Archive
Hedge Funds and Systemic Risk
Source: RAND Corporation
Hedge funds are a dynamic part of the global financial system. Their managers engage in innovative investment strategies that can improve the performance of financial markets and facilitate the flow of capital from savers to users. Although hedge funds play a useful role in the financial system, there is concern that they can contribute to financial instability. The collapse of Long-Term Capital Management (LTCM) in 1998 raised awareness that hedge funds could be a source of risk to the entire financial system. Hedge funds also invested heavily in many of the financial instruments at the heart of the financial crisis of 2007–2008, and it is appropriate to ask whether they contributed to the crisis. This report explores the extent to which hedge funds create or contribute to systemic risk (that is, the risk of a major and rapid disruption in one or more of the core functions of the financial system caused by the initial failure of one or more financial firms or a segment of the financial system) and the role hedge funds played in the financial crisis, the consequences of the 1998 failure of LTCM, and whether and how the Dodd-Frank Wall Street Reform and Consumer Protection Act of 2010 addresses the potential systemic risks posed by hedge funds.
U.S. Overseas Military Presence: What Are the Strategic Choices?
U.S. Overseas Military Presence: What Are the Strategic Choices?
Source: RAND Corporation
Since World War II, the United States has relied on a global network of military bases and forces to protect its interests and those of its allies. But the international environment has changed greatly over the decades, and economic concerns have risen, leading some to debate just what America’s role should now be in the world. This monograph addresses one aspect of this debate by introducing a new analytical approach to defining future U.S. military presence overseas. It does so by first considering U.S. global security interests, then focusing on specific threats to them in East Asia, Europe, and the Middle East. With that, the researchers designed a menu of global postures based on different strategic perspectives. They evaluated the global postures in terms of their operational performance and then compared them in terms of their associated U.S. Air Force bases, combat forces, active-duty personnel, and base operating costs. These analyses offer insights on the critical strategic choices that policymakers need to address and that the public needs to debate as they consider future overseas U.S. military presence. Among these choices are for the United States to depend more on its allies, rely more on U.S. based military forces, focus its presence more on East Asia or on the Middle East, or retain its current overseas presence in the face of expanding threats. Those involved in debates on the future global U.S. posture will need to make explicit their implicit underlying perspectives on what role overseas military presence can play in achieving U.S. global security interests.
When Patients Don’t Take Their Medicine: What Role Do Doctors Play in Promoting Prescription Adherence?
When Patients Don’t Take Their Medicine: What Role Do Doctors Play in Promoting Prescription Adherence?
Source: RAND Corporation
Analyses indicated that although physicians uniformly felt responsible for assessing and promoting adherence to prescriptions, only a minority of them asked detailed questions about adherence.
The U.S. Drug Policy Landscape; Insights and Opportunities for Improving the View
The U.S. Drug Policy Landscape; Insights and Opportunities for Improving the View
Source: RAND Corporation
Discussions about reducing the harms associated with drug use and antidrug policies are often politicized, infused with questionable data, and unproductive. This paper provides a nonpartisan primer that should be of interest to those who are new to the field of drug policy, as well as those who have been working in the trenches. It begins with an overview of problems and policies related to illegal drugs in the United States, including the nonmedical use of prescription drugs. It then discusses the efficacy of U.S. drug policies and programs, including long-standing issues that deserve additional attention. Next, the paper lists the major funders of research and analysis in the area and describes their priorities. By highlighting the issues that receive most of the funding, this discussion identifies where gaps remain. Comparing these needs, old and new, to the current funding patterns suggests eight opportunities to improve understanding of drug problems and drug policies in the United States: (1) sponsor young scholars and strengthen the infrastructure of the field, (2) accelerate the diffusion of good ideas and reliable information to decisionmakers, (3) replicate and evaluate cutting-edge programs in an expedited fashion, (4) support nonpartisan research on marijuana policy, (5) investigate ways to reduce drug-related violence in Mexico and Central America, (6) improve understanding of the markets for diverted pharmaceuticals, (7) help build and sustain comprehensive community prevention efforts, and (8) develop more sensible sentencing policies that reduce the excessive levels of incarceration for drug offenses and address the extreme racial disparities. The document offers some specific suggestions for researchers and potential research funders in each of the eight areas.
Identifying Barriers to Diversity in Law Enforcement Agencies
Identifying Barriers to Diversity in Law Enforcement Agencies
The authors describe how law enforcement agencies can use barrier analysis, a method of assessment aimed at identifying potential obstacles to obtaining resources or participating in a program, to better understand and address the challenge of creating diversity among their personnel. They examine key points in the career lifecycle, such as recruitment, hiring, promotion, and retention practices, to determine where women and racial/ethnic minorities face obstacles that might account for less-than-proportionate representation among applicants, hires, and senior leadership. They describe the barrier analysis process, illustrate how it can help law enforcement agencies increase the diversity of their workforce, and present case studies featuring police departments that have used barrier analysis.
Health and wellbeing at work in the United Kingdom
Health and wellbeing at work in the United Kingdom
In 2009, the Work Foundation led a partnership with RAND Europe and Aston Business School undertaking the research and analysis to support the Boorman review. RAND Europe led the study on whether health workplace interventions could be useful to mitigate health risk factors and to reduce the work-related costs associated with poor health and wellbeing in British workplaces and the NHS in England. This report, prepared for the Department of Health, presents the main findings of the research.
Should the Increase in Military Pay Be Slowed?
Should the Increase in Military Pay Be Slowed?
Source: RAND Corporation
Conditions are favorable for slowing the increase in military pay. Recruiting and retention are in excellent shape, and manpower requirements are planned to decrease. Basic pay grew 45 percent from 2000 to 2011, more than the Employment Cost Index (ECI) (up 33 percent) and the Consumer Price Index (CPI) (up 31 percent). Regular military compensation (RMC) grew even more. After adjusting for inflation, RMC grew an average of 40 percent for enlisted members and 25 percent for officers. RMC growth was higher because of increases in the basic allowance for housing. RMC is above the benchmark of 70th percentile of civilian pay and stands at the 80th percentile or higher for enlisted personnel and officers with a bachelor’s degree and the 75th percentile for officers with more than a bachelor’s. The authors discuss several approaches to slowing the rate of increase in military pay: (1) A one-time increase in basic pay set at half a percentage point below the ECI, (2) a one-year freeze in basic pay, and (3) a series of below-ECI increases, such as ECI minus half a percentage point for four years. The first option has lower cost savings, leaves open possible further action, yet may create more uncertainty about future pay changes. The second and third options provide several times more cost savings but may be politically more costly.
Improving School Leadership Through Support, Evaluation, and Incentives: The Pittsburgh Principal Incentive Program
In 2007, the Pittsburgh Public Schools (PPS) received funding from the U.S. Department of Education’s Teacher Incentive Fund (TIF) program to implement the Pittsburgh Urban Leadership System for Excellence (PULSE), a set of reforms designed to improve the quality of school leadership throughout the district. A major component of PULSE is the Pittsburgh Principal Incentive Program (PPIP), a system of support, performance-based evaluation, and compensation with two major components: (1) an annual opportunity for a permanent salary increase of up to $2,000 based primarily on principals’ performance on a rubric that is administered by assistant superintendents and that measures practices in several areas and (2) an annual bonus of up to $10,000 based primarily on student achievement growth. The district also offered bonuses to principals who took positions in high-need schools. PPIP provided principals with several forms of support. This report examines implementation and outcomes from school years 2007–2008 through 2010–2011, with a focus on understanding how principals and other school staff have responded to the reforms, and on documenting the student achievement outcomes that accompanied program implementation.
India’s and Pakistan’s Strategies in Afghanistan: Implications for the United States and the Region
India’s and Pakistan’s Strategies in Afghanistan: Implications for the United States and the Region
Source: RAND Corporation
India and Pakistan have very different visions for Afghanistan, and they seek to advance highly disparate interests through their respective engagements in the country. Pakistan views Afghanistan primarily as an environment in which to pursue its rivalry with India. India pursues domestic priorities (such as reining in anti-Indian terrorism, accessing Central Asian energy resources, and increasing trade) that require Afghanistan to experience stability and economic growth. Thus, whereas Pakistan seeks to fashion an Afghan state that would detract from regional security, India would enhance Afghanistan’s stability, security, economic growth, and regional integration. Afghanistan would welcome greater involvement from India, though it will need to accommodate the interests of multiple other external powers as well. India has a range of options for engaging Afghanistan, from continuing current activities to increasing economic and commercial ties, deploying forces to protect Indian facilities, continuing or expanding training for Afghan forces, or deploying combat troops for counterterrorism and counterinsurgency missions. To avoid antagonizing Pakistan, India is likely to increase economic and commercial engagement while maintaining, or perhaps augmenting, military training, though it will continue to conduct such training inside India. Increased Indian engagement in Afghanistan, particularly enhanced Indian assistance to Afghan security forces, will advance long-term U.S. objectives in central and south Asia. As the United States prepares to withdraw its combat forces from Afghanistan in 2014, it should therefore encourage India to fill the potential vacuum by adopting an increasingly assertive political, economic, and security strategy that includes increased security assistance.
Identifying a Cost-Effective Aviation Fleet for the U.S. Forest Service
Identifying a Cost-Effective Aviation Fleet for the U.S. Forest Service
Source: RAND Corporation
Wildfires are dangerous and costly. They threaten population centers and wildlife habitats, degrade watersheds, and contribute to air pollution. At the same time, they are a natural part of the ecosystem in much of the American West. The cost of fighting these fires has risen dramatically over the past decade — to an average of $1.65 billion annually.
The U.S. Forest Service currently operates an aging fleet of contracted fixed-wing airtankers that provide aerial support for wildland firefighting. After two fatal crashes in 2002 led to more than half of the fleet being taken out of service, the Forest Service sought to replace its fleet with newer, safer aircraft. In support of this effort, the agency asked RAND to determine the composition of a fleet of airtankers, scoopers, and helicopters that would minimize the total social costs of wildfires, including the cost of large fires and aircraft costs.
Is Inclusionary Zoning Inclusionary? A Guide for Practitioners
Is Inclusionary Zoning Inclusionary? A Guide for Practitioners
Inclusionary zoning (IZ) has become an increasingly popular tool for providing affordable housing in an economically integrative manner. IZ policies typically require developers to set aside a proportion of units in market-rate residential developments to be made affordable for lower-income households in exchange for development rights or zoning variances. These policies are considered “inclusionary” because they are intended to allow lower- and moderate-income households to buy or rent property in middle- and upper-income communities. This report examines 11 IZ programs across the United States to determine the extent to which the policies serve lower-income families and provide IZ recipients with access to low-poverty neighborhoods and residentially assign them to high-performing schools, thereby promoting the academic achievement and educational attainment of their children. It also considers ways in which IZ policies vary and how different design features might affect the success of the programs in promoting affordable housing and social inclusion for IZ recipients. Finally, it identifies key program-design aspects that shape the potential to meet the goals of providing affordable housing to low-income households and promoting social inclusion for IZ recipients.
Healthcare Coverage and Disability Evaluation for Reserve Component Personnel: Research for the 11th Quadrennial Review of Military Compensation
Because Reserve Component (RC) members have been increasingly used in an operational capacity, among the policy issues being addressed by the 11th Quadrennial Review of Military Compensation (QRMC) is compensation and benefits for the National Guard and Reserve. As part of the review, RAND was asked to analyze healthcare coverage and disability benefits for RC members, including participation in the TRICARE Reserve Select (TRS) program, the potential effects of national health reform on coverage rates, and disability evaluation outcomes for RC members. This report summarizes the results of RAND’s analysis. The author finds that 30 percent of RC members lack health insurance to cover care for non–service-related conditions. The TRS program offers the option of purchasing health insurance through the military on terms that are superior to typical employer benefits. Although program participation has increased, it remains low and TRS does not appear to be effectively targeting those most likely to be uninsured. TRS premiums are also lower than the premiums for the new options that will be available under health reform and the same as the penalty for not being insured. So health reform is likely to increase TRS enrollment. Finally, previously deployed RC members are referred to the Disability Evaluation System at a much lower rate than Active Component (AC) members, even for deployment-related conditions, but those who are referred receive dispositions (and thus benefits) similar to those for AC members. These findings suggest that the Department of Defense may want to consider ways to better coordinate TRS with other insurance options that will be available to RC members and that the identification of RC members who experience health consequences from deployment leading to disability merits further investigation.
Nurse Practitioners and Sexual and Reproductive Health Services: An Analysis of Supply and Demand
Nurse Practitioners and Sexual and Reproductive Health Services: An Analysis of Supply and Demand
Source: RAND Corporation
Use of Sexual and Reproductive Health (SRH) services is projected to grow between 10 and 20 percent from 2006 to 2020. This growth is driven largely by changes in the racial/ethnic make-up of the population of women of reproductive age and an increase in the number of people with insurance coverage because of new health care legislation.
Trends in supply and demand for SRH services, particularly for low-income individuals, suggest demand will outstrip supply in the next decade. Nurse Practitioners (NPs) with a women’s health focus are key providers of SRH care in Title X-funded clinics, which deliver a significant proportion of U.S. family planning and SRH services to low-income populations. This report looks at why numbers of women’s health NPs (WHNPs) have been declining, and are projected to continue to decline, despite significant growth in total numbers of NPs. Barriers to increasing the supply of NPs competent in SRH care — such as reduced funding for WHNP training, increased funding for primary care and geriatric NP training, and a shrinking proportion of WHNPs choosing to work in public health, clinics, and family planning — are identified.
From the standpoint that the evolution of the health care delivery system may serve as an opportunity to optimize the delivery of SRH services in the United States, a comprehensive set of options spanning education, federal and state regulations, and emerging models of care delivery are explored to reverse this trend of too few WHNPs, particularly for servicing Title X facilities and their patients.
New Challenges to U.S. Counterterrorism Efforts: An Assessment of the Current Terrorist Threat
New Challenges to U.S. Counterterrorism Efforts: An Assessment of the Current Terrorist Threat
Source: RAND Corporation
Testimony presented before the Senate Homeland Security and Governmental Affairs Committee on July 11, 2012.
Skin in the Game: How Consumer-Directed Plans Affect the Cost and Use of Health Care
Skin in the Game: How Consumer-Directed Plans Affect the Cost and Use of Health Care
Source: RAND Corporation
If half of Americans with employer-sponsored insurance switched from a traditional health plan to a consumer-directed health plan, annual health care costs would fall by an estimated $57 billion.
Improving Medical and Dental Readiness in the Reserve Components
Improving Medical and Dental Readiness in the Reserve Components
Source: RAND Corporation
Describes options for Department of Defense policy that would help the reserve components of the U.S. military achieve higher levels of individual medical readiness, including dental readiness.
Further study on the affordability of alcoholic beverages in the EU: A focus on excise duty pass-through, on- and off-trade sales, price promotions and statutory regulations
Source: RAND Corporation
Policies related to alcohol pricing, promotion and discounts provide opportunities to address harms associated with alcohol misuse. However, there are important gaps in information and knowledge about the regulations in place across parts of Europe and their impacts on consumer prices and locations of purchase.
Using market data, we explored the overall scale and trend of price promotions and discounts in the off-premise (e.g. supermarket) and on-premise (e.g. restaurants, pubs) across five EU Member States. To better understand the factors that may influence sales in the on- vs. off-premises, we performed regression analysis for four EU Member States with relevant data. This found that increases in broadband penetration and population density were associated with relatively higher levels of off-premise alcohol purchases and that increases in income were associated with relatively higher levels of on-premise purchases of alcohol. There was no statistically significant relationship for female higher education.
We further used time-series methods, drawing on data for Ireland, Latvia, Slovenia and Finland, to estimate the impact of changes in excise duty on price (‘pass-through’). This showed that a €1 increase in excise duty increased beer prices by €0.50-€2.50 in the off-premise, and increased spirits prices by €0.70-€1.40 in the off-premise. These findings suggest that, depending on the price sensitivity of consumers and other strategies employed by suppliers (e.g. advertising), changes in excise duty may be an effective instrument to reduce harmful alcohol consumption.
Which Path Leads to Cost Containment: Selection or Reputation?
Current initiatives to report health care provider costs are unlikely to motivate consumers to select lower-cost providers. Public reports could better engage consumers by focusing on out-of-pocket costs and high-value providers.
Medicines as a Service: A New Commercial Model for Big Pharma in the Postblockbuster World
Medicines as a Service: A New Commercial Model for Big Pharma in the Postblockbuster World
Source: RAND Corporation
The past decade has not been kind to large pharmaceutical companies. Their share prices have been lagging the market after many years of outperforming it. Many had to undergo painful restructuring and workforce reductions because their traditional blockbuster model is becoming extinct. More and more top-selling drugs are being replaced by cheap generics, and developing new drugs is more difficult because fewer opportunities exist and more-costly research and development (R&D) productivity has declined. Although this diagnosis is not disputed, the best course of treatment is not clear. Companies have tried to stop the bleeding with the help of mergers and reorganizations and infused new blood by acquiring biotech companies or their innovative products or by diversifying into products other than prescription drugs. In this paper, the authors propose that the pharmaceutical industry can reconfigure its considerable resources to develop innovative and meaningful business models that are based on services that improve access and adherence to prescription drugs for chronic conditions. They argue that such innovation beyond drug development is consistent with the core capabilities of large pharmaceutical companies and has the potential to achieve profit levels similar to those of its traditional models. Their argument is based on the fact that, although effective medicines for most chronic conditions exist, access and adherence to medicines is far from what would be needed to achieve full treatment efficacy. Therefore, value can be created by getting and keeping more patients on their drugs, and innovative business models would allow pharmaceutical companies to capture that value.
A New Look at Gender and Minority Differences in Officer Career Progression in the Military
Although military accessions of women and minorities have increased over time, the proportions of these groups in the senior officer corps remain relatively low. RAND research conducted in the late 1990s found that, on net, white and Hispanic women entering the officer ranks were less likely to achieve the field grade level (O4) than were white men, while black women had the same likelihood of achieving O4 as white men, and black men had a greater likelihood. This volume updates the earlier RAND study by tracking the promotion and retention of personnel who entered the officer ranks between 1971 and 2002 through the rank of O6, using data from January 1988 through September 2010. The newer data enables the researchers to investigate differences later in the career and to consider differences for Hispanic officers and other minorities. The authors discuss their findings in relation to those of the earlier study.This updated study also examines the career progression of women serving in military occupations that are partially closed to them — that is, occupations that are deemed open to women but that have some positions for which assignment of women is restricted. The authors find no statistically significant difference between the career progression of women in partially closed versus open occupations, relative to the differences among men serving in the same occupations.
