Beyond ‘America First’ Some Overseas Solutions to Domestic Challenges

America will start winning again, winning like never before.”                                             -President Donald Trump, January 20^th, 2017

Rabat – It’s admirable and expected for a nation’s chief executive to declare the nation’s economic and security interests to be paramount. One of former Speaker of the House Tip O’Neill’s dictates is still relevant in 2017: “All politics is local.” Retail politics have never been more important for national political leaders as economic nationalism seems to be a prominent feature of public political discourse.

In the depths of the Great Recession in 2008-09, the U.S. economy lost 8.7 million jobs. It then added 11 million jobs during President Obama’s eight years in office. The resiliency of the U.S. economy is impressive and the country ranked 4^th on the 2016 Global Innovation Index survey which measures the innovation capabilities and results of the world’s major economies. Business executives who attended the recent 2017 World Economic Forum in Davos, Switzerland were asked which countries (other than their company’s home nation) are the most important for the firm’s business performance in the next twelve months. The United States was named most frequently (43% of respondents). Six years earlier at the same WEF, China was the most frequent response.

The U.S. faces some significant challenges and many of them are domestic in nature. Three key domestic challenges – health care, job skill training, and immigration – have been at or near the top of political agendas for both Democrats and Republicans for two decades. In an interconnected world it may be that the best solutions to these challenges are not found at home but, perhaps, abroad. Keeping America great just might require some exotic ingredients from abroad.

Health care access: Japan and the Pacific Rim

U.S. per capita (per person) healthcare spending in 2015 was more than $9,400. That’s more than double what the average Australian paid. President Obama’s primary domestic accomplishment was the passage of the Affordable Care Act (ACA). It accomplished much: the percentage of uninsured Americans is just 11%, the lowest in decades. But health insurance for most Americans operates in a private-market atmosphere; most working adults receive health insurance through their employer. Each state has different coverage and accessibility regulations.

According to a 2014 Bloomberg index survey that assessed health measures like life expectancy and health-care spending per capita, the U.S. placed 50^th out of 55 nations surveyed. Health care expenditures (by individuals, agencies and corporations) now make up 17.8% of the total U.S. Gross Domestic Product. Many of the nations with the most efficient heath care systems spend about 5-7% of their GDP on health care. U.S. life expectancy is 79 years old, and while data indicates that some U.S. outcomes, cancer survival rates, for instance, are impressive, American life expectancy is a year and a half less than the average for all OECD (developed economies) nations. What can we learn?

The most efficient health care systems in the world, those that have low or moderate per-capita costs and impressive outcomes (high life expectancy, regular accessibility, for example) create a balance between public health priorities and personal consumer choices. It’s not always easy. Japan has universal healthcare, meaning citizens have a right to healthcare. It’s an obligation and part of being a citizen of Japan.

Singapore and South Korea, too, rank high on the Bloomberg ranking. The tree nations include a significant government role in health care spending: uniform established rates are set for medical procedures, medication and reimbursements to hospitals, both private and public. Employee and employer payroll taxes play a significant role in funding nearly all health care systems in the world. Candidate Donald Trump, as well as Republican leaders in Congress, campaigned ferociously against the ACA. Hopefully, they will look beyond the U.S. for innovative solutions that improve concrete outcomes: boost life expectancy, better support preventative maternal/child health, control reimbursement costs, reduce administrative redundancy and boost accessibility.

Vocational training for young adults: Germany’s dual training (apprenticeships)

Unemployment for young men (15-24 year olds) in the US is about 10%, and it’s nearly double that for some minority community young adults. The four-year college degree is indeed valuable and creates durable and varied career options for young adults, but the need for manufacturing industry workers with specific technical skills will continue to grow. The job networking website LinkedIn recently found that young college graduates will have held four different jobs in just their first ten years following college. The so-called “new economy” requires some new thinking by everyone.

A 2016 story on the business news website MarketWatch indicated that Indiana, a Midwest state with a large manufacturing industry presence, and the home of Vice President Mike Pence, may face a shortage of nearly one million manufacturing workers by 2025. So, how can political and business leaders help so-called blue-collar workers, young college graduates and young adults with no college degree? An apprenticeship, or dual training (on-the-job-training paired with classroom instruction), is one solution to meet a changing economy.

In the U.S., fewer than five percent of young people train as apprentices (often in the construction and building trades). In Germany, the number is closer to 50 percent—in diverse fields like advanced manufacturing, IT, banking, and government administration. Young adult unemployment in Germany is about half that of the U.S. While Germany’s social and economic culture is different from the U.S., building stronger ties between high schools, higher education institutions and growing employment sectors can help strengthen the U.S. economy and revitalize several at-risk regions, including the so-called “Rust Belt”. Dual training, apprenticeships and vocational education may have earned greater respect throughout the EU than their equivalent programs in the U.S. but the new economy requires some new thinking among politicians and policymakers alike. Particularly those coming from the business sector.

Migrant and refugee integration: Morocco and Canada

A headline from a 2015 Al Jazeera news feature: “Morocco sets unlikely precedent in hosting sub-Saharan migrants”. Most of the world’s attention is on the flow of migrants from Syria, Iraq and Afghanistan toward European Union nations, specifically Germany. But another exodus of refugees and economic migrants is underway from western Africa and Sub-Saharan Africa. Morocco is a transit route for those refugees and migrants trying to reach the EU. In 2014, Morocco became the first nation in the Arab world to establish a formal legal migration policy, creating a path for possible legal residency for roughly 20,000 migrants (during the first phase of the program) who find themselves in the kingdom.

Morocco’s ambitious response to the migration crisis created both new opportunities for the Moroccan economy and new challenges for Moroccan society. In January, King Mohammad VI extended the duration of residence permits from one to three years. This will help those migrants and refugees who plan on staying in Morocco to normalize their residency. The process may be a bumpy road at first, but formalizing the migration status of new arrivals helps create a more orderly administrative process, protects public safety and, importantly, it begins the task of informing the general population about civil society institutions and expectations.

Unemployment in Morocco is dropping and as the economy continues to develop significant manufacturing and professional service sectors the need for both technically trained and semi-skilled workers will increase. Along with the new migrant/refugee regularization policy, Morocco’s return to the African Union will add a layer of social integration to the growing economic cooperation between the kingdom and Sub-Saharan nations. It’s a fallacy that all migrants lack education or vocational skills. In the U.S., nearly one quarter of practicing physicians were trained abroad. Additionally, there’s often a synergy that develops when new faces and new skills arrive. The arrival of Hispanic, African and Asian immigrants and migrants have significantly revitalized many rural communities across the U.S.