NRI’s 2010 Challenge Winners
Worthy ideas from within and beyond the Beltway.


Kate O'Beirne

Malpractice reform for federal health-care plans. Keith Paige, a practicing surgeon from Washington State, suggests that commonsense tort reform be applied to federal health-care plans. He proposes that for all episodes of care that are billed primarily to the federal government — including Medicare, Medicaid, and Federal Employee Health Plans — malpractice awards be limited to economic damages plus a capped amount for pain and suffering. This reform would likely lead to a drop in costly tests and treatments driven more by fear of lawsuits than medical judgment. Dr. Paige performs a back-of-the-envelope calculation: Since defensive medicine is estimated to cost $70–100 billion a year and the government purchases approximately 40–45 percent of all health care, the potential savings from even a 50 percent reduction of defensive medicine in patients covered by the federal government would amount to $14–20 billion annually. (This reform would also reduce the coffers of the trial lawyers who lavishly fund liberal candidates and causes.)

Improve college access while reducing the cost to the taxpayer. It is well established that increases in student aid contribute to the rising cost of college. So how do we increase access to higher education while decreasing the burden on the taxpayers? Dan Lips in Washington, D.C., suggests three solutions. First, given the growing popularity of online learning, he proposes that states use online learning to streamline course offerings available at different universities in the same state. Second, he would require state-funded colleges to put their course content online and make it available to the public for free. MIT has already, with great success, made “virtually all” of its course material available online for free, and the Apple iTunes program offers free downloads of lectures given at some of the most respected universities in the world. Third, he proposes that state higher-education institutions expand credit-by-exam options — allowing students to work toward their degrees by demonstrating subject mastery on rigorous examinations. While these reforms are all state-based, Lips suggests that the federal government could consider requiring colleges that choose to receive federal funding to place a percentage of course content online and to offer credit-by-exam options. These reforms hold great promise for students and taxpayers alike.

Support the family. Robert Guenther of New Jersey suggests several policies as part of a “Year of the Middle Class”: “a package of family-centered legal and tax changes to strengthen families and eliminate the need for the outsourcing of parenting to the federal government.” Among his suggestions: Increase the child tax credit. Let parents use their own money to pay for child care, save for education, etc., instead of seeking federal programs to help out.

Put COLAs on a diet. Daniel Corrin from Washington, D.C., notes that “every January the federal government increases retirees’ Social Security payments, federal pensions, and government workers’ salaries by the growth in the Consumer Price Index.” He suggests that the federal government wait until the cost of living has gone up by 5 percent before implementing any of these Cost of Living Adjustments. Assuming a steady 3 percent inflation rate, for example, the federal government would give out a 5 percent COLA every 20 months instead of a 3 percent one every year. Over time, the savings add up (Corrin’s back-of-the-envelope calculation has the federal government cutting spending by more than $250 billion over the first five years).