlocking parts of the continent's economy. The UK is likely to wind up with a similar role in Europe's future.

Some people will worry about whether Brexit will weaken the EU's ability to stand up to Vladimir Putin as he causes unrest in eastern Europe. That is doubtful. The EU just last week renewed sanctions, with Germany and other continental countries leading the way. Britain's voice on such matters is important, but no more so than Germany's or France's, and it can remain important on the outside.

What about the US-UK "special relationship?" Again, I do not anticipate major problems. It is called a special relationship for a reason. We have been close allies for a century or more, and much of our best work together has happened bilaterally rather than through any EU, EC, UN, or other such multilateral mechanisms. That can continue.

The UK will remain in NATO, moreover — and NATO is, by far, the more important organization for global security, because it includes the United States while the European Union naturally does not. It is NATO, for example, that intervened in the Balkans wars in the 1990s and NATO that leads the Afghanistan mission even today. It is NATO that is sending battalions into eastern Europe today to stand up militarily to Putin.

On other issues, Britain has maintained its own prerogatives even while in the EU. In the Iran nuclear talks that led to last year's accord, for example, Britain had its own, independent role and voice. That won't change for similar situations in the future.

Even if, in coming years, Scotland secedes from the UK in order to rejoin the EU, that will cost the United Kingdom only 8% of its population (even if a higher percent of its castles, Loch Ness monsters, and men in skirts). Admittedly, the UK's ability to sustain nuclear forces could be challenged without access to Scottish ports—but those nuclear weapons, with all due respect to British friends, aren't really crucial pillars of today's global order in any event. Maybe Scottish secession would even persuade Britain to stop maintaining an unnecessary and costly nuclear deterrent.

To be sure, one can always find some hypothetical scenario in which having the UK outside of the European Union complicates life. To be sure, pulling out will make life temporarily harder for British and European diplomats and bureaucrats as they fashion a revised European order. And most of all, it is true that we need to take seriously the skepticism about globalization that UK voters have just voiced in a powerful and emphatic way. But the postwar global order is hardly falling apart.

The eurozone has three problems: national debt obligations that cannot be met, medium-term imbalances in trade competitiveness, and long-term structural flaws.

The short-run problem requires more of the monetary easing that Germany has, with appalling shortsightedness, been resisting, and less of the near-term fiscal restraint that Germany has, with equally appalling shortsightedness, been seeking. To insist that Greece meet all of its near-term current debt service obligations makes about as much sense as did French and British insistence that Germany honor its reparations obligations after World War I. The latter could not be and were not honored. The former cannot and will not be honored either.

The medium-term problem is that, given a single currency, labor costs are too high in Greece and too low in Germany and some other northern European countries. Because adjustments in currency values cannot correct these imbalances, differences in growth of wages must do the job—either wage deflation and continued depression in Greece and other peripheral countries, wage inflation in Germany, or both. The former is a recipe for intense and sustained misery. The latter, however politically improbable it may now seem, is the better alternative.

The long-term problem is that the eurozone lacks the fiscal transfer mechanisms necessary to soften the effects of competitiveness imbalances while other forms of adjustment take effect. This lack places extraordinary demands on the willingness of individual nations to undertake internal policies to reduce such imbalances. Until such fiscal transfer mechanisms are created, crises such as the current one are bound to recur.

Present circumstances call for a combination of short-term expansionary policies that have to be led or accepted by the surplus nations, notably Germany, who will also have to recognize and accept that not all Greek debts will be paid or that debt service payments will not be made on time and at originally negotiated interest rates. The price for those concessions will be a current and credible commitment eventually to restore and maintain fiscal balance by the peripheral countries, notably Greece.

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.