The eighth and final Strategic and Economic Dialogue (S&ED) of the Obama administration will take place in Beijing next week. On the economic side, it will be difficult this year to make progress on specific outcomes; but it’s an important year for having a frank conversation about macroeconomic and financial policies.

One reason that it will be hard to get specific outcomes is that the Chinese leadership has shown that economic reform doesn’t rank very high on its list of priorities. After laying out an ambitious reform agenda in its Third Plenum resolution in 2013, implementation of reform has been slow, except in some aspects of financial reform. Recent speeches have emphasized the need to close zombie firms and clean up non-performing loans in the banking system, but specific plans have been modest. 

In terms of the agenda between China and the United States, the most important issue is negotiating a Bilateral Investment Treaty (BIT). Many important sectors are still closed to inward direct investment in China. It would help China’s transition to a new growth model to open up these sectors to competition and to private investment, and a BIT is a smart way to commit to these reforms. However, China has been slow to produce a credible offer on the BIT because enterprises and ministries with vested interests have opposed opening up and the leadership is apparently not willing to take them on.

Another factor affecting this S&ED is that it is the last for the Obama administration. I would argue that this is a good time for China and the United States to demonstrate that regular, high-level exchange produces results, increasing the likelihood that whatever administration comes next will want to maintain something similar. However, it is more likely that Chinese leaders will want to wait and see what administration they will be dealing with and to save deliverables for those future negotiations.

S&ED is an opportunity for the top economic officials in the two countries to frankly discuss their policy choices and to avoid mistakes that can come from miscommunication.

My experience with the first four S&EDs was that the conversation was more important than the deliverables, which have often been modest, incremental steps. This year, China will be very interested in hearing what the Federal Reserve thinks. May labor market data will be published on June 3, just in advance of the S&ED, so there may be more clarity about when the Fed is likely to raise interest rates. Regardless of when the Fed moves, both China and the United States have an interest in seeing a relatively stable exchange rate for the yuan. China’s central bank officials have emphasized that the country still has a large current account surplus, so depreciation of the trade-weighted exchange rate is not warranted. Depreciation would exacerbate imbalances and would work against the transformation of China’s growth model because it favors industry at the expense of services. 

But if the Fed continues to normalize interest rates and the dollar rises against other major currencies, China does not want to follow the dollar up. Hence, its emphasis on stable value of the currency relative to a basket. S&ED is an opportunity for the top economic officials in the two countries to frankly discuss their policy choices and to avoid mistakes that can come from miscommunication. The most important outcome of the S&ED may well be avoidance of policy mistakes, a subtle outcome that will not be reflected in headlines. 

Steven Pifer joined Bernard Gwertzman to discuss Vice President Joseph Biden's recent trip to Ukraine and Georgia and how it was meant to balance President Barack Obama's Moscow summit earlier in the month.

Bernard Gwertzman: Vice President Joseph Biden has just completed a trip to Ukraine and Georgia to reassure both of those former Soviet republics that the American desire to "reset" relations--Biden's words in Munich last February--with Russia were not meant at their expense. But he also had what one Biden aide called "tough love" for both of them. Could you elaborate on this trip?

Steven Pifer: That was the first point of the trip: to reassure Kiev and Tbilisi that the United States remains interested in robust relations with Ukraine and Georgia, and that we will work to keep open their pathways to Europe and the North Atlantic community. When I was in Ukraine about five or six weeks ago, what I heard from the Ukrainians was a concern--and I suspect there is a parallel concern in Georgia--that the effort to reset relations with Russia would somehow come at Ukraine's expense. So part of the trip by the vice president was to assure both Ukraine and Georgia that the United States is not going to undercut relations with those two countries as it tries to develop relations with Russia. You've seen points made by this administration, indeed going back to the Munich speech itself, saying the reset of relations would not mean recognition of a Russian "sphere of influence" over the former Soviet states, and then repeated assurances that the United States supports the rights of countries such as Ukraine and Georgia as sovereign states to choose their own foreign policy course.

Gwertzman: What was also interesting to me was that in his speech in Ukraine, Biden was virtually demanding that the Ukrainian leadership get their act together. In Georgia, I don't think he was publicly as tough. Can you elaborate on the "tough love" part of the visits?

Pifer: Let me start with Ukraine. Certainly the primary goal of the visit was to reassure Ukraine, but there was also a tough message there. In Ukraine, it's not only due to the presidential election, but you've had a situation in the past year and a half where the government really hasn't functioned because of infighting between President Viktor Yushchenko and Prime Minister Yulia Tymoshenko. It's meant that Ukraine has passed up opportunities to accomplish some important things. A big part of the vice president's message in Kiev was to say, "You need to put aside political differences, come together as mature political leaders, find compromises, and get things done."

He also singled out the importance of Ukraine getting serious about reforming its energy sector. This is a huge national security vulnerability for Ukraine because they have a distorted price structure where people buy natural gas at prices that don't begin to cover the cost of the gas that Ukraine buys from Russia. As a result, Naftogaz, the national gas company, is perpetually in debt to Russia and on the verge of bankruptcy. That creates vulnerabilities for Ukraine.

Part of the vice president's message was, "You need to get serious about this." Part of the problem in Ukraine is if you are a household, you are probably paying a price that amounts to less than 30 percent of the actual cost of the gas bought from Russia. It's no wonder why Naftogaz is always in financial straits. But it's not just an economic problem because of the way it factors into the Ukraine-Russia relationship. It creates a national security issue for Ukraine. So there are two aspects to the tough message: One, the need for political leaders to get together, compromise, and produce good policy; and second, the special importance of tackling this energy security issue.

Read the full interview » (external link)

Editor’s note: This post is adapted from a forthcoming full-length case study; the second in a series from the Engelberg Center’s Merkin Initiative on Physician Payment Reform and Clinical Leadership designed to support clinician leadership of health care delivery, payment, and financing reform. The case study will be presented during the Merkin Initiative’s “MEDTalk” event on July 9 from 10:30 AM to 12:30 PM EDT, featuring live story-telling and knowledge-sharing from patients, providers, and policymakers.

Oncology practices and hospitals across the nation struggle with providing sustainable, comprehensive, and coordinated cancer care. Clinical leaders with strategies and models to improve the quality and value of health care often don’t know how to navigate the landscape of payment and delivery reform options to sustain their innovations.

We use a case study approach to investigate and tell the story of the New Mexico Cancer Center (NMCC), an independent cancer center that is experimenting with innovative ways to improve patient-centered oncology care. We identify challenges for creating sustainable and supportive payments models, and we share the broader strategic and policy lessons for adopting alternative payment models.

The Clinical Scenario: Living With Cancer

Vicky Bolton, a 58-year-old full-time medical legal coordinator from Albuquerque, has stage 4 adenocarcinoma lung cancer. She started chemotherapy in 2003 and has consistently received treatments over the last 11 years. Vicky is one of 13 million Americans currently living with cancer, with more than 1.6 million new diagnoses added each year.

Although Vicky’s condition is currently stable, she is at high risk for venous thrombosis (blood clots), life-threatening infections, and other complications, which put her at high risk for repeated hospitalizations. In the past six months, she has taken advantage of “after hours” care on three occasions as an outpatient at NMCC. Fortunately, each of her providers and services — oncology, radiation therapy, labs, x-rays, and internal medicine — are centralized in a single location at NMCC, reducing the need for emergency room (ER) visits or hospitalizations for these episodes.

The Challenge: Controlling Spending While Improving Patient-Centered Care

Cancer is the second leading cause of death in the U.S. Forty-one percent of Americans will be diagnosed with cancer during their lives. Cancer care is also expensive, accounting for $125 billion of total health care spending annually. In 2011, Medicare alone spent nearly $35 billion in fee-for-service (FFS) payments for cancer care, representing 9 percent of all Medicare FFS payments.

The high costs of cancer care are driven by issues that plague the entire health system: uncoordinated care delivery, duplication of services, fragmentation, and volume-based payments. A common impact of these drivers in oncology is the use of the ER to relieve symptoms associated with adverse effects of chemotherapy or other treatments that can also result in hospitalization.

For example, research shows that the most common reasons for cancer patient ER admissions are pain, respiratory distress, nausea, and vomiting. More than half of the ER visits occurred on weekends or in the evening, and over 60 percent resulted in hospital admission. This suggests that if a patient’s symptoms could be managed at home or in the community, costly hospital admissions could be avoided. ER visits, where patients are exposed to germs and infections as they wait — often hours — to be admitted, can have catastrophic outcomes for patients that are actively in treatment since they have weakened immune systems and are more prone to infections.

In addition to the inherent issues with fee-for-service (FFS) payments — with payments incentivizing volume of procedures rather than the value of care delivered — the current payment system further exacerbates problems: If a practice provides higher-value care to patients at a lower cost to the overall system (that is, they perform fewer services and have lower revenue), the financial winner is the payer who reimburses fewer services, not the practice (which merely has less revenue). This combination of the misaligned incentives of FFS and the lack of financial benefit for improving care while reducing costs means that many practices simply cannot afford to make the transformations needed without other funding mechanisms.

The Real World: How Has An Independent Cancer Center Responded To These Challenges?

NMCC delivers care to roughly 2,700 patients and provides care to one in three New Mexicans with cancer. The changes that the center has made have focused on reducing the impact of fragmentation of care on their patients (Table 1).

A key innovation was enhancing comprehensive after-hours and weekend care on site and creating a telephone and urgent care triage program to avoid expensive emergency room and inpatient care, which NMCC termed the COME HOME model.

As part of its redesign process in 2012, NMCC – along with six community oncology practices — secured a $20 million Center for Medicare and Medicaid Innovation (CMMI) Health Care Innovation Award (HCIA), for a three-year period. The award has an explicit aim of reducing ER visits by 50 percent and hospitalizations by 20 percent to justify the program costs.

Table 1: Care Redesign Elements Undertaken by NMCC

The Key Levers: How Can COME HOME Be Sustained?

On the heels of the Affordable Care Act (ACA) and numerous quality and payment focused initiatives in the private sector, health care organizations need to enhance the competitiveness and efficiency of their systems in the marketplace.

Alternative payment models (APMs) such as Accountable Care Organizations (ACOs), bundled payments, and patient-centered oncology medical homes (PCOMH) are just a few of the initiatives supported by public and private payers to align care redesign and payment reform and encourage continuous improvement. (Clinical pathways, a strategy recently embraced by WellPoint, offer PCOMH-like incentives to encourage adherence to practice guidelines, a strategy primarily geared to encourage higher-value chemotherapy practice.)

Broader or larger case-based payments may also provide stronger incentives to limit costs, to help assure that promising delivery reforms actually lead to cost reduction, but this exposes oncologists to greater levels of financial risk, as shown in Table 2. Consequently, implementing payment reforms that are viewed as feasible and desirable by both providers and payers is difficult.

Table 2: Comparison of Alternative Payment Models for Oncology

The Path Ahead: How Can These Models Assist NMCC?

NMCC currently receives approximately $70,000 per month from the CMMI grant and has not yet identified a clear strategy to sustain the delivery reforms in the COME HOME care model past the end of the grant (July 2015). As for payment reform options, NMCC has been unable to contract as part of a comprehensive ACO due to local health care market conditions.

Clinical pathways are geared primarily to guidelines and chemotherapy adherence, and are not designed to provide funding for after-hours care or triage programs that are intended to achieve offsetting savings through avoiding costly complications. Possible remaining options include:

• PCOMH: Using the data it gathers, NMCC intends to quantify the additional costs the COME HOME model requires, and the savings that it achieves. Based on that estimate, NMCC could suggest a per-member per-month (PMPM) payment from a private insurer to cover the costs of providing higher quality care. To encourage participation, NMCC could also enter into a risk-sharing agreement, in which overall costs of inpatient care and ER visits would be compared against a target. The PMPM payment could be at-risk if the targets are not achieved after a certain period of time.

• Bundled Payments: NMCC could potentially use the medical home approach with risk sharing (described above) as a first, interim step toward a bundled payment system, NMCC’s long-term preferred model. Computing actuarially sound expected costs for the bundled payments would require merging claims data with clinical data (for example, ICD-9 codes fail to distinguish between subtypes of breast cancer that have radically different treatments). A bundled payment pilot might be performed for high volume cancers, such as breast and lung.

Lessons Learned

The experience of innovative pioneers like NMCC can shed some light on potential barriers to conceptualizing and implementing sustainable clinical redesign. The lessons learned have been sorted into three main categories: relationships with payers and networks, payment model selection, and data collection and quality improvement considerations.

Relationships with payers and networks. Though counterintuitive, merely demonstrating significant value from care design, perhaps from lower utilization of inpatient and emergency department utilization, does not automatically create a financial pathway for sustainable delivery reform. To do so, innovative providers should consider involving lead payer partners early on to help identify end-points of interest to payers and potential payment strategies that may emerge later.

Providing support for health care delivery reforms requires new activities by payers towards aligning their payments with value, rather than volume and intensity of services. However, fragmented health care markets face the challenge of the “free rider” problem: payers may be unwilling to shoulder delivery transformation costs that may benefit other payers’ clients while they wait for CMS or others to make the financial investment, pay for the program evaluation, and enact policy change). Other challenges include payer inertia and long lag times between care redesign and subsequent data demonstrating results.

Large ACOs and other integrated payer-provider plans, including those large enough to form Medicare Advantage plans, are moving forward on negotiating payment and delivery reforms. This may be more difficult for innovative, smaller practices, even if they can provide higher-value clinical services. In turn, this may have anti-competitive consequences, such as discouraging delivery innovation that leads to “demand destruction” of high-cost hospital-based services. Private and public payers should be particularly interested in developing models that enable smaller, specialized providers like oncology practices to undertake key delivery reforms.

Sustainable Payment Model Selection. While substantial attention has been paid to primary care focused APMs, specialty-focused APMs are needed for practices like NMCC. Their development should be a high priority for public and private payers. Clinical transformation grants, such as those offered by CMMI, should include clear pathways for transitioning to APMs if initial cost savings targets or projections are met. Otherwise, delivery system innovations are at high risk of failure despite evidence of improved value.

Data Collection and Quality Improvement Considerations. Timely sharing of actionable information from claims and other administrative data remains a major challenge, with complex and varied procedures for obtaining claims from payers; smaller practices are particularly challenged in interpreting the claims data. Some states, such as Maryland, Massachusetts, Vermont, and Colorado (among others) are proceeding with creating all-payer claims databases. (Maryland, for example, offers almost instantaneous provider feedback from claims through their CRISP database.)

Others, such as Minnesota, are using “distributed” approaches in which multiple payers and systems produce measures in consistent ways. As NMCC’s early efforts illustrate, practices can produce more clinically sophisticated performance measures. Strategies to achieve consistent methods for sharing key data on cost and quality need to be expanded to encourage quality improvement and payment reform.

There is a marriage gap in America. This is not just a gap in choices and actions, but in norms and attitudes. Each generation is more liberal, on average, when it comes to issues like premarital relationships, same-sex marriage, and divorce. But generational averages can obscure other divides, including ideology—which in many cases is a more powerful factor.

Take opinions on the most important prerequisites for marriage, as explored in the American Family Survey conducted earlier this year by Deseret News and the Center for the Study of Elections and Democracy (disclosure: I am an adviser to the pollsters). There is widespread agreement that it is best to have a stable job and to have completed college before tying the knot. But there is less agreement in the 3,000-person survey on other questions, including premarital cohabitation.

In response to the question of whether it is “important to live with your future spouse before getting married,” a clear gap emerges between those who identify as Democrats and those who identify as Republicans. This gap trumps the generational one, with younger Republicans (under 40) more conservative than Democrats over the age of 40:

The importance of family stability for a child’s wellbeing and prospects is well-documented, not least in Isabel Sawhill’s book, Generation Unbound. The question is not whether stability matters, but how best to promote it. To the extent that biological parents stay together and provide a stable environment, it doesn’t much matter if they are married. For children living with both biological parents, there is no difference in outcomes between those being raised by a married couple compared to a cohabiting couple, according to research by Wendy Manning at Bowling Green State University.

But people who marry are much more likely to stay together:

Marriage, at least in America, does seem to act as an important commitment device, a “co-parenting” contract for the modern world, as I’ve argued in an essay for The Atlantic, “How to Save Marriage in America.”

Cohabitation can signal radically different situations. A couple who plan to live together for a couple of years, then marry, and then plan the timing of having children are very different from a couple who start living together, accidentally get pregnant, and then, perhaps somewhat reluctantly, get married.

There is some evidence that cohabitation is in fact becoming a more common bridge to marriage and commitment. First-time premarital cohabiting relationships are also lasting longer on average and increasingly turn into marriage: around seven in ten cohabiting couples are still together after three years, of whom four have married.

In the end what matters is planning, stability, and commitment. If cohabitation is a planned prelude to what some scholars have labeled “decisive marriages,” it seems likely to prove a helpful shift in social norms, by allowing couples to test life under the same roof before making a longer-term commitment. Sawhill’s distinction between “drifters” and “planners” in terms of pregnancy may also be useful when it comes to thinking about cohabitation, too.

Event Information

Thousands of Americans are already casting their votes in the 2012 elections through a variety of vote-by-mail and in-person balloting that allows citizens to cast their votes well in advance of November 6. From military personnel posted overseas to absentee voters, these early voting opportunities give voters the opportunity to make their voices heard even when they can’t stand in line on Election Day. However, there are pitfalls in the process.

Expert Michael McDonald says that while a great deal of attention has been focused on voter fraud, the untold story is that during the last presidential election, some 400,000 absentee ballots were discarded as improperly submitted. How can early voters make sure their voices are heard? What effect will absentee and other early voting programs have in this election year? On September 26, McDonald took your questions and comments in a live web chat moderated by Vivyan Tran of POLITICO.

12:30 Vivyan Tran: Welcome everyone, let's get started.

12:30 Michael McDonald: Early voting was 30% of all votes cast in the 2008 election. My expectation is that 35% of all votes in 2012 will be cast prior to Election Day. In some states, the volume will be much higher. In the battleground state of CO, about 85% of the votes will be cast early; 70% in FL; and 45% in Ohio.

What does it all mean? Hopefully I will be able to answer that question in today's chat!

12:30 Comment from JMC: At what point do you think that the in person early voters become less partisan types eager to cast their vote and more "regular folks" who would be more swayed by debate performances, TV ads, and the like?

12:30 Comment from Jason: 400,000 absentee ballots were discarded in 2008? How?

12:30 Michael McDonald: Reasons why election officials reject mail ballots: unsigned, envelope not sealed, multiple ballots in one envelope, etc. 400K rejected in 2008 does not include the higher rate of spoiled ballots that typically occur with paper mail ballots compared to electronic recording devices used in polling places. Moral: make sure you follow closely the proper procedures to cast your mail ballot!

12:31 Michael McDonald: @JMC: If they are going to vote early, most people wait until the week prior to the election. Those voting now have already made up their minds. But, the polls indicate many people have already done so, so maybe we see more early voting in 2012 as a consequence.

12:31 Comment from User: It was my understanding that absentee ballots are never counted unless the race is incredibly close in a particular state? Is that true - or do the rules for that vary by state?

12:32 Michael McDonald: No, all early votes are counted. What may not be counted, depending on state law and if the election is close enough for them to matter, are provisional ballots.

12:33 Comment from Damion: The blurb here says 400,000 early votes were discarded. Shouldn't the board of elections be reprimanded for that? Who was at fault and what consequences were there?

12:33: Michael McDonald: No, these are ballots "discarded" because people did not follow proper procedures and they must be rejected by law.

12:33 Comment from Shirley: Can you Facebook your vote in?

12:34 Michael McDonald: No. However, election officials are transmitting ballots electronically to overseas citizens and military voters. Voters must print the ballot, fill it out, sign it, scan it, and return. There are ways for these voters to verify that their ballot was received.

12:35 Comment from Karen K: What kind of impact could these discards have on the 2012 election?

12:36 Michael McDonald: Difficult to say. More Republicans vote by mail (excluding all mail ballot states). But, we don't know much about those who fail to follow the procedures. They might be less educated or elderly, and thus might counter the overall trend we see in mail balloting. Who knows?

12:37 Comment from User: This is the first I've heard of so many early votes getting discarded. Is this an issue people are addressing in a serious way?

12:38 Michael McDonald: Unfortunately, we are too focused on issues like voter fraud, which are low occurrence events, when there are many more important ways in which votes are lost in the system. Hopefully we can get the message out so fewer people disenfranchise themselves.

12:39 Comment from Anonymous: What do we know so far about absentee votes for 2012? Can we tell who they're leaning toward in specific states and how?

12:40 Michael McDonald: It's a little early :) yet. One of the major changes from 2008 is that the overseas civilian ballots -- a population that leans D -- was sent ballots much earlier this year than in 2008. We'll get a much better sense of the state of play in the two weeks prior to the election.

12:41 Michael McDonald: That said, the number of absentee ballot requests is running about the same as in 2008, if not a little higher, suggesting that the early vote will indeed be higher than in 2008, and perhaps that overall turnout will be on par with 2008, too.

12:41 Comment from Leslie: So, how can I ensure my early ballot is counted? There are so many rules and regulations, I'm never sure I've brought/filled out the paperwork.

12:42 Michael McDonald: Many states and localities allow people to check on-line the status of their ballot. Do a search for your local election official's webpage to see if that is available to you.

12:42 Comment from Daryyl: Can you define provisional ballots then?

12:44 Michael McDonald: Provisional ballots are required under federal law to allow people to vote if there is a problem with their voter registration. Election officials work after the election to resolve the situation.

If you vote in-person early, then you can resolve provisional ballot situations much sooner, which is good.

12:45 Michael McDonald: Some states use provisional ballots for other purposes: e.g., for a person who does not have the required id or to manage a change in voter registration address. One of the untold stories of this cycle is that FL will manage change of reg. address through provisional ballots. OH does so, and 200K provisionals were cast in 2008. Expect 300K in FL, which may mean we will not know the outcome in FL until weeks after the election. Can you say 2000?

12:45 Comment from Mark, Greenbelt: Is early voting a new phenomenon, or is it increasing? It seems we should make it easier for people to vote when they can.

12:46 Michael McDonald: We are seeing more people vote early, particularly in states that offer the option. However, only MD changed its law from 2008 to allow in-person early voting. OH is sending absentee ballot requests to all registered voters, which is not a change in law, but a change in procedure that is expected to significantly increase early voting there.

12:47 Comment from Jennifer S. : Why do we vote on Tuesday? It seems inconvenient. Wouldn't more people vote if we did it on the weekend? Or over a period of days that offered both morning and evening hours?

12:48 Michael McDonald: We used to have early voting in the US! Back at the Founding, elections were held over several days to allow people living in remote areas to get to the courthouse (the polling place back in the day) to vote. In the mid-1840s, the federal gov't set the current single day for voting because -- what else? -- claims of vote fraud. That people could vote more than once.

12:49 Comment from Winston: What percentage of the U.S. population votes? And, if you could make one change that would increase voting in the U.S. what would be?

12:50 Michael McDonald: I also calculate turnout rates for the country for the media and academics. 62.2% of the eligible voters cast a ballot that counted in 2008. If I were to wave a magic wand, I would have election day registration. California just adopted it yesterday (but starting 2015). States with EDR have +5-7 percentage points of turnout.

12:50 Comment from Bernie S.: One of your colleagues at Brookings, Bill Galston, has suggested that we make voting mandatory, as they do in Australia. What do you think of that idea? Is it even possible here?

12:51 Michael McDonald: That will never happen in a county that values individual freedom so deeply as the US. Fun fact: a few years back, AZ voters rejected a ballot initiative to have voters entered into a lottery.

12:51 Comment from James: If early voting becomes more and more common, shouldn't candidates start campaigning earlier?

12:53 Michael McDonald: They do. In fact, you will see the presidential candidates visit battleground states that have in-person early voting at the start of the period. In 2008, you could see how early voting increased in places where Obama held rallies.

12:53 Comment from Devi P. : What are the factors that drive turnout? How do we get people to the polls? And what can you say about the "microtargeting" strategies the political parties are using to get their voters out?

12:54 Michael McDonald: One of the major ways in which elections have changed in the past decade is that campaigns now place more effort into voter contacts. Over 50% of people reported a contact in 2008. These contacts are known to increase turnout rates by upwards of 10 percentage points. Even contacts from Facebook friends seems to matter!

12:54 Comment from Wendy P, Ohio: What's your position on electronic voting? Can't every voting machine be hacked? Isn't plain old paper balloting more secure?

12:56 Michael McDonald: I went to Caltech, so I am sensitive to the potential for hacking. That said, I encourage experimentation so that we can build a better system. There are counties that do hold electronic elections!

12:56 Comment from Leslie: 400,000 seems like a lot - does this actually have impact on the electoral votes, and if so, should we be worried in this coming election that a lengthy recall may occur?

12:57 Michael McDonald: It could affect the outcome. So please spread the word through your networks. This is the #1 way in which votes are lost in the system!

12:57 Comment from JVotes: Perhaps we should microtarget with ballot issues. Many Americans seem disappointed with the two candidates we have to choose from.

12:58 Michael McDonald: Actually, ballot issues are known to increase turnout. But only a small amount in a presidential election, about 1 percentage point. People vote in the main show: the presidential election.

12:58 Michael McDonald: Interesting aside on that: early voting seems to have a small turnout effect in presidential election, but a larger effect in state and local elections.

12:58 Comment from Jaime Ravenet: Is there a reading of the new voter ID requirements (in at least the 9 most contested states) that does not constitute an "abridgment" of citizens' voting rights?

1:00 Michael McDonald: Perhaps under state constitutions. But the US Supreme Court has already ruled in favor of Indiana's id law. Still, that does not mean that lawyers will try to find some way under federal law to overturn them. TX was blocked because their law was determined to be discriminatory, per Sec. 5 of the Voting Rights Act.

1:00 Vivyan Tran: Thanks for the questions everyone, see you next week!

Event Information

And more from the Brown Center Report on American Education

Girls outscore boys on practically every reading test given to a large population. And they have for a long time. A 1942 Iowa study found girls performing better than boys on tests of reading comprehension, vocabulary, and basic language skills, and girls have outscored boys on every reading test ever given by the National Assessment of Educational Progress (NAEP). This gap is not confined to the U.S. Reading tests administered as part of the Progress in International Reading Literacy Study (PIRLS) and the Program for International Student Assessment (PISA) reveal that the gender gap is a worldwide phenomenon.

On March 26, join Brown Center experts Tom Loveless and Matthew Chingos as they discuss the latest Brown Center Report on American Education, which examines this phenomenon. Hear what Loveless's analysis revealed about where the gender gap stands today and how it's trended over the past several decades - in the U.S. and around the world.

Tune in below or via Spreecast where you can submit questions. 

Spreecast is the social video platform that connects people.
Check out Girls, Boys, and Reading on Spreecast.

Event Information

The Common Core State Standards have been adopted as the reading and math standards in more than forty states, but are the frontline implementers—teachers and principals—enacting them? As part of the 2016 Brown Center Report on American Education, Tom Loveless examines the degree to which CCSS recommendations have penetrated schools and classrooms. He specifically looks at the impact the standards have had on the emphasis of non-fiction vs. fiction texts in reading, and on enrollment in advanced courses in mathematics.

On March 28, the Brown Center hosted an online discussion of Loveless's findings, moderated by the Urban Institute's Matthew Chingos.  In addition to the Common Core, Loveless and Chingos also discussed the other sections of the three-part Brown Center Report, including a study of the relationship between ability group tracking in eighth grade and AP performance in high school.

Watch the archived video below.

Spreecast is the social video platform that connects people.
Check out Reading and Math in the Common Core Era on Spreecast.