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Brothers Killing Brothers: The Current Infighting Will Test al Qaeda’s Brand

May 16, 2014 Comments off

Brothers Killing Brothers: The Current Infighting Will Test al Qaeda’s Brand
Source: RAND Corporation

Terrorists often resolve internal disputes the old-fashioned way: They kill each other. Battles between rival rebel groups and within terrorist organizations are not uncommon. Internal feuds have characterized terrorist movements throughout modern history, from the Russian Revolution to the Palestinian civil war.

In February 2014, members of the Islamic State of Iraq and the Levant (ISIL) are believed to have carried out the suicide attack that killed Abu Khaled al-Suri, the leader of a rival coalition of Islamist rebel groups in Syria. In response, Ayman al-Zawahiri took the unprecedented step of publicly expelling ISIL from al Qaeda. An open break like this creates real risks for both ISIL’s and al Qaeda’s leadership, setting up a showdown that could turn an internal dispute into a schism that cleaves across the jihadist universe.

In addition, it could create new intelligence and propaganda opportunities for the United States. If ISIL turns out to be the stronger movement, al Qaeda’s command over the global movement would be seriously weakened. The biggest opportunities for exploiting al Qaeda’s internal disputes may lie in countering al Qaeda’s future recruitment. The prospect of killing or being killed by fellow jihadists ought to be a less-attractive proposition than defending Islam against perceived infidel aggression. However, exploiting the favorable circumstances created by the current divisions requires detailed local knowledge and political-warfare know-how. Pursuing this unprecedented opportunity will require the creation of a dedicated task force to act as a focal point for analysis and action.

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Expanding the Use of Telehealth: Promise and Potential Pitfalls

May 6, 2014 Comments off

Expanding the Use of Telehealth: Promise and Potential Pitfalls
Source: RAND Corporation

Testimony presented before the House Energy and Commerce Committee, Subcommittee on Health on May 1, 2014.

Redirecting Innovation in U.S. Health Care — Options to Decrease Spending and Increase Value

May 6, 2014 Comments off

Redirecting Innovation in U.S. Health Care — Options to Decrease Spending and Increase Value
Source: RAND Corporation

New medical technologies are a leading driver of U.S. health care spending. This report identifies promising policy options to change which medical technologies are created, with two related policy goals: (1) Reduce total health care spending with the smallest possible loss of health benefits, and (2) ensure that new medical products that increase spending are accompanied by health benefits that are worth the spending increases. The analysis synthesized information from peer-reviewed and other literature, a panel of technical advisors convened for the project, and 50 one-on-one expert interviews. The authors also conducted case studies of eight medical products. The following features of the U.S. health care environment tend to increase spending without also conferring major health benefits: lack of basic scientific knowledge about some disease processes, costs and risks of U.S. Food and Drug Administration (FDA) approval, limited rewards for medical products that could lower spending, treatment creep, and the medical arms race.

The authors identified ten policy options that would help advance the two policy goals. Five would do so by reducing the costs and/or risks of invention and obtaining FDA approval: (1) Enable more creativity in funding basic science, (2) offer prizes for inventions, (3) buy out patents, (4) establish a public-interest investment fund, and (5) expedite FDA reviews and approvals. The other five options would do so by increasing market rewards for products: (1) Reform Medicare payment policies, (2) reform Medicare coverage policies, (3) coordinate FDA approval and Centers for Medicare & Medicaid Services coverage processes, (4) increase demand for technologies that decrease spending, and (5) produce more and more-timely technology assessments.

Healing Medical Product Innovation

April 30, 2014 Comments off

Healing Medical Product Innovation
Source: RAND Corporation

No matter how it’s tallied—in total, per capita, or as a percentage of gross domestic product—U.S. spending on health care outstrips that of any other nation. Many experts identify costly new technology as the biggest driver of health care spending. Previous studies aimed at reining in spending on technology have focused on changing how existing medical technologies are used. But what about also encouraging the creation of technologies that could improve health and reduce spending, or that provide large-enough health benefits to warrant any extra spending? A recent RAND study focused on policies that could help change which medical products—drugs, devices, and health information technologies—get invented in the first place.

To spur inventors to create medical products that lower health care spending and promote health, policymakers need to address the perverse financial incentives that lead inventors and investors in the opposite direction. Currently, large profits are most often available from creating increasingly expensive products that boost spending, whether or not they also substantially improve health. In contrast, inventors face relatively weak incentives to create products that would help decrease spending.

The RAND research team developed ten high-priority policy options that could change the costs, rewards, and risks that inventors and investors face. We synthesized information from scientific, trade, and popular literature; conducted interviews with more than 50 national experts from a variety of fields; sought input from a panel of accomplished technical advisors; and developed illustrative case studies of eight medical products.

Recruiting Older Youths Insights from a New Survey of Army Recruits

April 28, 2014 Comments off

Recruiting Older Youths: Insights from a New Survey of Army Recruits
Source: RAND Corporation

Since the advent of the all-volunteer force, little attention has been paid to high school graduates who do not enlist immediately after graduation, primarily those who seek employment in the private sector of the economy. However, over time, this group has made up a significant and increasing portion of total enlistments. However, since 2005, the majority of the Army’s recruits has not joined directly out of high school but has instead made the decision to join at a later time. Why these recruits initially chose not to join when they had the opportunity after graduating from high school and why they changed their minds several years later and enlisted are the subjects of this report. Given the importance of older recruits to the Army, the authors examine what is known about these recruits, their performance during military service, and why they came to join the Army after first choosing another postsecondary path. The results of a survey of 5,000 Army recruits designed to answer this question are presented. Finally, the implications of the survey results are discussed, along with suggestions of ways to gain additional insights by tracking this survey cohort through their Army careers.

The Impact on Federal Spending of Allowing the Terrorism Risk Insurance Act to Expire

April 25, 2014 Comments off

The Impact on Federal Spending of Allowing the Terrorism Risk Insurance Act to Expire
Source: RAND Corporation

Congress enacted the Terrorism Risk Insurance Act (TRIA) in 2002, in response to terrorism insurance becoming unavailable or, when offered, extremely costly in the wake of the 9/11 attacks. The law creates an incentive for a functioning private terrorism insurance market by providing a government reinsurance backstop for catastrophic terrorist attack losses. Extended first in 2005 and again in 2007, TRIA is set to expire at the end of 2014, and Congress is again considering the appropriate government role in terrorism insurance markets.

This policy brief examines the potential federal spending implications of allowing TRIA to expire. Combining information on federal spending through TRIA, the influence of TRIA on the availability of terrorism insurance coverage, and the relationship between uninsured losses and federal disaster assistance spending, the authors find that, in the absence of a terrorist attack, TRIA costs taxpayers relatively little, and in the event of a terrorist attack comparable to any experienced before, it is expected to save taxpayers money.

How Will the Patient Protection and Affordable Care Act Affect Liability Insurance Costs?

April 14, 2014 Comments off

How Will the Patient Protection and Affordable Care Act Affect Liability Insurance Costs?
Source: RAND Corporation

The Patient Protection and Affordable Care Act (ACA) will greatly expand private coverage and Medicaid while making major changes to payment rates and the health care delivery system. These changes will affect traditional health insurers, individuals, and government payers. In addition, a considerable amount of health care is paid for directly by or is indirectly paid for via legal settlements after the care occurs, by liability insurers. This report identifies potential mechanisms through which the ACA might affect claim costs for several major types of liability coverage, especially auto insurance, workers’ compensation coverage, and medical malpractice. The authors discuss the conceptual basis for each mechanism, review existing scholarly evidence regarding its importance, and, where possible, develop rough estimates of the size and direction of expected impacts as of 2016. They examine how each mechanism might operate across different liability lines and discuss how variation across states in legal rules, demographics, and other factors might moderate each mechanism’s operation. Overall, expected short-term effects of the ACA appear likely to be small relative to aggregate liability insurer payouts in the markets in question. However, under reasonable assumptions, some mechanisms can generate potential cost changes as high as 5 percent or more in particular states and insurance lines. The authors also discuss longer-run changes that could be fostered by the ACA that might exert more significant effects on insurance claim costs, including shifts in tort law, changes in physician supply, new pricing approaches under the accountable care organization model, and changes in population health.

EU — The future of public health: A horizon scan

April 10, 2014 Comments off

The future of public health: A horizon scan
Source: RAND Corporation

Public Health England (PHE) commissioned RAND Europe to undertake a horizon scanning study exploring the future of public health and related scientific services. This work was intended to help inform thinking at the strategic level within PHE, firstly in relation to the wider vision of the Agency (which was only established in April 2013) and, secondly, in relation to the proposals for the creation of an integrated public health science hub.

The report is based on a literature review, a brief Delphi exercise using the ExpertLens platform and key informant interviews with a range of PHE staff and external experts. It focuses on the different future public health science needs and the extent to which an integrated science hub could serve PHE as it evolves over the next twenty years. Thus, the report considers PHE’s future remit and objectives in order that decisions about an integrated and co-located science hub be made in context and with reference to expert perceptions about the future.

Improving Interagency Information Sharing Using Technology Demonstrations: The Legal Basis for Using New Sensor Technologies for Counterdrug Operations Along the U.S. Border

April 3, 2014 Comments off

Improving Interagency Information Sharing Using Technology Demonstrations: The Legal Basis for Using New Sensor Technologies for Counterdrug Operations Along the U.S. Border
Source: RAND Corporation

The Department of Defense (DoD) has developed new sensor technologies to support military forces operating in Iraq and Afghanistan. These new capabilities may be useful in counterdrug (CD) operations along the southern U.S. border. DoD has held technology demonstrations to test and demonstrate new technologies along the southern border — because the field conditions along the border closely resemble those in current military theaters of operation and because they can also reveal whether new technologies are useful for CD operations led by domestic law enforcement agencies. However, there are legal questions about whether such technology demonstrations fully comply with U.S. law and whether advanced DoD sensors can legally be used in domestic CD operations when they are operated by U.S. military forces.

In this report, the authors examine federal law and DoD policy to answer these questions. Some parts of U.S. law mandate information sharing among federal departments and agencies for national security purposes and direct DoD to play a key role in domestic CD operations in support of U.S. law enforcement agencies, while other parts of the law place restrictions on when the U.S. military may participate in law enforcement operations. Reviewing relevant federal law and DoD policy, the authors conclude that there is no legal reason why a DoD sensor should be excluded from use in an interagency technology demonstration or in an actual CD operation as long as a valid request for support is made by an appropriate law enforcement official and so long as no personally identifiable or private information is collected. The authors recommend DoD policy on domestic CD operations be formally clarified and that an approval process should be established for technology demonstrations with a CD nexus.

Venture Capital and Strategic Investment for Developing Government Mission Capabilities

April 2, 2014 Comments off

Venture Capital and Strategic Investment for Developing Government Mission Capabilities
Source: RAND Corporation

A wide range of military capability improvement efforts have benefited from development and procurement methods that accommodate urgent operational needs. Changes in the threat environment suggest a need for a fresh examination of the adequacy and suitability of acquisition methods for the coming decade. This report examines one class of acquisition method, known as government venture capital (GVC), or government strategic investment (GSI). The research extracts general observations from previous cases and from a partial economic model of the GSI type of initiative. Taken together, these analyses will help government acquisition managers to judge more thoroughly the suitability of strategic investment methods for motivating future government mission–oriented innovation by private firms.

The report does not explicitly compare GSIs and alternatives for their efficacy in advancing government mission objectives. If it had, it is likely that the main advantage of GSI would be improved access to information about alternative approaches available in the commercial market, resulting from the close relationships the GSI structure engenders between government and business.

A Health Care Puzzler

April 1, 2014 Comments off

A Health Care Puzzler
Source: RAND Corporation

An American Life Panel survey finds that a lack of knowledge about health reform and health insurance is especially acute among the poor, less educated, young, and females. This presents challenges for implementation of the Affordable Care Act.

Markets for Cybercrime Tools and Stolen Data: Hackers’ Bazaar

March 28, 2014 Comments off

Markets for Cybercrime Tools and Stolen Data: Hackers’ Bazaar
Source: RAND Corporation

Criminal activities in cyberspace are increasingly facilitated by burgeoning black markets for both tools (e.g., exploit kits) and take (e.g., credit card information). This report, part of a multiphase study on the future security environment, describes the fundamental characteristics of these markets and how they have grown into their current state to explain how their existence can harm the information security environment. Understanding the current and predicted landscape for these markets lays the groundwork for follow-on exploration of options to minimize the potentially harmful influence these markets impart. Experts agree that the coming years will bring more activity in darknets, more use of crypto-currencies, greater anonymity capabilities in malware, and more attention to encrypting and protecting communications and transactions; that the ability to stage cyberattacks will likely outpace the ability to defend against them; that crime will increasingly have a networked or cyber component, creating a wider range of opportunities for black markets; and that there will be more hacking for hire, as-a-service offerings, and brokers. Experts disagree, however, on who will be most affected by the growth of the black market (e.g., small or large businesses, individuals), what products will be on the rise (e.g., fungible goods, such as data records and credit card information; non-fungible goods, such as intellectual property), or which types of attacks will be most prevalent (e.g., persistent, targeted attacks; opportunistic, mass “smash-and-grab” attacks).

The Structural Genomics Consortium: A knowledge platform for drug discovery

March 27, 2014 Comments off

The Structural Genomics Consortium: A knowledge platform for drug discovery
Source: RAND Corporation

The Structural Genomics Consortium (SGC) supports drug discovery efforts through a unique, open access model of public-private collaboration. This report presents the results of an independent evaluation of the Structural Genomics Consortium, conducted by RAND Europe with the Institute on Governance. The evaluation aimed to establish the role of the SGC within the wider drug discovery and public-private partnership (PPP) landscape, assessing the merits of the SGC open access model relative to alternative models of funding R&D in this space, as well as the key trends and opportunities in the external environment that may impact on the future of the SGC. It also established the incentives and disincentives for investment, strengths and weaknesses of the SGC’s model, and the opportunities and threats the SGC will face in the future. This enabled us to assess the most convincing arguments for funding the SGC at present; important trade-offs or limitations that should be addressed in moving towards the next funding phase; and whether funders are anticipating changes either to the SGC or the wider PPP landscape. Finally, we undertook a quantitative analysis to ascertain what judgements can be made about the SGC’s past and current performance track record, before unpacking the role of the external environment and particular actors within the SGC in developing scenarios for the future.

Lessons for a Negotiated Settlement in Afghanistan — If History Serves as a Guide

March 21, 2014 Comments off

Lessons for a Negotiated Settlement in Afghanistan — If History Serves as a Guide
Source: RAND Corporation

Historical insurgencies that ended in settlement after a stalemate have generally followed a seven-step path. A “master narrative” distilled from these cases could help guide and assess the progress toward a negotiated settlement in Afghanistan.

Democracy in Afghanistan The 2014 Election and Beyond

March 18, 2014 Comments off

Democracy in Afghanistan The 2014 Election and Beyond
Source: RAND Corporation

Afghanistan’s upcoming presidential election is the most important political event in that country’s decade-long transition to democracy. A successful election would be a major blow to the Taliban and al Qaida, and would renew Afghan efforts to bring the war to a favorable conclusion. The defeat of the Taliban in Afghanistan would be a major setback for similar groups worldwide, many of which look to Afghanistan as a sort of template for how to accomplish a jihadist takeover. By contrast, a failed election and a renewed push by the Taliban could become a rallying cry and a morale boost to the same groups. Because the stakes are high, the international community should recognize that, despite a dozen years of frustration and halting progress, Afghanistan’s political and economic reconstruction needs one more push before the milestone election. Helping Afghanistan across the electoral finish line will increase the odds that the country will find some sort of solution to its internal stability and, thus, be able to deny safe haven to al Qaida and its affiliates.

Chinese Engagement in Africa: Drivers, Reactions, and Implications for U.S. Policy

March 17, 2014 Comments off

Chinese Engagement in Africa: Drivers, Reactions, and Implications for U.S. Policy
Source: RAND Corporation

Most analyses of Chinese engagement in Africa focus either on what China gets out of these partnerships or the impacts that China’s aid and investment have had on African countries. This analysis approaches Sino-African relations as a vibrant, two-way dynamic in which both sides adjust to policy initiatives and popular perceptions emanating from the other. The authors focus on (1) Chinese and African objectives in the political and economic spheres and how they work to achieve them, (2) African perceptions of Chinese engagement, (3) how China has adjusted its policies to accommodate often-hostile African responses, and (4) whether the United States and China are competing for influence, access, and resources in Africa and how they might cooperate in the region.

The authors find that Chinese engagement in the region is primarily concerned with natural resource extraction, infrastructure development, and manufacturing, in contrast to the United States’ focus on higher-technology trade and services as well as aid policies aimed at promoting democracy, good governance, and human development. African governments generally welcome engagement with China, as it brings them political legitimacy and contributes to their economic development. Some segments of African society criticize Chinese enterprises for their poor labor conditions, unsustainable environmental practices, and job displacement, but China has been modifying its approach to the continent to address these concerns. China and the United States are not strategic rivals in Africa, but greater American commercial engagement in African markets could generate competition that would both benefit African countries and advance U.S. interests.

Topics in Migration Research (Mexico and Germany)

March 12, 2014 Comments off

Topics in Migration Research
Source: RAND Corporation

With respective emigrant and immigrant stocks that are among the largest in the world, Mexico and Germany are affected by migration like few other countries are. They also exemplify that migratory movements need not be permanent, but are also often less temporary than initially assumed. This dissertation explores topics related to the determinants and consequences of migration in these two countries.

How Big is the U.S. Market for Illegal Drugs?

March 11, 2014 Comments off

How Big is the U.S. Market for Illegal Drugs?
Source: RAND Corporation

Using data from 2000 to 2010, RAND researchers estimated the number of users, expenditures, and consumption for four illicit drugs: cocaine (including crack), heroin, marijuana, and methamphetamine (meth).

See also: What America’s Users Spend on Illegal Drugs 2000–2010

Using Early Childhood Education to Bridge the Digital Divide

March 7, 2014 Comments off

Using Early Childhood Education to Bridge the Digital Divide
Source: RAND Corporation

Technology literacy plays an important role in a child’s ability to succeed in school and later life. Yet, despite rapid growth in society’s use of digital technology, many children in low-income families in the United States are not able to access and use technology in the same ways as their more-advantaged peers. This means they have fewer opportunities to learn, explore, and communicate digitally, and fewer chances to develop the workforce skills they will need to succeed in later life. Early childhood education can play a valuable role in ensuring that low-income children can access technology and learn how to use it. However, there are a number of important issues that need to be addressed. This Perspective frames a discussion on these subjects by exploring the role of early childhood education in bridging the digital divide. We highlight five key questions that need to be considered in the discussion of integrating technology into early childhood education.

Countering Others’ Insurgencies: Understanding U.S. Small-Footprint Interventions in Local Context

February 28, 2014 Comments off

Countering Others’ Insurgencies: Understanding U.S. Small-Footprint Interventions in Local Context
Source: RAND Corporation

This study examines the counterinsurgency strategies and practices adopted by threatened regimes and the conditions under which U.S. “small-footprint” partnerships are likely to help these governments succeed. The report’s findings are derived from a mixed-method research design incorporating both quantitative and qualitative analysis. Simple statistical analyses are applied to a dataset of counterinsurgencies that have terminated since the end of the Cold War (72 in all), and more in-depth analyses are provided of two recent cases of U.S. partnerships with counterinsurgent regimes, in the Philippines and Pakistan. The quantitative analysis finds that the cases of small-footprint U.S. operations that are commonly touted as “success stories” all occurred in countries approximating a best-case scenario. Such a verdict is not meant to deny the importance of U.S. assistance; rather, it is meant to highlight that similar U.S. policies with less promising partner nations should not be expected to produce anywhere near the same levels of success. The majority of insurgencies have taken place in worst-case conditions, and in these environments, counterinsurgent regimes are typically unsuccessful in their efforts to end rebellion, and they often employ violence indiscriminately. The case studies of the Philippines and Pakistan largely reinforce the findings of the quantitative analysis. They also highlight the challenges the United States faces in attempting to influence partner regimes to fight counterinsurgencies in the manner that the United States would prefer. The study concludes with policy recommendations for managing troubled partnerships.

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