What will the public services we use look like in the future? The Serco Institute’s monthly digest – The Thoughts That Count – pulls together some of the best thinking on public services policy from across the world.
The Covid-19 Case for Bigger Government is Weak – Cato Institute (US)
Cross‐country comparisons on pandemic preparedness, size of government, centralisation of government authority, and some measures of state capacity show little correlation with excess deaths in the pandemic, according to this research by the Cato Institute. As such, they argue that “since no grand theory of government appears robust in explaining pandemic performances across countries, we should be wary of those using COVID-19 to justify major increases in the size and scope of government.”
The Implications of Common Ownership and Capital Concentration in Australia: Submission to the Inquiry by the House of Representatives, Standing Committee on Economics – The McKell Institute (New Zealand)
In this forthright submission, the McKell Institute posits that capital concentration has the potential to distort market competition and increase rent-seeking behaviour. The issue, they say, can hinder businesses who seek to access capital for growth and the adoption of technology. The primary driver of capital inequality, the submission argues, is wealth inequality.
Spending it Better: Taking back control of public contracts to level up Britain – Centre for Social Justice (UK)
With the UK now outside the EU, the Centre for Social Justice (CSJ) urges the Government to rethink its procurement rules, link procurement directly to its ‘levelling up’ agenda and prioritise areas with high deprivation in awarding contracts. This should take the form of a “Levelling Up Test”, applied to all public agencies who should seek, wherever possible, to award contracts to firms which are active in deprived areas. The CSJ also suggests that the Cabinet Office devolve power to more deprived local authorities to allow them to directly award central government contracts and address local needs.
A Social Guarantee: The case for universal services – New Economics Foundation (UK)
The New Economics Foundation (NEF) argues that a new social guarantee must be introduced in Britain to affirm every person’s right to life’s essentials. This guarantee must include a living wage, a living income and more and better universal services: this third point is the focus of this report. Using the Universal Basic Services (UBS) model, NEF advocates making access to essential public services, including childcare, social care, housing, digital information and communications, energy and transport, universal in order to reduce the financial burden of paying for these services to many households and thus ensure a higher guaranteed standard of living for all.
Building back cancer services in England – Institute for Public Policy Research (UK)
This report examines the disruption caused by the Covid-19 pandemic to cancer services and treatments in England, including the ‘missing patient backlogs’ which have serious implications for cancer patients’ rate of survival. The Institute for Public Policy Research argues the UK Government’s three-year funding plan for the NHS is insufficient, calling instead for a ‘cancer pledge’ which builds capacity by growing the cancer workforce and improving diagnostic capability; harnesses innovation, such as by making better use of technological advancements and rethinking service design; and focuses on prevention, through such measures as levies on tobacco and junk food.
Increasing cost pressures in the commercial health care market – American Enterprise Institute
In this short analytical paper, measures to reduce the high costs of employer-sponsored insurance (ESI) are explored. ESI costs averaged over $21,000 and $7,400 for family and single coverage in 2020, respectively. The America Enterprise Institute argues that policymakers can improve cost competition by deterring future consolidation, expanding the market of providers, and limiting dominant providers’ ability to translate a lack of competition into high prices. They say one option to increase competition at the plan-choice level and influence bargaining dynamics through the market centres on an employer-provided health insurance credit with a regulated choice set. Employees would have at least one lower-cost option available to them and accrue cost savings if it was chosen.
The political economy of health reform: Price regulation vs. regulated competition – American Enterprise Institute
This paper sets out the debate between the ‘incremental’ moves towards greater government regulation of prices paid for insurance and services, or a structured market that leads the sector’s suppliers of medical services to set competitive prices on their own. The researcher argues that Medicare and Medicaid reveal that payment regulation can produce the desired reductions in spending, but also lead to special-interest influence and rigidity. However, the paper also notes that a structured market, with the right safeguards, can deliver strong results by self-correcting and being more resilient to outside manipulation, but will only be adopted if consumers believe it will lead to financial benefits and no risks, the paper concludes.
Racial, Ethnic, and Gender Disparities in Healthcare in Medicare Advantage – RAND Corporation (US)
This report describes the quality of healthcare received in 2018 by Medicare beneficiaries enrolled in Medicare Advantage (MA) plans nationwide (31.6% of all Medicare beneficiaries). The report highlights racial and ethnic differences in healthcare experiences and clinical care, compares quality of care for women and men, and looks at racial and ethnic differences in the quality of care.
The Coverage and Cost Effects of Key Health Insurance Reforms Being Considered by Congress – Urban Institute (US)
As part of the budget process for fiscal year 2022, the US Congress is considering a package of two reforms to the Affordable Care Act (ACA). Under the package, the enhanced premium subsidies included in the American Rescue Plan Act (ARPA) would become permanent. Additionally, the so-called Medicaid coverage gap would be filled by extending eligibility for marketplace subsidies to people earning below 100% of the federal poverty level (FPL) in 12 states that have not yet expanded Medicaid. The Urban Institute researchers find these two policies would broadly expand eligibility for marketplace subsidies, reduce the number of uninsured people, especially at lower income levels, and lessen household burdens for health care.
Older Adults Benefit If Congress Closes the Medicaid Coverage Gap and Boosts Premium Tax Credits – Center on Budget and Policy Priorities (US)
This short piece argues that post-pandemic recovery legislation in the US should prioritize permanently closing the Medicaid coverage gap and permanently boosting premium tax credits in the Affordable Care Act (ACA) marketplaces to extend coverage to people — including millions of older people — who otherwise have no coverage at all.
States Are Using One-Time Funds to Improve Medicaid Home- and Community-Based Services, But Longer-Term Investments Are Needed – Center on Budget and Policy Priorities (US)
In a review of Medicaid home- and community-based services (HCBS), the Center on Budget and Policy Priorities finds 37 US states are still using funding from emergency Covid legislation to fund services. These investments will help the Medicaid HCBS systems, particularly the direct support workforce, recover from the stress of the Covid-19 pandemic. However, the paper argues, to “make the transformational changes needed so that more low-income seniors and people with disabilities are able to live and thrive in home- and community-based settings deeper and longer-term investments are needed.”
What will the Government’s Proposals Mean for the Social Care System? – The King’s Fund (UK)
This ‘long read’ provides a summary of the current social care system and analyses the implications of the UK Government’s plans for reform. This includes how, under Government plans, the means test for public funding would be made more generous, social care payments would be capped at a certain threshold and social care workers and unpaid carers would be better supported.
A Cap on Care Costs is not Reform – we need a new deal for the workforce – Trades Union Congress (UK)
While the UK Government’s plans to reform social care focus on a cap on care costs, the TUC contends that this will not provide high-quality care to patients and high-quality employment to care workers, as increasing tax hits lower-paid workers the hardest. TUC analysis finds that seven in ten care workers are paid less than £10 per hour. As an estimated half a million care workers would benefit from a pay rise to a £10 hourly wage, the TUC urges the UK Government to include in its plans for social care reform a pay-rise for carers. The TUC calls for a tax on wealth by raising capital gains tax to the same level as income tax to pay for the proposed social care workers’ pay-rise.
Options for Containing the Cost of a new Medicare Dental, Hearing, and Vision Benefit – Brookings Institute (US)
Dental, hearing, and vision coverage is likely to be added to Medicare in upcoming US legislation. This short paper looks at ways that policymakers could reduce the cost of adding this new coverage to Medicare without reducing the generosity of that coverage.
Is Manchester Greater? A New Analysis of NHS Integration – Centre for Policy Studies (UK)
Ahead of NHS reforms in England which would see the creation of new Integrated Care Systems (ICSs), which (as the name implies) seek to drive integration and collaboration in health and social care, this report examines the evidence from Manchester where integration is most advanced. They find that results have generally been quite poor. As such they argue that the UK Government should prioritise bottom-up integration and collaboration, as well as gathering more evidence from existing pilot schemes, rather than pursuing another top-down reorganisation of the NHS on an insufficient evidence base - especially given the strain the health service is already under due to the pandemic.
Looking Back on a Year of Remote Work to See the Way Forward – American Enterprise Institute
This short but insightful report outlines some key statistics and arguments around the future of home-working following the pandemic. 35% of US employees worked from home during the peak of the pandemic and about 14% continue to do so, roughly double the pre-Covid-19 rate. The researcher claims employee outcomes included increased productivity and costs and savings in time and money. However, working from home may have harmed employees’ mental and physical health. On the other hand, employers benefited from increased worker productivity and the opportunity to reduce real estate footprints and costs. However, they faced challenges with company culture, cybersecurity, and new legal risks associated with equal treatment of in-office and remote employees. The future of remote work will be determined by a market-driven negotiation process between workers and employers navigating the costs and benefits of online work, the paper claims.
The Delta Variant will Cost Many Lives and Some GDP – American Enterprise Institute
This paper estimates that, although the Covid-19 Delta variant may cost more than 900,000 lives around the world, the impact on global GDP will be a more modest $200 billion, or less than 0.2 percent of GDP, than some might expect. Most of the lives lost to the Delta variant in the second half of this year will be in emerging market and developing economies (EMDEs), but this reflects their much larger population; adjusted for population, the advanced economies stand to be hit much harder. In fact, much of the human and economic costs of the Delta variant are concentrated in the United States, this paper claims. However, the research concludes that despite the EMDEs being hit less hard than the AEs by the Delta variant, the pandemic will still cost them nearly 1½ million lives and $190 billion in lost GDP in the second half of this year. Thus, the need to provide vaccines to these countries remains as urgent as ever.
Identifying Strategies to Boost COVID-19 Vaccine Acceptance in the United States – RAND Corporation (US)
This report explores the question of what strategies should be pursued to boost Covid-19 vaccination rates in the United States? Fundamentally it finds that strategies to boost Covid-19 vaccine acceptance need to be tailored to root causes of hesitancy in different populations. It also finds that hesitant populations might be willing to obtain the vaccine if the right influencer helps to convey a recommendation to do so.
Due to emergency measure brought in when Covid-19 emerged, the researchers behind this paper believe that by the end of 2021, 17 million more non-elderly people will be enrolled in Medicaid than before the pandemic, and also forecast that the number of Medicaid enrolees could decline by about 15 million people during 2022, after the public health emergency is expected to expire. A recent change in guidance from The Centers for Medicare & Medicaid Services (CMS) gives US States up to 12 months to restore normal income eligibility redeterminations for Medicaid enrolees once the pandemic expires. The researchers argue that a more gradual processing of enrolment over 12 months by States could reduce unnecessary losses of coverage by allowing more time for planning, outreach, and coordination with the Marketplaces.
The authors argue that vaccination passports can be an effective way to track vaccination records and status, but only with due regard for privacy and ethical considerations. They outline 12 ‘principles’ necessary for Australians to have confidence that passports “are safe, fair and consider everyone”.
This paper is a report on New Zealand’s current state with regard to Covid-19. It explains the current impact of Covid-19 globally and makes some observations about the way forward. It concludes that the current lockdown that began in August is “worth the effort”, but that New Zealand must find ways to redesign its constitutional framework to create the space for “anticipatory governance” to tackle crises of the future.
Directors of public health and the Covid-19 pandemic: ‘A year like no other’ – The King’s Fund (UK)
This report is the result of 58 interviews of directors of public health, conducted by the King’s Fund and supported by the Health Foundation, about their experiences of the Covid-19 pandemic and what they believe is needed in a public health response to recovery from the pandemic and future such crises. The report reveals the crucial role directors of public health have played in local handling of the pandemic and their potential to form a central part of population health management in the future, and outlines some of the measures necessary for this potential to be realised, such as safeguarding the relationship between directors of public health and local leaders, cooperation between local authorities and directly involving directors of public health in the design of national health systems.
A New Settlement for Living with the Virus – Confederation of British Industry (UK)
The CBI presents three guiding principles to allow the UK to learn to live with Covid-19 and for the British economy to remain open, and British workers and consumers to remain confident in going about their business, during what may be a difficult winter of rising Covid cases. These principles are to use mass testing to avoid mass isolation, using Covid-secure tools (such as workplace restrictions, hygiene, face covering guidance and even Covid status certification at large events), and continuing the vaccine rollout which has slowed considerably in recent months.
Prioritize Long-Range Nuclear Limits – American Enterprise Institute
Russia’s large arsenal of short-range nuclear weapons poses a challenge to future arms control negotiations, this paper claims. The threat posed by Russian shorter-range nuclear weapons is best met by modernizing America’s equivalent missiles to bolster deterrence, it claims. Finally, the paper argues that future arms control talks – which must be multi-lateral – should focus on limiting Russian long-range nuclear weapons, which pose the greatest threat to the United States and its allies.
Advanced Military Technology in Russia – Chatham House (UK)
Russia’s ‘super-weapons’ programme, unveiled in 2018, suggests Moscow plans to innovate in the defence-industrial field to counter the threat posed to Russian security by the United States and NATO. To this end, Russia is developing new robotics systems and integrating these into its defence capabilities, while also investing in AI technologies with a view to disrupting Western control systems and communications. Chatham House’s research paper outlines the extent of Russia’s increasingly advanced military technology and what this means for the West.
Readiness Implications of Coronavirus Infections on U.S. Navy Ships – RAND Corporation (US)
This paper evaluates the ability of the US Navy to manage a Covid outbreak, as well as lessons from the pandemic as to whether the Navy could successfully deal with an out-of-the-ordinary medical and/or mass-casualty event. The researchers conclude that it is difficult to say whether the measures used during the pandemic will be effective or appropriate long-term, but make a number of recommendations including using engineering and personnel controls to minimize the spread of diseases, including Covid-19.
AUKUS is a Big Deal, but Needs to be Put in Perspective – Royal United Services Institute (UK)
While much has rightly been made of the partnership between Australia, the UK and the US in delivering nuclear-powered submarines to Australia, this article makes three points to put this development into perspective. Firstly, this pact is the continuation of a years-long process of deepening military and security cooperation between Australia and the United States; secondly, China’s rapidly expanding naval power cannot be checked by Australian-operated submarines alone; and lastly, the timeline of the new agreement means Australia will likely not see the new naval-powered submarines enter service until at least the late 2020s.
AUKUS Reveals Much About the New Global Strategic Context – Chatham House (UK)
Chatham House summarises what the AUKUS pact says about the current state of global security cooperation. The article argues that the partnership indicates Australia’s concern about China’s growing influence in the Asia-Pacific region; despite this new commitment, Britain’s naval power remains concentrated in Europe, although its presence in Asia will be strengthened by the voyage of the Queen Elizabeth to the South China Sea; France’s furious reaction calling for a build-up of European strategic autonomy suggests that Paris sees said European autonomy more as a vehicle to project its own national sovereignty and military interests rather than European collective security; and that in spite of the disastrous retreat from Afghanistan, the US remains committed to its allies. Chatham House recommends, however, that London and Washington reach out to France and other EU partners for greater cooperation in the Indo-Pacific.
In this report, the authors provide an evidence base to inform the Australian Navy's thinking as it develops it’s ‘AI Strategy 2040’. The RAND Corporation researchers outline seven objectives that can drive integration of AI into the current and planned fleet.
The US Department of Defense's (DoD's) acquisition system has undergone significant reform. The authors of this report propose that DoD leaders manage the defense acquisition system (DAS) according to its ability to develop and produce capabilities that solve operational problems outlined in the 2018 National Defense Strategy (NDS), discuss why this perspective is warranted, and suggest steps that the Office of the Under Secretary of Defense for Acquisition & Sustainment (OUSD A&S) could take if it wishes to pursue this approach.
An Analysis of Alternative Approaches to Measuring Multinational Interoperability – RAND Corporation (US)
The National Defense Strategy (NDS) emphasises the need for US forces to be interoperable with capable allies and partners. To support the NDS, the US Army develops and executes doctrine and guidelines for how its units can achieve interoperability with partners. The Army wanted an enduring and standardised way to measure levels of interoperability achieved as a result of major training events. However, this paper claims that no current option of measurement had all the characteristics that would be required by the Army's interoperability system.
Target Secured? – Bright Blue (UK)
This edition of Bright Blue’s magazine ‘Centre Write’ focuses on the future of foreign and defence policy in the UK. It includes interviews with prominent past and present figures in UK foreign and defence policy, such as the Rt Hon Sir David Lidington, the Rt Hon Tobias Ellwood MP, and former Foreign Office minister the Rt Hon Sir Alan Duncan. Topics covered include current threats to Britain, the rise of China, and renewed partnerships between the English-speaking countries of the world.
What to Expect When You’re Expecting a National Defense Strategy – Hudson Institute (US)
Hudson Institute Senior Fellow Bryan Clark outlines a series of considerations for the new National Defense Strategy being drafted by the Biden administration. He says “it should assess core US strategic objectives and delineate the necessary Department of Defense capabilities, capacities, and forward posture required. This new strategy should be adequately resourced, or it will be destined for irrelevance.”
Deadline 2036 – Assessing the requirements and options for Canada’s future submarine force – Macdonald-Laurier Institute (Canada)
This paper by Canadian military expert Jeffery F. Collins argues that if “Canada wants to respond to the threat posed by a rising China’s naval power, contribute to the defence of itself and its allies, and acquire the patrol and surveillance capabilities needed to assert our sovereignty in the Arctic and along our coastlines, submarines are not a luxury but a necessity for the Royal Canadian Navy (RCN).”
Lessons for Preventing and Countering Violent Extremism: An Evidence-Based Approach – Royal United Services Institute (UK)
The concluding chapter to the RUSI’s ‘Prevention Project’ series, this paper summarises the series’ findings and makes recommendations for prevention and countering violent extremism (P/CVE) interventions. Key findings include: integrated interventions can mitigate harmful outcomes and improve the effectiveness of P/CVE programmes; identifying intervention target groups should be guided by evidence-based risk calculations rather than assumptions; others in the wider social environments of ‘at-risk’ individuals may be well-placed to spot signs of radicalisation but may be unwilling to recognise or report these signals; and the trust built between P/CVE intervention providers and participants can have an important impact on the effectiveness of the programme.
Space Settlement Report – Dubai Future Foundation (UAE)
This report outlines the findings of 35 projects aimed at advancing space research and the development of technological solutions “designed specifically for a Space Settlement on Mars”, a key plank of the UAE Government’s space strategy. Areas of study covered disciplines including science, mathematics, engineering, technology, economics, law, political science, and even art.
Can Electronic Monitoring Reduce Reoffending? – Cato Institute (US)
This research brief outlines the lack of research looking at the impacts of electronic monitoring on recidivism, before outlining new research which shows serving a sentence under electronic monitoring rather than in prison reduces reoffending from 58% to 42% – with the effect being significantly greater for younger offenders. The researcher’s “back‐of‐the‐envelope calculations” show that each US offender who serves his or her sentence under electronic monitoring rather than in prison saves the public purse close to $30,000 on reduced supervision and future court and prison costs.
Focused on the US justice system, experts from a broad spectrum of domains and policy perspectives seek to “offer policymakers with research-grounded analysis and recommendations to support sustained, bi-partisan reforms to move the criminal justice system toward a more humane and effective footing.”
Women in the Criminal Justice System: A better response to vulnerability – Social Market Foundation (UK)
This report outlines some of the issues faced by female offenders in the criminal justice system, and welcomes the Government’s planned female offender strategy. Social Market Foundation recommends that policymakers raise the profile of women in the criminal justice system and commit to meeting their needs, improve training and procedures to allow female offenders to more easily disclose abuse, and invest more in prevention and ‘upstream intervention’ through initiatives such as women’s centres and other forms of community provision.
AI Tools for Military Readiness – RAND Corporation (US)
The US military reports monthly on overall readiness. These quantified reports are accompanied by narratives explaining what is occurring in military units that is affecting current or future readiness. These assessments allow military leaders to calculate overall readiness and estimate how readiness could be affected by personnel, equipment, or training factors. There are likely many ways in which artificial intelligence (AI) can improve measurement and management of military readiness. In this report, the authors discuss work that advances the capability of computers to "understand" human language describing factors that promote or impede readiness.
Prosperity and Justice After the Pandemic – Institute for Public Policy Research (UK)
The Institute for Public Policy Research’s Centre for Economic Justice examines, in this report, what ‘building back better’ should and does mean for the people of the UK, and how concentrations of power might be changed to deliver the “best possible outcome for ordinary people: namely, prosperity and justice”. In addition to existing pledges by the UK Government to ‘level up’ the country and increase investment, power in the economy should be shifted: to employees and workers from employers and shareholders; to companies working in the public interest from companies extracting from society; to those who are excluded from wealth from a system which has distributed it unevenly; and to the nations, regions and local authorities of the UK away from Whitehall.
Full Employment and Good Jobs for All: Why the UK is seeing a lopsided jobs recovery – Institute for Public Policy Research (UK)
In this report, the Institute for Public Policy Research examines the state of the UK’s jobs recovery. It argues that the workforce is not en route to recovery as it appears, and structural weaknesses, such as the two million jobs which have not returned, widespread job insecurity and underemployment, and the loss of middle- and low-paying jobs in favour of high-paying ones must be addressed. The researchers urge the UK Government to use the autumn spending review to introduce an investment stimulus focused on medium-term growth, keeping the furlough scheme until the economy has recovered past its pre-pandemic level and adjusting it to encourage part-time work, providing a ‘skills-driven jobs shift’ to encourage long-term employment in priority industries, and improving labour conditions.
According to the authors of this report, the acceleration of the shift to online and remote learning and working brings new opportunities, but it also brings the potential for further inequities in the labour market. This report documents some of the barriers and opportunities that exist for older workers accessing online programs, with a focus on their digital skill levels.
Addressing Digital Exclusion in North East England – Institute for Public Policy Research (UK)
With the Covid-19 pandemic having precipitated a large increase in people’s reliance on digital services, inequalities in access to digital resources, which are closely associated with other inequalities, have been greatly exacerbated. This report explores the extent and implications of digital exclusion in England’s north east, and presents a strategic framework to address the problem of digital exclusion and the attendant inequality.
The Coronavirus Job Retention Scheme – Institute for Government (UK)
The Institute for Government (IfG) assesses the benefits of the Coronavirus Job Retention Scheme, commonly known as the ‘furlough scheme’, finding that it has helped protect 8 million people from unemployment and helped the UK labour market make a dramatic recovery in 2021. With restrictions ending, the economy opening back up and jobs rebounding, the IfG concludes that the Government’s decision to end the furlough scheme at the end of September 2021 is sound and workers still on the scheme should be allowed to find new jobs.
Levelling Up – Institute for Government (UK)
Ahead of the UK Government’s white paper on levelling up, the Institute of Government (IfG) examines existing ministerial rhetoric on the levelling up agenda and identifies some questions that have yet to be answered, including how the Government will be looking to measure its progress, the role of regions and local authorities in the levelling up agenda, whether the UK Government is prioritising areas of high deprivation or rather areas of low economic output, and how the Government will work with the devolved administrations, particularly in devolved policy areas, to level up all of the UK.
This report assesses the UK Government’s levelling up agenda, arguing that before the economic transformations of levelling up across the UK can be achieved, existing issues in the UK’s institutional structures must be ironed out. These include issues in the way funding is allocated from the centre, how various tiers of government interact with one another and with local stakeholders, and in the people hired by local and regional institutions. The report argues for funding to be reformed, for instance by allocating regional funds based on local conditions rather than institutional performance; clearly delineating the competencies of different levels of government and local and regional bodies; developing subnational institutions to attract talented people; and building stakeholder relations through methods such as good subnational governance and elected assemblies or officials.
Now is not the time to get complacent about jobs – Trades Union Congress (UK)
In this blog post, the TUC warns not to disregard the concerning elements in an otherwise positive picture showing a rebounding labour market, pre-pandemic numbers of employees and record-high vacancies. The TUC notes that the number of people in employment (rather than the number of employees) remains well below pre-pandemic levels, employment in hard-hit industries such as manufacturing, arts and entertainment is still far short of pre-pandemic levels, and the end of furlough may result in large numbers of people working for small employers at risk of losing their jobs. The Government, the blog post argues, should put in place a permanent short-time working scheme for workers at times of economic change, retain the £20 Universal Credit uplift, and invest massively in jobs, including a green recovery package to create 1.24 million green jobs.
After Brexit: Could bilateral agreements facilitate the free movement of persons? – European Policy Centre
This paper by migration law expert Diego Acosta argues that bilateral agreements – between individual EU Member States and the UK – should be explored and examined as a possible alternative to an EU-wide agreement with the UK to facilitate and govern cross-border mobility.
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