Tom Loveless, a nonresident senior fellow in Governance Studies, explains his latest research on measuring achievement of American students.

“The bottom line here: the implementation of the common core has appeared to have very little impact on student achievement,” Loveless says. In this episode, he discusses whether the common core is failing our students, whether AP achievement is indicative of student success, and the role of principals as instructional leaders.

Also in this episode: Get to know Constanze Stelzenmüller, the Robert Bosch Senior Fellow in the Center on the United States and Europe, during our "Coffee Break” segment. Also stay tuned to hear the final episode in our centenary series with current and past Brookings scholars.

Show Notes:

The Brown Center Report on American Education

Brookings Centenary Timeline

Subscribe to the Brookings Cafeteria on iTunes, listen in all the usual places, and send feedback email to BCP@Brookings.edu.

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.

Hypocrisy is not scarce in the world of politics. But the current House and Senate budget resolutions set new lows. Each proposes to cut about $5 trillion from government spending over the next decade in pursuit of a balanced budget. Whatever one may think of putting the goal of reducing spending when the ratio of the debt-to-GDP is projected to be stable above investing in the nation’s future, you would think that deficit-reduction hawks wouldn’t cut spending that has been proven to lower the deficit.

Yes, there are expenditures that actually lower the deficit, typically by many dollars for each dollar spent. In this category are outlays on ‘program integrity’ to find and punish fraud, tax evasion, and plain old bureaucratic mistakes. You might suppose that those outlays would be spared. Guess again. Consider the following:

Medicare. Roughly 10% of Medicare’s $600 billion budget goes for what officials delicately call ‘improper payments, according to the 2014 financial report of the Department of Health and Human Services. Some are improper merely because providers ‘up-code’ legitimate services to boost their incomes. Some payments go for services that serve no valid purpose. And some go for phantom services that were never provided. Whatever the cause, approximately $60 billion of improper payments is not ‘chump change.’

Medicare tries to root out these improper payments, but it lacks sufficient staff to do the job. What it does spend on ‘program integrity’ yields an estimated $14.40? for each dollar spent, about $10 billion a year in total. That number counts only directly measurable savings, such as recoveries and claim denials. A full reckoning of savings would add in the hard-to-measure ‘policeman on the beat’ effect that discourages violations by would-be cheats.

Fat targets remain. A recent report from the Institute of Medicine presented findings that veritably scream ‘fraud.’ Per person spending on durable medical equipment and home health care is ten times higher in Miami-Dade County, Florida than the national average. Such equipment and home health accounts for nearly three-quarters of the geographical variation in per person Medicare spending. Yet, only 4% of current recoveries of improper payments come from audits of these two items and little from the highest spending locations.

Why doesn’t Medicare spend more and go after the remaining overpayments, you may wonder? The simple answer is that Congress gives Medicare too little money for administration. Direct overhead expenses of Medicare amount to only about 1.5% of program outlays—6% if one includes the internal administrative costs of private health plans that serve Medicare enrollees. Medicare doesn’t need to spend as much on administration as the average of 19% spent by private insurers, because for example, Medicare need not pay dividends to private shareholders or advertise.

But spending more on Medicare administration would both pay for itself—$2 for each added dollar spent, according to the conservative estimate in the President’s most recent budget—and improve the quality of care. With more staff, Medicare could stop more improper payments and reduce the use of approved therapies in unapproved ways that do no good and may cause harm.

Taxes. Compare two numbers: $540 billion and $468 billion. The first number is the amount of taxes owed but not paid. The second number is the projected federal budget deficit for 2015, according to the Congressional Budget Office.

Collecting all taxes legally owed but not paid is an impossibility. It just isn’t worth going after every violation. But current enforcement falls far short of practical limits. Expenditures on enforcement directly yields $4 to $6 for each dollar spent on enforcement. Indirect savings are many times larger—the cop-on-the-beat effect again. So, in an era of ostentatious concern about budget deficits, you would expect fiscal fretting in Congress to lead to increased efforts to collect what the law says people owe in taxes.

Wrong again. Between 2010 and 2014, the IRS budget was cut in real terms by 20%. At the same time, the agency had to shoulder new tasks under health reform, as well as process an avalanche of applications for tax exemptions unleashed by the 2010 Supreme Court decision in the Citizens United case. With less money to spend and more to do, enforcement staff dropped by 15% and inflation adjusted collections dropped 13%.

One should acknowledge that enforcement will not do away with most avoidance and evasion. Needlessly complex tax laws are the root cause of most tax underpayment. Tax reform would do even more than improved administration to increase the ratio of taxes paid to taxes due. But until that glorious day when Congress finds the wit and will to make the tax system simpler and fairer, it would behoove a nation trying to make ends meet to spend $2 billion to $3 billion more each year to directly collect $10 billion to 15 billion a year more of legally owed taxes and, almost certainly, raise far more than that by frightening borderline scoff-laws.

Disability Insurance. Thirteen million people with disabling conditions who are judged incapable of engaging in substantial gainful activity received $161 billion in disability insurance in 2013. If the disabling conditions improve enough so that beneficiaries can return to work, benefits are supposed to be stopped. Such improvement is rare. But when administrators believe that there is some chance, the law requires them to check. They may ask beneficiaries to fill out a questionnaire or, in some cases, undergo a new medical exam at government expense. Each dollar spent in these ways generated an estimated $16 in savings in 2013.

Still, the Social Security Administration is so understaffed that SSA has a backlog of 1.3 million disability reviews. Current estimates indicate that spending a little over $1 billion a year more on such reviews over the next decade would save $43 billion. Rather than giving Social Security the staff and spending authority to work down this backlog and realize those savings, Congress has been cutting the agency’s administrative budget and sequestration threatens further cuts.

Claiming that better administration will balance the budget would be wrong. But it would help. And it would stop some people from shirking their legal responsibilities and lighten the burdens of those who shoulder theirs. The failure of Congress to provide enough staff to run programs costing hundreds of billions of dollars a year as efficiently and honestly as possible is about as good a definition of criminal negligence as one can find.

Led by presidential candidate Bernie Sanders, one-time supporters of ‘single-payer’ health reform are rekindling their romance with a health reform idea that was, is, and will remain a dream.  Single-payer health reform is a dream because, as the old joke goes, ‘you can’t get there from here.

Let’s be clear: opposing a proposal only because one believes it cannot be passed is usually a dodge.One should judge the merits. Strong leaders prove their skill by persuading people to embrace their visions. But single-payer is different. It is radical in a way that no legislation has ever been in the United States.

Not so, you may be thinking. Remember such transformative laws as the Social Security Act, Medicare, the Homestead Act, and the Interstate Highway Act. And, yes, remember the Affordable Care Act. Those and many other inspired legislative acts seemed revolutionary enough at the time. But none really was. None overturned entrenched and valued contractual and legislative arrangements. None reshuffled trillions—or in less inflated days, billions—of dollars devoted to the same general purpose as the new legislation. All either extended services previously available to only a few, or created wholly new arrangements.

To understand the difference between those past achievements and the idea of replacing current health insurance arrangements with a single-payer system, compare the Affordable Care Act with Sanders’ single-payer proposal.

Criticized by some for alleged radicalism, the ACA is actually stunningly incremental. Most of the ACA’s expanded coverage comes through extension of Medicaid, an existing public program that serves more than 60 million people. The rest comes through purchase of private insurance in “exchanges,” which embody the conservative ideal of a market that promotes competition among private venders, or through regulations that extended the ability of adult offspring to remain covered under parental plans. The ACA minimally altered insurance coverage for the 170 million people covered through employment-based health insurance. The ACA added a few small benefits to Medicare but left it otherwise untouched. It left unaltered the tax breaks that support group insurance coverage for most working age Americans and their families. It also left alone the military health programs serving 14 million people. Private nonprofit and for-profit hospitals, other vendors, and privately employed professionals continue to deliver most care.

In contrast, Senator Sanders’ plan, like the earlier proposal sponsored by Representative John Conyers (D-Michigan) which Sanders co-sponsored, would scrap all of those arrangements. Instead, people would simply go to the medical care provider of their choice and bills would be paid from a national trust fund. That sounds simple and attractive, but it raises vexatious questions.

• How much would it cost the federal government? Where would the money to cover the costs come from?
• What would happen to the $700 billion that employers now spend on health insurance?
• How would the $600 billion a year reductions in total health spending that Sanders says his plan would generate come from?
• What would happen to special facilities for veterans and families of members of the armed services?

Sanders has answers for some of these questions, but not for others. Both the answers and non-answers show why single payer is unlike past major social legislation.

The answer to the question of how much single payer would cost the federal government is simple: $4.1 trillion a year, or $1.4 trillion more than the federal government now spends on programs that the Sanders plan would replace. The money would come from new taxes. Half the added revenue would come from doubling the payroll tax that employers now pay for Social Security. This tax approximates what employers now collectively spend on health insurance for their employees...if they provide health insurance. But many don’t. Some employers would face large tax increases. Others would reap windfall gains.

The cost question is particularly knotty, as Sanders assumes a 20 percent cut in spending averaged over ten years, even as roughly 30 million currently uninsured people would gain coverage. Those savings, even if actually realized, would start slowly, which means cuts of 30 percent or more by Year 10. Where would they come from? Savings from reduced red-tape associated with individual insurance would cover a small fraction of this target. The major source would have to be fewer services or reduced prices. Who would determine which of the services physicians regard as desirable -- and patients have come to expect -- are no longer ‘needed’? How would those be achieved without massive bankruptcies among hospitals, as columnist Ezra Klein has suggested, and would follow such spending cuts? What would be the reaction to the prospect of drastic cuts in salaries of health care personnel – would we have a shortage of doctors and nurses? Would patients tolerate a reduction in services? If people thought that services under the Sanders plan were inadequate, would they be allowed to ‘top up’ with private insurance? If so, what happens to simplicity? If not, why not?

Let me be clear: we know that high quality health care can be delivered at much lower cost than is the U.S. norm. We know because other countries do it. In fact, some of them have plans not unlike the one Senator Sanders is proposing. We know that single-payer mechanisms work in some countries. But those systems evolved over decades, based on gradual and incremental change from what existed before. That is the way that public policy is made in democracies. Radical change may occur after a catastrophic economic collapse or a major war. But in normal times, democracies do not tolerate radical discontinuity. If you doubt me, consider the tumult precipitated by the really quite conservative Affordable Care Act.

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

Social Security faces a financial shortfall. If Congress does nothing about it, current projections indicate that benefits will be cut automatically by 21 percent in 2034. Congress could close the gap by raising revenues, lowering benefits, or doing some of both. If benefits seem generous, Congress is likely to lean toward benefit cuts more than revenue increases. If they seem stingy, then the reverse.

Given the split between the two parties on whether to cut benefits or to raise them, evidence on the adequacy of benefits is central to this key policy debate. Those perceptions will help determine whether Social Security continues to provide basic retirement income for workers with comparatively low earnings histories and a foundation of retirement income for most others or it will become just a minimal safety-net backstop against extreme destitution?

Down-in-the-weeds disagreements among analysts often seem too arcane for anyone other than specialists. But sometimes they are too important to ignore. A current debate about the adequacy of Social Security benefits is an example.

The not-so-simple question is this: are Social Security benefits ‘generous’ or ‘stingy’? To answer this question, people long looked to the Office of the Social Security Actuary. For many years that office published estimates of something called the ‘replacement rate’—that is, how high are benefits paid to retirees and the disabled relative what they earned during their working years. A 2014 retiree with median earnings had average lifetime earnings of about $46,000. That worker qualified for a benefit at age 66 of about $19,000, a replacement rate of about 41%. Replacement rates vary with earnings. Dollar benefits rise with earnings, but they rise less than proportionately. As a result, replacement rates of low earners are higher than replacement rates of high earners.

As you might suppose, there are many ways in which to compute such ‘replacement rates. Because of analytical disputes on which method is best, the Social Security trustees in 2014 decided to stop including replacement rate estimates in their annual reports.

In December 2015, the Congressional Budget Office (CBO) offered what it considered a better measure of the generosity of Social Security. It estimated that replacement rates for middle income recipients were about 60%–dramatically higher than the 41% that the Social Security Trustees had estimated.

The gap between the estimates of CBO and those of Social Security is even larger than it seems. To see why, one needs to recognize that to sustain living standards retirees on average need only about 75% to 80% as much income as they did when working. Retirees need less income because they are spared some work-related expenses, such as transportation to and from work. Those are only average of course; some need more, some less.

If one believed the SSA actuaries, Social Security provides median earners barely more than half of what they need to be as well off as they were when working. Benefit cuts from that modest level would threaten the well-being for the majority of retirees who are entirely or mostly dependent on Social Security benefits—and especially for those with large medical expenses uncovered by Medicare.

On the other hand, if one accepted CBO’s estimates, Social Security provids more than three-quarters of the retirement income target. Against that baseline, benefit cuts would still sting, but they would pose less of a threat, and not much of a threat at all for most retirees who have some income from private pensions or personal savings.

When the CBO estimates came out, conservative commentators welcomed the findings and cited CBO’s well-established and well-earned reputation for objectivity. They correctly noted that many retirees have additional income from private pensions, 401ks, or other personal savings, and asserted that there was no general retirement income shortage. By inference, cutting benefits a bit to help close the long-term funding gap would be no big deal. Social Security advocates were put on the defensive, hard-pressed to challenge the estimates of the widely-respected Congressional Budget Office.

But earlier this year, CBO acknowledged that it had made mistakes in its Decameter estimates and revised them. The new CBO estimate put the replacement rate for middle-level earners at around 42%, almost the same as the estimate of the Social Security actuaries, not the much higher level that had sent ripples through the policy community. One conservative analyst, Andrew Biggs, who had trumpeted the initial CBO finding in The Wall Street Journal, promptly and honorably retracted his article.

Two aspects of this green-eyeshade kerfuffle stand out. The first is that policy debates often depend on obscure technical analyses that are, in turn, remarkably sensitive to ‘black-box’ methods to which few or no outsiders have ready access. The second is that CBO burnished its reputation for honesty by owning up to its own mistakes — in this case, a whopping overestimate of a key number. Such candor is all too rare; it merits notice and praise.

But there is a broader lesson as well. Technical issues of comparable complexity surround numerous current political disputes. Is Bernie Sanders’ single-payer plan affordable? Will Marco Rubio’s tax plan cause deficits to balloon? To vote rationally, people must struggle to see through the rhetorical chaff that surrounds candidates’ favorite claims. There is, alas, no substitute for paying close attention to the data, even if they are ‘down in the weeds.’

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

One cannot help feeling a bit silly taking seriously the policy proposals of a person who seems not to take policy seriously himself. Donald Trump's policy positions have evolved faster over the years than a teenager's moods. He was for a woman's right to choose; now he is against it. He was for a wealth tax to pay off the national debt before proposing a tax plan that would enrich the wealthy and balloon the national debt. He was for universal health care but opposed to any practical way to achieve it.

Based on his previous flexibility, Trump's here-today proposals may well be gone tomorrow. As a sometime-Democrat, sometime-Republican, sometime-independent, who is now the leading candidate for the Republican presidential nomination, Trump has just issued his latest pronouncements on health care policy. So, what the hell, let's give them more respect than he has given his own past policy statements.

Perhaps unsurprisingly, those earlier pronouncements are notable for their detachment from fact and lack of internal logic. The one-time supporter of universal health care now joins other candidates in his newly-embraced party in calling for repeal of the only serious legislative attempt in American history to move toward universal coverage, the Affordable Care Act. Among his stated reasons for repeal, he alleges that the act has "resulted in runaway costs," promoted health care rationing, reduced competition and narrowed choice.

Each of these statements is clearly and demonstrably false. Health care spending per person has grown less rapidly in the six years since the Affordable Care Act was enacted than in any corresponding period in the last four decades. There is now less health care rationing than at any time in living memory, if the term rationing includes denial of care because it is unaffordable. Rationing because of unaffordability is certainly down for the more than 20 million people who are newly insured because of the Affordable Care Act. Hospital re-admissions, a standard indicator of low quality, are down, and the health care exchanges that Trump now says he would abolish, but that resemble the "health marts" he once espoused, have brought more choice to individual shoppers than private employers now offer or ever offered their workers.

Trump's proposed alternative to the Affordable Care Act is even worse than his criticism of it. He would retain the highly popular provision in the act that bars insurance companies from denying people coverage because of preexisting conditions, a practice all too common in the years before the health care law. But he would do away with two other provisions of the Affordable Care Act that are essential to make that reform sustainable: the mandate that people carry insurance and the financial assistance to make that requirement feasible for people of modest means.

Without those last two provisions, barring insurers from using preexisting conditions to jack up premiums or deny coverage would destroy the insurance market. Why? Because without the mandate and the financial aid, people would have powerful financial incentives to wait until they were seriously ill to buy insurance. They could safely do so, confident that some insurer would have to sell them coverage as soon as they became ill. Insurers that set affordable prices would go broke. If insurers set prices high enough to cover costs, few customers could afford them.

In simple terms, Trump's promise to bar insurers from using preexisting conditions to screen customers but simultaneously to scrap the companion provisions that make the bar feasible is either the fraudulent offer of a huckster who takes voters for fools, or clear evidence of stunning ignorance about how insurance works. Take your pick.

Unfortunately, none of the other Republican candidates offers a plan demonstrably superior to Trump's. All begin by calling for repeal and replacement of the Affordable Care Act. But none has yet advanced a well-crafted replacement.

It is not that the Affordable Care Act is perfect legislation. It isn't. But, as the old saying goes, you can't beat something with nothing. And so far as health care reform is concerned, nothing is what the Republican candidates now have on offer.

Editor's note: This piece originally appeared in U.S. News and World Report.

Health reform (aka Obamacare) is entering a new stage. The recent announcement by United Health Care that it will stop selling insurance to individuals and families through most health insurance exchanges marks the transition. In the next stage, federal and state policy makers must decide how to use broad regulatory powers they have under the Affordable Care Act (ACA) to stabilize, expand, and diversify risk pools, improve local market competition, encourage insurers to compete on product quality rather than premium alone, and promote effective risk management. In addition, insurance companies must master rate setting, plan design, and network management and effectively manage the health risk of their enrollees in order to stay profitable, and consumers must learn how to choose and use the best plan for their circumstances.

Six months ago, United Health Care (UHC) announced that it was thinking about pulling out of the ACA exchanges. Now, they are pulling out of all but a “handful” of marketplaces. UHC is the largest private vendor of health insurance in the nation. Nonetheless, the impact on people who buy insurance through the ACA exchanges will be modest, according to careful analyses from the Kaiser Family Foundation and the Urban Institute. The effect is modest for three reasons. One is that in some states UHC focuses on group insurance, not on insurance sold to individuals, where they are not always a major presence. Secondly, premiums of UHC products in individual markets are relatively high. Third, in most states and counties ACA purchasers will still have a choice of two or more other options. In addition, UHC’s departure may coincide with or actually cause the entry of other insurers, as seems to be happening in Iowa.

The announcement by UHC is noteworthy, however. It signals the beginning for ACA exchanges of a new stage in their development, with challenges and opportunities different from and in many ways more important than those they faced during the first three years of operation, when the challenge was just to get up and running. From the time when HealthCare.Gov and the various state exchanges opened their doors until now, administrators grappled non-stop with administrative challenges—how to enroll people, helping them make an informed choice among insurance offerings, computing the right amount of assistance each individual or family should receive, modifying plans when income or family circumstances change, and performing various ‘back office’ tasks such as transferring data to and from insurance companies. The chaotic first weeks after the exchanges opened on October 1, 2013 have been well documented, not least by critics of the ACA. Less well known are the countless behind-the-scenes crises, patches, and work-arounds that harried exchange administrators used for years afterwards to keep the exchanges open and functioning.

The ACA forced not just exchange administrators but also insurers to cope with a new system and with new enrollees. Many new exchange customers were uninsured prior to signing up for marketplace coverage. Insurers had little or no information on what their use of health care would be. That meant that insurers could not be sure where to set premiums or how aggressively to try to control costs, for example by limiting networks of physicians and hospitals enrollees could use. Some did the job well or got lucky. Some didn’t. United seems to have fallen in the second category. United could have stayed in the 30 or so state markets they are leaving and tried to figure out ways to compete more effectively, but since their marketplace premiums were often not competitive and most of their business was with large groups, management decided to focus on that highly profitable segment of the insurance market. Some insurers, are seeking sizeable premium increases for insurance year 2017, in part because of unexpectedly high usage of health care by new exchange enrollees.

United is not alone in having a rough time in the exchanges. So did most of the cooperative plans that were set up under the ACA. Of the 23 cooperative plans that were established, more than half have gone out of business and more may follow. These developments do not signal the end of the ACA or even indicate a crisis. They do mark the end of an initial period when exchanges were learning how best to cope with clerical challenges posed by a quite complicated law and when insurance companies were breaking into new markets. In the next phase of ACA implementation, federal and state policy makers will face different challenges: how to stabilize, expand, and diversify marketplace risk pools, promote local market competition, and encourage insurers to compete on product quality rather than premium alone. Insurance company executives will have to figure out how to master rate setting, plan design, and network management and manage risk for customers with different characteristics than those to which they have become accustomed.

Achieving these goals will require state and federal authorities to go beyond the core implementation decisions that have absorbed most of their attention to date and exercise powers the ACA gives them. For example, section 1332 of the ACA authorizes states to apply for waivers starting in 2017 under which they can seek to achieve the goals of the 2010 law in ways different from those specified in the original legislation. Along quite different lines, efforts are already underway in many state-based marketplaces, such as the District of Columbia, to expand and diversify the individual market risk pool by expanding marketing efforts to enroll new consumers, especially young adults. Minnesota’s Health Care Task Force recently recommended options to stabilize marketplace premiums, including reinsurance, maximum limits on the excess capital reserves or surpluses of health plans, and the merger of individual and small group markets, as Massachusetts and Vermont have done.

In normal markets, prices must cover costs, and while some companies prosper, some do not. In that respect, ACA markets are quite normal. Some regional and national insurers, along with a number of new entrants, have experienced losses in their marketplace business in 2016. One reason seems to be that insurers priced their plans aggressively in 2014 and 2015 to gain customers and then held steady in 2016. Now, many are proposing significant premium hikes for 2017.

Others, like United, are withdrawing from some states. ACA exchange administrators and state insurance officials must now take steps to encourage continued or new insurer participation, including by new entrants such as Medicaid managed care organizations (MCOs). For example, in New Mexico, where in 2016 Blue Cross Blue Shield withdrew from the state exchange, state officials now need to work with that insurer to ensure a smooth transition as it re-enters the New Mexico marketplace and to encourage other insurers to join it. In addition, state insurance regulators can use their rate review authority to benefit enrollees by promoting fair and competitive pricing among marketplace insurers. During the rate review process, which sometimes evolves into a bargaining process, insurance regulators often have the ability to put downward pressure on rates, although they must be careful to avoid the risk of underpricing of marketplace plans which could compromise the financial viability of insurers and cause them to withdraw from the market. Exchanges have an important role in the affordability of marketplace plans too. For example ACA marketplace officials in the District of Columbia and Connecticut work closely with state regulators during the rate review process in an effort to keep rates affordable and adequate to assure insurers a fair rate of return.

Several studies now indicate that in selecting among health insurance plans people tend to give disproportionate weight to premium price, and insufficient attention to other cost provisions—deductibles and cost sharing—and to quality of service and care. A core objective of the ACA is to encourage insurance customers to evaluate plans comprehensively. This objective will be hard to achieve, as health insurance is perhaps the most complicated product most people buy. But it will be next to impossible unless customers have tools that help them take account of the cost implications of all plan features and report accurately and understandably on plan quality and service. HealthCare.gov and state-based marketplaces, to varying degrees, are already offering consumers access to a number of decision support tools, such as total cost calculators, integrated provider directories, and formulary look-ups, along with tools that indicate provider network size. These should be refined over time. In addition, efforts are now underway at the federal and state level to provide more data to consumers so that they can make quality-driven plan choices. In 2018, the marketplaces will be required to display federally developed quality ratings and enrollee satisfaction information. The District of Columbia is examining the possibility of adding additional measures. California has proposed that starting in 2018 plans may only contract with providers and hospitals that have met state-specified metrics of quality care and promote safety of enrollees at a reasonable price. Such efforts will proliferate, even if not all succeed.

Beyond regulatory efforts noted above, insurance companies themselves have a critical role to play in contributing to the continued success of the ACA. As insurers come to understand the risk profiles of marketplace enrollees, they will be better able to set rates, design plans, and manage networks and thereby stay profitable. In addition, insurers are best positioned to maintain the stability of their individual market risk pools by developing and financing marketing plans to increase the volume and diversity of their exchange enrollments. It is important, in addition, that insurers, such as UHC, stop creaming off good risks from the ACA marketplaces by marketing limited coverage insurance products, such as dread disease policies and short term plans. If they do not do so voluntarily, state insurance regulators and the exchanges should join in stopping them from doing so.

Most of the attention paid to the ACA to date has focused on efforts to extend health coverage to the previously uninsured and to the administrative stumbles associated with that effort. While insurance coverage will broaden further, the period of rapid growth in coverage is at an end. And while administrative challenges remain, the basics are now in place. Now, the exchanges face the hard work of promoting vigorous and sustainable competition among insurers and of providing their customers with information so that insurers compete on what matters: cost, service, and quality of health care.

Editor's note: This piece originally appeared in Real Clear Markets. Kevin Lucia and Justin Giovannelli contributed to this article with generous support from The Commonwealth Fund.

We can be sure that the 2016 presidential candidates, whoever they are, will be in favor of promoting opportunity and cutting poverty. The question is: how? In our contribution to a new volume published today, “Campaign 2016: Eight big issues the presidential candidates should address,” we show that people who clear three hurdles—graduating high school, working full-time, and delaying parenthood until they in a stable, two-parent family—are very much more likely to climb to middle class than fall into poverty:

But what specific policies would help people achieve these three benchmarks of success?  Our paper contains a number of ideas that candidates might want to adopt. Here are a few examples: 

1. To improve high school graduation rates, expand “Small Schools of Choice,” a program in New York City, which replaced large, existing schools with more numerous, smaller schools that had a theme or focus (like STEM or the arts). The program increased graduation rates by about 10 percentage points and also led to higher college enrollment with no increase in costs.

2. To support work, make the Child and Dependent Care Tax Credit (CDCTC) refundable and cap it at $100,000 in household income. Because the credit is currently non-refundable, low-income families receive little or no benefit, while those with incomes above $100,000 receive generous tax deductions. This proposal would make the program more equitable and facilitate low-income parents’ labor force participation, at no additional cost.

3. To strengthen families, make the most effective forms of birth control (IUDs and implants) more widely available at no cost to women, along with good counselling and a choice of all FDA-approved methods. Programs that have done this in selected cities and states have reduced unplanned pregnancies, saved money, and given women better ability to delay parenthood until they and their partners are ready to be parents. Delayed childbearing reduces poverty rates and leads to better prospects for the children in these families.

These are just a few examples of good ideas, based on the evidence, of what a candidate might want to propose and implement if elected. Additional ideas and analysis will be found in our longer paper on this topic.

The U.S. is the only advanced country without a paid leave policy, enabling workers to take time off to care for a new baby or other family member. At least two Presidential candidates, Hillary Clinton and Marco Rubio, have been talking about it, making it likely that it will get attention in 2016.

The idea has broad appeal now that most two-parent families and almost all one-parent families struggle with balancing work and family. Polls show that it is favored by 81 percent of the public—94 percent of Democrats, 80 percent of Independents and 65 percent of Republicans. Three states, California, New Jersey, and Rhode Island, have each enacted policies that could become models for other states or for the nation.

Paid leave promotes inclusive growth

Overall, paid leave is good for workers, good for children, and possibly even good for employers because of its role in helping to retain workers. It is also a policy that encourages inclusive growth. Studies of European systems suggest that paid leave increases female labor force participation and that the lack of it in the U.S. may be one reason for the decline in female labor force participation since 2000 and the growing female participation gap between the U.S. and other countries, adversely affecting our absolute and relative growth. The policy would make growth more inclusive because it would disproportionately benefit lower-wage workers.

The devil is in the design

The major issues in designing a paid leave policy are:

1. Eligibility, and especially the extent of work experience required to qualify (often a year);
2. the amount of leave allowed (Clinton suggests three months; Rubio four weeks);
3. the wage replacement rate (often two-thirds of regular wages up to a cap), and
4. financing.

Legislation proposed by Rep. Rosa DeLauro (D-CT) and Sen. Kirsten Gillibrand (D-NY) calls for a 0.2 percent payroll tax on employers and employees. Most states have made paid leave a part of their temporary disability systems. Senator Rubio proposes to finance it through a new tax credit for employers. 

Getting it right on eligibility, length of leave, and size of benefit

My own view is that a significant period of work experience should be required for eligibility to encourage stable employment before the birth of a child. This would not only encourage work but also insure that the subsidy was an earned benefit and not welfare by another name (but see below on financing).   

Leave periods need to be long enough to enable parents to bond with a child during the child’s first year of life but not so long that they lead to skill depreciation and to parents dropping out of the labor force. Three months seems like a good first step although it is far less generous than what many European countries provide (an average of 14 months across the OECD). That said, the Europeans may have gone too far. While there is little evidence that a leave as long as 6 months would have adverse effects on employment, when Canada extended their leave from six months to a year, the proportion of women returning to work declined.

A replacement rate of two-thirds up to a cap also seems reasonable although a higher replacement rate is one way to encourage more parents to take the leave. Among other things, more generous policies would have positive effects on the health and well-being of children. They might also encourage more fathers to take leave.  

How to pay for it

On financing, social insurance is the appropriate way to share the putative burden between employers and employees and avoid the stigma and unpopularity of social welfare. It would, in essence, change the default for employees (who are otherwise unlikely to save for purposes of taking leave). Some may worry that imposing any new costs on employers will lead to fewer employment opportunities. However, many economists believe that the employer portion of the tax is largely borne by workers in the form of lower wages. Moreover, in a study of 253 employers in California, over 90 percent reported either positive or no negative effects on profitability, turnover, and employee morale. Reductions in turnover, in particular, are noteworthy since turnover is a major expense for most employers. 

Will paid leave cause discrimination against women?

Another worry is discrimination against women. Here there is some cause for concern unless efforts are made to insure that leave is equally available to, and also used by, both men and women. This concern has led some countries to establish a use-it-or-lose-it set aside for fathers. In the province of Quebec, the proportion of fathers taking leave after implementation of such a policy increased from 21 to 75 percent and even after the leave period was over, men continued to share more equally in the care of their children.

Will Congress enact a national paid leave policy in the next few years? That’s doubtful in our current political environment but states may continue to take the lead. In the meantime, it can’t hurt if the major candidates are talking about the issue on the campaign trail.       

The issue of paid leave is heating up in 2016. At least two presidential candidates — Democrat Hillary Clinton and Republican Sen. Marco Rubio (Fla.) — have proposed new federal policies. Several states and large cities have begun providing paid leave to workers when they are ill or have to care for a newborn child or other family member.

This forward movement on paid-leave policy makes sense. The United States is the only advanced country without a paid-leave policy. While some private and public employers already provide paid leave to their workers, the workers least likely to get paid leave are low-wage and low-income workers who need it most. They also cannot afford to take unpaid leave, which the federal government mandates for larger companies.

Paid leave is good for the health and development of children; it supports work, enabling employees to remain attached to the labor force when they must take leave; and it can lower costly worker turnover for employers. Given the economic and social benefits it provides and given that the private market will not generate as much as needed, public policies should ensure that such leave is available to all.

But it is important to do so efficiently, so as not to burden employers with high costs that could lead them to substantially lower wages or create fewer jobs.

States and cities that require employers to provide paid sick days mandate just a small number, usually three to seven days. Family or temporary disability leaves that must be longer are usually financed through small increases in payroll taxes paid by workers and employers, rather than by employer mandates or general revenue.

Policy choices could limit costs while expanding benefits. For instance, states should limit eligibility to workers with experience, such as a year, and it might make sense to increase the benefit with years of accrued service to encourage labor force attachment. Some states provide four to six weeks of family leave, though somewhat larger amounts of time may be warranted, especially for the care of newborns, where three months seems reasonable.

Paid leave need not mean full replacement of existing wages. Replacing two-thirds of weekly earnings up to a set limit is reasonable. The caps and partial wage replacement give workers some incentive to limit their use of paid leave without imposing large financial burdens on those who need it most.

While many states and localities have made sensible choices in these areas, some have not. For instance, the D.C. Council has proposed paid-leave legislation for all but federal workers that violates virtually all of these rules. It would require up to 16 weeks of temporary disability leave and up to 16 weeks of paid family leave; almost all workers would be eligible for coverage, without major experience requirements; and the proposed law would require 100 percent replacement of wages up to $1,000 per week, and 50 percent coverage up to $3,000. It would be financed through a progressive payroll tax on employers only, which would increase to 1 percent for higher-paid employees.

Our analysis suggests that this level of leave would be badly underfunded by the proposed tax, perhaps by as much as two-thirds. Economists believe that payroll taxes on employers are mostly paid through lower worker wages, so the higher taxes needed to fully fund such generous leave would burden workers. The costly policy might cause employers to discriminate against women.

The disruptions and burdens of such lengthy leaves could cause employers to hire fewer workers or shift operations elsewhere over time. This is particularly true here, considering that the D.C. Council already has imposed costly burdens on employers, such as high minimum wages (rising to $11.50 per hour this year), paid sick leave (although smaller amounts than now proposed) and restrictions on screening candidates. The minimum wage in Arlington is $7.25 with no other mandates. Employers will be tempted to move operations across the river or to replace workers with technology wherever possible.

Cities, states and the federal government should provide paid sick and family leave for all workers. But it can and should be done in a fiscally responsible manner that does not place undue burdens on the workers themselves or on their employers.

Editor's note: this piece originally appeared in The Washington Post. 

Far too many people reach their advanced years without planning for how they want their lives to end. The result too often is needless suffering, reduced dignity and autonomy, and agonizing decisions for family members.

Addressing these end-of-life issues is difficult. Most of us don’t want to confront them for ourselves or our family members. And until recently, many people resisted the idea of reimbursing doctors for end-of-life counselling sessions. In 2009, Sarah Palin labelled such sessions as the first step in establishing “death panels.” Although no such thing was contemplated when Representative Earl Blumenauer (D- Oregon) proposed such reimbursement, the majority of the public believed that death panels and euthanasia were just around the corner. Even the Obama Administration subsequently backed away from efforts to allow such reimbursement.

Fortunately, this is now history. In the past year or two the tenor of the debate has shifted toward greater acceptance of the need to deal openly with these issues. At least three developments illustrate the shift.

First, talk of “death panels” has receded, and new regulations, approved in late 2015 to take effect in January of this year, now allow Medicare reimbursement for end of life counselling. The comment period leading up to this decision was, according to most accounts, relatively free of the divisive rhetoric characterizing earlier debates. Both the American Medical Association and the American Hospital Association have signaled their support.

Second, physicians are increasingly recognizing that the objective of extending life must be balanced against the expressed priorities of their patients which often include the quality and not just the length of remaining life. Atal Gwande’s best-selling book, Being Mortal, beautifully illustrates the challenges for both doctors and patients. With well-grounded and persuasive logic, Gwande speaks of the need to de-medicalize death and dying.

The third development is perhaps the most surprising. It is a bold proposal advanced by Governor Jeb Bush before he bowed out of the Presidential race, suggesting that eligibility for Medicare be conditioned on having an advanced directive. His interest in these issues goes back to the time when as governor of Florida he became embroiled in a dispute about the removal of a feeding tube from a comatose Terry Schiavo. Ms. Schiavo’s husband and parents were at odds about what to do, her husband favoring removal and her parents wishing to sustain life. In the end, although the Governor sided with the parents, the courts decided in favor of the husband and allowed her to die. If an advanced directive had existed, the family disagreement along with a long and contentious court battle could have been avoided.

The point of such directives is not to pressure people into choosing one option over another but simply to insure that they consider their own preferences while they are still able. Making this a requirement for receipt of Medicare would almost surely encourage more people to think seriously about the type of care they would like toward the end of life and to talk with both their doctors and their family about these views. However, for many others, it would be a step too far and might reverse the new openness to advanced planning. A softer version nudging Medicare applicants to address these issues might be more acceptable. They would be asked to review several advance directive protocols, to choose one (or substitute their own). If they felt strongly that such planning was inappropriate, they could opt out of the process entirely and still receive their benefits.

Advanced care planning should not be linked only to Medicare. We should encourage people to make these decisions earlier in their lives and provide opportunities for them to revisit their initial decisions. This could be accomplished by implementing a similar nudge-like process for Medicaid recipients and those covered by private insurance.

Right now too few people are well informed about their end-of-life options, have talked to their doctors or their family members, or have created the necessary documents. Only about half of all of those who have reached the age of 60 have an advanced directive such as a living will or a power of attorney specifying their wishes. Individual preferences will naturally vary. Some will want every possible treatment to forestall death even if it comes with some suffering and only a small hope of recovery; others will want to avoid this by being allowed to die sooner or in greater comfort. Research suggests that when given a choice, most people will choose comfort care over extended life.

In the absence of advance planning, the choice of how one dies is often left to doctors, hospitals, and relatives whose wishes may or may not represent the preferences of the individual in their care. For example, most people would prefer to die at home but the majority do not. Physicians are committed to saving lives and relatives often feel guilty about letting a loved one “go.”

The costs of prolonging life when there is little point in doing so can be high. The average Medicare patient in their last year of life costs the government $33,000 with spending in that final year accounting for 25 percent of all Medicare spending. Granted no one knows in advance which year is “their last” so these data exaggerate the savings that better advance planning might yield, but even if it is 10% that represents over $50 billion a year. Dr. Ezekiel Emanuel, an expert in this area, notes that hospice care can reduce costs by 10 to 20 percent for cancer patients but warns that little or no savings have accompanied palliative care for heart failure or emphysema patients, for example. This could reflect the late use of palliative care in such cases or the fact that palliative care is more expensive than assumed.

In the end, Dr. Emanuel concludes, and I heartily agree, that a call for better advance planning should not be based primarily on its potential cost savings but rather on the respect it affords the individual to die in dignity and in accordance with their own preferences.

Editor's note: This piece originally appeared in Inside Sources.

At an event this past week, Hillary Clinton announced that, if elected, she planned to put Bill Clinton in charge of creating jobs. If he becomes the “First Gentlemen” -- or as she prefers to call him, the “First Dude,” – he just might have some success in this role. The country’s very strong record of job creation during the first Clinton administration is a hopeful sign. (Full disclosure: I served in his Administration.)

But assuming he's given the role of jobs czar, what would Bill Clinton do? The uncomfortable fact is that no one knows how to create enough jobs. Although about 50 percent of the public, according to Pew, worries that there are not enough jobs available, and virtually every presidential candidate is promising to produce more, economists are not sure how to achieve this goal.

The debate centers around why we think people are jobless. Unless we can agree on the diagnosis, we will not be able to fashion an appropriate policy response.

Some economists think that an unemployment rate hovering around 5 percent constitutes “full employment.” Those still looking for jobs, in this view, are either simply transitioning voluntarily from one job to another or they are “structurally unemployed.” The latter term refers to a mismatch, either between a worker’s skills and the skills that employers are seeking, or between where the workers live and where the jobs are geographically. (The decline in housing values or tighter zoning restrictions, for example, may have made it more difficult for people to move to states or cities where jobs are more available.)

Another view is that despite the recovery from the Great Recession, there is still a residue of “cyclical” unemployment. If the Federal Reserve or Congress were to boost demand by keeping interest rates low, reducing taxes, or increasing spending on, say, infrastructure, this would create more jobs – or so goes the argument. But the Fed can’t reduce interest rates significantly because they are already near rock-bottom levels and tax and spending policies are hamstrung by political disagreements.

In my view, the U.S. currently suffers from both structural and cyclical unemployment. The reason I believe there is still some room to stimulate the economy is because we have not yet seen a significant increase in labor costs and inflation. Political problems aside, we should be adding more fuel to the economy in the form of lower taxes or higher public spending.

High levels of structural unemployment are also a problem. The share of working-age men who are employed has been dropping for decades at least in part because of outsourcing and automation. The share of the unemployed who have been out of work for more than six months is also relatively high for an economy at this stage of the business cycle. One possibility is that the recession caused many workers to drop out of the labor force and that after a long period of joblessness, they have seen their skills atrophy and employers stigmatize them as unemployable.

The depressing fact is that none of these problems is easy to solve. Manufacturing jobs that employ a lot of people are not coming back. Retraining the work force for a high-tech economy will take a long time. Political disagreements won’t disappear unless there is a landslide election that sweeps one party into control of all three branches of government.

So what can Bill Clinton or anyone else do? We may need to debate some more radical solutions such as subsidized jobs or a basic income for the structurally unemployed or a shorter work week to spread the available work around. These may not be politically feasible for some time to come, but former President Clinton is the right person to engage communities and employers in some targeted job creation projects now and to involve the country in a serious debate about what to do about jobs over the longer haul.

Editor's note: This piece originally appeared in Inside Sources.

Today’s announcement of the restoration of diplomatic relations between Washington and Havana replaces over five decades of mutual hostility and aggressive name-calling with a new atmosphere of diplomatic civility. The re-opening of embassies in both capitals establishes platforms upon which to build more normal working relations. Now, the hard work begins, as the two nations gradually dismantle the comprehensive wall of restrictions separating them for two generations.

Expectations are running high, especially in Cuba, that diplomatic engagement will catalyze economic betterment on the island. To stimulate more travel and trade, the U.S. government needs to clarify rules for engaging with the emerging Cuban private sector, and make it clear to U.S. banks that they are permitted to support the use of credit cards by U.S. visitors in Cuba. The administration should also begin to consider another round of liberalizing initiatives, some under consideration in the U.S. Congress, to further relax travel restrictions, and to enable more U.S. firms—beyond agriculture and medicines—to assist the Cuban people.

For its part, the Cuban government should open efficient channels to facilitate the commercial exchanges now authorized by the Obama administration. Cuban entrepreneurs should be permitted ready access to U.S. firms wishing to sell building equipment for construction cooperatives, restaurant supplies for private-owned restaurants, and automotive spare parts for private taxis. Micro-enterprise lending should be authorized to support these emerging non-state enterprises.

If both nations build upon today’s welcome announcement by further opening these channels to travel and commerce, Presidents Barack Obama and Raúl Castro can help to safeguard their joint legacy. By fortifying and expanding constituencies on both sides of the Florida Straits, immersed in daily exchanges to mutual benefit, the two governments can render their diplomatic accomplishment politically irreversible in both capitals.

The global consumer products company Unilever Plc announced on Monday a $35 million investment in Cuba’s Special Development Zone at Mariel. Late last year, Brascuba, a joint venture with a Brazilian firm, Souza Cruz, owned by the mega-conglomerate British American Tobacco (BAT), confirmed it would built a $120 million facility in the same location.

So far, these are the two biggest investments in the much-trumpeted Cuban effort to attract foreign investment, outside of traditional tourism. Yet, neither investment is really new. Unilever had been operating in Cuba since the mid-1990s, only to exit a few years ago in a contract dispute with the Cuban authorities. Brascuba will be moving its operations from an existing factory to the ZED Mariel site.

What is new is the willingness of Cuban authorities to accede to the corporate requirements of foreign investors. Finally, the Cubans appear to grasp that Cuba is a price-taker, and that it must fit into the global strategies of their international business partners. Certainly, Cuban negotiators can strike smart deals, but they cannot dictate the over-arching rules of the game.

Cuba still has a long way to go before it reaches the officially proclaimed goal of $2.5 billion in foreign investment inflows per year. Total approvals last year for ZED Mariel reached only some $200 million, and this year are officially projected to reach about $400 million. For many potential investors, the business climate remains too uncertain, and the project approval process too opaque and cumbersome. But the Brascuba and Unilever projects are definitely movements in the right direction.

But Unilever feared that granting its Cuban partner 51% would yield too much management control and could jeopardize brand quality. Unilever also balked at exporting products made in Cuba, where product costs were as much as one-third higher than in bigger Unilever plants in other Latin American countries.

The 2012 collapse of the Unilever contract renewal negotiations adversely affected investor perceptions of the business climate. If the Cuban government could not sustain a good working relationship with Unilever—a highly regarded, marquée multinational corporation with a global footprint—what international investor (at least one operating in the domestic consumer goods markets) could be confident of its ability to sustain a profitable long-term operation in Cuba?

In the design of the new joint venture, Cuba has allowed Unilever a majority 60% stake. Furthermore, in the old joint venture, Unilever executives complained that low salaries, as set by the government, contributed to low labor productivity. In ZED Mariel, worker salaries will be significantly higher: firms like Unilever will continue to pay the same wages to the government employment entity, but the entity’s tax will be significantly smaller, leaving a higher take-home pay for the workers. Hiring and firing will remain the domain of the official entity, however, not the joint venture.

Unilever is also looking forward to currency unification, widely anticipated for 2016. Previously, Unilever had enjoyed comfortable market shares in the hard-currency Cuban convertible currency (CUC) market, but had been largely excluded from the national currency markets, which state-owned firms had reserved for themselves. With currency unification, Unilever will be able to compete head-to-head with state-owned enterprises in a single national market.

Similarly, Brascuba will benefit from the new wage regime at Mariel and, as a consumer products firm, from currency unification. At its old location, Brascuba considered motivating and retaining talent to be among the firm’s key challenges; the higher wages in ZED Mariel will help to attract and retain high-quality labor.

Brascuba believes this is a good time for expansion. Better-paid workers at Mariel will be well motivated, and the expansion of the private sector is putting more money into consumer pockets. The joint venture will close its old facility in downtown Havana, in favor of the new facility at Mariel, sharply expanding production for both the domestic and international markets (primarily, Brazil).

A further incentive for investment today is the prospect of the lifting of U.S. economic sanctions, even if the precise timing is impossible to predict. Brascuba estimated that U.S. economic sanctions have raised its costs of doing business by some 20%. Inputs such as cigarette filters, manufacturing equipment and spare parts, and infrastructure such as information technology, must be sourced from more distant and often less cost-efficient sources.

Another sign of enhanced Cuban flexibility: neither investment is in a high technology sector, the loudly touted goal of ZED Mariel. A manufacturer of personal hygiene and home care product lines, Unilever will churn out toothpaste and soap, among other items. Brascuba will produce cigarettes. Cuban authorities now seem to accept that basic consumer products remain the bread-and-butter of any modern economy. An added benefit: international visitors will find a more ready supply of shampoo!

The Unilever and Brascuba renewals suggest a new realism in the Cuban camp. At ZED Mariel, Cuba is allowing their foreign partners to exert management control, to hire a higher-paid, better motivated workforce, and it is anticipated, to compete in a single currency market. And thanks to the forward-looking diplomacy of Raúl Castro and Barack Obama, international investors are also looking forward to the eventual lifting of U.S. economic sanctions.

This piece was originally published in Cuba Standard.

Professor Riek Machar, former vice president of South Sudan and now leader of the rebel group that is fighting the government of South Sudan for control of the apparatus of the government, has publicly threatened to capture and take control of both the capital city of Juba and the oil-producing regions of the country. Branding South Sudan’s president, Salva Kiir, a “dictator” and arguing that he does not recognize the need to share power, Professor Machar stated that the present conflict, which has lasted for more than five months and resulted in the killing of many people and the destruction of a significant amount of property, will not end until Kiir is chased out of power.

Violent mobilization by groups loyal to Machar against the government in Juba began in December 2013. It was only after bloody confrontations between the two parties that targeted civilians based on their ethnicity had resulted in the deaths of many people (creating a major humanitarian crisis) that a cease-fire agreement was signed in Addis Ababa on January 23, 2014, with the hope of bringing to an end the brutal fighting. The cease-fire, however, was seen only as the first step towards negotiations that were supposed to help the country exit the violent conflict and secure institutional arrangements capable of guaranteeing peaceful coexistence.

If Machar and his supporters have the wherewithal to carry out the threats and successfully do so, there is no guarantee that peace would be brought to the country. For one thing, any violent overthrow of the government would only engender more violence as supporters of Kiir and his benefactors are likely to regroup and attempt to recapture their lost political positions. What South Sudan badly needs is an institutionalization of democracy and not a government led by political opportunists. In fact, an effective strategy to exit from this incessant violence must be centered around the election of an inclusive interim government—minus both Kiir and Machar—that would engage all of the country’s relevant stakeholders in negotiations to create a governing process that adequately constrains the state, establishes mechanisms for the peaceful resolution of conflict, enhances peaceful coexistence, and provides an enabling environment for the rapid creation of the wealth needed to deal with poverty and deprivation.

On March 9, 2012, less than a year after South Sudan gained independence, then-Vice President Machar met with several Brookings scholars, including myself, in New York City. The meeting was part of the new country’s efforts to seek assistance from its international partners to address complex and longstanding development challenges, including critical issues such as the effective management of the country’s natural resource endowments, gender equity, the building of government capacity to maintain law and order, the provision of other critical public goods and services, and poverty alleviation. Among participants in this critical consultation were Mwangi S. Kimenyi, senior fellow and director of the Africa Growth Initiative (AGI) at the Brookings Institution; Witney Schneidman, AGI nonresident fellow and former deputy assistant secretary of state for African Affairs; and me. The vice president, who appeared extremely energetic and optimistic about prospects for sustainable development in the new country, requested an analysis of the commitments and achievements that the government of South Sudan had made since independence and suggestions for a way forward. The scholars, working in close collaboration with their colleagues at Brookings, produced a policy report requested by the vice president. The report entitled, South Sudan: One Year After Independence—Opportunities and Obstacles for Africa’s Newest Country, was presented at a well-attended public event on July 28, 2012. Panelists included Peter Ajak, director of the Center for Strategic Analyses and Research in Juba; Ambassador Princeton Lyman, U.S. special envoy for South Sudan and Sudan; Nada Mustafa Ali scholar at the New School for Social Research; Mwangi S. Kimenyi and me.

The report provided a comprehensive review of the policy issues requested by the vice president—the provision of basic services; future engagement between South Sudan and the Republic of Sudan; efficient and equitable management of natural resources; ethnic diversity and peaceful coexistence; federalism; eradication of corruption; and the benefits of regional integration. Most important is the fact that the report placed emphasis on the need for the government of South Sudan to totally reconstruct the state inherited from the Khartoum government through democratic constitution making and produce a governing process that (i) guarantees the protection of human and fundamental rights, including those of vulnerable groups (e.g., women, minority ethnic groups); (ii) adequately constrains the government (so that impunity, corruption and rent seeking are minimized); (iii) enhances entrepreneurial activities and provides the wherewithal for wealth creation and economic growth; and (iv) establishes mechanisms for the peaceful resolution of conflict and creates an environment within which all of the country’s diverse population groups can coexist peacefully.

Unfortunately, when the report was completed, members of the ruling Sudan People’s Liberation Movement were already embroiled in a brutal power struggle that eventually led to President Kiir sacking his entire cabinet, including the vice president. The collapse of the government raised the prospects of violent and destructive mobilization by groups that felt the president’s actions were marginalizing them both economically and politically. The ensuing chaos created an environment that was hardly conducive to the implementation of policies such as those presented in the Brookings report.

The government of Sudan has failed to engage in the type of robust institutional reforms that would have effectively prevented President Kiir and his government from engaging in the various opportunistic policies that have been partly responsible for the violence that now pervades the country. South Sudan’s diverse ethnic groups put forth a united front in their war against Khartoum for self-determination. Following independence, the new government engaged in state formation processes that did not provide mechanisms for all individuals and groups to compete fairly for positions in the political and economic systems. Instead, the government’s approach to state formation politicized ethnic cleavages and made the ethnic group the basis and foundation for political, and to a certain extent, economic participation. This approach has created a "sure recipe for breeding ethnic antagonism," and has led to the crisis that currently consumes the country.

While the most important policy imperative in South Sudan today is the need to make certain that the cease-fire continues to hold, long-term prospects for peaceful coexistence and development call for comprehensive institutional reforms to provide the country with a governing process that guarantees the rule of law. Hence, both the opposition and the government—the two sides in the present conflict—should take advantage of the cease-fire and start putting together the framework that will eventually be used to put the state back together. A new interim government, without the participation of the two protagonists—Kiir and Machar—should be granted the power to bring together all of the country’s relevant stakeholders to reconstitute and reconstruct the state, including negotiating a permanent constitution.

Dear South Sudan's Leaders:

Today, the country that all of you and your fellow citizens fought to establish is at a crossroads. And you, the country’s leaders, are now standing at the proverbial “fork in the road.” The question now is: Which road will each of you take? Your choice will determine not only your place in history but will significantly impact the future of your shared country, its diverse peoples and your neighbors. Each of you can choose to chase after personal power, primitive accumulation, and self-enrichment—using the ethnic group that you belong to as a foundation for that quest. This disastrous decision would plunge your country further into violent and destructive mobilization, effectively shutting the door to the type of state formation that is undergirded by a desire to achieve national integration, peaceful coexistence and sustainable development. Alternatively, each of you can opt to maximize a different value, one that places you among the world’s greatest leaders—that is, those who, when they came to the fork in the road, chose to lead their people down the road of opportunities for peaceful coexistence, prosperity and liberty.

As the citizens of South Sudan watch and wait in utter fear and disgust, it is time for you, the country’s leaders, to decide whether you want to lead them into a future filled with unending violence, hunger, and desolation, or into one where all of the country’s various peoples, regardless of their ethnic or religious affiliation, gender, and economic status, can live together peacefully and pursue their values and interests without molestation from others.

In the early 1990s, Nelson Mandela and his compatriots found themselves at a similar crossroads. They chose not to act opportunistically and retreat to their various ethnic enclaves.  Like the great leaders that history has proven them to be, they knew that, as apparently beneficial as such an option would have been to them, they would have plunged their country into an abyss from which it was unlikely to recover anytime soon. Instead, they chose the road that led them and their country to the type of state formation that is undergirded by institutional arrangements that provide an enabling environment for wealth creation and economic growth. That is why, today, the country that they founded has one of the world’s most progressive and human-rights friendly constitutions.

South Sudan is a new and relatively underdeveloped country, but it has the potential to emerge as a highly developed and peaceful one. However, in order for that potential to be fully exploited and used effectively to enhance development, the latter must be provided with institutional arrangements that guarantee the rule of law.

To you, the leaders of this new country: All of you can gracefully exit the scene, serve as elder statesmen, and provide the country’s new crop of leaders with the type of advice and support that can help the country successfully emerge from its violent and destructive past, as well as chart a path towards peace, sustainable economic growth and development, and equitable and fair allocation of national resources.

How will history judge you? As tyrants, opportunists, despots, exploiters, and oppressors, who used their public positions to grab power and riches for themselves or as public servants who spearheaded and led the transformative processes that brought peace, security, and development to their country? The choice is yours.

Posterity will judge you well, but only if you choose wisely!

On Friday, October 31, 2014, President Blaise Campaoré, who had ruled Burkina Faso for the last 27 years, was forced out of office. The resignation and subsequent military takeover of the government has created instability and questions over leadership in the country—especially since the constitutional line of succession has been broken by the insertion of military leaders. The power of the military is clear, especially since it has already influenced a second change in leadership. This interruption, subsequent transition and suspension of the constitution, then, have seriously threatened the strength of the rule of law and the future of the Burkinabé government.

The violent demonstrations that eventually forced President Campaoré to flee with his family into exile in Côte d’Ivoire could have been avoided had he not considered himself above the law. The impetus for the mass demonstrations was his attempt to change the country’s constitution in order to secure for himself another five-year term in office. Campaoré’s initial reaction to the violent demonstrations was to dissolve the government but retain his position as president until new elections were carried out to select a new government. He also agreed not to seek another term in office. The opposition, however, insisted that he resign. Interestingly, in his resignation statement, issued shortly before he fled the country, President Campaoré called for “free and transparent” elections to be held in 90 days to form a new government.

Shortly after the president’s resignation, General Honoré Traoré, Campaoré’s aide de camp, proclaimed himself president of the republic. This immediate military intervention into Burkinabé politics betrays either a lack of appreciation for constitutional democracy or a willful attempt by the military to take advantage of the instability occasioned by the planned constitutional changes to maximize their corporate interests. But, could someone who had risen to the head of the Burkinabé military have such little understanding of and appreciation for the constitutional order? In announcing that he had assumed the office of head of state, Traoré actually stated as follows: “In line with constitutional measures, and given the power vacuum . . . I will assume as of today my responsibilities as head of state.”

Importantly, there is no provision in the constitution of Burkina Faso for the head of the military or some other military officer to assume the powers of the president in case of a vacancy in the office. Succession, in the case of a vacancy in the presidency of the republic, is governed by Article 43 of the Constitution of Burkina Faso, 1991, which states that, in a case like this, the functions of the presidency should be performed by the president of the senate. [1]

After Traoré’s quick takeover, the leaders of the protests rejected the government headed by such a close and trusted advisor of the ousted president, claiming it would not represent a full and effective break with the painful past, especially the attempted constitutional changes. In fact, according to Al Jazeera, many of the protesters proclaimed that “[t]he general is linked to Campoaré, and they don’t want anyone linked to Campaoré to lead the country.”

Thus, early on Saturday, November 1, 2014, Colonel Isaac Zida declared that the army had taken control of the state to prevent further violence and that he had assumed the functions of head of state, leading what he referred to as a “peaceful transition”—one that would guarantee the “continuity of the [Burkinabé] state.” He, however, was extremely vague, providing few details, especially regarding how long this transitional government would stay in power or if the elections planned for 2015 will be held. Again, it is difficult to imagine that Zida, like Traoré, was not aware that the resignation and subsequent exit of the president from the political scene did not call for military intervention in the political system. In fact, a military officer of his standing should have had enough familiarity with the constitution to be aware of Article 43.

Oddly, the protesters appeared to have accepted the leadership of Zida, who is said to have been the deputy head of Campaoré’s elite presidential guard. It appears that the deciding factor in the struggle between the two men to assume the position of head of state was acceptance by the military: In a statement issued early on Saturday, November 1, 2014, the military indicated that Zida had been unanimously elected by military chiefs to lead the post-Campaoré transitional government. But, again, in making this decision, were these military leaders not aware of Article 43 of the constitution, which sets out the succession procedures in case of a temporary or permanent vacancy in the presidency? If, indeed, they had knowledge of the provisions of Article 43, then why did they interfere with what should have been a constitutionally mandated succession?

The international community has called on all sides in the Burkinabé political crisis to follow “constitutionally mandated” procedures for the transfer of power. The international community (especially the African Union) is asking the Burkina Faso military not to exploit the constitutional crisis for its own benefit but to respect the desire of the majority of Burkinabé for democracy and peaceful coexistence. That, of course, calls for respect by all Burkinabé, including the military, for the constitution.

The president’s resignation in itself did not create a constitutional crisis in Burkina Faso. The Constitution of 1991 specifically anticipates the resignation or incapacitation of the president and prescribes procedures for succession. According to Article 43, if the president is temporarily incapacitated and is incapable of carrying out his or her duties, “his powers shall be provisionally exercised by the Prime Minister.” As noted above, in this particular case, where the president has resigned and created a permanent vacancy in the presidency, the constitution states that the functions of the presidency should be performed by the president of the senate. [2] The military should not have intervened—military intervention in the country’s political system actually created what is fast becoming a major constitutional crisis. The military has suspended the constitution and, without the guidance provided by it, the military is now governing the country extra-constitutionally through decrees. The military can end this unfolding crisis by restoring the constitution and handing power back to a civilian regime, led, as prescribed by their constitution, by the president of the senate. The latter will, of course, serve as a transitional head of state until elections are completed in 2015 to select a permanent president. International organizations, including especially the African Union, support this approach—on November 3, 2014, the AU issued a statement asking the Burkinabé military to exit the political system and hand power to a civilian ruler.

But what about the riots and violence that had enveloped the city of Ouagadougou and were gradually spreading to other cities? Should the army not have been called upon to quell the riots and bring about peace? In virtually all countries, including Burkina Faso, the police—not the army—should be the institution enforcing the law and maintaining order. There is no indication that military intervention was necessary to bring the rioting under control or that it actually did. Most of the people participating in the riots voluntarily stopped their activities after the president resigned and left the country.

However, what the army did was interfere with the constitutional process and in doing so, actually created this constitutional crisis—shortly after declaring himself head of state and leader of the transition, Zida suspended the constitution, as noted above. Although Zida has assured the people that the military will strive to quickly return Burkina Faso to democratic governance, such guarantees appear hollow, especially given the military’s past history of intervention—every time the Burkinabé military has intervened in politics, it has remained in power for a very long time, 27 years in the case of the Campaoré-led intervention of 1987.

Article 43 of the Constitution of Burkina Faso also states that elections should be held between 60 and 90 days after a vacancy has been declared in the presidency. Zida, who is now the de facto head of state in Burkina Faso, has stated that his would be a transitional government and that it would seek input from all stakeholders to organize and undertake democratic elections to choose a new government. However, the constitution, which would have provided the necessary guidelines for carrying out such elections, has been suspended. In addition, he has closed the country’s borders and imposed a general curfew, which severely restricts the right of citizens to live freely. Such restrictions could have a significant impact on economic activities and negatively affect what is already a relatively fragile economy. These initial draconian and extra-constitutional measures do not augur well for an early exit of the military from politics and the return of constitutional rule to the country. If history teaches us anything about the military and Burkinabé politics, it is that this military, like the one that intervened in 1987, is likely to stay in politics much longer than the 90 days needed to elect a new civilian government.

[1], [2] This is in line with the constitutional amendment of June 11, 2012 (Loi No. 033-2012/AN du 1 juin 2012).

Downloads

• Table of Contents
• Chapter One

• {9ABF977A-E4A6-41C8-B030-0FD655E07DBF}, 9780815726555, $32.00 Add to Cart

The Nile River is one of the most important resources in Africa and supports the livelihoods of millions of people. Recently, though, efficient and equitable utilization of the waters of the Nile River has become an increasingly contentious issue, with many of the riparian countries demanding a revision of what they believe is an inappropriate legal regime. Currently, allocation and utilization of the waters of the Nile River is governed by the colonial-era Nile Waters Agreements, which were negotiated and entered into with the help of Great Britain, but without the participation of most of the river’s riparian states. These agreements allocated most of the waters of the Nile River to the downstream riparians—Egypt and Sudan—largely ignoring the development needs of the upstream riparians, like Ethiopia, whose highlands provide most of the water that flows into the Nile River. The upstream riparians contend that they were not party to the Nile Waters Agreements and thus should not be bound by them. As such, they want these agreements set aside and a new, more equitable legal regime. Egypt, however, considers the existing legal regime binding on all the Nile River riparian states and, thus, is opposed to any changes that might interfere with or reduce its “historically acquired rights.” Already the decision by Addis Ababa to proceed with the construction of the Grand Ethiopian Renaissance Dam on the Blue Nile has caused significant deterioration in relations between Cairo and Addis Ababa.

With significant increases in population and pressure to deliver development, especially in the upstream riparian states, the demand for water has become a very important policy imperative in the region. In fact, earlier this year Egypt claimed that, in order to meet its growing water needs by 2050, it will need to add 21 billion cubic meters of water per year to its current water allocation of 55 billion cubic meters. Thus, there is a fear that if this issue is not fully resolved soon, it could morph into a military crisis.

In our new book, Governing the Nile River Basin: The Search for a New Legal Regime, we argue that the current legal regime governing the allocation and utilization of the waters of the Nile River is not tenable, and there is an urgent need for all the Nile River riparian states to enter into a mutually agreed upon legal regime. Issues pertaining to transboundary water resource management, the evolution of current agreements and the role and interests of colonial powers, theories of treaty succession, and the recent attempts by the riparian states to formulate a new legal agreement, are thoroughly examined. We conclude that the most effective way to deal with conflict arising from the allocation and utilization of the Nile River’s waters is for all the downstream and upstream riparians to engage in fresh negotiations to design and adopt a new legal regime. Through a fully consultative process, these countries can provide the Nile River Basin with a legal regime that enhances equitable allocation and utilization.