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Pharma Pays $825 Million to Doctors and Hospitals, ACA’s Sunshine Act Reveals

November 24, 2014 Comments off

Pharma Pays $825 Million to Doctors and Hospitals, ACA’s Sunshine Act Reveals
Source: Brookings Institution

A not so well-known provision of the Affordable Care Act is the Sunshine Act. The purpose of this act is to increase the transparency in the health care market by requiring doctors, hospitals, pharmaceutical companies, and medical device manufacturers to disclose their financial relationships. Mandated by the Sunshine Act, on September 30th, Centers for Medicare and Medicaid Services (CMS) publicly released the first set of data, under the Open Payments title. This data includes $3.5 billion paid to over half a million doctors and teaching hospitals in the last five months of 2013.

A subset of Open Payments data that is individually identifiable includes two categories of payments. The first category are the payments that are made for other reasons such as travel reimbursement, royalties, speaking and consulting fees and the second are payments which are made as research grants. These datasets together include more than 2.3 million financial transactions which amount to a total of more than $825 million.

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Why a Temporary Immigration Solution is Still Problematic for STEM Workers

November 21, 2014 Comments off

Why a Temporary Immigration Solution is Still Problematic for STEM Workers
Source: Brookings Institution

In 2007 and 2008 when immigration reform failed in Congress, President George W. Bush extended the one-year OPT to 29 months for foreign students who graduated with a bachelor’s degree or higher in STEM fields. In June 2012, President Obama maintained Bush’s 29-month OPT term limit for STEM fields and increased the number of fields eligible for extension by an additional 90 fields.

Based on my research released earlier this year, about 38 percent of all foreign students on F-1 visas, or 362,500, were studying in the STEM fields during the 2008 to 2012 time period. This means that at least 72,500 graduates per year may benefit from this STEM OPT extension.

Yet, this temporary solution is problematic on several fronts.

+ First, it does not offer a direct pathway from earning a degree to permanent residency. If F-1 visa holders want to work beyond their OPT period, their employers must compete for H-1B visas for highly specialized workers. The current visa system still limits the number of H-1B visas to 85,000 for private employers per year, of which 20,000 are set aside for graduates of U.S. universities. While H-1B visas are an option for students, only 35 percent of H-1B visas in 2010 went to former F-1 visa holders, including those extended through OPT.

+ Second, if a foreign student’s employer is able to obtain an H-1B visa and then sponsors a green card application, the wait time for permanent residency can be more than 10 years due to per-country limits (each country can only get 7 percent of all green cards), a problem particularly for Indian and Chinese nationals—two of the largest foreign student populations. This executive action can potentially add more foreign workers into the green card pipeline, creating even longer wait times.

+ Third, there are no minimum wage or salary requirements for foreign student graduates under the OPT program. Unlike the H-1B visa that involves the Department of Labor in ensuring that foreign workers are paid a prevailing wage for their specific occupation, the OPT does not collect wage nor occupational data. OPT is missing these important protections since it was originally created as an educational program to provide a year of work experience, rather than used as an employment-based visa.

See also:
Obama’s Immigration Order Isn’t a Power Grab
Four Realities about Executive Actions; Moving Beyond the Rhetoric of Immigration Reform

Major Decisions: Graduates’ Earnings Growth and Debt Repayment

November 20, 2014 Comments off

Major Decisions: Graduates’ Earnings Growth and Debt Repayment
Source: Brookings Institution

Student debt is becoming the norm for young adults in America. Aggregate student loan debt has more than tripled over the past decade, as both the number of borrowers and the size of the average balance have increased. Today, roughly 70 percent of American bachelor’s graduates leave school with debt. For these borrowers, the typical balance is $26,500—half owe more than this amount and half owe less.

The high incidence of student debt says nothing about whether taking out student loans to pay for college is a good idea. In a previous economic analysis Major Decisions: What Graduates Earn Over Their Lifetimes, The Hamilton Project examined earnings for approximately 80 majors and found that, throughout the entire career, median earnings for every major are higher than those for high school graduates. Differences in earnings reflect both the return to skills acquired in pursuit of a degree and the underlying capability and work ethic of individuals who pursue college education. However, experts agree that for most students, college will pay off by large margins over a lifetime.

But how easily students can repay the loans used to pay for college is another matter. While career earnings tend to grow rapidly for almost every major, student loans are typically repaid in the first decade of the career when earnings are at their lowest. Such a repayment strategy places a particularly heavy burden on graduates whose earnings start low before rising later in their careers. For these students, college likely still pays off in the end, but it may not provide the cash flow needed to easily pay off loans in the years immediately following graduation.

In this second economic analysis in the Major Decisions series, The Hamilton Project turns to the question of loan repayment. The analysis explores the relationship between earnings growth over one’s career and the relative burden of debt repayment across 80 majors. Specifically, we examine the share of monthly earnings needed to make monthly loan repayments for each major under the traditional 10-year repayment plan. Accompanying the analysis is a new interactive feature that combines a debt repayment calculator with major-specific earnings trajectories, allowing the user to see what share of earnings will go to debt repayment for each year of the repayment period.

Drones and Aerial Surveillance: Considerations for Lawmakers

November 18, 2014 Comments off

Drones and Aerial Surveillance: Considerations for Lawmakers
Source: Brookings Institution

The looming prospect of expanded use of unmanned aerial vehicles, colloquially known as drones, has raised understandable concerns for lawmakers.[1] Those concerns have led some to call for legislation mandating that nearly all uses of drones be prohibited unless the government has first obtained a warrant. Privacy advocates have mounted a lobbying campaign that has succeeded in convincing thirteen states to enact laws regulating the use of drones by law enforcement, with eleven of those thirteen states requiring a warrant before the government may use a drone.[2] The campaigns mounted by privacy advocates oftentimes make a compelling case about the threat of pervasive surveillance, but the legislation is rarely tailored in such a way to prevent the harm that advocates fear. In fact, in every state where legislation was passed, the new laws are focused on the technology (drones) not the harm (pervasive surveillance). In many cases, this technology centric approach creates perverse results, allowing the use of extremely sophisticated pervasive surveillance technologies from manned aircraft, while disallowing benign uses of drones for mundane tasks like accident and crime scene documentation, or monitoring of industrial pollution and other environmental harms.

Think Tank 20 — Growth, Convergence, and Income Distribution: The Road From the Brisbane G-20 Summit

November 14, 2014 Comments off

Think Tank 20 — Growth, Convergence, and Income Distribution: The Road From the Brisbane G-20 Summit
Source: Brookings Institution

On November 15-16, world leaders will gather in Brisbane, Australia for the ninth G-20 summit. Leaders are aiming to increase world GDP and chart a pathway to sustainable, inclusive growth and resilience through both short and medium-term actions. In this report, experts from Brookings and around the world address interrelated debates about growth, convergence and income distribution, three key elements that are likely to shape policy debates beyond the Brisbane summit.

The U.S.-Turkey-Israel Triangle

November 7, 2014 Comments off

The U.S.-Turkey-Israel Triangle
Source: Brookings Institution

The confrontation between Israel and Hamas during the summer of 2014 deepened tensions between Israel and Turkey. Now, in the fall of 2014, U.S.-Turkish relations are strained over Turkey’s role in the fight against ISIS, while gaps between the United States and Israel over policies on Iran and Palestine serve as points of friction in the relationship. Clearly the U.S.-Turkey-Israel triangle has suffered many setbacks in recent years on all sides, but the Turkish-Israeli relationship has suffered the most, as it has been in a state of semi-paralysis for the last four years.

Ten Suburbs with the Fastest Growth in Foreign-Born Population since 2000

November 6, 2014 Comments off

Ten Suburbs with the Fastest Growth in Foreign-Born Population since 2000
Source: Brookings Institution

The population of foreign-born residents in the U.S. is increasingly spreading outside the major metropolitan areas and into smaller cities and suburbs throughout the U.S., according to new research by the Metropolitan Policy Program’s Jill Wilson and Nicole Prchal Svajlenka. There are now 41.3 million foreign-born residents in the U.S., accounting for 13.1 percent of the total population, only slightly higher than 13 percent in 2000. However, immigrants are dispersing to new parts of the country, with larger metro areas such as Los Angeles beginning to see a decrease in their foreign-born population while smaller cities and suburban areas, such as Cape Coral, Charlotte, and Nashville, are experiencing significant growth.

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