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Rapid	
  Results	
  for	
  USA	
  Jobs,	
  Health	
  &	
  Wealth:	
  
      Restoring	
  Our	
  Futures	
  With	
  Low-­‐Cost	
  Strategies	
  
      Funded	
  by	
  Repatriated	
  Overseas	
  Corporate	
  Funds	
  
                                                                                                     Prepared	
  by:	
  Dennis	
  D.	
  Embry,	
  Ph.D.	
  
                    President/Senior	
  Scientist,	
  PAXIS	
  Institute,	
  Tucson,	
  AZ	
  •	
  1-­‐520-­‐299-­‐6770	
  •	
  dde@paxis.org	
  

Abstract	
                                                                             Additionally,	
  the	
  Our	
  Futures	
  Fund	
  would	
  invest	
  
                                                                                       in	
  expanding	
  the	
  implementation	
  across	
  the	
  
Reuters	
  News	
  Service	
  estimates	
  that	
  $1.5	
                              country	
  of	
  previously	
  proven	
  and	
  tested,	
  very	
  
trillion	
  in	
  profits	
  are	
  held	
  overseas.	
  	
  Pressure	
                cost-­‐efficient	
  strategies	
  that	
  can	
  significantly	
  
has	
  been	
  increasing	
  to	
  repatriate	
  those	
  funds,	
                     reduce	
  current	
  Medicaid	
  and	
  healthcare	
  costs,	
  
but	
  not	
  to	
  repeat	
  the	
  failure	
  of	
  the	
  2004	
                    future	
  health-­‐care,	
  improve	
  public	
  safety,	
  and	
  
repatriation	
  that	
  experts	
  claim	
  did	
  not	
  lead	
  to	
                 improve	
  our	
  global	
  competitiveness.	
  
an	
  increase	
  in	
  domestic	
  investment,	
  
                                                                                       Individual,	
  business,	
  organizational	
  and	
  
employment	
  or	
  R&D.	
  	
  
                                                                                       government	
  beneficiary	
  entities	
  will	
  have	
  a	
  
Existing	
  law	
  plus	
  innovations	
  in	
  “Pay	
  for	
                          contract	
  to	
  pay	
  back	
  the	
  Our	
  Futures	
  Fund	
  based	
  
Success	
  Contracts”	
  (aka	
  Social	
  Impact	
  Bonds),	
                         on	
  careful	
  measures	
  of	
  success	
  and	
  principles	
  
however,	
  provides	
  a	
  pathway	
  for	
  repatriating	
                          established	
  by	
  previous	
  successful	
  experiments	
  
those	
  pent	
  up	
  profits	
  as	
  USA	
  investments.	
  	
  In	
                in	
  the	
  US	
  and	
  other	
  countries	
  involving	
  Social	
  
turn,	
  those	
  funds	
  can	
  be	
  used	
  to	
  increase	
                       Impact	
  Bonds.	
  	
  Thus,	
  the	
  success	
  of	
  new	
  
employment	
  by	
  the	
  nation’s	
  4.6	
  million	
  small	
                       employees,	
  businesses,	
  and	
  reductions	
  of	
  
businesses	
  (<25	
  employees)	
  plus	
  rapidly	
                                  crushing	
  costs	
  to	
  local,	
  state	
  and	
  federal	
  
reduce	
  major	
  costly	
  health,	
  educational,	
  and	
                          governments	
  (e.g.,	
  Medicaid,	
  unemployment	
  
safety	
  problems	
  harming	
  the	
  global	
                                       payments,	
  crime,	
  etc.)	
  would	
  payback	
  the	
  Our	
  
competitiveness	
  of	
  the	
  United	
  States.	
                                    Futures	
  Fund	
  and	
  its	
  investors	
  both	
  principle	
  
                                                                                       and	
  interest—the	
  companies	
  repatriating	
  
Current	
  law	
  allows	
  American	
  businesses	
  to	
                             overseas	
  corporate	
  profits.	
  A	
  sweetener	
  could	
  
repatriate	
  overseas	
  profits	
  by	
  purchasing	
  US	
                          be	
  added	
  to	
  the	
  existing	
  law:	
  Interest	
  payments	
  
investments	
  (e.g.,	
  T-­‐bills),	
  and	
  only	
  paying	
  tax	
                 from	
  the	
  Our	
  Futures	
  Fund	
  would	
  be	
  non-­‐
on	
  the	
  interest.	
  This	
  is	
  already	
  happening,	
  in	
                  taxable.	
  
part	
  because	
  of	
  the	
  instability	
  of	
  the	
  European	
  
Union.	
  	
  By	
  tweaking	
  this	
  law,	
  we	
  can	
  create	
  a	
             In	
  theory,	
  if	
  US	
  corporations	
  repatriated	
  the	
  
new	
  investment	
  mechanism,	
  tentatively	
  called:	
                            same	
  profits	
  as	
  they	
  did	
  in	
  2004	
  of	
  $360	
  billion	
  
“Our	
  Futures	
  Fund:	
  An	
  American	
  Families	
  &	
                          to	
  the	
  Our	
  Futures	
  Fund,	
  millions	
  of	
  new,	
  
Employment	
  Impact	
  Bond.”	
                                                       sustainable	
  jobs	
  could	
  be	
  created	
  across	
  every	
  
                                                                                       American	
  community;	
  and	
  hundreds	
  of	
  billions	
  
The	
  Our	
  Futures	
  Fund	
  would	
  then	
  invest	
  in	
                       of	
  dollars	
  of	
  crushing	
  health,	
  welfare,	
  and	
  
staking	
  “no-­‐risk”	
  hires	
  of	
  unemployed	
  by	
                            prison	
  costs	
  would	
  be	
  averted	
  at	
  a	
  local,	
  state	
  
qualified	
  small	
  businesses	
  (<25	
  employees)	
  to	
                         and	
  federal	
  level.	
  The	
  US	
  economy	
  would	
  
ramp	
  up	
  products,	
  services,	
  marketing	
  and	
                             rebound,	
  and	
  our	
  global	
  competitiveness	
  would	
  
sales.	
                                                                               be	
  increased	
  for	
  all	
  our	
  futures.


      	
                                                                       1	
  
Predicting	
  America’s	
  Future	
  from	
  Current	
  Facts	
  
Unless	
  current	
  FACTS	
  are	
  altered,	
  multiple	
                                      job	
  loss	
  increases	
  youth	
  smoking,	
  
adverse	
  trends	
  can	
  be	
  predicted	
  for	
  America.	
  	
                             forecasting	
  many	
  lifetime	
  health	
  problems.9	
  
Current	
  FACTS	
  predict	
  a	
  perfect	
  storm	
  of	
                                •    A	
  longitudinal	
  study	
  of	
  9,500	
  persons	
  shows	
  
worsening	
  problems	
  for	
  our	
  economy,	
  our	
                                         that	
  unemployment	
  most	
  adversely	
  affects	
  
public	
  safety,	
  our	
  health,	
  our	
  economy,	
  our	
                                  the	
  most	
  conscientious,	
  good	
  employees	
  for	
  
global	
  competitiveness,	
  and	
  our	
  national	
                                           future	
  employment.10	
  
security.	
  Fortunately,	
  the	
  United	
  States	
  actually	
                          •    Two	
  population-­‐based	
  longitudinal	
  studies	
  
possesses	
  the	
  best	
  science	
  to	
  alter	
  these	
  trends.	
  	
                     of	
  U.	
  S.	
  workers	
  show	
  that	
  involuntary	
  job	
  
Applying	
  this	
  world-­‐class	
  science	
  can	
  save	
  Our	
                             loss	
  causes	
  serious	
  cognitive	
  depression	
  and	
  
Futures	
  in	
  America.	
                                                                      poorer	
  overall	
  health.11	
  Another	
  
                                                                                                 longitudinal	
  study	
  of	
  unemployed	
  workers	
  
                                                                                                 shows	
  that	
  symptoms	
  of	
  common	
  mental	
  
                                                                                                 disorders	
  then	
  cause	
  greater	
  time	
  in	
  
                                                                                                 unemployment	
  over	
  four	
  years.12	
  Increased	
  
                                                                                                 psychiatric	
  hospitalization	
  follows	
  
                                                                                                 unemployment	
  in	
  another	
  12-­‐year	
  study.13	
  
                                                                                                 The	
  mental	
  health	
  effects	
  of	
  unemployment	
  
                                                                                                 cause	
  many	
  more	
  persons	
  to	
  migrate	
  to	
  
                                                                                                 disability	
  benefits.14	
  	
  	
  
                                                                                            •    Poor	
  mental	
  health	
  caused	
  by	
  becoming	
  
                                                                                                 unemployed	
  cause	
  parents	
  to	
  be	
  more	
  
                                                                             	
                  negative	
  and	
  punishing	
  to	
  their	
  children.15	
  
                                                                                                 Becoming	
  unemployed	
  as	
  mothers	
  increases	
  
FACT:	
  Unemployment	
  has	
  profound	
  physical	
                                           ADHD	
  among	
  dependent	
  children,16	
  which	
  
and	
  behavioral	
  impact	
  on	
  adults,	
  their	
                                          in	
  turn	
  predicts	
  unemployment	
  for	
  those	
  
current	
  children,	
  and	
  their	
  future	
  children	
                                     children	
  as	
  they	
  age.17	
  
                                                                                            •    Losing	
  employment	
  causes	
  subsequent	
  
Unemployment	
  has	
  one	
  of	
  the	
  most	
  devastating	
                                 infants	
  born	
  to	
  be	
  more	
  premature	
  and	
  
impacts	
  on	
  persistent	
  mental	
  and	
  physical	
                                       unhealthy.18	
  
health	
  on	
  adults	
  and	
  their	
  dependent	
  children.	
                          •    Fathers’	
  job	
  loss	
  increases	
  suicide	
  among	
  
Consider	
  a	
  few	
  examples:	
                                                              their	
  dependent	
  children.19	
  
•      The	
  US	
  National	
  Longitudinal	
  Survey	
  of	
                              •    Increases	
  in	
  community	
  unemployment,	
  
       Youth	
  shows	
  girls	
  tend	
  to	
  become	
  obese	
  in	
                          mortgage	
  delinquency,	
  and	
  foreclosure	
  
       periods	
  of	
  local	
  and	
  national	
                                               predict	
  future	
  hospitalizations	
  for	
  serious	
  
       unemployment,1	
  which	
  then	
  predicts	
  future	
                                   child	
  maltreatment,20	
  including	
  traumatic	
  
       disability	
  pension	
  status2	
  and	
  long-­‐term	
                                  brain	
  injuries.21	
  	
  In	
  turn,	
  this	
  predicts	
  
       health	
  costs	
  for	
  both	
  young	
  woman,	
  lower	
                              lifetime	
  employment	
  problems	
  by	
  the	
  
       fertility,	
  and	
  unhealthy	
  future	
  offspring.3-­‐6	
                             child.22	
  
•      The	
  US	
  National	
  Longitudinal	
  Survey	
  of	
                              Re-­‐employment,	
  however,	
  typically	
  improves	
  
       Youth	
  shows	
  that	
  unemployment	
  increases	
                                health	
  indicators	
  quickly.23	
  	
  And	
  a	
  warm	
  family	
  
       risky	
  sexual	
  behavior	
  and	
  risk	
  of	
  sexually	
                       environment	
  protects	
  a	
  child	
  from	
  future	
  
       transmitted	
  diseases.7	
  	
  The	
  same	
  survey	
                             unemployment	
  as	
  an	
  adult.24-­‐26	
  	
  
       shows	
  higher	
  risk	
  of	
  serious	
  lifetime	
  
       substance	
  abuse	
  or	
  alcohol	
  abuse.8	
  Parental	
  

	
                                                                                  2	
  
FACT:	
  American	
  Children	
  Have	
  the	
  Highest	
                                  The	
  Mission	
  Readiness	
  Group	
  (Retired	
  4-­‐Star	
  
Rate	
  of	
  Mental,	
  Emotional,	
  Behavioral	
  and	
                                 Generals)	
  finds	
  that	
  3-­‐out-­‐of-­‐four	
  17	
  through	
  24	
  
Related	
  Physical	
  Illnesses	
  Among	
  Rich	
                                        year-­‐old	
  youth	
  in	
  America	
  are	
  not	
  eligible	
  for	
  
                                                                                           military	
  service,	
  based	
  on	
  national	
  
Democracies.	
  
                                                                                           epidemiological	
  data—not	
  entrance	
  exams.	
  
The	
  evidence	
  for	
  this	
  sorry	
  state	
  comes	
  from	
  
multiple	
  studies,	
  sources	
  and	
  indicators	
  cited	
  in	
  
the	
  2009	
  Institute	
  of	
  Medicine	
  Report.27	
  The	
  
trends	
  have	
  been	
  worsen	
  for	
  at	
  least	
  the	
  past	
  20	
  
years,	
  and	
  now	
  it	
  appears	
  that	
  our	
  current	
  
children	
  may	
  have	
  a	
  short	
  lifespan	
  than	
  current	
  
adults	
  as	
  a	
  consequence	
  of	
  multiple	
  underlying	
  
connected	
  factors	
  from	
  adverse	
  childhood	
  
experiences,	
  violence,	
  suicide,	
  injuries,	
  plus	
                                                                                                          	
  
related	
  metabolic	
  disorders.	
                                                       The	
  Great	
  Smokey	
  Mountains	
  Longitudinal	
  
                                                                                           Study	
  finds	
  that	
  ever	
  two	
  years,	
  young	
  people	
  
For	
  example,	
  the	
  National	
  Longitudinal	
  Study	
  of	
                        are	
  having	
  earlier	
  and	
  earlier	
  onset	
  of	
  mental,	
  
Adolescence	
  (see	
  below)	
  shows	
  that	
  one-­‐out-­‐of-­‐                        emotional,	
  and	
  behavioral	
  disorders,	
  and	
  the	
  
two	
  18	
  year	
  olds	
  in	
  America	
  will	
  meet	
  an	
                         percentage	
  with	
  the	
  disorders	
  is	
  rising	
  with	
  
objective	
  diagnoses	
  of	
  one	
  major	
  mental	
  health	
                         each	
  younger	
  cohort.	
  
problem	
  that	
  impair	
  work	
  performance,	
  
educational	
  attainment,	
  compromise	
  health,	
  
and	
  increase	
  risk	
  of	
  criminal	
  offenses.	
  	
  




                                                                                                                                                                             	
  
                                                                                  The	
  Wall	
  Street	
  Journal	
  did	
  independent	
  
                                                                                  analyses	
  of	
  prescription	
  drug	
  use	
  among	
  
                                                                             	
   America’s	
  children	
  and	
  youth.	
  Their	
  December	
  
The	
  National	
  Co-­‐Morbidity	
  Study	
  shows	
  that	
  the	
   28,	
  2010	
  report	
  notes	
  that	
  40.4	
  million	
  of	
  our	
  
onset	
  and	
  proportion	
  of	
  birth-­‐cohorts	
  having	
  a	
              young	
  people	
  received	
  at	
  least	
  one	
  prescription	
  
major	
  depression	
  has	
  been	
  steadily	
  increasing,	
                   for	
  a	
  psychotropic	
  medication	
  in	
  2009.	
  
as	
  shown	
  below.	
  This	
  is	
  not	
  the	
  result	
  of	
  over-­‐
diagnoses,	
  which	
  is	
  filtered	
  out	
  of	
  the	
  study.	
  




                                                                                                                                                                                    	
  
                                                                                    	
  

	
                                                                                3	
  
The	
  2009	
  Institute	
  of	
  Medicine	
  Report	
  on	
  the	
                                              there	
  are	
  fewer	
  new	
  companies	
  making	
  any	
  
Prevention	
  of	
  Mental,	
  Emotional,	
  and	
  Behavioral	
                                                 hires	
  at	
  all.	
  
Disorders	
  Among	
  Young	
  People	
  (go	
  to	
  
http://bit.ly/IOM2009)	
  finds	
  that	
  most	
  of	
  these	
                      FACT:	
  US	
  Small	
  Business	
  Is	
  Smaller	
  Than	
  Most	
  
problems	
  are	
  preventable	
  at	
  a	
  public-­‐health	
                        Other	
  Rich	
  Democracies1	
  
programmatic	
  level,	
  based	
  on	
  funded	
  science	
  in	
  
                                                                                      The	
  United	
  States	
  has	
  among	
  the	
  lowest	
  shares	
  
the	
  United	
  States.	
  Other	
  rich	
  democracies	
  are	
  
                                                                                      of	
  employment	
  in	
  small	
  businesses	
  in	
  
using	
  this	
  science,	
  but	
  the	
  federal,	
  state	
  and	
  
                                                                                      manufacturing.	
  Only	
  11.1	
  percent	
  of	
  the	
  U.S.	
  
local	
  governments	
  of	
  America	
  are	
  not.	
  
                                                                                      manufacturing	
  workforce	
  is	
  in	
  enterprises	
  with	
  
FACT:	
  US	
  Small	
  Business	
  Is	
  Smaller	
  Now	
                            fewer	
  than	
  20	
  employees.	
  Eighteen	
  other	
  rich	
  
                                                                                      countries	
  have	
  a	
  higher	
  share	
  of	
  manufacturing	
  
Virtually	
  every	
  elected	
  official	
  in	
  the	
  United	
                    employment	
  in	
  enterprises	
  of	
  this	
  size,	
  as	
  
States	
  concurs	
  that	
  small	
  business	
  is	
  the	
                         shown	
  in	
  the	
  figure	
  on	
  the	
  next	
  page.	
  
backbone	
  of	
  our	
  economy	
  and	
  our	
  communities.	
  
Across	
  the	
  country,	
  there	
  are	
  nearly	
  4.8	
  million	
               What	
  if	
  the	
  cut	
  off	
  is	
  put	
  higher,	
  say	
  firms	
  with	
  
businesses	
  that	
  employ	
  25	
  or	
  fewer	
  workers.	
  	
  	
               less	
  than	
  500	
  employees	
  in	
  manufacturing?	
  	
  The	
  
                                                                                      United	
  States	
  is	
  at	
  the	
  bottom	
  (no	
  data	
  available	
  
Just	
  imagine	
  if	
  each	
  one	
  of	
  those	
  small	
                        on	
  Luxembourg	
  or	
  Switzerland).	
  
businesses	
  took	
  on	
  one	
  new	
  employee	
  this	
  year.	
  	
  
That	
  would	
  reduce	
  unemployment	
  from	
  about	
                            Similar	
  trends	
  hold	
  true	
  for	
  firms	
  involved	
  in	
  
12.7	
  million	
  people	
  to	
  7.9	
  million—a	
  38%	
                          research	
  and	
  development,	
  computer	
  services,	
  
reduction.	
  Think	
  what	
  that	
  would	
  do	
  for	
                           and	
  even	
  low-­‐tech	
  services.	
  
confidence	
  in	
  the	
  future,	
  our	
  jobs	
  report,	
  the	
  
                                                                                      What	
  Keeps	
  Small	
  Firms	
  from	
  Hiring?	
  
mood	
  of	
  the	
  country,	
  and	
  our	
  overall	
  economic	
  
security.	
  Let’s	
  consider	
  how	
  to	
  jump	
  start	
  hiring	
              Various	
  polls	
  suggest	
  that	
  small	
  businesses	
  
by	
  very	
  small	
  businesses	
  of	
  25	
  or	
  fewer	
                        (<25	
  to	
  50	
  employees)	
  are	
  not	
  in	
  a	
  hiring	
  mood.	
  
employees.	
  First,	
  consider	
  some	
  facts.	
                                  Mostly	
  this	
  is	
  about	
  confidence	
  in	
  the	
  future	
  to	
  
                                                                                      make	
  a	
  profit	
  from	
  the	
  investment	
  new	
  
Small	
  Business	
  today	
  is	
  getting	
  smaller	
  in	
  many	
  
                                                                                      employees.	
  	
  If	
  you	
  are	
  a	
  small	
  business,	
  adding	
  
ways:	
  
                                                                                      one	
  employee	
  is	
  a	
  big	
  deal.	
  If	
  you	
  are	
  a	
  large	
  
•      Online	
  payroll	
  services	
  company,	
                                    business,	
  a	
  few	
  more	
  or	
  less	
  employees	
  are	
  
       SurePayroll,	
  found	
  that	
  50	
  percent	
  of	
  the	
                  marginal	
  costs.	
  	
  	
  
       surveyed	
  small-­‐business	
  owners	
  are	
  
       "experiencing	
  increased	
  revenue	
  and	
  
       growth	
  in	
  their	
  business,"	
  but	
  those	
  same	
  
       business	
  owners	
  aren’t	
  hiring.	
  
•      A	
  recent	
  Kaufman	
  Foundation	
  study	
  found	
  
       the	
  average	
  new	
  business	
  establishment	
  
       opened	
  its	
  doors	
  with	
  about	
  7.5	
  employees	
  
       in	
  the	
  1990’s—compared	
  to	
  about	
  4.9	
  jobs	
  
       per	
  startup	
  today.	
  
•      Additionally,	
  the	
  Kaufman	
  study	
  reports	
  
       that	
  the	
  number	
  of	
  new	
  businesses	
  hiring	
  
       employees	
  has	
  contracted	
  by	
  more	
  than	
  27	
  
       percent	
  since	
  2006.	
  So	
  not	
  only	
  are	
  there	
               	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  	
  
       fewer	
  employees	
  per	
  new	
  company,	
  but	
                          1http://www.cepr.net/documents/publications

                                                                                      /small-­‐business-­‐2009-­‐08.pdf	
  

	
                                                                            4	
  
 




It	
  cannot	
  be	
  just	
  an	
  issue	
  of	
  “government	
                         care	
  reforms	
  in	
  the	
  US.	
  Virtually	
  every	
  one	
  of	
  
regulation,”	
  as	
  the	
  fundamental	
  regulations	
                                the	
  countries	
  with	
  higher	
  percentages	
  of	
  small	
  
related	
  to	
  employees	
  today	
  are	
  about	
  the	
  same	
                     business	
  actually	
  have	
  single-­‐payer,	
  health-­‐care	
  
as	
  two	
  decades	
  ago:	
  pay	
  all	
  the	
  payroll	
  taxes,	
                 systems.	
  
don’t	
  endanger	
  your	
  employees,	
  and	
  don’t	
  
engage	
  in	
  egregious	
  discrimination	
  or	
                                      The	
  real	
  issue	
  for	
  small	
  business	
  of	
  new	
  hires	
  is	
  
harassment.	
  These	
  are	
  fair	
  play	
  rules.	
  	
  	
                          the	
  fear	
  of	
  not	
  making	
  return	
  on	
  the	
  investment.	
  
                                                                                         “Maybe	
  it	
  won’t	
  pay	
  off”.	
  “Maybe	
  I	
  would	
  do	
  
It	
  is	
  also	
  important	
  to	
  note	
  that	
  regulations	
                     better	
  to	
  save	
  the	
  dollars	
  or	
  invest	
  in	
  
governing	
  small	
  businesses	
  are	
  more	
  strict	
  and	
                       marketing.”	
  Or,	
  “What	
  if	
  I	
  hire	
  the	
  wrong	
  
difficult	
  in	
  most	
  of	
  the	
  other	
  countries	
  with	
                     person?”	
  Or,	
  “What	
  if	
  cash	
  flow	
  goes	
  down?”	
  
higher	
  percentages	
  of	
  small	
  businesses.	
  	
  It	
  is	
  
also	
  questionable	
  that	
  the	
  issue	
  is	
  taxation	
                         These	
  are	
  not	
  abstractions	
  for	
  us	
  at	
  PAXIS	
  
rates,	
  as	
  most	
  of	
  the	
  other	
  countries	
  have	
                        Institute.	
  We	
  are	
  a	
  small	
  business.	
  
actually	
  higher	
  marginal	
  taxes	
  (fewer	
                                      If	
  the	
  relative	
  risk	
  of	
  a	
  new	
  hire	
  were	
  reduced,	
  
deductions),	
  excluding	
  VAT	
  or	
  GST	
  compared	
  to	
                        small	
  business	
  owners	
  would	
  hire	
  more	
  
the	
  United	
  States.	
                                                               employees.	
  	
  How	
  might	
  that	
  happen?	
  	
  
It	
  is	
  noteworthy,	
  too,	
  that	
  this	
  difference	
  is	
  not	
             	
  
likely	
  to	
  be	
  because	
  of	
  newly	
  enacted	
  health	
  
            	
  




	
                                                                               5	
  
Our	
  Futures	
  Fund:	
  An	
  American	
  Families	
  &	
  Employment	
  Impact	
  Bond	
  




                                                                                                                                                          	
  
	
  
Corporations	
  are	
  able	
  to	
  invest	
  their	
  foreign	
             which	
  is	
  a	
  specially	
  constructed	
  public-­‐
earnings	
  in	
  U.S.	
  assets	
  without	
  treating	
                     private	
  partnership.	
  
them	
  as	
  “repatriated”	
  and	
  subject	
  to	
  
                                                                              Here	
  is	
  a	
  broad-­‐brush	
  idea	
  to	
  increase	
  
taxation,	
  because	
  the	
  federal	
  tax	
  code,	
  
specifically	
  Section	
  956(c)(2),	
  already	
                            repatriated	
  funds,	
  and	
  improve	
  
allows	
  U.S.	
  corporations	
  to	
  use	
  foreign	
                      employment.	
  
funds	
  to	
  make	
  a	
  wide	
  range	
  of	
  U.S.	
                     A	
  public	
  investment	
  fund	
  might	
  be	
  created,	
  
investments	
  without	
  incurring	
  tax	
  liability.	
  	
                called	
  “Our	
  Futures”	
  as	
  a	
  Families	
  and	
  
If	
  those	
  U.S.	
  investments	
  then	
  produce	
                       Employment	
  Impact	
  Bond.	
  	
  This	
  could	
  be	
  
income,	
  that	
  additional	
  income	
  may	
  be	
                        done	
  in	
  states	
  or	
  nationally	
  or	
  both.	
  	
  The	
  
subject	
  to	
  taxation.	
  	
                                              talent	
  to	
  create	
  such	
  Social	
  Impact	
  Bonds	
  
Legislation	
  could	
  be	
  introduced	
  to	
  waive	
                     clearly	
  exists	
  in	
  the	
  state	
  of	
  Connecticut.	
  	
  
                                                                              This	
  public	
  investment	
  fund	
  would	
  be	
  
the	
  tax	
  on	
  investment	
  income,	
  providing	
  
that	
  investment	
  was	
  in	
  a	
  qualified	
  Social	
                 aimed	
  at	
  expanding	
  employment	
  in	
  the	
  4	
  
Impact	
  Bond	
  or	
  Fund	
  to	
  improve	
  jobs	
  and	
                million	
  plus	
  small	
  businesses	
  under	
  25	
  
                                                                              employees	
  in	
  the	
  US.	
  	
  	
  The	
  fund	
  would	
  also	
  
the	
  wellbeing	
  of	
  children	
  and	
  families—

	
                                                                    6	
  
be	
  aimed	
  at	
  reduce	
  mental,	
  emotional,	
                          •    A	
  study	
  funded	
  by	
  the	
  Centers	
  for	
  
behavioral	
  and	
  related	
  physical	
  illnesses	
                              Disease	
  Control	
  and	
  Prevention	
  proved	
  
among	
  children	
  and	
  families.	
                                              that	
  Triple	
  P	
  can	
  prevent	
  multiple	
  
                                                                                     indicators	
  of	
  child	
  maltreatment	
  for	
  
Local	
  public	
  entities	
  and	
  local	
  small	
  
                                                                                     whole	
  counties,	
  at	
  the	
  cost	
  of	
  $15	
  per	
  
businesses	
  will	
  form	
  an	
  Our	
  Futures	
  
                                                                                     child	
  in	
  the	
  county.28	
  
partnership,	
  and	
  local	
  folks	
  seeking	
  
                                                                                •    Triple	
  P	
  can	
  be	
  delivered	
  effectively	
  via	
  
employment	
  may	
  become	
  members	
  of	
  this	
  
                                                                                     mass	
  media.29-­‐31	
  
effort.	
  	
  They	
  will	
  prepare	
  a	
  charter	
  that	
  
embraces	
  specific	
  actions	
  in	
  their	
  settings	
                    •    Triple	
  P	
  can	
  be	
  delivered	
  via	
  phone	
  to	
  
to	
  become	
  beneficiary	
  partners	
  in	
  local	
  or	
                       remote	
  areas.32	
  
regional	
  American	
  Employment	
  Impact	
                                  •    Triple	
  P	
  averts	
  or	
  prevents	
  serious	
  
Bonds	
                                                                              problems	
  like	
  oppositional	
  defiance	
  or	
  
                                                                                     conduct	
  disorders.33	
  
This	
  investment	
  fund—The	
  American	
                                    •    Triple	
  P	
  reduces	
  parental	
  depression.34	
  
Families	
  and	
  Employment	
  Impact	
  Bonds—                                    35	
  
would	
  do	
  several	
  types	
  of	
  investments	
  in	
                    •    Triple	
  P	
  improves	
  marital	
  and	
  step-­‐
increasing	
  health	
  and	
  wellbeing	
  for	
  the	
                             family	
  relationships.36	
  
population	
  of	
  children	
  and	
  families	
  as	
  well	
                 •    Triple	
  P	
  reduces	
  obesity.37	
  38	
  
as	
  employment	
  in	
  targeted	
  political	
  
jurisdictions—e.g.,	
  municipalities,	
  counties,	
                           Multiple	
  projects	
  and	
  studies	
  show	
  that	
  
and	
  states.	
                                                                Triple	
  P	
  works	
  well	
  in	
  America.	
  

Example	
  Children	
  and	
  Families	
  Investments:	
                        A	
  recently	
  published	
  cost-­‐savings	
  estimator	
  
                                                                                shows	
  how	
  many	
  cases	
  of	
  child	
  
The	
  fund	
  would	
  invest	
  in	
  two	
  of	
  the	
  most	
              maltreatment	
  might	
  be	
  saved	
  in	
  each	
  state	
  
highlighted	
  strategies	
  in	
  the	
  IOM	
  Report	
                       and	
  how	
  much	
  money	
  would	
  be	
  saved	
  as	
  a	
  
with	
  a	
  potential	
  to	
  rapidly	
  improve	
  health	
                  consequence.39	
  	
  The	
  estimator	
  may	
  be	
  
and	
  safety	
  indicators	
  among	
  children	
  and	
                       downloaded	
  at	
  
families	
  at	
  a	
  population,	
  public-­‐health	
  level:	
               http://paxis.org/triplep/Default.aspx	
  
Triple	
  P	
  and	
  the	
  Good	
  Behavior	
  Game.	
  
These	
  two	
  interventions	
  have	
  evidence	
  for	
                      A	
  video	
  about	
  the	
  study	
  and	
  results	
  may	
  be	
  
being	
  population	
  level	
  approaches	
  with	
                            viewed	
  http://slidesha.re/triplepvideo	
  
cost	
  effective	
  outcomes	
  across	
  many	
                               Proven	
  Good	
  Behavior	
  Outcomes	
  
problems.	
                                                                     The	
  Good	
  Behavior	
  Game40	
  is	
  a	
  “behavioral	
  
Proven	
  Triple	
  P	
  Outcomes	
                                             vaccine”	
  used	
  everyday	
  in	
  a	
  classroom,	
  and	
  
Triple	
  P	
  is	
  a	
  system	
  of	
  parenting	
  supports	
               can	
  be	
  implemented	
  in	
  a	
  public-­‐health	
  
from	
  which	
  parents	
  can	
  choose.	
  Various	
                         model.39	
  
studies	
  show	
  that	
  these	
  parenting	
  supports	
                     The	
  Game	
  is	
  used	
  during	
  any	
  instructional	
  
can	
  be	
  delivered	
  by	
  many	
  different	
  types	
  of	
              activity,	
  by	
  dividing	
  the	
  class	
  into	
  teams	
  
people	
  and	
  via	
  many	
  different	
  media,	
  all	
                    who	
  may	
  work	
  together	
  to	
  earn	
  simple,	
  
with	
  proven	
  effects	
  via	
  many	
  randomized-­‐                       brief	
  activity	
  rewards	
  like	
  a	
  “giggle	
  fest.”	
  
control	
  trials	
  around	
  the	
  world,	
  including	
                     The	
  Game	
  teaches	
  children	
  how	
  to	
  pay	
  
the	
  US.	
  Many	
  of	
  those	
  studies	
  can	
  be	
  seen	
             attention	
  voluntarily,	
  and	
  ignore	
  the	
  
at:	
  http://bit.ly/TRIPLE-­‐P-­‐CITES	
  .	
                                  misbehaviors	
  of	
  other	
  students.	
  The	
  



	
                                                                      7	
  
children	
  learn	
  that	
  they	
  can	
  “better	
  their	
                results.	
  The	
  Substance	
  Abuse	
  and	
  Mental	
  
world,	
  and	
  better	
  themselves.”	
                                     Health	
  Administration	
  has	
  20	
  sites	
  using	
  
                                                                              the	
  Game,	
  showing	
  that	
  it	
  is	
  widely	
  
One	
  can	
  view	
  videos	
  about	
  the	
  province-­‐                   replicable	
  in	
  America.	
  
wide	
  launch	
  of	
  the	
  Good	
  Behavior	
  Game	
  
(commercially	
  branded	
  as	
  PAX	
  GBG)	
  in	
                         Using	
  economic	
  data	
  from	
  the	
  Washington	
  
Manitoba	
  and	
  an	
  earlier	
  pilot	
  here:	
                          State	
  Institute	
  for	
  Policy	
  Research	
  (WSIPR),	
  
                                                                              it	
  is	
  possible	
  to	
  estimate	
  the	
  impact	
  of	
  the	
  
http://bit.ly/ManitobaPAXLaunch	
  
                                                                              Good	
  Behavior	
  Game	
  if	
  it	
  were	
  provided	
  to	
  
http://bit.ly/ManitobaPAXGBGPilot	
                                           every	
  first	
  grader	
  in	
  America.	
  	
  WSIPR	
  
                                                                              estimates	
  the	
  Game	
  saves	
  $4,637	
  for	
  each	
  
The	
  Game	
  has	
  been	
  repeatedly	
  tested	
  with	
                  student.	
  	
  Assuming	
  4,000,000	
  First	
  Graders	
  
randomized	
  studies	
  with	
  very	
  long-­‐term	
                        each	
  year	
  in	
  the	
  US,	
  this	
  saves	
  $18	
  billion	
  
follow-­‐up	
  (20+	
  years)	
  after	
  just	
  using	
  the	
              every	
  1st	
  Grade	
  cohort	
  by	
  age	
  21.	
  	
  
game	
  in	
  First	
  Grade.	
  	
  A	
  recent	
  publication	
  
summarized	
  many	
  of	
  the	
  key	
  findings.41	
  	
  
The	
  table	
  on	
  the	
  next	
  page	
  shows	
  those	
  




                                                                                                                                                     	
  
	
  
Incentivizing	
  Providers	
  and	
  Organizations	
  to	
                      My	
  colleagues	
  and	
  I	
  have	
  demonstrated	
  
Implement	
  Proven	
  Practices	
  for	
  Population-­‐                        that	
  large	
  numbers	
  of	
  American	
  providers	
  
Level	
  Prevention	
  Results	
                                                can	
  be	
  incentivized	
  and	
  organized	
  to	
  
To	
  achieve	
  the	
  results	
  needed	
  to	
  “bend	
                      deliver	
  a	
  previously	
  proven	
  prevention	
  
the	
  curve”	
  for	
  improving	
  the	
  condition	
  of	
                   strategy	
  and	
  achieve	
  cost	
  effective	
  change	
  
America’s	
  children	
  and	
  families,	
  many	
                             for	
  whole	
  states,	
  using	
  standardized	
  
organizations	
  must	
  be	
  recruited	
  across	
                            federally	
  mandated	
  and	
  collected	
  health	
  
the	
  community	
  implement	
  the	
  same	
                                  and	
  policy	
  indicators.	
  
strategies—just	
  like	
  has	
  been	
  pioneered	
  
                                                                                This	
  example	
  can	
  be	
  found	
  at	
  the	
  National	
  
when	
  America	
  faced	
  other	
  epidemics	
  such	
  
                                                                                Registry	
  of	
  Effective	
  Programs	
  and	
  
as	
  polio	
  or	
  other	
  diseases.	
  


	
                                                                    8	
  
Practices,	
  see	
                                                             everyday	
  tobacco	
  use	
  as	
  measured	
  by	
  the	
  
http://bit.ly/rewardandreminder	
                                               Centers	
  for	
  Disease	
  Control.	
  
This	
  strategy	
  quickly	
  achieved	
                                       We	
  have	
  outlined	
  an	
  implementation	
  and	
  
compliance	
  with	
  federally	
  mandated	
                                   monitoring	
  logic	
  model	
  for	
  achieving	
  
policy	
  requirements,	
  and	
  the	
                                         population-­‐level,	
  public	
  health	
  outcomes,	
  
implementation	
  also	
  significantly	
  reduce	
                             which	
  appears	
  next.
any	
  tobacco	
  use	
  in	
  the	
  last	
  30	
  days	
  and	
  




                                                                                                                                                	
  
	
  

Employment	
  and	
  Job	
  Creation	
  Investments

Employment	
  Investment	
  #1:	
  	
  	
                                     additional,	
  monthly	
  incentive	
  for	
  their	
  work	
  
We	
  propose	
  incentives	
  for	
  employing	
                             efforts,	
  and	
  the	
  business	
  would	
  receive	
  a	
  
persons	
  receiving	
  unemployment	
                                        small	
  placement	
  incentive.	
  Something	
  like	
  
insurance.	
  	
  Small	
  businesses	
  could	
  “hire”	
                    was	
  successful	
  in	
  New	
  Zealand,	
  when	
  it	
  
the	
  unemployment	
  insurance	
  recipient	
  of	
                         faced	
  a	
  serious	
  economic	
  downturn	
  in	
  the	
  
their	
  choice,	
  and	
  the	
  employment	
  insurance	
                   1980s.	
  
would	
  continue	
  for	
  the	
  individual.	
  The	
  
“hire”	
  would	
  also	
  receive	
  a	
  significant	
  


	
                                                                    9	
  
Employment	
  Investment	
  #2:	
  	
                                             along	
  with	
  the	
  boundaries	
  of	
  the	
  funds	
  
In	
  this	
  track,	
  an	
  existing,	
  credit	
  worthy	
                     or	
  resources	
  being	
  managed.	
  
small	
  businesses	
  would	
  submit	
  a	
  brief	
                       2.   Proportional	
  costs	
  and	
  benefits.	
  
business	
  plan	
  to	
  expand	
  their	
  business	
  for	
  a	
               Everyone	
  is	
  expected	
  do	
  their	
  fair	
  share	
  
subsidized	
  new	
  hire	
  who	
  is	
  no	
  longer	
                          and	
  those	
  who	
  go	
  beyond	
  the	
  call	
  of	
  
eligible	
  for	
  unemployment	
  yet	
  wish	
  to	
  get	
                     duty	
  are	
  appropriately	
  recognized.	
  
employment.	
  	
  The	
  small	
  business	
  would	
                       3.   Consensus	
  decision-­‐making:	
  Participants	
  
have	
  to	
  commit	
  to	
  providing	
  health	
                               will	
  work	
  hard	
  to	
  implement	
  a	
  
insurance	
  for	
  the	
  new	
  employee,	
  the	
  space,	
                    consensus	
  decision—to	
  do	
  what	
  “we”	
  in	
  
etc.	
  	
  The	
  investment	
  for	
  such	
  an	
  employee	
                  the	
  group	
  want,	
  not	
  what	
  they	
  want.	
  In	
  
would	
  be	
  for	
  12	
  months	
  to	
  jumpstart	
                           addition,	
  the	
  best	
  decisions	
  often	
  
business	
  expansion.	
                                                          require	
  knowledge	
  of	
  local	
  
                                                                                  circumstances	
  that	
  we	
  have	
  and	
  they	
  
Repayment	
  of	
  Investors	
                                                    lack,	
  making	
  consensus	
  decision-­‐making	
  
As	
  significant	
  beneficiaries,	
  municipal,	
                               doubly	
  important.	
  
county	
  and/or	
  and	
  state	
  governments	
                            4.   Monitoring:	
  Since	
  individuals,	
  groups	
  
would	
  have	
  a	
  binding	
  agreement	
  to	
                                businesses,	
  or	
  public	
  beneficiaries	
  
payback	
  pro-­‐rata	
  funds	
  to	
  the	
  Social	
  Impact	
                 might	
  try	
  to	
  actively	
  game	
  the	
  system,	
  a	
  
Bond	
  based	
  on	
  designed	
  criteria	
  related	
  to	
                    system	
  of	
  monitoring	
  desired	
  outcomes	
  
reduced	
  mental,	
  emotional,	
  behavioral,	
  and	
                          and	
  transgressions	
  would	
  agreed	
  upon	
  
related	
  physical	
  health	
  outcomes	
  as	
  well	
  as	
              5.   Graduated	
  sanctions:	
  The	
  local	
  groups	
  
unemployment,	
  using	
  economic	
  modeling.	
  	
  	
                         often	
  can	
  be	
  self-­‐correcting,	
  but	
  
                                                                                  stronger	
  sanctions	
  need	
  to	
  be	
  provided	
  
Also	
  as	
  beneficiaries,	
  contracted	
  businesses	
                        from	
  punishments	
  to	
  exclusion.	
  
would	
  agree	
  to	
  pay	
  pro-­‐rata	
  funds	
  into	
  the	
          6.   Fast	
  and	
  fair	
  conflict	
  resolution:	
  	
  When	
  
Social	
  Impact	
  Fund,	
  based	
  on	
  a	
  reasonable	
                     conflicts	
  arise,	
  they	
  must	
  be	
  resolved	
  
formula	
  of	
  impact	
  on	
  their	
  increased	
                             quickly	
  and	
  in	
  a	
  manner	
  that	
  all	
  parties	
  
business	
  (if	
  any)	
  over	
  a	
  specified	
  time.	
                      consider	
  fair.	
  This	
  typically	
  involves	
  a	
  
                                                                                  hearing	
  in	
  which	
  respected	
  members	
  of	
  
Finally,	
  the	
  hired	
  person	
  would	
  agree	
  to	
  
                                                                                  the	
  group,	
  who	
  can	
  be	
  expected	
  to	
  be	
  
make	
  pro-­‐rata	
  payments	
  back	
  to	
  the	
  Impact	
  
                                                                                  impartial,	
  and	
  make	
  an	
  equitable	
  
Fund	
  based	
  on	
  federally	
  reported	
  taxes	
  
                                                                                  decisions.	
  
over	
  a	
  period	
  of	
  time,	
  for	
  W2	
  wages.	
  
                                                                             7.   Local	
  autonomy:	
  Many	
  smaller	
  groups	
  of	
  
Fund	
  Integrity	
                                                               beneficiaries	
  will	
  be	
  nested	
  in	
  larger	
  
                                                                                  groups.	
  They	
  will	
  need	
  to	
  have	
  some	
  
A	
  series	
  of	
  checks	
  and	
  balances	
  would	
  be	
                   powers	
  to	
  make	
  local	
  decisions.	
  
established	
  for	
  this	
  fund,	
  based	
  on	
  the	
  well	
          8.   Nested	
  governances:	
  When	
  a	
  group	
  
proven	
  principles	
  from	
  the	
  Nobel	
  Prize	
  in	
                     beneficiaries	
  is	
  nested	
  with	
  a	
  larger	
  
Economics	
  for	
  Common	
  Pool	
  Resources	
  to	
                           society,	
  relationships	
  among	
  groups	
  and	
  
Elinor	
  Ostrum	
  and	
  colleagues.	
  There	
                                 higher-­‐level	
  entities	
  (such	
  as	
  state	
  and	
  
proven	
  principles	
  include:	
                                                federal	
  regulatory	
  agencies)	
  must	
  
1. Group	
  Identity:	
  all	
  parties	
  have	
  a	
  strong	
                  reflect	
  the	
  same	
  principles	
  outlined	
  
   sense	
  of	
  group	
  identity	
  and	
  know	
  the	
                       above	
  for	
  single	
  groups.	
  
   rights	
  and	
  obligations	
  of	
  membership,	
  



	
                                                                      10	
  
Next	
  Steps	
                                                                                       	
  
                                                                                                      These	
  discussions	
  would	
  identify	
  major	
  
Soon,	
  there	
  needs	
  to	
  be	
  discussion	
  with	
  
                                                                                                      partners,	
  timelines,	
  and	
  mechanisms	
  to	
  
various	
  elected	
  officials	
  and	
  other	
  experts	
  
                                                                                                      refine	
  and	
  promote	
  the	
  plan.
to	
  refine	
  this	
  plan.	
  


References	
  Cited
	
                                                                                                    14.	
  Lamberg	
  T,	
  Virtanen	
  P,	
  Vahtera	
  J,	
  Luukkaala	
  T,	
  
1.	
  Arkes	
  J.	
  How	
  the	
  economy	
  affects	
  teenage	
  weight.	
  Social	
                             Koskenvuo	
  M.	
  Unemployment,	
  depressiveness	
  
                Science	
  &	
  Medicine	
  2009;68(11):1943-­‐47.	
                                                and	
  disability	
  retirement:	
  A	
  follow-­‐up	
  study	
  of	
  
2.	
  Neovius	
  K,	
  Johansson	
  K,	
  Rossner	
  S,	
  Neovius	
  M.	
  Disability	
                            the	
  Finnish	
  HeSSup	
  population	
  sample.	
  Social	
  
                pension,	
  employment	
  and	
  obesity	
  status:	
  a	
                                          Psychiatry	
  and	
  Psychiatric	
  Epidemiology	
  
                systematic	
  review.	
  Obes	
  Rev	
  2008;9(6):572-­‐81.	
                                       2010;45(2):259-­‐64.	
  
3.	
  Jokela	
  M,	
  Elovainio	
  M,	
  Kivimaki	
  M.	
  Lower	
  fertility	
                       15.	
  McLoyd	
  VC,	
  Jayaratne	
  TE,	
  Ceballo	
  R,	
  Borquez	
  J.	
  
                associated	
  with	
  obesity	
  and	
  underweight:	
  the	
  US	
                                 Unemployment	
  and	
  work	
  interruption	
  among	
  
                National	
  Longitudinal	
  Survey	
  of	
  Youth.	
  Am	
  J	
  Clin	
                             African	
  American	
  single	
  mothers:	
  effects	
  on	
  
                Nutr	
  2008;88(4):886-­‐93.	
                                                                      parenting	
  and	
  adolescent	
  socioemotional	
  
4.	
  Olshansky	
  SJ,	
  Passaro	
  DJ,	
  Hershow	
  RC,	
  Layden	
  J,	
  Carnes	
                              functioning.	
  Child	
  Dev	
  1994;65(2	
  Spec	
  No):562-­‐
                BA,	
  Brody	
  J,	
  et	
  al.	
  A	
  potential	
  decline	
  in	
  life	
                        89.	
  
                expectancy	
  in	
  the	
  United	
  States	
  in	
  the	
  21st	
                    16.	
  Harvey	
  E.	
  Parental	
  employment	
  and	
  conduct	
  problems	
  
                century.[see	
  comment].	
  New	
  England	
  Journal	
  of	
                                      among	
  children	
  with	
  attention-­‐
                Medicine	
  2005;352(11):1138-­‐45.	
                                                               deficit/hyperactivity	
  disorder:	
  An	
  examination	
  of	
  
5.	
  Krassas	
  GE,	
  Tzotzas	
  T.	
  Do	
  obese	
  children	
  become	
  obese	
                               child	
  care	
  workload	
  and	
  parenting	
  well-­‐being	
  as	
  
                adults:	
  childhood	
  predictors	
  of	
  adult	
  disease.	
                                     mediating	
  variables.	
  Journal	
  of	
  Social	
  and	
  Clinical	
  
                Pediatr	
  Endocrinol	
  Rev	
  2004;1	
  Suppl	
  3:455-­‐9.	
                                     Psychology	
  1998;17(4):476-­‐90.	
  
6.	
  Gavard	
  JA.	
  Health	
  care	
  costs	
  of	
  obesity	
  in	
  women.	
  Obstet	
           17.	
  Zwaan	
  M,	
  Gru√ü	
  B,	
  M√ºller	
  A,	
  Graap	
  H,	
  Martin	
  A,	
  
                Gynecol	
  Clin	
  North	
  Am	
  2009;36(2):213-­‐26,	
  xii.	
                                    Glaesmer	
  H,	
  et	
  al.	
  The	
  estimated	
  prevalence	
  and	
  
7.	
  Davis	
  MJ.	
  The	
  effects	
  of	
  unemployment	
  and	
  poverty	
  on	
                                correlates	
  of	
  adult	
  ADHD	
  in	
  a	
  German	
  
                sexual	
  appetite	
  and	
  sexual	
  risk	
  in	
  emerging	
  and	
                              community	
  sample.	
  European	
  Archives	
  of	
  
                young	
  adults.	
  Sexual	
  Addiction	
  &	
  Compulsivity	
                                      Psychiatry	
  and	
  Clinical	
  Neuroscience	
  
                2009;16(4):267-­‐88.	
                                                                              2012;262(1):79-­‐86.	
  
8.	
  Mossakowski	
  KN.	
  Is	
  the	
  duration	
  of	
  poverty	
  and	
                           18.	
  Lindo	
  JM.	
  Parental	
  job	
  loss	
  and	
  infant	
  health.	
  J	
  Health	
  
                unemployment	
  a	
  risk	
  factor	
  for	
  heavy	
  drinking?	
                                  Econ	
  2011;30(5):869-­‐79.	
  
                Social	
  Science	
  &	
  Medicine	
  2008;67(6):947-­‐55.	
                          19.	
  Aleck	
  O,	
  Stefania	
  M,	
  James	
  T,	
  James	
  D,	
  Ruth	
  H,	
  Lisa	
  C,	
  et	
  
9.	
  Unger	
  JB,	
  Hamilton	
  JE,	
  Sussman	
  S.	
  A	
  family	
  member's	
                                 al.	
  The	
  impact	
  of	
  fathers'	
  physical	
  and	
  
                job	
  loss	
  as	
  a	
  risk	
  factor	
  for	
  smoking	
  among	
                               psychosocial	
  work	
  conditions	
  on	
  attempted	
  and	
  
                adolescents.	
  Health	
  Psychol	
  2004;23(3):308-­‐13.	
                                         completed	
  suicide	
  among	
  their	
  children.	
  BMC	
  
10.	
  Boyce	
  CJ,	
  Wood	
  AM,	
  Brown	
  GDA.	
  The	
  dark	
  side	
  of	
                                  Public	
  Health	
  2006;6:77.	
  
                conscientiousness:	
  Conscientious	
  people	
                                       20.	
  Ben-­‐Arieh	
  A.	
  Socioeconomic	
  correlates	
  of	
  rates	
  of	
  child	
  
                experience	
  greater	
  drops	
  in	
  life	
  satisfaction	
                                      maltreatment	
  in	
  small	
  communities.	
  Am	
  J	
  
                following	
  unemployment.	
  Journal	
  of	
  Research	
  in	
                                     Orthopsychiatry	
  2010;80(1):109-­‐14.	
  
                Personality	
  2010;44(4):535-­‐39.	
                                                 21.	
  Wood	
  JN,	
  Medina	
  SP,	
  Feudtner	
  C,	
  Luan	
  X,	
  Localio	
  R,	
  
11.	
  Burgard	
  SA,	
  Brand	
  JE,	
  House	
  JS.	
  Toward	
  a	
  better	
                                    Fieldston	
  ES,	
  et	
  al.	
  Local	
  macroeconomic	
  trends	
  
                estimation	
  of	
  the	
  effect	
  of	
  job	
  loss	
  on	
  health.	
                           and	
  hospital	
  admissions	
  for	
  child	
  abuse,	
  2000-­‐
                Journal	
  of	
  Health	
  and	
  Social	
  Behavior	
                                              2009.	
  Pediatrics	
  2012;130(2):e358-­‐64.	
  
                2007;48(4):369-­‐84.	
                                                                22.	
  Zielinski	
  DS.	
  Child	
  maltreatment	
  and	
  adult	
  
12.	
  Butterworth	
  P,	
  Leach	
  LS,	
  Pirkis	
  J,	
  Kelaher	
  M.	
  Poor	
                                 socioeconomic	
  well-­‐being.	
  Child	
  Abuse	
  Negl	
  
                mental	
  health	
  influences	
  risk	
  and	
  duration	
  of	
                                   2009;33(10):666-­‐78.	
  
                unemployment:	
  A	
  prospective	
  study.	
  Social	
                               23.	
  Schuring	
  M,	
  Mackenbach	
  J,	
  Voorham	
  T,	
  Burdorf	
  A.	
  The	
  
                Psychiatry	
  and	
  Psychiatric	
  Epidemiology	
                                                  effect	
  of	
  re-­‐employment	
  on	
  perceived	
  health.	
  
                2012;47(6):1013-­‐21.	
                                                                             Journal	
  of	
  Epidemiology	
  and	
  Community	
  Health	
  
13.	
  Eriksson	
  T,	
  Agerbo	
  E,	
  Mortensen	
  PB,	
  Westergaard-­‐                                         2011;65(7):639-­‐44.	
  
                Nielsen	
  N.	
  Unemployment	
  and	
  mental	
  disorders:	
                        24.	
  Barling	
  J.	
  A	
  response	
  to	
  Kokko	
  and	
  Pulkkinen"s	
  
                Evidence	
  from	
  Danish	
  panel	
  data.	
  International	
                                     "Aggression	
  in	
  childhood	
  and	
  long-­‐term	
  
                Journal	
  of	
  Mental	
  Health	
  2010;39(2):56-­‐73.	
                                          unemployment	
  in	
  adulthood."".	
  Prevention	
  &	
  
                                                                                                                    Treatment	
  2000;3(1):No	
  Pagination	
  Specified.	
  


	
                                                                                               11	
  
25.	
  Kokko	
  K,	
  Pulkkinen	
  L.	
  Aggression	
  in	
  childhood	
  and	
                   37.	
  West	
  F,	
  Sanders	
  MR,	
  Cleghorn	
  GJ,	
  Davies	
  PSW.	
  
                long-­‐term	
  unemployment	
  in	
  adulthood:	
  A	
  cycle	
                                  Randomised	
  clinical	
  trial	
  of	
  a	
  family-­‐based	
  
                of	
  maladaptation	
  and	
  some	
  protective	
  factors.	
                                   lifestyle	
  intervention	
  for	
  childhood	
  obesity	
  
                Prevention	
  &	
  Treatment	
  2000;3(1):No	
  Pagination	
                                     involving	
  parents	
  as	
  the	
  exclusive	
  agents	
  of	
  
                Specified.	
                                                                                     change.	
  Behaviour	
  Research	
  and	
  Therapy	
  
26.	
  Kokko	
  K,	
  Pulkkinen	
  L.	
  Aggression	
  in	
  childhood	
  and	
                                  2010;48(12):1170-­‐79.	
  
                long-­‐term	
  unemployment	
  in	
  adulthood:	
  A	
  cycle	
                   38.	
  Einfeld	
  SL,	
  Stancliffe	
  RJ,	
  Gray	
  KM,	
  Sofronoff	
  K,	
  Rice	
  L,	
  
                of	
  maladaptation	
  and	
  some	
  protective	
  factors.	
                                   Emerson	
  E,	
  et	
  al.	
  Interventions	
  provided	
  by	
  
                Developmental	
  Psychology	
  2000;36(4):463-­‐72.	
                                            parents	
  for	
  children	
  with	
  intellectual	
  disabilities	
  
27.	
  O'Connell	
  ME,	
  Boat	
  T,	
  Warner	
  KE,	
  editors.	
  Preventing	
                               in	
  low	
  and	
  middle	
  income	
  countries.	
  Journal	
  of	
  
                Mental,	
  Emotional,	
  and	
  Behavioral	
  Disorders	
                                        Applied	
  Research	
  in	
  Intellectual	
  Disabilities	
  
                Among	
  Young	
  People:	
  Progress	
  and	
  Possibilities.	
  .	
                            2012;25(2):135-­‐42.	
  
                Washington,	
  DC:	
  Institute	
  of	
  Medicine;	
  National	
                  39.	
  Embry	
  DD.	
  Behavioral	
  Vaccines	
  and	
  Evidence-­‐Based	
  
                Research	
  Council,	
  2009.	
                                                                  Kernels:	
  Nonpharmaceutical	
  Approaches	
  for	
  the	
  
28.	
  Prinz	
  RJ,	
  Sanders	
  MR,	
  Shapiro	
  CJ,	
  Whitaker	
  DJ,	
  Lutzker	
                          Prevention	
  of	
  Mental,	
  Emotional,	
  and	
  Behavioral	
  
                JR.	
  Population-­‐based	
  prevention	
  of	
  child	
                                         Disorders.	
  Psychiatric	
  Clinics	
  of	
  North	
  America	
  
                maltreatment:	
  	
  The	
  U.S.	
  Triple	
  P	
  System	
                                      2011;34(March):1-­‐34.	
  
                Population	
  Trial.	
  Prevention	
  Science	
                                   40.	
  Embry	
  DD.	
  The	
  Good	
  Behavior	
  Game:	
  a	
  best	
  practice	
  
                2009;10(March):1-­‐13.	
                                                                         candidate	
  as	
  a	
  universal	
  behavioral	
  vaccine.	
  
29.	
  Sanders	
  MR,	
  Montgomery	
  DT,	
  Brechman-­‐Toussaint	
                                             Clinical	
  Child	
  &	
  Family	
  Psychology	
  Review	
  
                ML.	
  The	
  mass	
  media	
  and	
  the	
  prevention	
  of	
  child	
                         2002;5(4):273-­‐97.	
  
                behavior	
  problems:	
  The	
  evaluation	
  of	
  a	
                           41.	
  Kellam	
  SG,	
  Mackenzie	
  AC,	
  Brown	
  CH,	
  Poduska	
  JM,	
  
                television	
  series	
  to	
  promote	
  positive	
  outcome	
  for	
                            Wang	
  W,	
  Petras	
  H,	
  et	
  al.	
  The	
  good	
  behavior	
  game	
  
                parents	
  and	
  their	
  children.	
  Journal	
  of	
  Child	
                                 and	
  the	
  future	
  of	
  prevention	
  and	
  treatment.	
  
                Psychology	
  &	
  Psychiatry	
  2000;41(7):939-­‐48.	
                                          Addict	
  Sci	
  Clin	
  Pract	
  2011;6(1):73-­‐84.	
  
30.	
  Sanders	
  M,	
  Calam	
  R,	
  Durand	
  M,	
  Liversidge	
  T,	
  Carmont	
  
                SA.	
  Does	
  self-­‐directed	
  and	
  web-­‐based	
  support	
  
                for	
  parents	
  enhance	
  the	
  effects	
  of	
  viewing	
  a	
  
                                                                                                  	
  
                reality	
  television	
  series	
  based	
  on	
  the	
  Triple	
  P-­‐
                Positive	
  Parenting	
  Programme?	
  J	
  Child	
  Psychol	
                    	
  
                Psychiatry	
  2008;49(9):924-­‐32.	
  
31.	
  Sanders	
  MR,	
  Turner	
  KMT.	
  The	
  role	
  of	
  the	
  media	
  and	
  
                primary	
  care	
  in	
  the	
  dissemination	
  of	
  evidence-­‐
                based	
  parenting	
  and	
  family	
  support	
  
                interventions.	
  Behavior	
  Therapist	
  
                2002;25(9):156-­‐66.	
  
32.	
  Connell	
  S,	
  Sanders	
  MR,	
  Markie-­‐Dadds	
  C.	
  Self-­‐directed	
  
                behavioral	
  family	
  intervention	
  for	
  parents	
  of	
  
                oppositional	
  children	
  in	
  rural	
  and	
  remote	
  areas.	
  
                Behavior	
  Modification	
  1997;21(4):379-­‐408.	
  
33.	
  Mihalopoulos	
  C,	
  Sanders	
  MR,	
  Turner	
  KMT,	
  Murphy-­‐
                Brennan	
  M,	
  Carter	
  R.	
  Does	
  the	
  Triple	
  P-­‐Positive	
  
                Parenting	
  Program	
  provide	
  value	
  for	
  money?	
  
                Australia	
  and	
  New	
  Zealand	
  Journal	
  of	
  Psychiatry	
  
                2007;41(3):239-­‐46.	
  
34.	
  Sanders	
  MR,	
  McFarland	
  M.	
  Treatment	
  of	
  depressed	
  
                mothers	
  with	
  disruptive	
  children:	
  A	
  controlled	
  
                evaluation	
  of	
  cognitive	
  behavioral	
  family	
  
                intervention.	
  Behavior	
  Therapy	
  2000;31(1):89-­‐
                112.	
  
35.	
  Sanders	
  MR,	
  Ralph	
  A,	
  Sofronoff	
  K,	
  Gardiner	
  P,	
  
                Thompson	
  R,	
  Dwyer	
  S,	
  et	
  al.	
  Every	
  family:	
  a	
  
                population	
  approach	
  to	
  reducing	
  behavioral	
  and	
  
                emotional	
  problems	
  in	
  children	
  making	
  the	
  
                transition	
  to	
  school.	
  J	
  Prim	
  Prev	
  2008;29(3):197-­‐
                222.	
  
36.	
  Nicholson	
  JM,	
  Sanders	
  MR.	
  Randomized	
  controlled	
  
                trial	
  of	
  behavioral	
  family	
  intervention	
  for	
  the	
  
                treatment	
  of	
  child	
  behavior	
  problems	
  in	
  
                stepfamilies.	
  Journal	
  of	
  Divorce	
  &	
  Remarriage	
  
                1999;30(3-­‐4):1-­‐23.	
  


	
                                                                                           12	
  

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Rapid results for usa jobs and child family wellbeing

  • 1. Rapid  Results  for  USA  Jobs,  Health  &  Wealth:   Restoring  Our  Futures  With  Low-­‐Cost  Strategies   Funded  by  Repatriated  Overseas  Corporate  Funds   Prepared  by:  Dennis  D.  Embry,  Ph.D.   President/Senior  Scientist,  PAXIS  Institute,  Tucson,  AZ  •  1-­‐520-­‐299-­‐6770  •  dde@paxis.org   Abstract   Additionally,  the  Our  Futures  Fund  would  invest   in  expanding  the  implementation  across  the   Reuters  News  Service  estimates  that  $1.5   country  of  previously  proven  and  tested,  very   trillion  in  profits  are  held  overseas.    Pressure   cost-­‐efficient  strategies  that  can  significantly   has  been  increasing  to  repatriate  those  funds,   reduce  current  Medicaid  and  healthcare  costs,   but  not  to  repeat  the  failure  of  the  2004   future  health-­‐care,  improve  public  safety,  and   repatriation  that  experts  claim  did  not  lead  to   improve  our  global  competitiveness.   an  increase  in  domestic  investment,   Individual,  business,  organizational  and   employment  or  R&D.     government  beneficiary  entities  will  have  a   Existing  law  plus  innovations  in  “Pay  for   contract  to  pay  back  the  Our  Futures  Fund  based   Success  Contracts”  (aka  Social  Impact  Bonds),   on  careful  measures  of  success  and  principles   however,  provides  a  pathway  for  repatriating   established  by  previous  successful  experiments   those  pent  up  profits  as  USA  investments.    In   in  the  US  and  other  countries  involving  Social   turn,  those  funds  can  be  used  to  increase   Impact  Bonds.    Thus,  the  success  of  new   employment  by  the  nation’s  4.6  million  small   employees,  businesses,  and  reductions  of   businesses  (<25  employees)  plus  rapidly   crushing  costs  to  local,  state  and  federal   reduce  major  costly  health,  educational,  and   governments  (e.g.,  Medicaid,  unemployment   safety  problems  harming  the  global   payments,  crime,  etc.)  would  payback  the  Our   competitiveness  of  the  United  States.   Futures  Fund  and  its  investors  both  principle   and  interest—the  companies  repatriating   Current  law  allows  American  businesses  to   overseas  corporate  profits.  A  sweetener  could   repatriate  overseas  profits  by  purchasing  US   be  added  to  the  existing  law:  Interest  payments   investments  (e.g.,  T-­‐bills),  and  only  paying  tax   from  the  Our  Futures  Fund  would  be  non-­‐ on  the  interest.  This  is  already  happening,  in   taxable.   part  because  of  the  instability  of  the  European   Union.    By  tweaking  this  law,  we  can  create  a   In  theory,  if  US  corporations  repatriated  the   new  investment  mechanism,  tentatively  called:   same  profits  as  they  did  in  2004  of  $360  billion   “Our  Futures  Fund:  An  American  Families  &   to  the  Our  Futures  Fund,  millions  of  new,   Employment  Impact  Bond.”   sustainable  jobs  could  be  created  across  every   American  community;  and  hundreds  of  billions   The  Our  Futures  Fund  would  then  invest  in   of  dollars  of  crushing  health,  welfare,  and   staking  “no-­‐risk”  hires  of  unemployed  by   prison  costs  would  be  averted  at  a  local,  state   qualified  small  businesses  (<25  employees)  to   and  federal  level.  The  US  economy  would   ramp  up  products,  services,  marketing  and   rebound,  and  our  global  competitiveness  would   sales.   be  increased  for  all  our  futures.   1  
  • 2. Predicting  America’s  Future  from  Current  Facts   Unless  current  FACTS  are  altered,  multiple   job  loss  increases  youth  smoking,   adverse  trends  can  be  predicted  for  America.     forecasting  many  lifetime  health  problems.9   Current  FACTS  predict  a  perfect  storm  of   • A  longitudinal  study  of  9,500  persons  shows   worsening  problems  for  our  economy,  our   that  unemployment  most  adversely  affects   public  safety,  our  health,  our  economy,  our   the  most  conscientious,  good  employees  for   global  competitiveness,  and  our  national   future  employment.10   security.  Fortunately,  the  United  States  actually   • Two  population-­‐based  longitudinal  studies   possesses  the  best  science  to  alter  these  trends.     of  U.  S.  workers  show  that  involuntary  job   Applying  this  world-­‐class  science  can  save  Our   loss  causes  serious  cognitive  depression  and   Futures  in  America.   poorer  overall  health.11  Another   longitudinal  study  of  unemployed  workers   shows  that  symptoms  of  common  mental   disorders  then  cause  greater  time  in   unemployment  over  four  years.12  Increased   psychiatric  hospitalization  follows   unemployment  in  another  12-­‐year  study.13   The  mental  health  effects  of  unemployment   cause  many  more  persons  to  migrate  to   disability  benefits.14       • Poor  mental  health  caused  by  becoming   unemployed  cause  parents  to  be  more     negative  and  punishing  to  their  children.15   Becoming  unemployed  as  mothers  increases   FACT:  Unemployment  has  profound  physical   ADHD  among  dependent  children,16  which   and  behavioral  impact  on  adults,  their   in  turn  predicts  unemployment  for  those   current  children,  and  their  future  children   children  as  they  age.17   • Losing  employment  causes  subsequent   Unemployment  has  one  of  the  most  devastating   infants  born  to  be  more  premature  and   impacts  on  persistent  mental  and  physical   unhealthy.18   health  on  adults  and  their  dependent  children.   • Fathers’  job  loss  increases  suicide  among   Consider  a  few  examples:   their  dependent  children.19   • The  US  National  Longitudinal  Survey  of   • Increases  in  community  unemployment,   Youth  shows  girls  tend  to  become  obese  in   mortgage  delinquency,  and  foreclosure   periods  of  local  and  national   predict  future  hospitalizations  for  serious   unemployment,1  which  then  predicts  future   child  maltreatment,20  including  traumatic   disability  pension  status2  and  long-­‐term   brain  injuries.21    In  turn,  this  predicts   health  costs  for  both  young  woman,  lower   lifetime  employment  problems  by  the   fertility,  and  unhealthy  future  offspring.3-­‐6   child.22   • The  US  National  Longitudinal  Survey  of   Re-­‐employment,  however,  typically  improves   Youth  shows  that  unemployment  increases   health  indicators  quickly.23    And  a  warm  family   risky  sexual  behavior  and  risk  of  sexually   environment  protects  a  child  from  future   transmitted  diseases.7    The  same  survey   unemployment  as  an  adult.24-­‐26     shows  higher  risk  of  serious  lifetime   substance  abuse  or  alcohol  abuse.8  Parental     2  
  • 3. FACT:  American  Children  Have  the  Highest   The  Mission  Readiness  Group  (Retired  4-­‐Star   Rate  of  Mental,  Emotional,  Behavioral  and   Generals)  finds  that  3-­‐out-­‐of-­‐four  17  through  24   Related  Physical  Illnesses  Among  Rich   year-­‐old  youth  in  America  are  not  eligible  for   military  service,  based  on  national   Democracies.   epidemiological  data—not  entrance  exams.   The  evidence  for  this  sorry  state  comes  from   multiple  studies,  sources  and  indicators  cited  in   the  2009  Institute  of  Medicine  Report.27  The   trends  have  been  worsen  for  at  least  the  past  20   years,  and  now  it  appears  that  our  current   children  may  have  a  short  lifespan  than  current   adults  as  a  consequence  of  multiple  underlying   connected  factors  from  adverse  childhood   experiences,  violence,  suicide,  injuries,  plus     related  metabolic  disorders.   The  Great  Smokey  Mountains  Longitudinal   Study  finds  that  ever  two  years,  young  people   For  example,  the  National  Longitudinal  Study  of   are  having  earlier  and  earlier  onset  of  mental,   Adolescence  (see  below)  shows  that  one-­‐out-­‐of-­‐ emotional,  and  behavioral  disorders,  and  the   two  18  year  olds  in  America  will  meet  an   percentage  with  the  disorders  is  rising  with   objective  diagnoses  of  one  major  mental  health   each  younger  cohort.   problem  that  impair  work  performance,   educational  attainment,  compromise  health,   and  increase  risk  of  criminal  offenses.       The  Wall  Street  Journal  did  independent   analyses  of  prescription  drug  use  among     America’s  children  and  youth.  Their  December   The  National  Co-­‐Morbidity  Study  shows  that  the   28,  2010  report  notes  that  40.4  million  of  our   onset  and  proportion  of  birth-­‐cohorts  having  a   young  people  received  at  least  one  prescription   major  depression  has  been  steadily  increasing,   for  a  psychotropic  medication  in  2009.   as  shown  below.  This  is  not  the  result  of  over-­‐ diagnoses,  which  is  filtered  out  of  the  study.         3  
  • 4. The  2009  Institute  of  Medicine  Report  on  the   there  are  fewer  new  companies  making  any   Prevention  of  Mental,  Emotional,  and  Behavioral   hires  at  all.   Disorders  Among  Young  People  (go  to   http://bit.ly/IOM2009)  finds  that  most  of  these   FACT:  US  Small  Business  Is  Smaller  Than  Most   problems  are  preventable  at  a  public-­‐health   Other  Rich  Democracies1   programmatic  level,  based  on  funded  science  in   The  United  States  has  among  the  lowest  shares   the  United  States.  Other  rich  democracies  are   of  employment  in  small  businesses  in   using  this  science,  but  the  federal,  state  and   manufacturing.  Only  11.1  percent  of  the  U.S.   local  governments  of  America  are  not.   manufacturing  workforce  is  in  enterprises  with   FACT:  US  Small  Business  Is  Smaller  Now   fewer  than  20  employees.  Eighteen  other  rich   countries  have  a  higher  share  of  manufacturing   Virtually  every  elected  official  in  the  United   employment  in  enterprises  of  this  size,  as   States  concurs  that  small  business  is  the   shown  in  the  figure  on  the  next  page.   backbone  of  our  economy  and  our  communities.   Across  the  country,  there  are  nearly  4.8  million   What  if  the  cut  off  is  put  higher,  say  firms  with   businesses  that  employ  25  or  fewer  workers.       less  than  500  employees  in  manufacturing?    The   United  States  is  at  the  bottom  (no  data  available   Just  imagine  if  each  one  of  those  small   on  Luxembourg  or  Switzerland).   businesses  took  on  one  new  employee  this  year.     That  would  reduce  unemployment  from  about   Similar  trends  hold  true  for  firms  involved  in   12.7  million  people  to  7.9  million—a  38%   research  and  development,  computer  services,   reduction.  Think  what  that  would  do  for   and  even  low-­‐tech  services.   confidence  in  the  future,  our  jobs  report,  the   What  Keeps  Small  Firms  from  Hiring?   mood  of  the  country,  and  our  overall  economic   security.  Let’s  consider  how  to  jump  start  hiring   Various  polls  suggest  that  small  businesses   by  very  small  businesses  of  25  or  fewer   (<25  to  50  employees)  are  not  in  a  hiring  mood.   employees.  First,  consider  some  facts.   Mostly  this  is  about  confidence  in  the  future  to   make  a  profit  from  the  investment  new   Small  Business  today  is  getting  smaller  in  many   employees.    If  you  are  a  small  business,  adding   ways:   one  employee  is  a  big  deal.  If  you  are  a  large   • Online  payroll  services  company,   business,  a  few  more  or  less  employees  are   SurePayroll,  found  that  50  percent  of  the   marginal  costs.       surveyed  small-­‐business  owners  are   "experiencing  increased  revenue  and   growth  in  their  business,"  but  those  same   business  owners  aren’t  hiring.   • A  recent  Kaufman  Foundation  study  found   the  average  new  business  establishment   opened  its  doors  with  about  7.5  employees   in  the  1990’s—compared  to  about  4.9  jobs   per  startup  today.   • Additionally,  the  Kaufman  study  reports   that  the  number  of  new  businesses  hiring   employees  has  contracted  by  more  than  27   percent  since  2006.  So  not  only  are  there                                                                                                                   fewer  employees  per  new  company,  but   1http://www.cepr.net/documents/publications /small-­‐business-­‐2009-­‐08.pdf     4  
  • 5.   It  cannot  be  just  an  issue  of  “government   care  reforms  in  the  US.  Virtually  every  one  of   regulation,”  as  the  fundamental  regulations   the  countries  with  higher  percentages  of  small   related  to  employees  today  are  about  the  same   business  actually  have  single-­‐payer,  health-­‐care   as  two  decades  ago:  pay  all  the  payroll  taxes,   systems.   don’t  endanger  your  employees,  and  don’t   engage  in  egregious  discrimination  or   The  real  issue  for  small  business  of  new  hires  is   harassment.  These  are  fair  play  rules.       the  fear  of  not  making  return  on  the  investment.   “Maybe  it  won’t  pay  off”.  “Maybe  I  would  do   It  is  also  important  to  note  that  regulations   better  to  save  the  dollars  or  invest  in   governing  small  businesses  are  more  strict  and   marketing.”  Or,  “What  if  I  hire  the  wrong   difficult  in  most  of  the  other  countries  with   person?”  Or,  “What  if  cash  flow  goes  down?”   higher  percentages  of  small  businesses.    It  is   also  questionable  that  the  issue  is  taxation   These  are  not  abstractions  for  us  at  PAXIS   rates,  as  most  of  the  other  countries  have   Institute.  We  are  a  small  business.   actually  higher  marginal  taxes  (fewer   If  the  relative  risk  of  a  new  hire  were  reduced,   deductions),  excluding  VAT  or  GST  compared  to   small  business  owners  would  hire  more   the  United  States.   employees.    How  might  that  happen?     It  is  noteworthy,  too,  that  this  difference  is  not     likely  to  be  because  of  newly  enacted  health       5  
  • 6. Our  Futures  Fund:  An  American  Families  &  Employment  Impact  Bond       Corporations  are  able  to  invest  their  foreign   which  is  a  specially  constructed  public-­‐ earnings  in  U.S.  assets  without  treating   private  partnership.   them  as  “repatriated”  and  subject  to   Here  is  a  broad-­‐brush  idea  to  increase   taxation,  because  the  federal  tax  code,   specifically  Section  956(c)(2),  already   repatriated  funds,  and  improve   allows  U.S.  corporations  to  use  foreign   employment.   funds  to  make  a  wide  range  of  U.S.   A  public  investment  fund  might  be  created,   investments  without  incurring  tax  liability.     called  “Our  Futures”  as  a  Families  and   If  those  U.S.  investments  then  produce   Employment  Impact  Bond.    This  could  be   income,  that  additional  income  may  be   done  in  states  or  nationally  or  both.    The   subject  to  taxation.     talent  to  create  such  Social  Impact  Bonds   Legislation  could  be  introduced  to  waive   clearly  exists  in  the  state  of  Connecticut.     This  public  investment  fund  would  be   the  tax  on  investment  income,  providing   that  investment  was  in  a  qualified  Social   aimed  at  expanding  employment  in  the  4   Impact  Bond  or  Fund  to  improve  jobs  and   million  plus  small  businesses  under  25   employees  in  the  US.      The  fund  would  also   the  wellbeing  of  children  and  families—   6  
  • 7. be  aimed  at  reduce  mental,  emotional,   • A  study  funded  by  the  Centers  for   behavioral  and  related  physical  illnesses   Disease  Control  and  Prevention  proved   among  children  and  families.   that  Triple  P  can  prevent  multiple   indicators  of  child  maltreatment  for   Local  public  entities  and  local  small   whole  counties,  at  the  cost  of  $15  per   businesses  will  form  an  Our  Futures   child  in  the  county.28   partnership,  and  local  folks  seeking   • Triple  P  can  be  delivered  effectively  via   employment  may  become  members  of  this   mass  media.29-­‐31   effort.    They  will  prepare  a  charter  that   embraces  specific  actions  in  their  settings   • Triple  P  can  be  delivered  via  phone  to   to  become  beneficiary  partners  in  local  or   remote  areas.32   regional  American  Employment  Impact   • Triple  P  averts  or  prevents  serious   Bonds   problems  like  oppositional  defiance  or   conduct  disorders.33   This  investment  fund—The  American   • Triple  P  reduces  parental  depression.34   Families  and  Employment  Impact  Bonds— 35   would  do  several  types  of  investments  in   • Triple  P  improves  marital  and  step-­‐ increasing  health  and  wellbeing  for  the   family  relationships.36   population  of  children  and  families  as  well   • Triple  P  reduces  obesity.37  38   as  employment  in  targeted  political   jurisdictions—e.g.,  municipalities,  counties,   Multiple  projects  and  studies  show  that   and  states.   Triple  P  works  well  in  America.   Example  Children  and  Families  Investments:   A  recently  published  cost-­‐savings  estimator   shows  how  many  cases  of  child   The  fund  would  invest  in  two  of  the  most   maltreatment  might  be  saved  in  each  state   highlighted  strategies  in  the  IOM  Report   and  how  much  money  would  be  saved  as  a   with  a  potential  to  rapidly  improve  health   consequence.39    The  estimator  may  be   and  safety  indicators  among  children  and   downloaded  at   families  at  a  population,  public-­‐health  level:   http://paxis.org/triplep/Default.aspx   Triple  P  and  the  Good  Behavior  Game.   These  two  interventions  have  evidence  for   A  video  about  the  study  and  results  may  be   being  population  level  approaches  with   viewed  http://slidesha.re/triplepvideo   cost  effective  outcomes  across  many   Proven  Good  Behavior  Outcomes   problems.   The  Good  Behavior  Game40  is  a  “behavioral   Proven  Triple  P  Outcomes   vaccine”  used  everyday  in  a  classroom,  and   Triple  P  is  a  system  of  parenting  supports   can  be  implemented  in  a  public-­‐health   from  which  parents  can  choose.  Various   model.39   studies  show  that  these  parenting  supports   The  Game  is  used  during  any  instructional   can  be  delivered  by  many  different  types  of   activity,  by  dividing  the  class  into  teams   people  and  via  many  different  media,  all   who  may  work  together  to  earn  simple,   with  proven  effects  via  many  randomized-­‐ brief  activity  rewards  like  a  “giggle  fest.”   control  trials  around  the  world,  including   The  Game  teaches  children  how  to  pay   the  US.  Many  of  those  studies  can  be  seen   attention  voluntarily,  and  ignore  the   at:  http://bit.ly/TRIPLE-­‐P-­‐CITES  .   misbehaviors  of  other  students.  The     7  
  • 8. children  learn  that  they  can  “better  their   results.  The  Substance  Abuse  and  Mental   world,  and  better  themselves.”   Health  Administration  has  20  sites  using   the  Game,  showing  that  it  is  widely   One  can  view  videos  about  the  province-­‐ replicable  in  America.   wide  launch  of  the  Good  Behavior  Game   (commercially  branded  as  PAX  GBG)  in   Using  economic  data  from  the  Washington   Manitoba  and  an  earlier  pilot  here:   State  Institute  for  Policy  Research  (WSIPR),   it  is  possible  to  estimate  the  impact  of  the   http://bit.ly/ManitobaPAXLaunch   Good  Behavior  Game  if  it  were  provided  to   http://bit.ly/ManitobaPAXGBGPilot   every  first  grader  in  America.    WSIPR   estimates  the  Game  saves  $4,637  for  each   The  Game  has  been  repeatedly  tested  with   student.    Assuming  4,000,000  First  Graders   randomized  studies  with  very  long-­‐term   each  year  in  the  US,  this  saves  $18  billion   follow-­‐up  (20+  years)  after  just  using  the   every  1st  Grade  cohort  by  age  21.     game  in  First  Grade.    A  recent  publication   summarized  many  of  the  key  findings.41     The  table  on  the  next  page  shows  those       Incentivizing  Providers  and  Organizations  to   My  colleagues  and  I  have  demonstrated   Implement  Proven  Practices  for  Population-­‐ that  large  numbers  of  American  providers   Level  Prevention  Results   can  be  incentivized  and  organized  to   To  achieve  the  results  needed  to  “bend   deliver  a  previously  proven  prevention   the  curve”  for  improving  the  condition  of   strategy  and  achieve  cost  effective  change   America’s  children  and  families,  many   for  whole  states,  using  standardized   organizations  must  be  recruited  across   federally  mandated  and  collected  health   the  community  implement  the  same   and  policy  indicators.   strategies—just  like  has  been  pioneered   This  example  can  be  found  at  the  National   when  America  faced  other  epidemics  such   Registry  of  Effective  Programs  and   as  polio  or  other  diseases.     8  
  • 9. Practices,  see   everyday  tobacco  use  as  measured  by  the   http://bit.ly/rewardandreminder   Centers  for  Disease  Control.   This  strategy  quickly  achieved   We  have  outlined  an  implementation  and   compliance  with  federally  mandated   monitoring  logic  model  for  achieving   policy  requirements,  and  the   population-­‐level,  public  health  outcomes,   implementation  also  significantly  reduce   which  appears  next. any  tobacco  use  in  the  last  30  days  and       Employment  and  Job  Creation  Investments Employment  Investment  #1:       additional,  monthly  incentive  for  their  work   We  propose  incentives  for  employing   efforts,  and  the  business  would  receive  a   persons  receiving  unemployment   small  placement  incentive.  Something  like   insurance.    Small  businesses  could  “hire”   was  successful  in  New  Zealand,  when  it   the  unemployment  insurance  recipient  of   faced  a  serious  economic  downturn  in  the   their  choice,  and  the  employment  insurance   1980s.   would  continue  for  the  individual.  The   “hire”  would  also  receive  a  significant     9  
  • 10. Employment  Investment  #2:     along  with  the  boundaries  of  the  funds   In  this  track,  an  existing,  credit  worthy   or  resources  being  managed.   small  businesses  would  submit  a  brief   2. Proportional  costs  and  benefits.   business  plan  to  expand  their  business  for  a   Everyone  is  expected  do  their  fair  share   subsidized  new  hire  who  is  no  longer   and  those  who  go  beyond  the  call  of   eligible  for  unemployment  yet  wish  to  get   duty  are  appropriately  recognized.   employment.    The  small  business  would   3. Consensus  decision-­‐making:  Participants   have  to  commit  to  providing  health   will  work  hard  to  implement  a   insurance  for  the  new  employee,  the  space,   consensus  decision—to  do  what  “we”  in   etc.    The  investment  for  such  an  employee   the  group  want,  not  what  they  want.  In   would  be  for  12  months  to  jumpstart   addition,  the  best  decisions  often   business  expansion.   require  knowledge  of  local   circumstances  that  we  have  and  they   Repayment  of  Investors   lack,  making  consensus  decision-­‐making   As  significant  beneficiaries,  municipal,   doubly  important.   county  and/or  and  state  governments   4. Monitoring:  Since  individuals,  groups   would  have  a  binding  agreement  to   businesses,  or  public  beneficiaries   payback  pro-­‐rata  funds  to  the  Social  Impact   might  try  to  actively  game  the  system,  a   Bond  based  on  designed  criteria  related  to   system  of  monitoring  desired  outcomes   reduced  mental,  emotional,  behavioral,  and   and  transgressions  would  agreed  upon   related  physical  health  outcomes  as  well  as   5. Graduated  sanctions:  The  local  groups   unemployment,  using  economic  modeling.       often  can  be  self-­‐correcting,  but   stronger  sanctions  need  to  be  provided   Also  as  beneficiaries,  contracted  businesses   from  punishments  to  exclusion.   would  agree  to  pay  pro-­‐rata  funds  into  the   6. Fast  and  fair  conflict  resolution:    When   Social  Impact  Fund,  based  on  a  reasonable   conflicts  arise,  they  must  be  resolved   formula  of  impact  on  their  increased   quickly  and  in  a  manner  that  all  parties   business  (if  any)  over  a  specified  time.   consider  fair.  This  typically  involves  a   hearing  in  which  respected  members  of   Finally,  the  hired  person  would  agree  to   the  group,  who  can  be  expected  to  be   make  pro-­‐rata  payments  back  to  the  Impact   impartial,  and  make  an  equitable   Fund  based  on  federally  reported  taxes   decisions.   over  a  period  of  time,  for  W2  wages.   7. Local  autonomy:  Many  smaller  groups  of   Fund  Integrity   beneficiaries  will  be  nested  in  larger   groups.  They  will  need  to  have  some   A  series  of  checks  and  balances  would  be   powers  to  make  local  decisions.   established  for  this  fund,  based  on  the  well   8. Nested  governances:  When  a  group   proven  principles  from  the  Nobel  Prize  in   beneficiaries  is  nested  with  a  larger   Economics  for  Common  Pool  Resources  to   society,  relationships  among  groups  and   Elinor  Ostrum  and  colleagues.  There   higher-­‐level  entities  (such  as  state  and   proven  principles  include:   federal  regulatory  agencies)  must   1. Group  Identity:  all  parties  have  a  strong   reflect  the  same  principles  outlined   sense  of  group  identity  and  know  the   above  for  single  groups.   rights  and  obligations  of  membership,     10  
  • 11. Next  Steps     These  discussions  would  identify  major   Soon,  there  needs  to  be  discussion  with   partners,  timelines,  and  mechanisms  to   various  elected  officials  and  other  experts   refine  and  promote  the  plan. to  refine  this  plan.   References  Cited   14.  Lamberg  T,  Virtanen  P,  Vahtera  J,  Luukkaala  T,   1.  Arkes  J.  How  the  economy  affects  teenage  weight.  Social   Koskenvuo  M.  Unemployment,  depressiveness   Science  &  Medicine  2009;68(11):1943-­‐47.   and  disability  retirement:  A  follow-­‐up  study  of   2.  Neovius  K,  Johansson  K,  Rossner  S,  Neovius  M.  Disability   the  Finnish  HeSSup  population  sample.  Social   pension,  employment  and  obesity  status:  a   Psychiatry  and  Psychiatric  Epidemiology   systematic  review.  Obes  Rev  2008;9(6):572-­‐81.   2010;45(2):259-­‐64.   3.  Jokela  M,  Elovainio  M,  Kivimaki  M.  Lower  fertility   15.  McLoyd  VC,  Jayaratne  TE,  Ceballo  R,  Borquez  J.   associated  with  obesity  and  underweight:  the  US   Unemployment  and  work  interruption  among   National  Longitudinal  Survey  of  Youth.  Am  J  Clin   African  American  single  mothers:  effects  on   Nutr  2008;88(4):886-­‐93.   parenting  and  adolescent  socioemotional   4.  Olshansky  SJ,  Passaro  DJ,  Hershow  RC,  Layden  J,  Carnes   functioning.  Child  Dev  1994;65(2  Spec  No):562-­‐ BA,  Brody  J,  et  al.  A  potential  decline  in  life   89.   expectancy  in  the  United  States  in  the  21st   16.  Harvey  E.  Parental  employment  and  conduct  problems   century.[see  comment].  New  England  Journal  of   among  children  with  attention-­‐ Medicine  2005;352(11):1138-­‐45.   deficit/hyperactivity  disorder:  An  examination  of   5.  Krassas  GE,  Tzotzas  T.  Do  obese  children  become  obese   child  care  workload  and  parenting  well-­‐being  as   adults:  childhood  predictors  of  adult  disease.   mediating  variables.  Journal  of  Social  and  Clinical   Pediatr  Endocrinol  Rev  2004;1  Suppl  3:455-­‐9.   Psychology  1998;17(4):476-­‐90.   6.  Gavard  JA.  Health  care  costs  of  obesity  in  women.  Obstet   17.  Zwaan  M,  Gru√ü  B,  M√ºller  A,  Graap  H,  Martin  A,   Gynecol  Clin  North  Am  2009;36(2):213-­‐26,  xii.   Glaesmer  H,  et  al.  The  estimated  prevalence  and   7.  Davis  MJ.  The  effects  of  unemployment  and  poverty  on   correlates  of  adult  ADHD  in  a  German   sexual  appetite  and  sexual  risk  in  emerging  and   community  sample.  European  Archives  of   young  adults.  Sexual  Addiction  &  Compulsivity   Psychiatry  and  Clinical  Neuroscience   2009;16(4):267-­‐88.   2012;262(1):79-­‐86.   8.  Mossakowski  KN.  Is  the  duration  of  poverty  and   18.  Lindo  JM.  Parental  job  loss  and  infant  health.  J  Health   unemployment  a  risk  factor  for  heavy  drinking? 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