RAND Review
News
- Counterinsurgency Lessons Can Inform Global War on Terror
- Maritime Terrorism Risk Involves More Than Just Container Shipping
- Felons Reload While No One Is Watching, Report Finds
- As for Implementation, Comprehensive School Reform Is Anything But
- Public Spends Little to Provide Health Care for the Undocumented
- New Study Suggests Three Steps to Improve Mental Health Care
Counterinsurgency Lessons Can Inform Global War on Terror
As the U.S. military struggles with ever-evolving insurgencies in Iraq and Afghanistan, it does not need to reinvent the wheel, according to a new summary of the lessons learned from RAND’s five decades of counterinsurgency research. Tactics used to battle Cold War–era insurgencies — such as offering amnesty to combatants and securing national borders — could help the United States in its current confrontations with insurgents in Iraq and Afghanistan.
The new report argues that while counterinsurgency details may vary greatly between the Cold War and today, many of the differences are overstated. For example, some today view the fragmented nature of the Iraqi insurgency as almost without precedent. Yet “many insurgencies during the Cold War were fragmented, with rebel groups fighting each other as well as a central opposition force,” said Austin Long, author of the RAND report.
Long, a doctoral candidate in securities studies at the Massachusetts Institute of Technology, reviewed dozens of past RAND studies about tactics used against insurgencies in such disparate places as Vietnam, Algiers, and El Salvador to distill lessons for today’s conflicts. His work included efforts to declassify several reports so that their lessons could be incorporated into his study.
The best way to organize against insurgencies would be to bring together political and military components into one decisionmaking group so that the efforts of one do not undercut the progress of the other. |
He found four lessons of particular relevance to today’s ongoing battles: the proper organization of counterinsurgency efforts; the use of amnesty and reward programs; the control of national borders; and pacification of a nation’s population.
He concluded that the best way to organize against insurgencies would be to bring together political and military components into one decisionmaking group so that the efforts of one do not undercut the progress of the other. He suggested that the Provincial Reconstruction Teams currently operating in Iraq and Afghanistan be expanded to create similar efforts at the regional and national levels.
Another proven strategy would both extend amnesty to those involved in an insurgency and offer rewards to people who turn in those involved in insurgent fighting. Amnesty should be offered in Iraq even to insurgents who have been involved in killings, said Long, but only if the combatants agree to cooperate fully with the government and relocate away from insurgent-dominated areas. He noted that the current reward program in Iraq is heavily focused on top leaders, with little funding to encourage reporting on rank-and-file insurgents.
A third recommendation is to improve border security systems for each country. The use of technologies such as remote-piloted vehicles cued by ground-based sensors could provide a cost-effective way to monitor border infiltration, allowing troops to respond quickly, said Long.
The fourth recommendation is to focus on ways to pacify local areas rather than an entire nation. In addition, development efforts should target local areas that show a willingness to support their own defense, while development efforts at the national level should emphasize the improvement of infrastructure and other shared resources.
The report also highlights the relevance of two RAND-formulated theories: “hearts and minds” and “cost/benefit.” The former stresses the need to win popular support by ameliorating some of the negative effects of economic development while accelerating the delivery of modernity’s benefits. The latter points out that coercive methods could actually stimulate an insurgency, leading to a spiral of fighting between insurgent and counterinsurgent — a spiral that might be unwinnable by modern democracies with moral and political limitations on the use of force. 
For more information:
On “Other War”: Lessons from Five Decades of RAND Counterinsurgency Research, ISBN 978-0-8330-3926-2, 2006.
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Maritime Terrorism Risk Involves More Than Just Container Shipping
A new RAND report has found that the heightened perception of maritime terrorism risks does not conform to the reality of today’s threats and vulnerabilities. The study assessed whether the maritime terrorism threat is increasing, what maritime terrorist scenarios appear to be the most worrisome, and whether current liability rules can help the private sector manage the risks.
The study compared a series of attack scenarios within three shipping categories: container ships, cruise ships, and ferries. It assessed the magnitude of the human and economic consequences of the various scenarios and the likelihood of their occurrence — as determined by target vulnerability and terrorist intent and capability.
Two Classes of Risk Emerge as Most Important: Unlikely but Catastrophic Scenarios and More Likely but Moderate Scenarios |
SOURCE: Maritime Terrorism: Risk and Liability, 2006. |
As shown in the figure, which plots the scenarios within the three groups, two classes of risk emerge as most important. First, although container shipping attacks are less likely, some — such as the detonation of a nuclear bomb in a container within a port — merit attention because of their extreme potential consequences. Second, smaller attacks on cruise and ferry ships — such as onboard bombs or food and water contamination — are considered important because they are well within the capabilities of contemporary terrorists and have direct ramifications for human life, even if the overall consequences are relatively moderate.
According to Peter Chalk, one of the report’s coauthors, both classes of risk would variously “meet the interrelated terrorist requirements of disruption, destruction, and publicity.”
The study offers a number of recommendations. It argues that policymakers should base maritime terrorism policy on empirical risk analysis rather than on perceived threats. In addition, because the greatest risks to human life turn out to involve onboard bombs or biological attacks on cruise ships and ferries, the study stresses the need for policymakers to audit the soundness of vessel and facility security procedures for passenger ships, to improve security measures at ports for passengers and luggage, and to implement vigorous procedures for documenting crew and staff.
“Focusing solely on securing the container supply chain without defending other parts of the maritime environment is like bolting the front door and leaving the back door wide open,” said Henry Willis, a report coauthor.
The authors state that civil liability is the de facto, principal approach to managing maritime terrorism risks through private-sector incentives. However, current liability standards in this context are so ambiguous that “the civil justice system may not be effective either as a compensation mechanism or in generating clear incentives for private-sector firms,” according to coauthor Michael Greenberg.
Because current civil liability standards provide so little guidance to firms, the study argues that policymakers should both review the rationale of third-party liability for terrorist attacks (by which firms are held responsible for attacks perpetrated by terrorists) and consider the pros and cons of civil liability as a method for dealing with maritime terrorism risks and injuries.
For more information:
Maritime Terrorism: Risk and Liability, ISBN 978-0-8330-4030-5, 2006.
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Felons Reload While No One Is Watching, Report Finds
Federal and state laws prohibit certain criminals from possessing ammunition, but that did not stop 52 such criminals from purchasing more than 10,000 rounds of ammunition in a two-month period, according to a new RAND report published in the October 2006 issue of Injury Prevention.
Of 133 buyers with criminal records, 52 were explicitly prohibited by law from buying ammunition. |
The study is based on information collected from ten ammunition retailers by the Los Angeles Police Department and screened by the federal Bureau of Alcohol, Tobacco, Firearms, and Explosives to see whether the buyers appeared in federal or state criminal databases. The study covers the months of April and May 2004.
Few Who Purchased Ammunition Were Legally Prohibited from Doing So, But Those Few Still Bought More Than 10,000 Rounds in Two Months |
SOURCE: “The Criminal Purchase of Firearm Ammunition,” Injury Prevention, Vol. 12, No. 5, October 2006, pp. 308-311, G.E. Tita, A.A. Braga, G. Ridgeway, G.L. Pierce.NOTE: Ammunition was purchased over a two-month period (April and May 2004) from ten retailers in Los Angeles. |
Over those two months, more than 2,000 people bought ammunition from the ten retailers, and the vast majority had no criminal records (see figure). Of the 133 buyers with criminal records, 52 were explicitly prohibited by law from buying ammunition. Those 52 people bought 2.3 percent of the nearly 440,000 rounds of ammunition sold, amounting to more than 10,000 rounds.
Past studies have shown that guns and ammunition possessed by felons and others prohibited from owning weapons are more likely to be used in violent crimes than are weapons bought by people with no criminal histories, but there are no mechanisms to prevent ammunition purchases. Los Angeles and a few other cities require ammunition sellers to collect information about ammunition buyers, but in the past those records have not been routinely reviewed.
“If lawmakers want to prohibit the illegal sale of ammunition, they could extend the instant background checks required before guns are sold to also cover the sale of ammunition,” said report coauthor Greg Ridgeway. “But unless such a step is taken at the state level, a felon could simply purchase ammunition in a nearby city to avoid the check.”
Another alternative is for law enforcement officials to monitor the sales records of ammunition to gather tips about felons who might illegally possess firearms. “Ammunition logs have been used by Los Angeles area law enforcement officials to obtain search warrants that have led to the recovery of illegal firearms,” noted lead author and criminologist George Tita.
Felons might resort to underground dealers. However, a study conducted in Chicago communities with high levels of gun violence found that stricter enforcement of ammunition policies did not necessarily lead to a black market in the product.
Although the study focused on one part of Los Angeles, the researchers point out that the findings have implications for other states and nations that monitor firearm sales but not ammunition purchases.
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As for Implementation, Comprehensive School Reform Is Anything But
To improve student performance, more than 8,000 schools across the United States have adopted comprehensive school reform (CSR) models that are intended to align the core components of education with a coherent vision. The schools have used more than $2 billion in federal funds to implement various CSR strategies.
So far, evaluations have shown mixed results. “The effectiveness of any intervention depends on whether it’s delivered as its designers intended,” said Georges Vernez, lead author of a new RAND study on the topic. “Our research shows that schools are not fully implementing the CSR models they adopted.”
The study quantifies the levels of implementation of four different CSR models in 250 schools in two states (Florida and Texas). The implementation scores are based on a survey of principals and teachers, supplemented with in-depth case studies in 12 schools, allowing researchers to compare a large sample of CSR schools and to compare CSR schools with non-CSR schools.
As shown in the table, few CSR schools have implemented the core components very highly. For all four models, the mean (average) scores for the schools surveyed do not approach 2.0 (full implementation) in any component.
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Regardless of the model chosen, some core components, such as curriculum and student assessments, were implemented more fully than others, such as methods of instruction and increasing parental involvement. But the study found that implementation falls short of the recommended levels.
In general, teachers reported only a lukewarm commitment to implementing a school’s model, with most feeling that the training received did not adequately prepare them to start using the model.
“One of the more surprising findings,” said Vernez, “was that, on average, all schools in the survey engaged in many of the same activities at the same frequency and level of intensity, regardless of whether schools used one of the four CSR models.” Only a handful of practices differed either among the types of model schools or between the model schools and their matched non-model schools.
The findings, if replicated in future studies, have several broad implications, with this particularly salient one: At the current level of implementation, CSR models are likely to have modest or no effects on student achievement.
There is significant room to raise the level of implementation. For instance, schools could ensure that teachers receive the necessary initial training and are committed to implementing the adopted models. Without such support, the implementation of CSR models cannot be expected to help schools meet the federal No Child Left Behind goal of 100-percent proficiency in reading and mathematics by 2014.
For more information:
Evaluating Comprehensive School Reform Models at Scale: Focus on Implementation, 2006, available online only.
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Public Spends Little to Provide Health Care for the Undocumented
Much political attention has focused on the public burden of providing health care for non-elderly undocumented immigrants. But a new RAND study in the November/December 2006 issue of Health Affairs by Dana P. Goldman, James P. Smith, and Neeraj Sood shows that a relatively small amount of U.S. tax money is spent on health services for this population.
Researchers analyzed information collected by the Los Angeles Family Neighborhood Survey, which interviewed families in 65 L.A. County neighborhoods during 2000 and 2001. The county has the largest concentration of immigrants in the nation. Nonelderly participants — those between the ages of 18 and 64 — were asked about their health status, whether they had health insurance, the type and amount of care used, and their immigration status, a “very rare piece of information about immigrants,” said Smith.
Undocumented Immigrants Account for a Small Amount of Medical Costs and Pay More for Health Care Out of Pocket Than Do Other U.S. Residents |
SOURCE: “Immigrants and the Cost of Medical Care,” Health Affairs, Vol. 25, No. 6, November/December 2006, pp. 1–12, Dana P. Goldman, James P. Smith, Neeraj Sood. |
After deriving estimates for L.A. county, the researchers extrapolated estimates to the national level. As shown on the left side of the figure, total national medical spending for nonelderly adults in 2000 was nearly $430 billion. Native-born residents accounted for 87 percent of the population but for 91.5 percent of the spending.
Foreign-born residents (including U.S. citizens, permanent residents, undocumented immigrants, and temporary legal immigrants) accounted for 13 percent of the population but for only 8.5 percent of spending. Undocumented immigrants, who constituted 3.2 percent of the nation’s population, accounted for only about 1.5 percent of medical costs, according to the study.
The lower medical spending is driven by lower utilization of health services. In L.A. County, many foreign-born residents had almost no contact with the formal health care system. Whereas only about a tenth of native-born residents had never had a checkup, that fraction jumped to a quarter for foreign-born residents and to a third for undocumented immigrants. Moreover, because L.A. County is known as an immigrant-friendly location for services, the national estimates may overstate undocumented immigrant service use and, thus, overstate medical costs.
One key reason for the lower use of services is that immigrants, especially the undocumented, appear to be much healthier than native-born residents.
The right side of the figure shows that foreign-born residents use less funding from public insurers (such as Medicare and Medicaid) and pay more for health care out of pocket than do native-born residents — a pattern even more pronounced for undocumented immigrants.
Given these findings, the study argues, the policy debate over immigration should focus not on health care costs but on a fuller analysis of the fiscal benefits and costs of immigrants. “A more comprehensive analysis would incorporate the taxes paid by immigrants. But it also should include other public benefits received — in particular, public school costs, where the costs of all types of immigrants, including undocumented immigrants, are likely to be much larger,” said Smith.
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New Study Suggests Three Steps to Improve Mental Health Care
| Involving Multiple Stakeholders Is Key in Expanding the Range of Quality Improvement Programs for Mental Health Care | ||||||||||||||||
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According to the National Healthcare Quality Report, published by the U.S. Agency for Healthcare Research and Quality, only 4 of 179 quality indicators relate to mental health care.
“Mental health has not been well-represented in nationwide quality improvement initiatives, and it has not been clear how to accelerate progress,” said Kavita Patel, a RAND Corporation researcher and lead author of a study published in the May/June 2006 issue of Health Affairs.
The study makes a case for how to accelerate progress, identifying three steps. The first step involves expanding the range of mental health disorders for which quality improvement programs exist and adapting those programs for more diverse ages, groups, and service settings. For example, the strongest mental health quality improvement programs have centered on treating depression in well-established primary care settings (such as hospital- based outpatient clinics), but further progress is needed to adapt these programs to other current practice settings (such as those of individual practitioners or private group practices).
Second, the mental health system needs a better set of accountability mechanisms. Cognitive-behavioral treatment, for example, currently has no standards or certification requirements, and consumers have no easy way to identify practitioners who deliver the best quality care. The profession needs strong leadership to develop standards and minimum competency requirements, according to the study, which argues for harnessing market forces to help enforce them. For example, insurance firms could offer financial incentives for providers to seek additional training.
Third, health care financing should be linked directly to innovations in quality improvement and mental health care delivery. The study suggests one approach — pay-for-performance — which would link salary bonuses or other monetary rewards to quality indicators, such as patient satisfaction. Fully developing such an approach to mental health care would need to account for the system’s complexity — its division into public and private spheres — while balancing the needs for access, efficiency, and quality.
The study concludes that taking these three steps would require engaging the public in a meaningful fashion, and it outlines the roles that each group of stakeholders could play in taking each step. The table illustrates the potential roles for those involved in the first step.
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