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1. Revising Organ Procurement Organization Guidelines to Obtaining Family Consent for Deceased Donation: An Anthropologically Informed Policy Proposal

Author:
Gillian Tisdale
Publication Date:
04-2024
Content Type:
Journal Article
Journal:
Journal of Public and International Affairs (JPIA)
Institution:
School of Public and International Affairs (SPIA), Princeton University
Abstract:
Organ transplantation has become a widespread medical practice with public policy designed to increase rates of deceased donation. When individuals have not registered as organ donors, next-of-kin are called on to make donation decisions—requiring families to grapple with the often-confusing concept of ‘brain death’ and parse their understanding of what the deceased would have wanted. Current public policy is explicitly designed to promote high donation rates without clear regard to the experiences of donor-families; at best, these policies prime donation conversations to involve unethical practices, while at worst, the disregard of kin’s experiences may also diminish deceased donation rates. Anthropological literature has documented the often aggressive tactics used by transplant organizations that demonstrate a disregard for the emotional experiences of kin. In 2023, Congress passed the Securing the U.S. Organ Procurement and Transplantation Network Act, prompting the United States Department of Health and Human Services (HHS) to reevaluate organ donation policies and solicit requests for proposal for a new federal contractor to take over the network responsible for overseeing all organ sharing. This article leverages the relevant anthropological literature to provide guiding principles and proposed language amending the Centers for Medicare & Medicaid Services (CMS) Interpretive Guidance that HHS could implement as part of its modernization initiative. These principles aim to improve experiences for kin without lowering donation rates. The article recommends that HHS and its contractors collect metrics to measure the quality of Organ Procurement Organization (OPO) interactions, counterbalancing current benchmarks focused on procurement rates. It also recommends improved protocols to empathically and systematically support kin’s understanding of brain death.
Topic:
Legislation, Public Policy, Procurement, and Organ Transplants
Political Geography:
North America and United States of America

2. Housing in Wyoming: Constraints and Solutions

Author:
Thảo-Nguyên Bùi, Tim Freeman, Ricardo Hausmann, Farah Kaddah, Lucas Lamby, Tim O'Brien, and Eric Protzer
Publication Date:
04-2023
Content Type:
Working Paper
Institution:
The John F. Kennedy School of Government at Harvard University
Abstract:
Quantitative evidence supports the contention that Wyoming’s housing market is constrained, to a greater degree than many other parts of the US. Prices are persistently above expectations given economic fundamentals in most parts of the state, and the supply of new housing in Wyoming is on average less responsive to price increases than in other US counties. This has undermined natural population growth and contributed to a low amount of population density close to city centers in Wyoming, as compared to other US cities with comparable population levels. Importantly, this phenomenon is not simply the result of pandemic-era economic frictions. The evidence shows that these constraints have durably persisted in Wyoming. This housing constraint weighs heavily on the broader Wyoming’s economy, and chokes off growth in new industries that could add to the Wyoming economy beyond its natural resource base. Businesses consistently report a lack of access to workforce as a leading problem that ultimately results from a lack of housing. Some businesses have even tried to create their own housing for employees, and news reports abound of teachers and nurses who secure jobs in Wyoming communities but then have to leave because they cannot find housing. Key problems behind Wyoming’s housing constraints include excessive regulations concerning housing density and insufficient investment in arterial infrastructure. For example, there is evidence that over-regulated minimum lot sizes in Wyoming are blocking the creation of supply to match free-market demand for houses with smaller amounts of land. Other areas of over-regulation include those concerning allowable housing types, building height, parking spaces per dwelling, and the housing approval process itself. This may be seen as surprising given Wyoming’s reputation as a low-regulation state, but Wyoming maintains restrictions that other states and countries have discarded as outdated and highly counterproductive. Besides outright restrictions on housing development, we find that the most common cost driver undermining the housing development has to do with low public investment in needed arterial infrastructure, especially water systems. Land supply as well as material and construction costs are not primary constraints to housing development across the state, but may matter for select communities. We suggest a portfolio of policy changes for the state of Wyoming to explore in order to solve its housing constraints. One category of changes is regulatory, and focuses on deregulation, reducing bureaucratic overhead, and shifting from veto-cratic to democratic housing approval procedures. Another category is focused on investment on infrastructure to support housing, and exploration of state-local funding structures to facilitate continuous infrastructure improvement. If implemented, these changes will not only help to solve Wyoming’s housing constraints but also facilitate housing development in a way that combats urban sprawl, and in doing so protects open spaces outside of cities that Wyomingites value.
Topic:
Development, Economics, Public Policy, and Housing
Political Geography:
North America and United States of America

3. Community Living for People with Disabilities in Public Housing: Evaluating the Frank Melville Supportive Housing Investment Act of 2010

Author:
Sawyer Rogers, Rosalyn Impink, and Alison Ziegler
Publication Date:
05-2023
Content Type:
Journal Article
Journal:
Journal of Public and International Affairs (JPIA)
Institution:
School of Public and International Affairs (SPIA), Princeton University
Abstract:
The Frank Melville Supportive Housing Investment Act of 2010 created a federal program to advance community living for people with disabilities. [1] This program’s enactment followed the Supreme Court’s 1999 ruling in Olmstead v. L.C. which categorized unnecessary institutionalization and segregated living of people with disabilities as discriminatory. In the intervening years, amid the continued fallout of the Great Recession, the COVID-19 pandemic, and an ever-challenged affordable housing stock, it is prudent to evaluate the Melville Act’s effectiveness in achieving its goals from a national and programmatic perspective. We find that while the Melville Act successfully promoted mixed community living on a programmatic scale, it lacked a national-level impact due to under-resourcing, was not as cost-effective as predicted, and recipients were less satisfied with their housing than other programs. We recommend that actors in the policy design process advocate for the allocation of more resources to public housing programs with community living for people with disabilities and incorporate the principles of the “Nothing About Us Without Us” movement into the policy development and implementation process. [2]
Topic:
Discrimination, Disability, Legislation, Public Policy, Housing, and Public Housing
Political Geography:
North America and United States of America

4. Using Real-Time Google Search Activity to Target Emergency Fiscal Stimulus

Author:
John Kearns
Publication Date:
05-2023
Content Type:
Journal Article
Journal:
Journal of Public and International Affairs (JPIA)
Institution:
School of Public and International Affairs (SPIA), Princeton University
Abstract:
In the aftermath of the COVID-19 pandemic, the U.S. Congress transferred nearly $1 trillion USD to state and local governments between April 2020 and March 2021 to support vaccination efforts, keep schools open, and sustain economic recovery. As of March 2023, much of this money remained unspent, raising questions about the underlying process of determining the size and distribution of aid. This paper explores how Google search data and machine learning models can work in real-time to assist policy makers in evaluating fiscal policy proposals. These results are among the first pieces of evidence that economic models can feasibly integrate alternative sources of data to provide real-time estimates of economic activity at the state level. The author’s models provide reliable and accurate estimates of state and local fiscal need and indicate the states that need relief the most months ahead of official estimates. The more tailored models presented in this paper could lead to more equitable and effective outcomes at a fraction of the cost to taxpayers when used to inform emergency fiscal stimulus distribution in the future.
Topic:
Economics, Public Policy, Fiscal Policy, and COVID-19
Political Geography:
North America and United States of America

5. Ocean Issues in Alaska: From Fisheries Management to Public Safety and Security

Author:
Fran Ulmer
Publication Date:
08-2023
Content Type:
Policy Brief
Institution:
Belfer Center for Science and International Affairs, Harvard University
Abstract:
Alaska is an important region for the Department of Homeland Security (DHS), given the Department’s statutory authority and responsibilities. This reality applies with particular force to the U.S. Coast Guard (USCG), with its jurisdiction over fisheries enforcement, drug interdiction, marine safety, oil spill response, search and rescue, and more. Challenges facing the USCG in its domains of operation around Alaska—the Arctic Ocean, the North Pacific Ocean, the Bering Sea, the Chukchi Sea, and the adjacent communities—include the following:
Topic:
Security, Science and Technology, Natural Resources, Oceans and Seas, Public Policy, Sustainability, Fishing, and Public Safety
Political Geography:
North America, Alaska, and United States of America

6. Contested Deployment

Author:
Bert B. Tussing, John Eric Powell, and Benjamin C. Leitzel
Publication Date:
04-2022
Content Type:
Special Report
Institution:
The Strategic Studies Institute of the U.S. Army War College
Abstract:
As indicated in the 2018 National Defense Strategy and evolving Multi-Domain Operations doctrine, the assumption the homeland will provide a secure space for mobilization and deployment is no longer valid. This integrated research project goes beyond affirming this assumption and contributes to efforts to mitigate the concerns a contested deployment entails. Following the introductory chapter, Chapter 2, “Army Deployments in a Contested Homeland: A Framework for Protection,” explores how current coordination and cooperation mechanisms between the DoD and state and local government may need realignment, with civil authorities preparing themselves to support military mobilization. Chapter 3, “Strategic Seaports and National Defense in a Contested Environment,” examines the 22 strategic seaports across the United States, identifying issues with throughput, structural integrity, security, readiness, funding, and authorities. Chapter 4, “Single Point of Failure,” identifies how strict adherence to a business efficiency model for munition production and distribution may jeopardize the successful employment of military forces. Chapter 5, “The Interstate Highway System: Reinvestment Needed before a Contested Deployment,” provides the status of the deteriorating road network and explains how associated vulnerabilities could be exploited by an adversary. The two appendices provide points for consideration on cyberattacks and defense and the impacts a full mobilization of reserve forces would have on the homeland.
Topic:
Defense Policy, National Security, Military Affairs, Crisis Management, Public Policy, Army, and Troop Deployment
Political Geography:
North America and United States of America

7. The National Flood Insurance Program: Solving Congress’s Samaritan’s Dilemma

Author:
Peter Van Doren
Publication Date:
03-2022
Content Type:
Policy Brief
Institution:
The Cato Institute
Abstract:
Who should pay for the damages caused by natural disaster? The American ethos has long called on personal responsibility and private charity, rather than broad public aid, to secure people’s welfare. Although public emergency services play a vital role during and immediately after a catastrophe, this ethos looks to private insurance and disaster‐​oriented organizations, such as the Red Cross, to be the main modes of recovery from a flood or storm, as well as prior care in siting and constructing buildings to blunt the effects of wind and rain.
Topic:
Government, Natural Disasters, Public Policy, and Insurance
Political Geography:
North America and United States of America

8. The GameStop Episode: What Happened and What Does It Mean?

Author:
Allan M. Malz
Publication Date:
10-2021
Content Type:
Journal Article
Journal:
The Cato Journal
Institution:
The Cato Institute
Abstract:
The GameStop stock trading episode that began in January 2021 has been unprecedented in some ways, especially in the ability of market participants to organize collective action openly yet anonymously. In other ways, it’s been an unsurprising repetition of past experience. Financial markets are imperfect, they display many frictions, and the imperfect alignment of interests is a perpetual dilemma in designing both contracts and public policy.
Topic:
Regulation, Economy, Public Policy, and Stock Markets
Political Geography:
United States of America

9. The American Jobs Plan: The Made-in-America Tax Plan

Author:
Committee for Economic Development of the Conference Board
Publication Date:
04-2021
Content Type:
Policy Brief
Institution:
The Conference Board
Abstract:
President Biden proposes to follow up on his $1.9 trillion “American Rescue Plan” with a new “American Jobs Plan” and a “Made-in-America Tax Plan.” A White House fact sheet was released early on Wednesday, March 31. It did not include a clearly itemized cost statement, but the total of the initiatives is apparently in excess of $2 trillion over eight years. Some portion of that cost is claimed to be offset— over 15 years—by corporate income tax increases included in the tax plan.
Topic:
Employment, Tax Systems, Public Policy, and Joe Biden
Political Geography:
North America and United States of America

10. President Bush’s 2005 Mongolia Visit

Author:
Pamela J. Slutz and Brian L. Goldbeck
Publication Date:
08-2020
Content Type:
Journal Article
Journal:
American Diplomacy
Institution:
American Diplomacy
Abstract:
President George W. Bush’s November 2005 visit to Mongolia marked an important milestone in U.S.-Mongolia relations. When the two countries established diplomatic relations in 1987 after many years of Cold War frostiness, Mongolia was a communist country closely allied to the Soviet Union.Bush’s visit, the first by a sitting U.S. president, re-affirmed Mongolia’s transformation from communism to democracy and a free market economy.
Topic:
Diplomacy, Public Policy, and Memoir
Political Geography:
Mongolia, Asia, North America, and United States of America