"An Outsourced Staff" --Cicero Institute and Homelessness Policy

A number of posts have discussed the conservative movement.

Ellen Barry and Jason DeParle at NYT:

A team from the Cicero Institute, an upstart think tank, flew to Indiana this year to help make it a crime for homeless people to sleep on the street.

It was their third attempt. Even in the conservative state, previous efforts to ban street camping had failed. Catholic leaders said the measure would hurt the poor, and sheriffs had warned that arrests would crowd the jails. “We’re Hoosiers — we’re better than that,” a Republican state senator, Ron Alting, said last year, urging a more caring approach.

But much had changed since the group, founded by Joe Lonsdale, a billionaire ally of President Trump’s, had made its initial efforts. Mr. Trump had issued an executive order on homelessness that so fully reflected Cicero’s agenda it was hard to tell 
where the group stopped and White House policy began. The sponsor of the Indiana law was fresh from a Cicero conference, Cicero lobbyists worked the bill, and three Cicero analysts testified that the threat of arrests would push homeless people into treatment for mental illness or addiction.

The ban passed just before the legislature adjourned.

...

With few rival groups working on homelessness, the institute had its lane. After Texas passed a statewide camping ban in 2021, Cicero made it into a model bill to take to other states.

Cicero was too small to matter in Washington, but about two dozen states had Republican control of the legislature and governorship. For harried legislators frustrated by encampments, Cicero’s bill offered a stance. And with no housing or services included, it required no spending.

“In most states, state legislators don’t even have policy staff,” explained Jared Meyer, an early Cicero recruit, on Mr. Lonsdale’s podcast. “The best thing you can do is be an outsourced staff.”

Implementation and Public Groceries

Many posts have discussed public administration.

New York's Mayor Mamdani wants to set up public grocery stores.  As usual, good intentions crash into the reality of implementation.

California businessman Nick Kokonas at X:

I downloaded and reviewed NYC's grocery store RFP... as someone who has built biz's and bought a lot of food... wow.

Forget for a moment whether or not the govt should own a grocery store. Let's review the doc instead. Here you go... /1

NYC strongly prefers bidders who commit to all 5 stores. But 3 of the 5 sites haven’t been identified. Bidders are supposed to price unknown stores in unknown neighborhoods by assuming they’re “about 15,000 sq ft.” Absurd.

Bidders get preference for operating all 5 stores, presumably b/c scale lowers costs. But NYC awards each store separately, so an all-5 bidder may win only 1. They want scale pricing while refusing to award scale.

The stores must use a “limited SKU” model. They must also carry full grocery departments, household goods, culturally specific products, plus kosher, halal, vegan, gluten-free, dairy-free and diabetic options. Pick one.

The RFP says stores won’t have deli counters or on-site food prep. Then its Core Basket includes chicken salad, egg salad, potato salad, fruit salad and other deli-prepared foods. So, a deli w/o a deli. Oh... you're going to ship them in every day prepared. Gotcha...

NYC chooses and pays for the design, equipment, refrigeration and fitout. The operator pays utilities, maintenance, cleaning and security. So NYC makes the capital decisions while someone else pays for the consequences. That's how they control the goalposts.

The “best” bid promises 30% discounts, best-in-class wages/benefits, local sourcing, sustainability, community programs and full-time jobs. Then 20% of the score goes to whoever claims they need the least subsidy. Lowballing is the strategy.... and then cost overruns are guar.

Core Basket discounts must be universal “sticker prices,” not promotions. Then the operator must create a membership card to “implement the discount program.” Which is it? Universal shelf price or an ID card system -- btw, also says it's available to all people...

and it doesn't even properly target their goals b/c the subsidy isn’t targeted. No means test. Anyone can shop there. So taxpayers will subsidize groceries for affluent shoppers who happen to live nearby, while needy families elsewhere get zero.

I always *thought* that this was a terrible idea. They could much better help people with $$ and hey, there are already programs that they could expand. But after reading -- now I *know* it's a ridiculous idea. We have an efficient system... just change the outcomes.

so naturally one asks -- why would they *want* to build crappy grocery stores that have conflicting goals and will be mismanaged? Because either that's the goal... or else they have no idea how to actually craft an RFP or run a business.

Policy Schools Are Short on Conservative Voices

Many posts have discussed the politics of colleges and universities in the United States.

Frederick Hess at AEI:

It’d be good for everyone if there were a deeper bench of Republican policy professionals who really knew how government works. That’s why it’s such a big problem that the nation’s public policy schools serve as owned-and-operated subsidiaries of the Democratic Party.

Faculty at leading programs lean lopsidedly to the left; unsurprisingly, they emphasize predictable priorities, such as prison reform, homelessness, or healthcare. The technocratic progressives are joined by colleagues who go further still, recasting policy debates in identity-driven and baldly ideological terms to “expose” systemic racism and the evils of U.S. capitalism.

Right-leaning priorities are routinely marginalized or dismissed as backward-looking, as is the case with immigration enforcement, entitlement reform, educational choice, or tax-cutting. As a result of this bias, a broad swath of aspiring conservative policy professionals has sensibly opted to avoid these programs altogether. The result: Republicans are short on skilled policy professionals, while left-leaning students and scholars operate in a blue bubble in which they too rarely engage with those who think differently.

Reflecting on Covid

Many posts have discussed COVID and pandemic preparedness.

Stephen Macedo and Frances Lee, In COVID's Wake:  How Our Politics Failed Us (Princeton University Press, 2025), 197, 199, 294.

The central message of this book is that several tenets of basic rationality evaporated under the stress of the Covid onslaught. One of the greatest failures, as we have shown, was the failure to weigh the expected costs of policy against the expected benefits. Such failures were evident in government advising processes, as well as outside government in news media coverage and academic analysis. These failures occurred despite the public health field’s substantial investment in developing pandemic plans before 2020.  These pre-2020 pandemic plans correctly anticipated many of the costs and ethical dilemmas that emerged during the Covid pandemic response. But such considerations played  little role in informing discussion about what to do in 2020. Previously untested, unproven policies were implemented  wholesale across society in earnest hope of benefits, heedless of costs.

...

 The pandemic response also raises some other troubling concerns about the quality of democratic deliberation involved. Pandemic policy seems to have been driven by a profound form of short-term bias. Any benefits of the policies in delaying infection and death were top of mind for policymakers. For many months, national newspapers, cable news outlets, and even local news led their daily coverage with the latest num-bers of Covid infections, hospitalizations, and deaths. Meanwhile, in almost all cases, the costs were much less vis i ble and experienced at some delay. Many of  these second-  and third-order costs—for education, mental health, cancer diagnoses, social disorder—unfolded only over lengthy timelines and emerge clearly only in hindsight. Clearly, democracies are likely to struggle with any policies having  these features, as political incentives for elected officials are to attend predominantly to the short term and to discount the long term.

...

Experts, including scientific experts, play an important role in the policy  process, but it is also of necessity a  limited role. Experts must stay in their lane, so to speak. We must be more willing to engage in  political deliberation, including or especially with  those on the other side of the political spectrum. American democracy is defined deeply by polariza-tion based on having (or not having) a four-year college degree; educational polarization, in turn, has the unfortunate but unmistakable effect of placing the weight of the experts on one side of the partisan divide. A rebalancing of the role of experts could help address that tendency. At minimum, we have relearned that it is important to listen to more than one kind of expert in formulating policy on complex, society-wide issues. We must also not forget that experts tend to come from well-off positions in society and can be oblivious to their class biases

Policy Schools Have Few Conservative Faculty Members

 Frederick M. Hess and Riley Fletcher at the Manhattan Institute:

Setting aside concerns about the broader shape of the American professoriate, we examined faculty at leading public affairs programs, where faculty focus explicitly on government, civic leadership, and public policy. Among the 10 programs and 443 teaching faculty members who had identifiable affiliations, those with left-leaning affiliations outnumbered their right-leaning counterparts 7-to-1.

The leftward tilt was more pronounced among tenure-track faculty than among limited-term faculty, but the progressive lean was still 6-to-1 even among the latter group. This is especially important because these positions could—and should—help promote a healthy ideological balance. These patterns were broadly consistent across all 10 schools, with right-leaning faculty dramatically outnumbered by left-leaning (and centrist) faculty in every case.

The takeaways here are straightforward. Schools of public policy and government must do a better job of cultivating a faculty that captures the breadth of views, values, and perspectives that constitute the larger world of American political thought. It is more than a little surprising that this even needs to be said. After all, it’s not as though these schools are unaware of the importance of diversity and inclusion.

In its mission statement, for instance, Princeton’s School of Public and International Affairs promises that its faculty and students approach “the challenges of public and international affairs, with particular emphasis on diverse scholarly perspectives and evidence-based analysis.”[14] Well, when it comes to the study of government and public policy, ideological and political perspectives are a crucial dimension of diversity. To state the obvious, right-leaning and left-leaning Americans have fundamental disagreements about how best to approach public and international affairs.

Schools seeking to equip their students for the rigors of leadership and public affairs need to help them grapple with competing views on the role of government, desirable public policy, and the role of the U.S. in the world. That’s why it is so problematic that, of the 58 faculty members with identifiable political affiliations at Princeton’s School of Public and International Affairs, there are eight left-leaning faculty members for every one right-leaning member.

If there is any field where exposure to a robust range of competing viewpoints is essential, it’s the study of public policy and government. While one can dream up rationales (no matter how tortuous) as to why ideological groupthink is acceptable elsewhere in the academy, such claims collapse when it comes to schools of public policy. Today’s academic discourse about health care, gender identity, race, immigration, abortion, DEI, or Israel does little to support the claim that progressive scholars are able and willing to forcefully articulate right-leaning views on such questions. Indeed, recent developments on campus pose a particular burden for those who would claim that left-leaning faculty are creating room for robust discourse or exposing students to good-faith accounts of conservative thought.

Public Knowledge and the Constitution

 From the Annenberg Public Policy Center:

The 2024 edition of the Annenberg Constitution Day Civics Survey, released annually to celebrate Constitution Day on September 17, finds that:

• Nearly two-thirds of Americans (65%) can name all three branches of government.
• Asked what specific rights are guaranteed by the First Amendment, nearly three-quarters of respondents (74%) name freedom of speech. The other four rights are recalled by far fewer people: the second most-often cited, freedom of religion, is named by just 39%.
• A little over half of U.S. adults know which party controls the Senate and which controls the House of Representatives.
• Over 80% of Americans support prohibiting Supreme Court justices from participating in cases in which they have “personal or financial interests.” Nearly as many people support creation of a formal ethics code for the court.

“Civics knowledge matters,” says Kathleen Hall Jamieson, director of the Annenberg Public Policy Center. “Those who do not understand the rights protected by the Constitution can neither cherish nor invoke them; those who do not know which party controls the House and Senate may misattribute credit or blame for action or inaction.”

Description in Political Science

Carolyn E. Holmes, Meg K. Guliford, Mary Anne S. Mendoza-Davé and Michelle Jurkovich have an article as PS: Political Science and Politics titled "A Case for Description." Abstract:

Descriptive research—work aimed at answering “who,” “what,” “when,” “where,” and “how” questions—is vital at every stage of social scientific inquiry. The creative and analytic process of description—through concepts, measures, or cases, whether in numeric or narrative form—is crucial for conducting research aimed at understanding politics in action. Yet, our field tends to devalue such work as “merely descriptive” (Gerring 2012), subsidiary to or less valuable than hypothesis-drive causal inference. This article posits four key areas in which description contributes to political science: in conceptualization, in policy relevance, in the management and leveraging of data, and in challenging entrenched biases and diversifying our field.

From the article:

Although the subject of policy or public relevance occasionally is debated as a goal of political science (see, e.g., Rogowski Reference Rogowski 2013), to the extent that there is an ambition to inform the policy-making process or the public at large, description is a central piece of the process. Informed and curated description of events and circumstances often is a front-line request by policy makers and mass media outlets, insofar as the expertise brought by political scientists can contextualize key points of tension and problems (Seay 2022; Shively 2022). Policy makers and the public want to know the who-what-when-where-how of complicated policy problems, which is currently evident especially in areas such as climate policy (Albistegui Adler 2022). Thorough qualitative description can help policy makers by cautioning them from excessive attention to outliers or in changing the framing of events with attention to cultural or institutional differences across contexts (Peh 2022).

Through generating summaries of data samples, statistical description can illuminate trends over time or illustrate the center, scope, and outliers of data samples. Additionally, experts can help to craft descriptive narratives to understand the precursors and key moments that have led to a particular point of public interest or a policy challenge (Lakin 2022) or to adjudicate among different explanations for outcomes (Harbin 2022). This work is important in part because “descriptive statistics, case studies, and similar material may be more valuable and accessible for policy makers and citizens, who typically learn and reason via discrete operating principles (or theory) as well as descriptive evidence” (Shively 2022).

 

Homelessness in California

A number of posts have dealt with homelessness.  

 A release from UC San Francisco:

The University of California, San Francisco BenioffHomelessness and Housing Initiative (BHHI) today released the largest representative study ofhomelessness in the United States since the mid-1990s, providing a comprehensive look at the causes and consequences of homelessness in California and recommending policy changes to shape programs in response. 

The California Statewide Study of People Experiencing Homelessness (CASPEH) used surveys and in-depth interviews to develop a clear portrait of homelessness in California, where 30% of the nation’s homeless population and half of the unsheltered population live.

The study found that, for most of the participants, the cost of housing had simply become unsustainable. Participants reported a median monthly household income of $960 in the six months prior to their homelessness, and most believed that either rental subsidies or one-time financial help would have prevented their homelessness.

...  

The study found that the state’s homeless popula`on is aging, with 47% of all adults aged 50 or older, and that Black and Native Americans are dramatically overrepresented. Contrary to myths of homeless migration, most were Californians: 90% of participants lost their last housing in California and 75% of participants live in the same county as where they were last housed. Nine out of ten spent time unsheltered since they became homeless. The median length of homelessness was 22 months.

One in five participants entered homelessness from an institution. Of those who hadn’t been in an institution, 60% came from situations where they weren’t leaseholders, such as doubling up with family or friends. Participants were disconnected from the job market and services, but almost half were looking for work.

...

 Participants had experienced multiple forms of trauma throughout their life, increasing their vulnerability to homelessness and contributing to their mental health and substance use challenges. Two-thirds reported current mental health symptoms and more than a third experienced physical or sexual violence during this episode of homelessness. More than a third had visited an Emergency Department in the prior six months. One in five who used substances reported that they wanted substance use treatment—but couldn’t get it. 

Unions, Policy Advocacy, and Public Relations

IZA Institute of Labor Economics DP No. 16014: 

Does Policy Advocacy Generate Good PR? Evidence from Labor Unions and Minimum Wages

Jeffrey Clemens, Michael R. Strain 

Abstract:

We develop new facts relating news coverage, interest groups, and events in the legislative histories of minimum wage increases. First, we create and validate a database of news articles that includes coverage of minimum wages and organized labor. Second, we show that policy changes predict increases in news coverage that connects organized labor and minimum wages, in particular when those articles reference high-profile interest groups and research output. Third, these policy events lead coverage of organized labor to shift towards articles about minimum wages. We observe that the minimum wage’s popularity with the public makes this shift qualify as “good PR,” an assessment that is supported by sentiment analysis of articles about organized labor. This public relations channel can thus help rationalize why interest groups engage in policy advocacy.

Life Experience and Politics

 Erick Erickson:

Last week, an urban planning warrior denounced the need for in-unit washers and dryers. He insisted no one ever needed to do laundry every day and once a week or two at a laundromat should be fine. He is a single childless twenty-something. He has no lived experience.

I do not think one must be in a demographic to opine on that demographic. A man should be as able to discuss issues related to women as women can with men. Civilians should be able to make informed opinions and policy decisions about the military, even with a lack of service. But credentials also should not be substituted for a lived life.

Like with the left, parts of the right are increasingly being held captive to the voices and opinions of spectacularly unaccomplished young men and women with brash Twitter personalities hiding their lack of lived lives. We probably should not be trying to set policies related to the working class based on the musings of a pampered progressive brat or of a pampered right-winger subsidized by dad. Nor should we set public policy by people who have only ever lived a political life. Unfortunately, both sides are more and more catering to the least accomplished, loudest voices whose only work experience is a political cause.

Civil Society and Government Reform

Many posts have discussed public administration and public service.

Daniel Stid:

The civil society actors now responding to our present challenges are not doing so within the boundaries of one organization or network but in a wide-ranging and self-organizing pattern. Consider, for example, the work of the policy advocates, practitioners, and scholars from across the ideological spectrum participating in the Fix Congress cohort. A scan of the hearings of the House Select Committee on the Modernization of Congress demonstrates how much its members have been relying on the cohort to advance their work. The Select Committee is something of a unicorn on Capitol Hill. Its scrupulously bipartisan proceedings, consensus-backed recommendations, practical agenda for institutional reform, and steady focus on implementation run counter to the standard narratives of a polarized, grandstanding, institutional-slashing, do-nothing Congress. But there it is, working away and making progress behind the scenes. The Fix Congress participants are standing shoulder-to-shoulder with committee members, informing their deliberations, serving as their sounding board, and helping others appreciate the importance of their work.

Additional nonprofits are stepping up to help legislators do better work at the federal and state levels. The Project on Government Oversight, the Lugar Center, and the Levin Center have been advising members and training congressional staff on how to conduct more effective and bipartisan oversight. The Levin Center is now rolling out resources and capacity-building assistance to support state legislators seeking to do likewise. Meanwhile, the Millennial Action Project has established bipartisan future caucuses of younger lawmakers in Congress and 30+ statehouses, helping them build networks and develop policy agendas they can pursue together.

When it comes to improving the federal executive branch, the Partnership for Public Service has been an indispensable organization for more than two decades. The Partnership highlights examples of excellence, innovation, and leadership among federal civil servants through its annual Service to America or Sammies awards. Its recurring assessments of federal employee engagement, organizational culture, and leadership (or the lack thereof) across agencies generate information that administration and cabinet leaders closely track and use. The Partnership conducts ongoing research to better understand and advance improvements in executive branch performance. Finally, it trains and coaches established and rising leaders throughout the federal workforce.

Multiple nonprofits work at all levels of government to build administrative capacity and results-driven implementation through the provision of technical assistance and training. This work is especially important in state and local agencies, where administrative resources and capabilities can be spotty. The Pew Trusts’ Results First Initiative has for a decade been an important resource for multiple states seeking to implement evidence-based policies. Results for America, the Kennedy School’s Government Performance Lab, and Third Sector have likewise teamed up with state and local government officials to help them identify and implement evidence-based solutions. Via their own growing teams and the public servants they are supporting, these nonprofits are steadily increasing the number of well-trained and dedicated people tackling our most vexing social problems.

Along similar lines, Code for America marshals technical assistance and resources to help government agencies harness technology and improve the delivery and citizen experience of public services. Drawing on their technological acumen and experience, Code for America has also articulated a vision of human-centered government that illuminates an appealing path forward in the digital age.

Another crucial line of work is inspiring and attracting talented people to serve in our governing institutions. This has been a longstanding emphasis of the Volcker Alliance, with its core belief that, “public service is a high calling, and it is critical to engage our most thoughtful and accomplished citizens in service to the public good.” The TechTalent Project has a similar but sharper focus on helping government at all levels recruit public servants with the technological skills agencies need to carry out their missions. TechCongress is working toward this same goal via fellowship programs that bring technologists into the first branch of the federal government. Their efforts are already paying off, as demonstrated by the growing sophistication of congressional hearings and legislative activities on technology issues.

California Does Not Work Well

At CalMatters, Dan Walters writes about California public policy, starting with an annual report by the Howard Jarvis Taxpayers Association:

This year’s version, called “Follow the Money 2021,” contains dozens of examples of how public funds have been squandered, embezzled or otherwise misused, plus situations HJTA says show politicians getting special treatment.

One could quibble with some of the examples, but in the main they indicate that taxpayers often are not getting as much bang for their bucks as they should.

So, one might wonder, how does California compare with other states in that regard?

By happenstance, as HJTA was preparing its report, an organization called Wallet Hub was offering an answer.

In March, Wallet Hub, a website devoted to consumer finance, released a study of what it calls “return on investment,” merging tax burdens with quality of services to develop an index that compares states on how efficiently they spend public funds.

The factors included in the service side of the equation include schools, roadways, hospitals, crime, water quality and poverty. Minnesota is scored as having the best services.

Unfortunately — but perhaps not surprisingly — California does not fare well in its “return on investment” score. In fact, it’s the fourth worst overall, just ahead of Hawaii, New Mexico and North Dakota. New Hampshire scores the highest, followed by Florida and South Dakota.

Study Casts Doubt on Value of Pre-K

 

Effects of a statewide pre-kindergarten program on children’s achievement and behavior through sixth grade.© Request Permissions

Durkin, K., Lipsey, M. W., Farran, D. C., & Wiesen, S. E. (2022). Effects of a statewide pre-kindergarten program on children’s achievement and behavior through sixth grade. Developmental Psychology. Advance online publication. https://doi.org/10.1037/dev0001301.  Abstract:

As state-funded pre-kindergarten (pre-K) programs expand, it is critical to investigate their short- and long-term effects. This article presents the results through sixth grade of a longitudinal randomized control study of the effects of a scaled-up, state-supported pre-K program. The analytic sample includes 2,990 children from low-income families who applied to oversubscribed pre-K program sites across the state and were randomly assigned to offers of admission or a wait list control. Data through sixth grade from state education records showed that the children randomly assigned to attend pre-K had lower state achievement test scores in third through sixth grades than control children, with the strongest negative effects in sixth grade. A negative effect was also found for disciplinary infractions, attendance, and receipt of special education services, with null effects on retention. The implications of these findings for pre-K policies and practices are discussed.

From the article:

While a state pre-K program is the focus of this article, a large body of research has focused on the Head Start program. However, there is only one randomized study of longer-term Head Start effects (Puma et al., 2012), one that also randomized applicants to oversubscribed programs. Head Start children had larger gains than controls on literacy and language measures (but not math) prior to kindergarten entry, but these effects disappeared by the end of kindergarten. Focusing on earlier Head Start programs, Deming (2009) conducted a study comparing siblings within the same family born between 1976 and 1986 who did or did not attend Head Start, and found long-term positive Head Start effects on adult outcomes even though test score differences faded. In a similar analysis, Pages et al. (2020) found that using the Deming sample but extending the measurement period decreased the adult effects, and data for children attending more recent Head Start programs showed mostly negative effects. Siblings who attended Head Start were less likely to be employed or enrolled in school compared to their siblings who mostly received home care. These later Head Start programs occurred within the same time window as the implementation of the Tennessee Voluntary Pre-K (TNVPK) program that is the topic of the current article

Deming, D. (2009). Early childhood intervention and life cycle skill development: Evidence from Head Start. American Economic Journal. Applied Economics, 1(3), 111–134. https://doi.org/10.1257/app.1.3.111

Pages, R., Lukes, D. J., Bailey, D. H., & Duncan, G. J. (2020). Elusive longer-run impacts of Head Start: Replication within and across cohorts. Educational Evaluation and Policy Analysis, 42(4), 471–492. https://doi .org/10.3102/0162373720948884

Puma, M., Bell, S., Cook, R., Heid, C., Broene, P., Jenkins, D., Mashburn, A., & Downer, J. (2012). Third Grade Follow-up to the Head Start Impact Study Final Report (OPRE Report # 2012-45). Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services

 

 

Vaccine Incentives Don't Work: Time for Mandates

 Thirumurthy, Harsha and Milkman, Katherine L. and Volpp, Kevin and Buttenheim, Alison and Pope, Devin G., Association between statewide financial incentive programs and COVID-19 vaccination rates (August 27, 2021). Available at SSRN: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3912786&download=yes

To encourage COVID-19 vaccination, many states in the US have introduced financial incentives ranging from small, guaranteed rewards to lotteries that give vaccinated individuals a chance to win $1 million or more. We compiled information on statewide incentive programs along with data on daily vaccine doses administered per 100,000 individuals in each state. Leveraging variation across states in the daily presence of incentives, we used difference-in-differences regressions to examine the association between these incentive program indicators and vaccination rates. Difference-in-differences analysis showed that 24 statewide incentive programs were associated with a non-significant relative decline in daily vaccination rates of 8.9 per 100,000 individuals (95% CI [-64.3,46.5]; p=0.75). Furthermore, there was no significant difference in vaccination trends between states with and without incentives in any of the 14 days before or after incentives were introduced. Lotteries and other incentives offered by 24 states were not associated with a significant change in COVID-19 vaccination rates. More substantial incentives or mandates may be necessary to raise vaccination rates.

Consultants and COVID

Isaac Stanley-Becker at WP:

California wasn’t alone in using private contractors to manage the vaccination campaign. At least 25 states, along with federal agencies and many cities and counties, hired consulting firms, according to a Washington Post tally. The American vaccination drive came to rely on global behemoths such as McKinsey and Boston Consulting Group (BCG), with downsized state and local health departments and even federal health agencies relying on the private sector to make vaccines available to their citizens, according to hundreds of pages of contract documents, emails and text messages obtained through public records requests.

McKinsey’s role extended beyond California to other states, including Ohio and New Jersey. Deloitte worked in 10 states. BCG received millions of dollars from the federal government to coordinate vaccine planning, while at least 11 states also worked with the company, in some cases paying it to address gaps in federal planning.

Consultants say they helped save lives by supporting overextended public servants with specialized expertise. “Our work helped state decision-makers quickly size up key factors impacting the effective distribution of vaccines,” said McKinsey spokesman Neil Grace. “All our work was based on state-defined priorities, and the data we analyzed was provided by state and local public health authorities.”

 But critics question whether such contracts improve government performance, arguing the arrangements are costly and difficult to oversee. Taxpayers have no way to know what precisely they are getting under no-bid contracts worth millions of dollars because the internal documents of private consultancies are not subject to public records laws.

...

In some instances, current and former health authorities said consultants gave elected leaders political cover while taking on few substantive tasks. But the deeper problem is when private firms are entrusted with too much, rather than contributing too little, said Robin Taylor Wilson, a former chair of the American Public Health Association’s epidemiology section and an associate professor at Temple University in Philadelphia.


“The contractors leave and we’re not retaining that expertise,” she said. “So the next time an emergency hits, we’re going to have another delayed reaction.”

Vaccine Distribution Problems

 

Margaret Harding McGill and Kim Hart at Axios:

[Last year] the federal government focused on vaccine production, but left it to the states to figure out how to actually get shots in arms.

• Local governments — dealing with significant budget and staff shortages — generally lack digital teams that can quickly stand up technology infrastructure.
• Tech-savvy public interest groups have offered assistance, but the services they can provide — and the government's willingness to accept them — has been limited.
• Government IT procurement processes failed to anticipate the needs for vaccine distribution or effectively vet vendors, leaving a fractured system.

.The big picture: "Actually delivering services means being tech-savvy today. And that piece is missing," Hana Schank, director of strategy for Public Interest Technology at New America, told Axios.

Early on in the pandemic, it was clear that vaccines would eventually arrive and that technology infrastructure would be needed for mass distribution. But local jurisdictions were preoccupied with contact tracing and securing personal protective equipment — two other areas where tech solutions fell short.

• "Contact tracing was the first big massive red flag for vaccines," said DJ Patil, former U.S. chief data scientist who is now Chief Technology Officer of Devoted Health, and worked directly on state COVID-19 response efforts in California. "People didn't see the opportunity that was coming and the chance to get it right."
• "You can have unbelievable amounts of technologists willing to show up, but we still don't know how to plug them in" to government processes, he said. "So they go with a vendor instead."

 Even when governments turned to tried-and-true vendors, problems arose.

...

Reality check: County health departments are often responsible for distributing vaccines — but their budgets have been gutted during the pandemic.In a survey conducted last June by the National Association of County and City Health Departments, more than 89% of local health departments said general COVID-19 response efforts had diverted resources away from immunizations.

The bottom line: Obtaining a vaccine will get easier, but that's mainly because vaccine supplies will continue to increase.

Science, Policy, and Deliberation

M. Anthony Mills at AEI:

Scientific evidence is indeed vital to public policy. The pandemic has made this undeniable, if it was not already obvious enough. But science does not offer a repository of neutral evidence that arrives, ready-made, onto the political scene. On the contrary, scientific knowledge is an achievement, the result of a complex process in which the judgment of scientific experts — call it expert judgment — plays a decisive role. Utilizing such knowledge to make policy decisions is even more complex, requiring not only expert judgment but also the judgment of those non-experts — call it non-expert judgment — whose experience, knowledge, or know-how is also needed to deliberate well about the best course of action. It follows that judgment and deliberation are not secondary, lesser processes, that we must rely on when integrating scientific evidence into the policymaking process. Rather, judgment and deliberation are essential to this process, in part because they are essential to science itself. Failure to appreciate this fact risks engendering unrealistic expectations about what scientific knowledge can accomplish in practical decision-making, thus inviting not only disappointment, distrust, and skepticism, but also bad policy.

In what follows, I will make a case for this alternative account of scientific knowledge by examining the role that expert judgment plays in scientific reasoning. I will then consider what implications this account has for how we understand practical decision-making informed by scientific knowledge. I conclude by suggesting that integrating scientific evidence into public policy is by nature deliberative, a reciprocal process in which both expert and non-expert judgments must play roles, and which requires that both experts and non-experts act with prudence.

 Full paper here: "The Role of Judgment and Deliberation in Science-Based Policy," by M. Anthony Mills CSAS Working Paper 21-16

Results

 Ezra Klein at NYT:

“The wisdom from much of the political science research is that partisanship trumps everything,” says Amy Lerman, a political scientist at the University of California at Berkeley, and author of “Good Enough for Government Work.” “But one of the insights from the policy feedback literature in particular is that when people experience policy, they don’t necessarily experience it as partisans. They experience it as a parent sending their child to school or a patient visiting a doctor, not as a Democrat or Republican. And because people are often thinking in nonpolitical terms during their day-to-day lives, they are much more open to having their views changed when they see the actual, tangible benefits of a policy in their lives. It’s a way of breaking through partisanship.”

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 In her book “Good Enough for Government Work,” Ms. Lerman argues that the U.S. government is caught in a reputation crisis where its poor performance is assumed, the public is attuned to its flaws and misses its virtues, and fed up citizens stop using public services, which further harms the quality of those services. The Trump years add another dimension to the analysis: Frustration with a government that doesn’t solve problems leads people to vote for demagogic outsiders who create further crises. But this is not an inevitability. Her titular phrase, she notes, “originated during World War II to describe the exacting standards and high quality required by government.” It was only in the 1960s and ’70s that it became a slur.

Public Health, Federalism, and Fragmentation

Alan Greenblatt at Governing:

To some extent, public health has been a victim of its own success. Over the past century, the focus of American health care has shifted from public health — which is concerned with infectious diseases and the overall well-being of the community — to treating individuals. Nearly all the health policy energy is devoted to debating questions about how many individuals should be covered and who should pay the bill.

As a result, public health is always a low priority, until it’s the highest possible priority. Public health is lucky to receive a penny or two out of every dollar spent on health care. Before the novel coronavirus struck, funding had been cut in half over the past decade for both public health emergency preparedness and response programs at the federal Centers for Disease Control and Prevention (CDC) and the federal hospital preparedness program.

Throughout American history, public health has been fragmented, with first local governments and later states playing a more active role than the federal government. After nearly every modern epidemic, panels of experts have called for Washington to play a more robust role. Those recommendations typically go nowhere.

The problem during the coronavirus crisis is not so much that the federal government hasn’t taken full charge, says John Auerbach, president of the Trust for America’s Health, a nonprofit that advocates for public health. There’s always been a “division of labor” between the levels of government in responding to public health emergencies. The problem is communication between those levels.

Typically, the federal government takes the lead role in setting the medical and scientific strategy, leaving its plans largely to states and localities to carry out, each offering consistent messages. Federal, state and local responses were well-coordinated following the Sept. 11, 2001, terrorist attacks, Hurricane Katrina, the H1N1 virus, Ebola and Zika, Auerbach says.

In response to COVID-19, however, the CDC has been virtually sidelined. Its daily briefings were canceled back in March. More recently, the White House vetoed a set of detailed guidelines that the CDC prepared for states, localities and businesses to follow in opening back up. In prior crises, you didn't have states competing against each other for resources.

Public Administration

At The American Interest, Francis Fukuyama laments the decline of the study of public administration.

This then brings us back to the crisis in public administration as a field. After a period of innovation and creativity driven by the economists, the field seems to have lost its way again. Since the heyday of principal-agent theory (which was largely driven by scholars outside traditional public administration) there has been no dominant approach to public sector reform generated by administrative scholars. Public administration programs have either disappeared or have been folded into public policy programs, with increasing focus on policy analysis rather than practical skill-building. The field has relatively little interchange with the other discipline that provides training for government, administrative law, and it is increasingly hard to get tenure as a public administration scholar. There is no clear path from a public administration school to a job in the Federal government.

One individual who is trying to push against this tide is former Fed Chairman Paul Volcker, who established the Volcker Alliance to push back against these trends. Volcker, whose background is in public administration, likes to tell the story of a conversation with a very prominent Princeton economist. Volcker lamented the decline of teaching in public administration, to which the economist replied, “But public administration isn’t even a field!” Volcker went on to point out that some prominent public administration scholars have gone on to great prominence, even rising to be presidents of major universities. The economist professed not to believe this, and wanted an example. The example Volcker gave was Woodrow Wilson, former president of Princeton University.