Madhurita Sengupta, MPA
In January 2004, President Bush announced his Vision for Space Exploration, setting forth executive policy that would send us back to the moon and onto Mars. Though it meant that the end of the Shuttle Program – created in 1981 – was imminent, this promise ignited hope and inspiration in those of us who spent their youths dreaming of “slipping the surly bonds of Earth” (to quote Magee by way of Reagan) and setting foot on extraterrestrial soil, while honoring the legacy of those who’ve made space exploration possible.
And yet, on February 1, 2010, the fabric of our nation’s space program was effectively rewoven, as President Obama announced a new plan for the future of NASA. Constellation, the program that would take us to the moon and onto Mars, was abruptly cancelled. In its place, a crop of commercial efforts would soon be undertaken to ferry US crew and cargo to the International Space Station, effectively freeing resources for NASA to concentrate on developing the next generation of launch and crew vehicles and advanced technologies for future missions. In the meantime, as predicted, the shuttle program officially ended in August of this year, one month after the final flight of the space shuttle Atlantis. (Currently, without a shuttle program, the Russian Soyuz vehicle is our sole mode of transportation to the Space Station, for which the US pays on the order of $60M per seat.)
Many protested Obama’s radically different plan and today, a year and a half after that announcement, NASA sits at a pivotal juncture – one that will determine the future of our nation’s human spaceflight program. The recently passed FY12 budget promised the agency $17B for the fiscal year (which equates to roughly $0.005 per taxpayer), but NASA remains at an impasse. In this budget, Congress has not only cut funding to the commercial efforts, but also attached conditions to this funding contingent on progress made in the development of the next generation launch/crew vehicle, effectively forcing NASA to extend the schedules of both programs, or prematurely choose one commercial provider over another.
Regardless of funding allocations, we, as a nation, now have the opportunity to set the course for the future of human space exploration. Never before has NASA been faced with such apathy and lack of support and funding; and yet, it presents the agency and the nation with a challenge to overcome. How can NASA prove to the administration, Congress, the American public, our international partners, and the rest of the world that it is truly capable of pioneering the future of human spaceflight? Moreover, how can NASA demonstrate that investments in science and technology today are apt to yield dividends of various magnitudes for years to come?
Since the inception of the US human spaceflight program, countless individuals have devoted their livelihoods to further the cause of exploration, to test the limits of mankind’s knowledge and experience, and to expand the boundaries of our terrestrial existence. NASA has been, is, and forever will remain an agency of people who believe in space exploration. It is a collective group of passionate, dedicated workers who are inspired by the contributions of spaceflight to humanity. It is men and women who were awed by Sputnik, by Neil Armstrong’s first steps, by the first joint Russian-American venture in space, by the space shuttle’s maiden voyage, by the building of the International Space Station, piece by piece, before our eyes and who are still inspired on a daily basis by the feats that they themselves help accomplish. They are motivated by man’s innate desire to achieve the impossible, to paraphrase Kennedy, not because it is easy, but because it is hard.
Our nation now has the opportunity to draw on all of our many impressive years of experience and inspire others to not only marvel at our ingenuity and initiative, but to contribute and invest in it. With the end of the shuttle program, we now stand at a crossroads, at which we are fortunate to have the opportunity to honor those who have given their lives to help mankind escape the gravitational bonds that have tethered us to this lustrous planet for centuries, and explore the recesses of the unknown, bit by bit, in order to understand, appreciate, and provide for our species. No matter what path we ultimately take, let us not forget that we are all passionate about many common things; let us not ignore our inner child, who declared his/her desire to become an astronaut at age eight; and all the while, let us honor the legacies of the past, by embracing the possibilities and potential of the future. We owe those who have sacrificed their lives for the advancement of mankind, who accomplished seemingly impossible tasks, at the very least, that much.
Showing posts with label budget. Show all posts
Showing posts with label budget. Show all posts
Thursday, December 1, 2011
Friday, November 25, 2011
Saving Congress From Itself: Can the Independent Payment Advisory Board make Congress’s Medicare cost control problems go away?
David Mitchell, MPA
With the Joint Select Committee on Deficit Reduction – a.k.a., the Super Committee – missing a major deadline this week, the prospects for a debt deal before the next election seem bleaker than ever.
Eventually, Congress will have to act. The long-term deficit situation is truly unsustainable and the sequestration trigger agreed upon in August will begin sharply cutting Defense Department programs and Medicare provider payments in January 2013 (assuming Congress and the President allow it to stay in effect).
But for those hoping that responsible decision-making on the country’s entitlement and tax programs will materialize after next year’s election, prepare to be disappointed. In particular, Medicare – the public health insurance program for the aged and disabled, and by far the largest contributor to our long-term fiscal mess – has been subject to congressional mismanagement now for years.
As Wes Joines pointed out in a post earlier this month, the Medicare physician payment system is broken and has been so for more than a decade. Private insurance carriers that participate in the Medicare Advantage program have been overpaid since 2003, when the Republican-controlled Congress set artificially high payment rates as part of the same bill that expanded subsidized prescription drugs at the government's expense. And members of both parties have proven themselves unable to withstand the temptation of using the Medicare program to steer benefits to special interests. Whether it’s boosting payments to rural hospitals, delaying competitive bidding for durable medical equipment, or shielding beneficiaries from scheduled benefit cuts, there are many recent examples of costly Congressional micromanaging on both sides of the aisle.
Underlying this mismanagement is a simple political calculus: members of Congress believe that they must avoid being linked to any policy that will hurt the country’s 47 million Medicare beneficiaries (not to mention the tens of millions more about to join the program) or risk defeat at the polls. Cutting benefits is one obvious no-no, but cutting provider payments is also politically dangerous, since doctors and hospitals may then stop treating Medicare patients or otherwise incite seniors’ anger.
So what can be done? One hope is that legislators themselves may be looking for a way out of this Medicare cost-control political vortex, especially given the hard decisions that most political elites know will have to be made as part of an eventual debt reduction deal.
One sign of this thinking is Congress’s recent decision to establish an Independent Payment Advisory Board (IPAB) as part of last year’s health reform legislation.[1] The IPAB is designed to take Medicare payment policymaking out of the hands of Congress and put it into the hands of expert technocrats. Though the IPAB was not a major focus of the yearlong debate on health care legislation (Americans were otherwise obsessed with abortion, the public option, and death panels[2]), it may prove to be one of the most consequential provisions included in the ACA. In the words of former budget director Peter Orszag, IPAB represents “the largest yielding of sovereignty from the Congress since the creation of the Federal Reserve.”
Here’s how it works: A 15-member board appointed by the president and confirmed by the Senate will propose sharp cuts to Medicare payments if cost growth in the program continues on its current trajectory. What makes this Board different from past Medicare commissions – or even the current Super Committee – is that the recommended cuts will go into effect unless Congress finds equal savings elsewhere in the program or supermajorities in Congress vote to waive the new rules (and even then only if the president signs the resulting bill). There is concern that future Congresses will not allow themselves to be constrained by these parliamentary hurdles and will try to prevent the cuts by simply not confirming IPAB appointees or passing a new law revoking some or all of IPAB’s powers. But the IPAB provision includes rules to check these congressional urges, so there is reason to believe that IPAB will have teeth.
Beyond the technical details, one’s optimism about the Board depends in large part on what one believes is ailing the US health care system. If high prices are the culprit (as many on the left believe), IPAB could prove effective at withstanding political pressure from doctors, hospitals, and other providers and keeping prices low. If over-utilization is the main cost driver (as many on the right believe), IPAB’s usefulness will be limited. This is partly by design: currently, the Board can only recommend changes to provider payment rates, not benefits.
But many outside experts – including some who sat on the US Fiscal Commission last year – recommend expanding IPAB’s powers. And the president has urged Congress to lower IPAB’s cost growth rate target, making it more likely that recommendations will be triggered. Some have even speculated that IPAB could be the vehicle by which a new all-payer rate setting scheme could be implemented.
It’s unlikely that Congress will go along with any of the above proposals any time soon. Indeed, many in Congress have called for IPAB’s repeal. And it’s true that further empowering a board of unelected technocrats is not an easy sell to the American people (especially since the biggest problems facing Medicare – and the federal budget as a whole – require moral, not mathematical, answers). But as the extent of our long-term structural deficit becomes more apparent – and the situation grows more urgent – members of Congress may be tempted to delegate more and more tough decisions to IPAB. Some might view this as an undemocratic and irresponsible abdication of authority – in other words, the coward’s way out. But as Edgar Allan Poe once wrote: “That man is not truly brave who is afraid either to seem or to be, when it suits him, a coward.”
With the Joint Select Committee on Deficit Reduction – a.k.a., the Super Committee – missing a major deadline this week, the prospects for a debt deal before the next election seem bleaker than ever.
Eventually, Congress will have to act. The long-term deficit situation is truly unsustainable and the sequestration trigger agreed upon in August will begin sharply cutting Defense Department programs and Medicare provider payments in January 2013 (assuming Congress and the President allow it to stay in effect).
But for those hoping that responsible decision-making on the country’s entitlement and tax programs will materialize after next year’s election, prepare to be disappointed. In particular, Medicare – the public health insurance program for the aged and disabled, and by far the largest contributor to our long-term fiscal mess – has been subject to congressional mismanagement now for years.
As Wes Joines pointed out in a post earlier this month, the Medicare physician payment system is broken and has been so for more than a decade. Private insurance carriers that participate in the Medicare Advantage program have been overpaid since 2003, when the Republican-controlled Congress set artificially high payment rates as part of the same bill that expanded subsidized prescription drugs at the government's expense. And members of both parties have proven themselves unable to withstand the temptation of using the Medicare program to steer benefits to special interests. Whether it’s boosting payments to rural hospitals, delaying competitive bidding for durable medical equipment, or shielding beneficiaries from scheduled benefit cuts, there are many recent examples of costly Congressional micromanaging on both sides of the aisle.
Underlying this mismanagement is a simple political calculus: members of Congress believe that they must avoid being linked to any policy that will hurt the country’s 47 million Medicare beneficiaries (not to mention the tens of millions more about to join the program) or risk defeat at the polls. Cutting benefits is one obvious no-no, but cutting provider payments is also politically dangerous, since doctors and hospitals may then stop treating Medicare patients or otherwise incite seniors’ anger.
So what can be done? One hope is that legislators themselves may be looking for a way out of this Medicare cost-control political vortex, especially given the hard decisions that most political elites know will have to be made as part of an eventual debt reduction deal.
One sign of this thinking is Congress’s recent decision to establish an Independent Payment Advisory Board (IPAB) as part of last year’s health reform legislation.[1] The IPAB is designed to take Medicare payment policymaking out of the hands of Congress and put it into the hands of expert technocrats. Though the IPAB was not a major focus of the yearlong debate on health care legislation (Americans were otherwise obsessed with abortion, the public option, and death panels[2]), it may prove to be one of the most consequential provisions included in the ACA. In the words of former budget director Peter Orszag, IPAB represents “the largest yielding of sovereignty from the Congress since the creation of the Federal Reserve.”
Here’s how it works: A 15-member board appointed by the president and confirmed by the Senate will propose sharp cuts to Medicare payments if cost growth in the program continues on its current trajectory. What makes this Board different from past Medicare commissions – or even the current Super Committee – is that the recommended cuts will go into effect unless Congress finds equal savings elsewhere in the program or supermajorities in Congress vote to waive the new rules (and even then only if the president signs the resulting bill). There is concern that future Congresses will not allow themselves to be constrained by these parliamentary hurdles and will try to prevent the cuts by simply not confirming IPAB appointees or passing a new law revoking some or all of IPAB’s powers. But the IPAB provision includes rules to check these congressional urges, so there is reason to believe that IPAB will have teeth.
Beyond the technical details, one’s optimism about the Board depends in large part on what one believes is ailing the US health care system. If high prices are the culprit (as many on the left believe), IPAB could prove effective at withstanding political pressure from doctors, hospitals, and other providers and keeping prices low. If over-utilization is the main cost driver (as many on the right believe), IPAB’s usefulness will be limited. This is partly by design: currently, the Board can only recommend changes to provider payment rates, not benefits.
But many outside experts – including some who sat on the US Fiscal Commission last year – recommend expanding IPAB’s powers. And the president has urged Congress to lower IPAB’s cost growth rate target, making it more likely that recommendations will be triggered. Some have even speculated that IPAB could be the vehicle by which a new all-payer rate setting scheme could be implemented.
It’s unlikely that Congress will go along with any of the above proposals any time soon. Indeed, many in Congress have called for IPAB’s repeal. And it’s true that further empowering a board of unelected technocrats is not an easy sell to the American people (especially since the biggest problems facing Medicare – and the federal budget as a whole – require moral, not mathematical, answers). But as the extent of our long-term structural deficit becomes more apparent – and the situation grows more urgent – members of Congress may be tempted to delegate more and more tough decisions to IPAB. Some might view this as an undemocratic and irresponsible abdication of authority – in other words, the coward’s way out. But as Edgar Allan Poe once wrote: “That man is not truly brave who is afraid either to seem or to be, when it suits him, a coward.”
----------------------
Notes
[1] The Affordable Care Act also created the Center for Medicare and Medicaid Innovation (CMI), which has broad powers to experiment with new payment systems like accountable care organizations and bundling, and then apply the most successful models nationwide – all without further congressional action. This is a promising idea, but the Congressional Budget Office and others are skeptical of its cost-saving potential and so it will not figure as prominently as IPAB in debt reduction negotiations.
[2] Since the bill’s passage, some have used the “death panel” moniker to describe IPAB, but during the debate that phrase was used in reference to a provision that attempted to expand the use of living wills.
Friday, November 11, 2011
New Year's Irresolution: Medicare’s sustainable growth rate and physician reimbursement
Wes Joines, MPA
Unless Congress acts between now and the end of 2011, at least one group will not be experiencing a happy New Year: physicians who provide services to Medicare patients. Under current law, starting in 2012, reimbursement for Medicare-provided services will be reduced by an estimated 30%. Why is this happening? It is all related to policies enacted nearly 15 years ago in an earlier iteration of debt reduction efforts.
The Balanced Budget Act of 1997 was signed into law on August 5, 1997 and was designed to balance the federal budget by 2002. Of its $160 billion in spending cuts during that time period, $112 billion was applicable to the Medicare program, which is the primary health coverage program for older and some disabled Americans. A key component of the cuts to Medicare included, for the first time, a budgetary restraint on Medicare’s total expenditures to maintain budget neutrality. Known as the sustainable growth rate (SGR), it is a major component of the current formula for determining annual updates to physician reimbursement. While Medicare payment rate increases since 1992 had been tied to trends in physician utilization (i.e. efficient use of medical tests and facilities by a doctor), in 1997, for the first time, the implementation of the SGR meant that Medicare reimbursement changes would be linked to four factors: 1) changes in input costs, 2) changes in Medicare fee-for-service enrollment, 3) changes in the volume of physician services relative to growth in the national economy, and 4) changes in expenditures due to changes in law and/or regulation.
The SGR resulted in annual increases to the Medicare fee schedule until 2002, when a 4.8% reduction took place. Since that time, rate reductions called for by the formula have been deferred, although Congress has not changed the underlying SGR formula or the cumulative spending targets. Because of vast increases in the volume and complexity of health care services for the Medicare population in recent years, especially when compared to the SGR designers’ projections, the formula specifies cuts in physician payments that become more severe with each passing year. In fact, at a cost of $19 billion, a last-minute December 2010 vote delayed a scheduled 25% reduction in the SGR that was to take place in January 2011.
So, here we are again, this time in late 2011, deciding whether or not reimbursement for Medicare providers will be cut. Even before the current debt reduction debate and increasing prevalence of political gridlock in Congress, policy movement regarding the SGR involved numerous short-term fixes. For example, from 2003 through 2010, Congress included provisions in 13 separate pieces of legislation to forestall reimbursement cuts. As a long-term fix for the SGR – e.g. replacing it with a current fee freeze – would be extremely costly to the taxpayer (some estimates currently peg it around $300 billion over 10 years), short-term fixes have generally proved to be an easier bargain (as much as they have irritated physicians and their respective trade associations).
At this point, anyone’s guess is as good as another’s regarding the level of reimbursement for Medicare services on January 1, 2012. Although the current political climate is not one that generally supports massive spending to doctors that would be required for a long-term fix, many believe that cuts of the magnitude prescribed by the SGR would not be conducive to ensuring beneficiary access to services. Therefore, another short-term fix might be in the works as a stop-gap measure. However, there is also a chance that the currently-convened deficit reduction “Super Committee” might address the SGR as part of its proceedings.
If compromise is within reach, within or outside of the Joint Select Committee on Deficit Reduction, it may be similar to a plan recently recommend by the Medicare Payment Advisory Commission (MedPAC), which ironically enough, was also established by the Balanced Budget Act of 1997 and serves as an independent advisor to Congress. MedPAC’s plan, which would cost $200 billion over 10 years (instead of the $300 billion of the fee freeze), would protect both primary care and specialty physicians from the deep cuts called for by SGR. Primary care physicians would see physician fees associated with Medicare services frozen for 10 years, while specialists would see smaller cuts (of 5.9% per year) over the first three years that would then remain frozen for the remaining seven years in the budget window.
Granted, MedPAC’s suggestion is not a panacea, but it is a good start. At the very least, it should focus us on attempting to resolve this looming crisis.
Unless Congress acts between now and the end of 2011, at least one group will not be experiencing a happy New Year: physicians who provide services to Medicare patients. Under current law, starting in 2012, reimbursement for Medicare-provided services will be reduced by an estimated 30%. Why is this happening? It is all related to policies enacted nearly 15 years ago in an earlier iteration of debt reduction efforts.
The Balanced Budget Act of 1997 was signed into law on August 5, 1997 and was designed to balance the federal budget by 2002. Of its $160 billion in spending cuts during that time period, $112 billion was applicable to the Medicare program, which is the primary health coverage program for older and some disabled Americans. A key component of the cuts to Medicare included, for the first time, a budgetary restraint on Medicare’s total expenditures to maintain budget neutrality. Known as the sustainable growth rate (SGR), it is a major component of the current formula for determining annual updates to physician reimbursement. While Medicare payment rate increases since 1992 had been tied to trends in physician utilization (i.e. efficient use of medical tests and facilities by a doctor), in 1997, for the first time, the implementation of the SGR meant that Medicare reimbursement changes would be linked to four factors: 1) changes in input costs, 2) changes in Medicare fee-for-service enrollment, 3) changes in the volume of physician services relative to growth in the national economy, and 4) changes in expenditures due to changes in law and/or regulation.
The SGR resulted in annual increases to the Medicare fee schedule until 2002, when a 4.8% reduction took place. Since that time, rate reductions called for by the formula have been deferred, although Congress has not changed the underlying SGR formula or the cumulative spending targets. Because of vast increases in the volume and complexity of health care services for the Medicare population in recent years, especially when compared to the SGR designers’ projections, the formula specifies cuts in physician payments that become more severe with each passing year. In fact, at a cost of $19 billion, a last-minute December 2010 vote delayed a scheduled 25% reduction in the SGR that was to take place in January 2011.
So, here we are again, this time in late 2011, deciding whether or not reimbursement for Medicare providers will be cut. Even before the current debt reduction debate and increasing prevalence of political gridlock in Congress, policy movement regarding the SGR involved numerous short-term fixes. For example, from 2003 through 2010, Congress included provisions in 13 separate pieces of legislation to forestall reimbursement cuts. As a long-term fix for the SGR – e.g. replacing it with a current fee freeze – would be extremely costly to the taxpayer (some estimates currently peg it around $300 billion over 10 years), short-term fixes have generally proved to be an easier bargain (as much as they have irritated physicians and their respective trade associations).
At this point, anyone’s guess is as good as another’s regarding the level of reimbursement for Medicare services on January 1, 2012. Although the current political climate is not one that generally supports massive spending to doctors that would be required for a long-term fix, many believe that cuts of the magnitude prescribed by the SGR would not be conducive to ensuring beneficiary access to services. Therefore, another short-term fix might be in the works as a stop-gap measure. However, there is also a chance that the currently-convened deficit reduction “Super Committee” might address the SGR as part of its proceedings.
If compromise is within reach, within or outside of the Joint Select Committee on Deficit Reduction, it may be similar to a plan recently recommend by the Medicare Payment Advisory Commission (MedPAC), which ironically enough, was also established by the Balanced Budget Act of 1997 and serves as an independent advisor to Congress. MedPAC’s plan, which would cost $200 billion over 10 years (instead of the $300 billion of the fee freeze), would protect both primary care and specialty physicians from the deep cuts called for by SGR. Primary care physicians would see physician fees associated with Medicare services frozen for 10 years, while specialists would see smaller cuts (of 5.9% per year) over the first three years that would then remain frozen for the remaining seven years in the budget window.
Granted, MedPAC’s suggestion is not a panacea, but it is a good start. At the very least, it should focus us on attempting to resolve this looming crisis.
Friday, April 15, 2011
Rebalancing civilian-military operations: A two-way street
Rashad Badr, MPA
There is a great deal of discussion about the need to adjust the balance between civilian agencies and the military in executing U.S. foreign policy and programs. The easiest argument to make is that the vast American defense complex overshadows US diplomatic and developmental efforts in almost every way. The Department of Defense (DoD) budget in 2010 was $691 billion, whereas the State Department’s budget for that year was just $16.4 billion. The United States Agency for International Development (USAID), the development arm of State, similarly faced a shorter stack in pursuing its goals abroad. However one wants to add it up, defense spending surpasses civilians projects by about 40 to 1.
Other State advocates point to the sprawling manpower that the military possesses when compared to its civilian counterparts. Just one example of this mismatch: the personal staff of the Central Command Combatant Commander (CCDR) – known for previously serving a famous Woodrow Wilson School graduate, General David Petraeus *85 *87 – is larger than many of the embassies that fall into Central Command’s theatre. When CCDRs travel, they normally arrive with a small army of assistants and personnel. When I saw Assistant Secretary of State Jeff Feltman travel to the Middle East last summer, he traveled with a single assistant.
Secretary of Defense Robert Gates has argued before Congress that the State Department needs more funding. Secretary of State Hillary Clinton, with the help of our very own former dean, Professor Anne-Marie Slaughter, has pioneered the Quadrennial Diplomacy and Development Review (QQDR). In it, Clinton and Slaughter aim to remap American diplomatic and developmental efforts, putting them on par with defensive operations, in accordance with President Obama’s “3D” approach to foreign policy: defense, diplomacy, and development. This document has many creative ideas and useful insights. But what have we seen of it so far?
More importantly, we’ve heard all of this before. So what should we do about it?
Unfortunately, the situation is bit more complex than a simple issue of funding parity or even mission creep. But first off, let’s get one thing straight: I’m a big fan of State and a staunch advocate for the need to elevate diplomacy as a tool of national security. That being said, the department needs to critically alter its mission and operations in three ways.
First, State has to get serious about assuming greater risks while conducting diplomacy. Current security measures, left largely in the hands of Regional Security Officers abroad, effectively keep diplomats trapped behind embassy walls. If a country is deemed “dangerous,” then diplomats have to jump through numerous hoops before they are allowed to leave compound – and when they do get permission, they have to be escorted by armed guards and in armored vehicles. There is something counter-intuitive about effectively marginalizing our Foreign Service Officers in the places that need the greatest diplomatic efforts. Of course relaxing these standards will come with attendant risks and dangers, but diplomacy is a dangerous endeavor. Unfortunately, the State Department’s allergy to potentially hostile situations – to which the military is largely immune – has ultimately led to its marginalization.
Second, the department needs to reassert control over peacekeeping, nation building, and wartime operations. The US’s two biggest engagements currently are in Iraq and Afghanistan. A study of peacekeeping operations and nation building efforts in both of these countries reveal DoD dominance in both developmental and diplomatic activities. Diplomats and aid workers argue that they simply don’t have the funding or the operational capacity to work in these environments. Fine, but let’s also not forget that the State Department’s mission has been steadily cut down since the Clinton presidency (without much of a fight might I add) and traditional State and USAID operations have been farmed out to DoD. In fact, one of the biggest complaints I hear from people in uniform (at all levels) is that State and USAID are just not stepping up to the plate. State and USAID will have to not only reassert themselves in these areas on a macro level, but take substantive steps to fund and train civilians in taking over from DoD.
Which brings me to my third point: the State Department needs to implement its goal of “engaging beyond the state,” as referenced in the QDDR. In Iraq and Afghanistan, that means picking up some of the work done by Special Operations in navigating and channeling tribal and ethnic currents. Elsewhere in the world, it means engaging outside of our “comfort zone,” to include more engagement with Islamist groups and opposition movements. American diplomatic efforts will always be limited if we (read: American policymakers) are content engaging with official, traditional government counterparts and Western, liberal thinkers. American diplomacy cannot be considered robust if it is not widened to take into account the full spectrum and picture of political actors operating in today’s complex international environment.
These criticisms may come off as a bit harsh on the State Department and USAID, but these are necessary issues to keep in mind if civilian efforts will ever near parity with military power. Because at the end of the day, American policymakers can’t just ask DoD to give up turf; they need to have a strong and aggressive civilian sector willing to pick up and take over.
There is a great deal of discussion about the need to adjust the balance between civilian agencies and the military in executing U.S. foreign policy and programs. The easiest argument to make is that the vast American defense complex overshadows US diplomatic and developmental efforts in almost every way. The Department of Defense (DoD) budget in 2010 was $691 billion, whereas the State Department’s budget for that year was just $16.4 billion. The United States Agency for International Development (USAID), the development arm of State, similarly faced a shorter stack in pursuing its goals abroad. However one wants to add it up, defense spending surpasses civilians projects by about 40 to 1.
Other State advocates point to the sprawling manpower that the military possesses when compared to its civilian counterparts. Just one example of this mismatch: the personal staff of the Central Command Combatant Commander (CCDR) – known for previously serving a famous Woodrow Wilson School graduate, General David Petraeus *85 *87 – is larger than many of the embassies that fall into Central Command’s theatre. When CCDRs travel, they normally arrive with a small army of assistants and personnel. When I saw Assistant Secretary of State Jeff Feltman travel to the Middle East last summer, he traveled with a single assistant.
Secretary of Defense Robert Gates has argued before Congress that the State Department needs more funding. Secretary of State Hillary Clinton, with the help of our very own former dean, Professor Anne-Marie Slaughter, has pioneered the Quadrennial Diplomacy and Development Review (QQDR). In it, Clinton and Slaughter aim to remap American diplomatic and developmental efforts, putting them on par with defensive operations, in accordance with President Obama’s “3D” approach to foreign policy: defense, diplomacy, and development. This document has many creative ideas and useful insights. But what have we seen of it so far?
More importantly, we’ve heard all of this before. So what should we do about it?
Unfortunately, the situation is bit more complex than a simple issue of funding parity or even mission creep. But first off, let’s get one thing straight: I’m a big fan of State and a staunch advocate for the need to elevate diplomacy as a tool of national security. That being said, the department needs to critically alter its mission and operations in three ways.
First, State has to get serious about assuming greater risks while conducting diplomacy. Current security measures, left largely in the hands of Regional Security Officers abroad, effectively keep diplomats trapped behind embassy walls. If a country is deemed “dangerous,” then diplomats have to jump through numerous hoops before they are allowed to leave compound – and when they do get permission, they have to be escorted by armed guards and in armored vehicles. There is something counter-intuitive about effectively marginalizing our Foreign Service Officers in the places that need the greatest diplomatic efforts. Of course relaxing these standards will come with attendant risks and dangers, but diplomacy is a dangerous endeavor. Unfortunately, the State Department’s allergy to potentially hostile situations – to which the military is largely immune – has ultimately led to its marginalization.
Second, the department needs to reassert control over peacekeeping, nation building, and wartime operations. The US’s two biggest engagements currently are in Iraq and Afghanistan. A study of peacekeeping operations and nation building efforts in both of these countries reveal DoD dominance in both developmental and diplomatic activities. Diplomats and aid workers argue that they simply don’t have the funding or the operational capacity to work in these environments. Fine, but let’s also not forget that the State Department’s mission has been steadily cut down since the Clinton presidency (without much of a fight might I add) and traditional State and USAID operations have been farmed out to DoD. In fact, one of the biggest complaints I hear from people in uniform (at all levels) is that State and USAID are just not stepping up to the plate. State and USAID will have to not only reassert themselves in these areas on a macro level, but take substantive steps to fund and train civilians in taking over from DoD.
Which brings me to my third point: the State Department needs to implement its goal of “engaging beyond the state,” as referenced in the QDDR. In Iraq and Afghanistan, that means picking up some of the work done by Special Operations in navigating and channeling tribal and ethnic currents. Elsewhere in the world, it means engaging outside of our “comfort zone,” to include more engagement with Islamist groups and opposition movements. American diplomatic efforts will always be limited if we (read: American policymakers) are content engaging with official, traditional government counterparts and Western, liberal thinkers. American diplomacy cannot be considered robust if it is not widened to take into account the full spectrum and picture of political actors operating in today’s complex international environment.
These criticisms may come off as a bit harsh on the State Department and USAID, but these are necessary issues to keep in mind if civilian efforts will ever near parity with military power. Because at the end of the day, American policymakers can’t just ask DoD to give up turf; they need to have a strong and aggressive civilian sector willing to pick up and take over.
Wednesday, March 30, 2011
National (dis)service: Symbolic budget cuts with real consequences
Larry Handerhan, MPA
When the House of Representatives passed $60 billion in fiscal year 2011 spending cuts last month, the programs on the chopping block ranged from the perfectly logical (repetitive fighter jet contracts) to the overtly political (Environmental Protection Agency). However, these efforts can not be taken as a serious deficit reduction strategy: by primarily targeting non-defense discretionary spending, which accounts for just 12% of the federal budget, it is clear that these cuts were more symbolic than substantive.
However, even in a climate where political symbolism is the cause du jour, it is alarming – and counter intuitive – that House Republicans would defund the Corporation for National and Community Service (CNCS), the agency that administers AmeriCorps and Senior Corps.
At a time where politicians and civic leaders champion public service, there must be some other option beyond joining the military. Volunteerism has never been more crucial: as cities and states cut services in response to budget shortfalls, volunteers are increasingly responsible for ensuring that the social safety net remains intact. And in addition to supporting its own volunteers, CNCS provides crucial capacity-building to some of the nation’s most well-respected and effective non-profits like City Year, Teach for America, and Habitat for Humanity.
If anything, fiscal conservatives should appreciate such a prudent program: most AmeriCorps members serve for an annual stipend of just $12,000.
Defunding CNCS is further perplexing because national service has not been – and should not become – a partisan issue. Bill Clinton launched AmeriCorps after successful pilot programs instigated by Republican predecessor George H. W. Bush. And George W. Bush increased the size of the program from 50,000 to 75,000 participants.
As any national service champion can attest, these symbolic cuts will have real consequences.
These consequences can be measured in fewer meals served, fewer students tutored, and fewer houses built. Unfortunately, the “softer” benefits of this work are equally as important but harder to quantify.
National service invests in communities, but also invests in the volunteer. This fosters positive externalities that extend far beyond time spent in a CNCS program and are not easily captured by traditional performance metrics.
Consider:
66% of AmeriCorps alums go on to work in public service, and are more likely than their peers to volunteer later in life.[1]
Volunteering has been shown to improve the mental and physical health of service-providers, particular older Americans.
And federal dollars incubate innovation. One salient example hits close to home: CNCS helped bring Teach for America to scale after it started as Wendy Kopp’s undergraduate thesis here at the Woodrow Wilson School. Due to the program’s success and popularity, it now attracts an additional $4 in private, state, and local funds for every federal dollar it receives.[2]
That sounds like a pretty good return on investment to me.
Note: Larry Handerhan served as a Team Leader in AmeriCorps*NCCC in 2005-06, aiding victims of Hurricane Katrina in the Gulf Coast.
----------------
References:
[1] AmeriCorps: Changing Lives, Changing America – A Report on AmeriCorps’ Impact on Members and Nonprofit Organizations,” Corporation for National and Community Service, 2007.
[2] Matt Kramer (president of Teach for America), Congressional Testimony, March 8, 2010.
When the House of Representatives passed $60 billion in fiscal year 2011 spending cuts last month, the programs on the chopping block ranged from the perfectly logical (repetitive fighter jet contracts) to the overtly political (Environmental Protection Agency). However, these efforts can not be taken as a serious deficit reduction strategy: by primarily targeting non-defense discretionary spending, which accounts for just 12% of the federal budget, it is clear that these cuts were more symbolic than substantive.
However, even in a climate where political symbolism is the cause du jour, it is alarming – and counter intuitive – that House Republicans would defund the Corporation for National and Community Service (CNCS), the agency that administers AmeriCorps and Senior Corps.
At a time where politicians and civic leaders champion public service, there must be some other option beyond joining the military. Volunteerism has never been more crucial: as cities and states cut services in response to budget shortfalls, volunteers are increasingly responsible for ensuring that the social safety net remains intact. And in addition to supporting its own volunteers, CNCS provides crucial capacity-building to some of the nation’s most well-respected and effective non-profits like City Year, Teach for America, and Habitat for Humanity.
If anything, fiscal conservatives should appreciate such a prudent program: most AmeriCorps members serve for an annual stipend of just $12,000.
Defunding CNCS is further perplexing because national service has not been – and should not become – a partisan issue. Bill Clinton launched AmeriCorps after successful pilot programs instigated by Republican predecessor George H. W. Bush. And George W. Bush increased the size of the program from 50,000 to 75,000 participants.
As any national service champion can attest, these symbolic cuts will have real consequences.
These consequences can be measured in fewer meals served, fewer students tutored, and fewer houses built. Unfortunately, the “softer” benefits of this work are equally as important but harder to quantify.
National service invests in communities, but also invests in the volunteer. This fosters positive externalities that extend far beyond time spent in a CNCS program and are not easily captured by traditional performance metrics.
Consider:
66% of AmeriCorps alums go on to work in public service, and are more likely than their peers to volunteer later in life.[1]
Volunteering has been shown to improve the mental and physical health of service-providers, particular older Americans.
And federal dollars incubate innovation. One salient example hits close to home: CNCS helped bring Teach for America to scale after it started as Wendy Kopp’s undergraduate thesis here at the Woodrow Wilson School. Due to the program’s success and popularity, it now attracts an additional $4 in private, state, and local funds for every federal dollar it receives.[2]
That sounds like a pretty good return on investment to me.
Note: Larry Handerhan served as a Team Leader in AmeriCorps*NCCC in 2005-06, aiding victims of Hurricane Katrina in the Gulf Coast.
----------------
References:
[1] AmeriCorps: Changing Lives, Changing America – A Report on AmeriCorps’ Impact on Members and Nonprofit Organizations,” Corporation for National and Community Service, 2007.
[2] Matt Kramer (president of Teach for America), Congressional Testimony, March 8, 2010.
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