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2017 Spring President's Update | Manhattan Institute President’s Update Spring 2017 Manhattan Institute President’s Update 2 Spring 2017 Douglas Holtz-Eakin, Tom Coburn, and Paul Howard DEAR FRIENDS AND SUPPORTERS, he American Health Care Act competition—ideas that we are pleased to see (AHCA), on which Congress failed the administration embracing. As adjunct fel- to come to an agreement last low Yevgeniy Feyman explained in an MI paper month, was a disastrous start to earlier this year, the Department of Health and the root-and-branch reform of the Human Services (HHS) can offer states “waiv- Thealthcare system that America needs. Un- ers” from many of the ACA’s most expensive and der the current Affordable Care Act (ACA, or onerous regulations, including the individual Obamacare), premiums for many Americans mandate and the law’s subsidy structure—per- continue to soar as insurers leave the market. mitting policy experiments that can point the Obamacare also remains a burden on eco- way toward broader change. MI senior fellows nomic growth and the creation of new jobs. Tom Coburn and Paul Howard championed this From our point of view, the next iteration of course of action in their USA Today op-ed, “Let reform must go straight to the heart of Amer- States Lead on Replacing Obamacare.” In mid- ica’s healthcare crisis: the lack of a transpar- March, HHS secretary Tom Price took their ad- ent marketplace where providers compete vice, issuing a letter to governors, inviting them based on price and quality. As we celebrate to apply for waivers, which will allow states to our 40th anniversary in 2017, this will be develop innovative health-care models. among MI’s top priorities in our mission to We do not, however, dismiss the pros- “turn intellect into influence.” pect of Congress taking constructive action on Despite the recent setback in Congress, re- health care. To that end, MI fellows have been form can still move forward. Since before the educating policymakers on much-needed sys- inauguration, MI fellows have been promoting temic reforms in many areas. This includes ideas on how the Trump administration can, Medicaid, the federal health-care program for in the absence of new legislation, move toward low-income, elderly, and disabled Americans a health-care system with more choices and that expanded dramatically as a result of the 3 Senate Clears Bill to Ease FDA Drug and Device Approvals Affordable Care Act. As currently administered, ber, helped lay the intellectual groundwork for INNOVATION Medicaid has failed to improve health outcomes this legislation, educating members of Con- POLICY BOOK for recipients—a point that senior fellow Oren gress and the general public about the need to Now Available Cass emphasized in his latest issue brief, “Will develop a faster, safer drug and medical-device Repealing Obamacare Kill People?” In 2015, pipeline. With 21st Century Cures now on the mortality rose more in states that adopted books, its effectiveness in furthering precision Obamacare’s optional Medicaid expansion than medicine tailored to individual patient needs states that didn’t. As Paul Howard explained in will depend on how the FDA will use the tools congressional testimony, giving states greater that are now at its discretion. Project FDA will flexibility in how they manage Medicaid and monitor the implementation of the act, hold- other safety-net spending would better serve ing fast to our core recommendations: shift- our most vulnerable citizens and should be a ing more decision-making power to patients bipartisan priority of the 115th Congress. and physicians by approving new medicines Nor is access the only frontier for import- and medical devices based on early evidence of ant healthcare reform. MI’s health-policy team safety and efficacy, and then monitoring their played a key role in a successful 2016 reform performance in the market. In an essay called initiative focused on removing obstacles to the “Biopharmaceutical Policy for American Lead- development of new drugs and medical devices ership in the 21st Century,” Howard and Huber that can both save lives and reduce costs. With laid out detailed recommendations for em- bipartisan backing, the 21st Century Cures Act powering patients and keeping America at the overhauled the regulatory regime for testing forefront of biomedical innovation. This essay and approving new drugs and devices, bring- appeared in Policy Reforms to Advance Inno- ing review and approval protocols more in line vation, part of the Unleashing Opportunity with what science is making possible. MI’s series of policy books published by the journal Project FDA, led by Paul Howard and Peter Hu- National Affairs. Manhattan Institute President’s Update 4 Spring 2017 Tax reform is among years. With roughly a third of all U.S. air traf- the next top items on fic passing through the New York metropolitan the Trump adminis- area every day, we’ve developed and published tration’s agenda—and specific plans for reforming the Port Author- with good reason. Sim- ity, which oversees airports in the region—as plifying the tax code well as the governance of airports in general. and lowering rates, As infrastructure improvement has become a while keeping spending national priority, MI senior fellow and Harvard down, will be essential economist Edward Glaeser and City Journal to fostering conditions contributing editor John Tierney are showing for stronger economic the right way to do it, starting with the privat- growth. The politics of ization of airports. As many cities across the tax reform, however, globe have demonstrated, when private com- IDEAS FOR are challenging—even with unified party gov- panies take over airports, they are incentivized THE NEW ernment. To keep pressure on policymakers to hold down costs and entice customers with ADMINISTRATION to pursue the public interest in tax and bud- lots of flights, competitive fares, and terminals MI policy memos were get matters, we have brought on a new senior with appealing stores and restaurants. cited roughly 200 times in fellow, Brian Riedl, former chief economist for Replacing a government monopoly with outlets such as Bloomberg, Senator Rob Portman (R-OH). Working in our competition has delivered great advantages in CNN Money, and Politico. The special post election Washington, D.C.-based research division, e21: K–12 education. MI research has long shown video series received more Economic Policies for the 21st Century, Riedl how charter schools, in particular, have opened than 100,000 views. will provide rapid-response commentary as up greater opportunity and improved learning the debate over tax and budget reform unfolds. outcomes for poor and minority students. Already, as an MI fellow Riedl has written a se- When vested interests like teachers’ unions ries of op-eds on topics such as the Trump bud- try to spread misleading information about get, defense spending, and the need to take on educational choice, MI fellows have been at BRIAN RIEDL our unsustainable entitlement programs. the ready with the facts—for example, when The current political climate affords us with unions, politicians, and the New York Times an opportunity to think about energy policy crusaded against the nomination of Betsy DeVos in bold ways. So argued senior fellows Robert as secretary of education, claiming that she Bryce, Oren Cass, and Mark Mills in their con- had undermined public education in her native tributions to MI’s “Ideas for the New Adminis- Michigan through her support of charters. MI tration,” a series of short policy memos that we senior fellow Max Eden coauthored an article released surrounding the inauguration. Their for the journal Education Next, “The Data recommendations included expediting per- on Detroit,” disproving those accusations mitting processes for energy infrastructure, and demonstrating, to the contrary, that the opening up more public lands and waters to charter sector that she supported significantly natural-resource development, expanding and outperforms the traditional district system. In enhancing America’s nuclear sector, expand- his latest report, Eden takes on another issue that ing energy exports, and restructuring federal has had considerable ramifications for minority- energy R&D. Expect our fellows to speak and student success: school discipline. Across the write early and often about the benefits of im- country, school districts have been under plementing these ideas. pressure from the Obama administration to cut Throughout the 2016 campaign, President back on suspensions (on the premise that racial Trump repeatedly spoke about the need to bias has led to disproportionate suspension rates strengthen America’s transportation infra- for blacks and Hispanics). As Eden’s analysis structure, something we’ve written about for of trends in New York City schools shows, the 5 THIS WAY UP SUMMIT Clockwise from top: MI Vice President of Research and Publications Howard Husock, former Michigan governor John Engler, with former commissioner of the New York City Robert Doar; Brandon Chrostowski of the Edwins Leadership Institute and MI senior fellow Oren Cass; City Journal’s Kay Hymowitz; and Speaker of the House Paul Ryan. reduction in suspensions has led to deteriorating bringing people on the margins of society into learning environments, with black and Hispanic the economic mainstream. With the Trump students being the biggest victims (“School administration opening the possibility of new Discipline Reform and Disorder: Evidence from approaches, we teamed up with Opportunity New York City Public Schools, 2012–16”). America, led by former MI fellow Tamar Jaco- by, and several other organizations to host a REINVIGORATING ECONOMIC conference in December 2016: “This Way Up: GROWTH IS A BASELINE Ensuring Economic Mobility for Poor and Mid- “ CONDITION FOR ENCOURAGING dle-Class Americans.” The event included a keynote address by House Speaker Paul Ryan UPWARD MOBILITY AND FOR and featured big-think discussion panels on THAT, WE NEED INNOVATIVE IDEAS issues such as reforming the safety net, mak- ing college work, unemployment, education, ON PROMOTING HUMAN CAPITAL“ AND BRINGING PEOPLE ON THE entrepreneurship, and criminal justice.
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