Recent GAO reports

Budget

Long-Term Budget Outlook: Deficits Matter--Saving Our Future Requires Tough Choices Today, GAO-07-389T, January 23, 2007
      Abstract (html)    Testimony (pdf, 24pp/308kB)

      Main points of testimony by the Comptroller General:

• The current financial condition in the United States is worse than is widely understood.
• The current fiscal path is both imprudent and unsustainable.
• Improvements in information and processes are needed and can help.
• Meeting the long-term fiscal challenge will require (1) significant entitlement reform to change the path of those programs; (2) reprioritizing, restructuring and constraining other spending programs; and (3) more revenues--hopefully through a reformed tax system.
• This will take bipartisan cooperation and compromise.

Drugs

Prescription Drugs: An Overview of Approaches to Negotiate Drug Prices Used by Other Countries and U.S. Private Payers and Federal Programs, GAO-07-358T, January 11, 2007
      Highlights (pdf, 1p/68kB)    Report (pdf, 21pp/252kB)

• Other countries limit their drug purchase costs by such means as: establishing maximum prices manufacturers may charge; using local or international price comparisons of drugs in a therapeutically similar group to establish a single or maximum price; limiting a manufacturer's profits per product or within a specified period of time.
• U.S. private payers generally contract with pharmacy benefit managers to manage prescription drug benefits.
• While adhering to U.S. laws and health care delivery, federal programs utilize elements common to approaches used by other countries and by private payers.

Medicaid Outpatient Drugs: Estimated 2007 Federal Upper Limits for Reimbursement Compared with Retail Pharmacy Acquisition Costs, GAO-07-239R, December 22, 2006
      Abstract (html)    Report (pdf, 31pp/820kB)

      Discusses the new methodology for calculating the federal upper limit (FUL) for drugs, the maximum that state Medicaid programs may receive in federal matching funds for reimbursements. Previously 150 percent of the lowest price for a drug, from Jan. 1, 2007, a drug's FUL will be based on the average manufacturer price.

Education

Highlights of a GAO Forum: Global Competitiveness: Implications for the Nation's Higher Education System, GAO-07-135SP, January 23, 2007
      Highlights (pdf, 1p/68kB)    Report (pdf, 26pp/7.2MB)

Steps the U.S. needs to take to continue to attract talented international students:

• Develop a national strategic plan - to recruit students and improve coordination among the federal government and other organizations as well as with students.
• Consider changes to the U.S. immigration system.
• Explore new sources of students, such as developing countries.

Poverty

Poverty in America: Economic Research Shows Adverse Impacts on Health Status and Other Social Conditions as well as the Economic Growth Rate, GAO-07-344, January 24, 2007
      Highlights (pdf, 1p/56kB)    Report (pdf, 35pp/436kB)

      GAO was asked to review economic literature on the links between (1) poverty and adverse social conditions, such as poor health, crime, and participation in the labor force, and (2) poverty and economic growth.

D.C. beat, e-style

National politics press gets a new online news provider. Recruiting writers from such established press as The Washington Post and launched January 23, The Politico self-described emphasis is "on the 'backstories' -- those that illuminate the personalities, relationships, clashes, ideas and political strategies playing out in the shadows of official Washington."

We will focus on three arenas. The first is Congress and the constant flow of agendas, personalities and power struggles that define daily life on Capitol Hill. The second is the 2008 presidential campaign, a race already churning and one likely to shape history in ways far beyond the typical election. The third is lobbying and advocacy, a part of the capital economy undergoing rapid growth and change.

With a slick, sophisticated look of an east coast news magazine, The Politico offers the expected modern, blog features of permanent links to articles and columns, reader comments interaction, and registered user access to email alerts and participation in chats and forums.

Running on the broadband

A post-election survey by Pew/Internet reports "the number of Americans using the Internet as the source of most of their political news doubled since the last mid-term election." Examining the rate of primary use of news sources (TV, newspapers, radio, Internet, magazines), the survey finds only the Internet steadily increased in popularity . The remaining sources lost in popularity: TV and newspapers the bigger losers reporting political source popularity dropping from 82% to 69% and 57% to 34% respectively, with radio rising from 12% to a high of 19% then dropping to 17%. Magazines lost a 11% popularity among voters to a low of 2%.

The survey also reported:

• 31% of Americans used the internet during the 2006 campaign to get political news and information and discuss the races through email.
• Relatively young broadband users say the internet is a more important political news source than newspapers.
• A new online political elite is emerging as 23% of campaign internet users became online political activists.
• A majority of Internet users now get political material from blogs, comedy sites, government websites, candidate sites, or alternative news sites.
• More than half of campaign Internet users cite the Internet's breadth of information and perspectives as a major reason for their online activity.

Election 2006 Online
(January 2007, pdf, 33pp/308kB)

A system in need of change

The newest installment in the recently published Pathways to Quality Health Care series by the National Academies Press (NAP) bluntly states:

The overall quality of healthcare delivered to Americans is worse than it should be. While many quality improvement efforts have been undertaken, their success has been limited by current payment systems. The existing systems do not reflect the relative value of health care services in important aspects of quality...

Rewarding Provider Performance: Aligning Incentives in Medicare (Pathways to Quality Health Care Series)
(2007, Open Book, NAP, 227pp)

How medical care is organized, financed and delivered is a current concern of The American College of Physicians (ACP) as reported in a Monday Reuters story and voiced in ACP's State of the Nation's Health Care 2007: ACP Releases Comprehensive Reforms to Move towards Patient-Centered Care.

NCLB in Congress

Anticipating that Congress will amend and extend the Elementary and Secondary Education Act which was most recently amended by the No Child Left Behind (NCLB) Act of 2001 (P.L. 107-110), the Congressional Research Service (CRS) issued a report on NCLB reauthorization issues that it believes Congress will focus on:

• Assessments
• Adequate Yearly Progress (AYP)
• Performance based sanctions - which generally apply only to Title I-A schools
• Staff qualifications - regarding "highly qualified teachers"
• Funding levels
• International competitiveness
• Federal role

A Jan. 15 editorial in the Honolulu Advertiser noted, "Last year, 66 percent of public schools in Hawaii failed to meet the AYP requirements under No Child Left Behind...(but) it did show an overall improvement in student proficiency in both math and English." The editorial urges the federal government to allow states to use such student progress as an assessment measure rather than a rigid pass or fail benchmark.

It's unfair to deny students the chance to be measured against this more-forgiving scale. During the next few months, Congress will decide whether to reauthorize the law, or make improvments to it. Considering the stakes--our children's education--making improvements is not an option. It's an obligation.

The No Child Left Behind Act: An Overview of Reauthorization Issues for the 110th Congress, CRS Report RL33749 (pdf, 33pp/196kB, from Open CRS), December 16, 2006

See related FR post: NCLB - Measuring progress

Language access in the Library

In the 2006 session, the Hawaii Legislature passed HB 2778, CD1 (pdf, 7pp/20kB) (Act 290, SLH 2006), which provides for the language access needs of persons with limited English proficiency.

Act 290 has been codified in Part II of chapter 371, Hawaii Revised Statutes, §§371-31 through 371-37. §371-33 requires state agencies to "take reasonable steps to ensure meaningful access to services, programs, and activities by limited English proficient persons, which will be determined by a totality of circumstances..." In response, the Library has acquired dictionaries for the following languages: Chinese, French, German, Ilocano, Italian, Japanese, Korean, and Spanish, adding to the Hawaiian dictionaries already in its collection. All dictionaries may be found in the reference section.

What next? (sounds pretty good)

According to a Pew Research Center report, the coming American generation, Generation Next, is the most comfortable with the tools of technology, more tolerant of different lifestyles (including same-sex couples and marriage), politically more liberal, more global in world view, and less cynical of government and political leaders than previous generations.

The report is drawn from polling data from Sept. 6-Oct. 2, 2006 and includes "extensive generational analysis of Pew Research Center surveys dating back to 1987."

For purposes of this report, Generation Next is made up of 18-25 year-olds (born between 1981 and 1988). Generation X was born between 1966 and 1980 and ranges in age from 26-40. The Baby Boom generation, born between 1946 and 1964, ranges in age from 41-60. Finally, those over age 60 (born before 1946) are called the Seniors...

The report is divided into four main sections: (1) Outlook and World View, (2) Technology and Lifestyle, (3) Politics and Policy, and (4) Values and Social Issues.

How Young People View Their Lives, Futures and Politics:
A PORTRAIT OF "GENERATION NEXT"
(January 9, 2007, pdf, 45pp/160kB)

Summary (available in html)

So far, so so

According to a new Pew Research Center survey, most Americans are "moderately upbeat about their family's financial prospects in the coming year." The survey found a majority expecting a degree of improvement in 2007.

Among the group that says they don't earn enough now, most expect to earn enough in the future to lead the life they want. Just 18% of all employed respondents in the survey say both that they don't make enough now and that they don't expect ever to make enough to have the life they want.

The least optimistic group is 65 and older, mostly retired and mostly feeling "their financial situation will stay-the-course or get worse."

Though moderately optimistic, the majority of survey respondents write the biggest problems they face are financial concerns, and forty percent feel their family's income is falling behind the cost of living. An alarming "four-in-ten (38%) adults and 32% of all workers say they have no retirement plan other than Social Security."

Most Americans Moderately Upbeat About Family Finances in 2007
(January 2007, pdf, 21pp/200kB)

Video watch

The National Institute on Media and the Family issued its 11th annual video game report card at the end of November. The Institute stated:

For the past ten years, we have used this annual report card to challenge the video game industry to improve its record of attending to the welfare of younger players. More recently, we urged retailers to step up to their reponsbility to keep adult games out of the hands of children and youth. This year we acknowledge the strides taken by both sectors of the industry.

In October, the Institute and Iowa State University sponsored the first National Summit on Video Games, Youth and Public Policy at which academics, public health officials, child health advocates and video game industry representatives convened. There the Entertainment Software Rating Board (ESRB) pledged additional funding for ratings education for parents. ESRB ratings include E (Everyone) and E10+ (Everyone 10+).

The report noted:

...some video game makers are focusing on kid-friendly games and technologies. The Nintendo DS, for example, has gained a reputation as a "clean console" because of the vast number of E-rated games it supports, and Microsoft is said to be investing heavily in E and E10+ games.

According to its website, the Institute is "the world's leading and most respected research-based organization on the positive and harmful effects of media on children and youth."

11th Annual Video Game Report Card (pdf, 13pp/84kB), November 28, 2006

See related FR post, Minors and violent, sexual video games, Jan. 06