Do California Legislators Understand What is Driving Rising Health Care Costs?

Based on newly revised Bureau of Economic Analysis data, we find that rising labor compensation for health care workers accounted for $55 billion, or 40%, of the increase in personal health care spending in 2016. By comparison, in May, 2017, we calculated that pharmaceuticals accounted for only $15 billion, or 11% of the rise in personal health care spending in 2016.  In other words, the rising number of health care workers is by far the single most important factor driving higher health care costs.

This simple fact—which has held true every year we have done this analysis—makes us wonder about heavy-handed legislation like California’s SB17, now up for consideration.  The bill would purportedly control rising health care costs by forcing pharma and biotech companies to give 60-day advance notification of most price increases. The bill would also require pharma and biotech companies to give “a description of the specific financial and nonfinancial factors used to make the decision to increase the wholesale acquisition cost of the drug“ – a regulatory requirement levied on almost no other sector of the economy.

In fact, the real health care cost problem in California, as in the rest of the country, is not the cost of pharmaceuticals. The real health care cost driver is that health care employment growth is far outpacing population growth.  In 2016, California health care employment rose by 2.9%, more than four times as fast as the 0.7% increase of the state’s population, as reported by the Census Bureau (below)..  As long as health care employment keeps growing out of control, intrusive bills like SB17 risk doing damage to the pharma and biotech industries without having any significant effect on the cost of health care for patients and employers.  All pain, no gain.

Osborne for the Wall Street Journal: “Charter Schools Are Flourishing on Their Silver Anniversary”

On Sept. 8, 1992, the first charter school opened, in St. Paul, Minn. Twenty-five years later, some 7,000 of these schools serve about three million students around the U.S. Their growth has become controversial among those wedded to the status quo, but charters undeniably are effective, especially in urban areas. After four years in a charter, urban students learn about 50% more a year than demographically similar students in traditional public schools, according to a 2015 report from Stanford’s Center for Research on Education…

 Read more at the Wall Street Journal. 

Osborne for the Philadelphia Inquirer, “These three fast-improving school districts have lessons for Philly”

For almost two decades, education reform has been a source of conflict in the City of Brotherly Love. Much progress has been made, but too much energy is still devoted to fruitless district vs. charter debates. Those invested in such debates should take a look at the nation’s fastest-improving big cities, to see what can happen when conflict turns to collaboration.

The most rapid improvement over the last decade has come in New Orleans, where all but a handful of public schools have been converted to charter schools. Charters are public schools operated independently of the district, with freedom from many state and district rules but accountable for performance. If their children are not learning, they are supposed to be closed or replaced by a stronger operator.

Like Philadelphia, New Orleans has intense poverty: more than 80 percent of its public school students are low-income, and an equal percentage are African American. Yet on two key measures — graduation and college-going rates — New Orleans is the first high-poverty city to outperform its state.

Continue reading at the Philadelphia Inquirer.

Bledsoe for The Hill, “High-paying energy jobs are key for Democrats in 2018”

Clean-energy policies championed by Democrats over the last decade have helped create millions of high-paying energy jobs for American workers. And innovative Democratic policies going forward can help spur millions more good jobs — in energy efficiency, natural gas, nuclear energy, carbon capture, wind, solar, electric vehicles and infrastructure — in coming years.

This record of high-wage job creation stands in stark contrast to Donald Trump’s false coal-dust promises to somehow bring back jobs using 19th century energy strategies.

But, as Democrats look toward the mid-term elections, their candidates must talk about energy in the right way. They must put high-wage energy jobs first, national security gains second and environmental benefits third, to tap into voters’ concerns to garner the electoral benefits their policies deserve.

Continue reading at The Hill.

Disassembling Kodak

Kodak is regularly held up as an example of how a “real” innovation company behaves. For example, a recent New York Times story compared Apple unfavorably to Kodak, saying.

“Think about the contrast between George Eastman, who pioneered fundamental innovations in photography, and Steve Jobs,” Mr. Summers wrote in 2014. “While Eastman’s innovations and their dissemination through the Eastman Kodak Co. provided a foundation for a prosperous middle class in Rochester for generations, no comparable impact has been created by Jobs’s innovations” at Apple.

But the NYT story did not actually look at the number of people employed by Kodak over time, and compare it to the workers employed by by Apple and other tech companies.  So we’ve peered through years of annual reports to start disassembling Kodak.

Kodak was founded in 1888, but it incorporated in 1902 in its “modern” form.  Its worldwide employment peaked at 145K in 1988. At that time, 40% of its workforce was outside the United States. After that point, the company’s workforce fell off sharply, heading towards bankruptcy in 2012 (not shown). Note that there is a gap in reported worldwide employment during the war years. Also, worldwide employment was not reported for 1902 and 1903, and US employment was not reported for 1902.

It took Kodak 51 years to reach 70K employees worldwide, and 65 years to reach 100K employees. By contrast, today’s tech leaders got to those employment levels much faster

Years to reach this workforce
70K 100K
Kodak 51 65
Amazon 16 17
Apple 32 35
Facebook * *
Google 13 *
Microsoft 22 30

 

Here’s some charts that show this difference graphically.  We age-adjust employment by matching Kodak’s date of incorporation, 1902, with the 1981 FY of Apple’s IPO. This charge shows that at year 36, Apple’s workforce is almost triple the size of Kodak’s at the same age

Here are comparable charts for the other tech leaders.

 

 

 

 

How Ecommerce Creates Jobs and Reduces Income Inequality

The last retail revolution, the rise of the big box store, was not a good thing for the typical sales clerk or cashier.

“Warehouse clubs” and “supercenters” started popping up everywhere in the late 1980s. Retail productivity as measured by the government doubled from 1987 to 2007, as this new retail format was more efficient than traditional department stores and mom-and-pop operations, many of which were pushed out of business. Nevertheless, average real wages for
retail workers actually fell from 1987 to 2007, and the pay gap between retail workers and the rest of the workforce widened.

Now comes the ecommerce revolution. Given the bad experience of workers with the last retail revolution, it’s only natural to worry that this one will have an equally bad effect. As of the new first quarter of 2017, ecommerce has less than 9% of retail sales. What will happen to brick-and-mortar retail workers as 10% or 20%of sales move onto the Internet? Are we facing
a retail “apocalypse” that will destroy jobs that employ 15% of the American work.



			

Osborne for the Boston Globe: “A New Paradigm of Public Education”

If we were creating school systems from scratch, would we teach the same way we did 50 years ago, before the advent of personal computers? Would we send children to school for only eight-and-a-half months a year? Would we let schools survive if, year after year, a third of their students dropped out? Would we give teachers lifetime jobs after their third year?

Few of us would answer yes to such questions. And thankfully, public schools are changing, particularly in cities, where the needs are greatest. In Boston, for instance, 86 percent of students are minorities, 45 percent speak English as a second language, 20 percent have disabilities, and 70 percent are “economically disadvantaged.”

Cookie-cutter public schools can’t meet the needs of all these children, so we are innovating. Boston has 27 independent public charter schools, which use their freedom from most district and state rules to create new models that work for inner-city children.

Read more at the Boston Globe. 

An Analysis of Job and Wage Growth in the Tech/Telecom Sector

This paper examines job growth at leading tech/telecom firms. We compare them to leading industrial firms, both in the first half of the 20th century and in the post-war era, and show that they have similar employment trajectories. Then we consider wage and industrial structure trends. We find that real wages in the tech/ telecom sector are higher and rising faster than in the physical sector. To correct for composition effects, we examine detailed occupational categories and find that, for middle-skill occupations such as sales and office support, the tech/telecom sector has significantly higher wages than the physical sector.

This paper incorporates and updates portions of earlier reports and blog posts, including: “A Historical Perspective on Tech Job Growth” (January 2017); “The Creation of a New Middle Class?: A Historical and Analytic Perspective on Job and Wage Growth in the Digital Sector, Part I” (March 2017); and “Do today’s tech/telecom companies employ too few workers?” (June 2017).



			

David Osborne Shares a Sneak Peek of His New Book, ‘Reinventing America’s Schools’

David Osborne’s eyes light up when he talks about proof.

A nationally renowned public policy reformer who is most well known for writing the New York Times bestseller Reinventing Government: How the Entrepreneurial Spirit is Transforming the Public Sector, and who now serves as a director of the forward-thinking Reinventing America’s Schools project at the Progressive Policy Institute, his animated tone and the sparkle in his eye suggest this particular proof is especially compelling.

And not just that, it’s living.

The proof he’s talking about is the significant, life-altering student achievement gains in big cities across the countries, including New Orleans, Denver, and Washington, D.C., which have embraced innovation full force in recent years in an effort to reinvent public education.

In his new book, Reinventing America’s Schools: Creating a 21st Century Education System, which is out September 5 along with an immersive multimedia experience curated in partnership with The 74, David vividly and specifically unpacks his theory of how U.S. education must be redesigned and sketches out a roadmap for cities and policymakers across America to adopt.

Read more at The 74. 

Rotherham for US News, “American Greatness Is Lost on Trump”

The president almost never celebrates the U.S., instead griping about perceived ills.

Here’s something curious and hidden in plain sight: For all his talk about “making America great again,” President Donald Trump spends precious little time actually talking about American greatness. From the campaign to his dark nomination acceptance, a dystopian inaugural address, right up to the present, when is the last time you heard the president talking about the strengths and beauty of America with the frequency or fervor he talks about perceived ills or his critics? A city upon a hill this is not.

Trump tosses rhetorical bouquets at soldiers and first responders, and his scripted Warsaw speech underlined the importance of Western values – but then he came home and continued his off-the-cuff attacks on the media. We get “fire and fury,” but a lot less about our ideals and values. When is the last time you heard the president thank America for the opportunities he and his family enjoyed and enjoy here in this great land today? His wife is an immigrant, yet we hear little of the celebration of how immigrants made and continue to make this land great. He rarely celebrates the rich American story of progress and possibility. Instead, despite all the advantages he’s enjoyed, the president is the man from nope.

Continue reading at U.S. News. 

Indianapolis Grows A 21st Century System: Indianapolis Public Schools Calls for Quality School Partners to Open Innovation Network Schools

In a recent media release, Indianapolis Public Schools (IPS) announced they are looking for “quality partners” to launch innovation network schools for the 2018-2019 school year. IPS explains their innovation school network as a group of “public schools with expanded autonomy to make academic and operational decisions that will maximize student achievement. Innovation schools also expand quality choices for all families.”

In 2014, IPS Superintendent Dr. Lewis Ferebee realized that the centralized policies of IPS prevented principals and teachers from making significant changes in their schools. He began to look for ways to empower them.

Ferebee publicly supported state legislation to allow the creation of innovation network schools. These schools are exempt from the same laws and regulations that charters are exempt from, and they operate outside IPS’s union contracts. The principal and teachers are employed by a nonprofit corporation with its own board, not IPS. Yet all the innovation network schools operate in IPS buildings. They have five-to-seven year performance contracts with the district. If a school fails to fulfill the terms of its contract, the district can terminate it or refuse to renew it, but otherwise it cannot interfere with the school’s autonomy.

There are already 16 innovation network schools, out of 70 total in IPS. They come in four varieties:

  1. New start-ups, some of which are also charter schools.
  2. Existing charter schools that choose to become innovation schools and are housed in district buildings.
  3. Failing district schools restarted as innovation schools.
  4. Existing IPS schools that choose to convert to innovation status.

 

Regardless of the type of innovation network school, all of the schools benefit from full charter-style autonomy. With that autonomy, IPS has seen a growth in the types of schools the district has to offer.

Francis Scott Key Elementary School, a failing district school that became the first innovation school, has focused heavily on creating a culture of parent involvement: the school hires parent advocates, invites parents to regular events at school, and has a breakfast program for fathers and kids. Teachers do home visits before each school year begins.

School 93 is a teacher-run school. Project Restore, a group of teachers who were tired of top-down initiatives created by those far removed from the classroom, had earned a reputation for turning around district schools. Ferebee encouraged them to bring their model to School 93, and the teachers chose to pursue innovation network status for the school.

Global Preparatory Academy is the first dual-language immersion school to be chartered in Indiana. Mariama Carson, the founder of the school, recruited teachers worldwide to get 50 percent native Spanish speakers on staff. Her school is both a charter, authorized by the mayor’s office, and an innovation network school, located in an IPS building. “I thought I would never again work inside a district,” she says, “but I think this way of working inside a district will work for us.”

By embracing school autonomy, IPS has spurred the creation of unique and successful district schools. Soon the charter sector and innovation network schools will educate half of all public school students within IPS’s boundaries.

By calling for new partners to open other innovation network schools, IPS is showing its continued effort to expand the diversity of school designs and its intent to create a 21st century school system.

IPS has decided to open the application process to “attract a broader pool of diverse applicants with innovative ideas.” The call for applicants is open to any non-profit group, charter school operator, or individual. The application can be found here.

Osborne and Langhorne for US News, “Let Schools Judge Teachers”

Since President Obama’s Race to the Top competition made teacher evaluation systems based in part on academic growth a central requirement of winning, most states have mandated them.

Making teachers accountable for student success is a laudable goal, but district-wide approaches don’t usually work. Most teachers regard evaluations as part of a bureaucratic checklist that creates unnecessary paperwork and presents an incomplete picture of the work they do. And recent research shows that in the majority of states, the number of teachers rated “unsatisfactory” remains less than 1 percent, even in struggling school districts.

The data on school performance suggests that it’s far more effective to hold schools accountable for student learning than individual teachers. Districts should replace schools where students are falling too far behind and expand or replicate schools that succeed. If they face such consequences, most schools will figure out how to evaluate their teachers, in ways that fit their cultures and goals.

 

Continue reading at US News.

Fulfillment Centers: The Nodes of a Packet-Switched Physical Distribution Network?

Warning! Wonky post ahead.

At PPI, we are focused on understanding where the new jobs of the future are coming from, and how policymakers can help foster their growth. That sometimes requires identifying underlying trends that may not be obvious.

The growth of multiple networks of ecommerce fulfillment centers–built by retailers such as Amazon, Walmart, Nordstrom and many others–is effectively a transition from “circuit-switched” physical distribution networks to “packet-switched” physical distribution networks. Analogous to the shift from circuit-switched telephone networks to the packet-switched networks that make up the Internet, the new ecommerce distribution networks are capable of much greater flexibility and lower costs than the dumb warehouses which preceded them.

And just like the Internet helped create a wave of new industries in tech hubs, this new “Internet of Goods” is going to enable a new wave of business and job creation in domestic manufacturing and food production. With the right policy, this growth in domestic manufacturing and food production jobs will benefit states across the country.

Background

The old telephone networks were “circuit-switched”–that means the telephone company would set up a separate circuit for each call, and the callers would “own” the circuit until the call was over. The connections were solid, but they were not flexible, and they wasted network resources (since so much of a voice conversation is dead air). By contrast, the multiple networks that make up the Internet break down data (including voice) into packets, which are then routed to their destinations and reassembled.  Packet switching requires a lot more intelligence in the system, but it’s much more flexible and lower cost than circuit switching.

As we’ve seen over the past two decades, the widespread introduction of packet switching in telecom opens up all sorts of possibility for entrepreneurs and existing companies to create new digital products and services. The Internet revolution transformed digital industries, creating millions of jobs in the process. In particular, since December 2007, the tech-ecommerce sector has generated 1.7 million jobs. That’s around half of private sector job growth, outside of health and education.

The old warehouse-retail distribution system was analogous to circuit switching. Big trucks would bring boxes of identical goods from manufacturers or importers. The warehouses would break down the incoming goods into predictable patterns.  All the boxes of identical lamps, for example, would be stored together for easy retrieval when it was time to put together the shipments to individual retail stores.  The shipments were regular and straightforward, and didn’t require much “intelligence” in the networks.

Ecommerce fulfillment centers are much more like the “routing nodes” of the Internet. They take in goods from a wide variety of sources, at irregular interviews, including returns from consumers. They store the goods according to their own internal schema. For example, Amazon uses a “random stow” method that distributes incoming products across the fulfillment center in a way that maximizes the odds of products in the same order being close together. Since most consumers don’t order multiples of the same item, the Amazon random stow method might distribute  the most popular items across the whole fulfillment center, rather than clumping them all together. Then the ecommerce fulfillment center puts together consumer orders and ships them out.

The Internet of Goods

In effect, these multiple networks of fulfillment centers are creating a new packet-switched “Internet of Goods.”  The first economic consequence, as we have described, is the creation of hundreds of thousands of jobs in electronic shopping companies and fulfillment centers. This is analogous to the first wave of Internet growth in the 1990s.

The next step, we believe, will be the creation of new businesses in domestic manufacturing and food production that make use of the flexibility and low cost of the Internet of Goods. For example, we can visualize custom manufacturing operations that are located near fulfillment centers. They take production orders from customers, and then ship out the product on the same day via the fulfillment center. The cost of distribution would go way down compared to today’s situation, giving domestic custom manufacturers a sustainable competitive advantage against foreign rivals.

To get an idea of magnitudes, consider that as  of 2015, 57% of the retail price of furniture was the cost of distribution (transportation, wholesale, and retail).  For women’s clothing, 59% of the retail price was the cost of distribution, and for food, 40% of the retail price was the cost of distribution. Reducing the cost of local distribution while shortening the distribution time could open up new sustainable business models for domestic manufacturers and food producers.

 

 

 

 

 

 

 

 

 

 

 

 

 

Langhorne for The 74, “When Pursuing Education Becomes a Crime, It’s the System That Should Be Scrutinized, Not the Students”

In a recent article, Derrell Bradford mentioned New Jersey and the state’s practice of having off-duty police officers follow students home to make sure the students are attending school in their assigned district.

“When we’ve criminalized the pursuit of a good school, we must ask whether the mission and intent we ascribe to public education are really being served,” Bradford writes.

It is a thought-provoking sentence. I assume that Bradford would have liked for me to think about how children’s ZIP codes are the largest predictor of the type of education they’ll receive (the subject of his excellent article); instead, I thought about Emilio.

Emilio (not his real name) was a student in my 9th grade ESOL (English for Speakers of Other Languages) English class. While I couldn’t claim he was one of my better students or that he possessed a particularly strong work ethic, he was prompt and polite, engaged while in class, and gifted with a wonderful sense of humor.

Prior to reading Shakespeare, the class studied literary devices — pun, oxymoron, simile, etc. I have never seen a student laugh so hard at the sign for “Dry Creek Water Park.”

Around the beginning of February, Emilio told me he would miss next class because his family was moving.

 

Continue reading at The 74 Million.

Rotherham for US News, “Let Kids Experience the Eclipse”

“We are going to be speaking with athletic directors, activity directors and our extended-day programs to keep all activities inside until the duration of the eclipse.”

Yes, that’s one school district’s response to Monday’s rare solar eclipse – visible across the United States. And they’re hardly alone in this reaction. While some school districts are making plans for students to experience this rare natural phenomenon, many are treating it as a menace to be avoided and something to protect students from, like a storm or a criminal on the loose.

When Mark Twain remarked that you should never let your schooling get in the way of your education, this was the kind of thing he had in mind.

 Continue reading at US News.