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3141. Unnecessary Relics: The Surgeon General and the Public Health Service Commissioned Corps

Author:
Jeffrey A. Singer, Akiva Malamet, Bautista Vivanco, and Michael F. Cannon
Publication Date:
07-2025
Content Type:
Policy Brief
Institution:
The Cato Institute
Abstract:
The US surgeon general has morphed from an apolitical supervisor of medical personnel to a divisive activist who undermines public health. Successive administrations have turned the Office of the Surgeon General into a highly political platform that opines on divisive non–public health issues ranging from gun control and social media to labor and housing policy. Such mission creep undermines the effectiveness of legitimate government public health activities. The surgeon general oversees the 6,000-member Public Health Service Commissioned Corps—a uniformed, noncombatant service that provides personnel for various federal agencies, including many non–public health roles. The Commissioned Corps takes longer to deploy than civilian alternatives, and many of its functions are redundant. A 2010 report from the Department of Health and Human Services estimated that employing Corps officers costs 15 percent more than hiring civilians. Replacing Corps officers with equivalent civilian employees could save $1.3 billion annually. Eliminating the surgeon general’s divisive political advocacy would be a step toward restoring trust in public health officials. Congress should dissolve the Office of the Surgeon General and the Commissioned Corps, eliminate their non–public health activities, and reassign any legitimate public health activities to other agencies.
Topic:
Government, Budget, Public Health, Public Spending, and Surgeon General
Political Geography:
North America and United States of America

3142. Immigrants Cut Victimization Rates, Boost Crime Reporting

Author:
David Bier and Julián Salazar
Publication Date:
08-2025
Content Type:
Policy Brief
Institution:
The Cato Institute
Abstract:
Americans are concerned about immigrants’ involvement in crime and their potential reluctance to cooperate with law enforcement. The National Crime Victimization Survey (NCVS) can help address these concerns. First, since criminals typically commit offenses near where they live and against people with similar demographics, the victimization rate can show whether immigrant communities are experiencing higher crime rates. Second, the NCVS can prove whether immigrants are less likely to report crimes to the police. The NCVS started recording citizenship status in 2017. From 2017 to 2023, immigrants were 44 percent less likely than US-born Americans to be victimized by violent criminals and were 64 percent less likely to be harmed by someone they knew. Immigrants also worked with police to solve violent crimes. Immigrant victims were 29 percent more likely than US-born victims to personally report violent crime to the police. Immigrants worked with police on 5.1 million crimes during that time. Victims’ cooperation with police led to nearly half a million criminal arrests and about 300,000 arrests of violent offenders. Because they commit fewer violent crimes, immigrants lower the violent-victimization rate in the United States. Furthermore, at least prior to the current mass deportation efforts, immigrants cooperated more with police to solve violent crimes when they occurred. Americans should trust that their immigrant neighbors help create safer communities.
Topic:
Crime, Immigration, Law Enforcement, and Victimization
Political Geography:
North America and United States of America

3143. Reforming Federal Laws on Private Sector Labor Unions

Author:
Charles W. Baird
Publication Date:
07-2025
Content Type:
Working Paper
Institution:
The Cato Institute
Abstract:
In America’s labor markets, interactions between employers and employees are generally based on voluntary exchange. Employers make offers of wages and benefits, while workers offer their services at terms that are suitable to them. In the absence of force and fraud, job providers and job applicants can bargain to reach agreement in a mutually beneficial manner. In the early 20th century, however, the idea that employers had too much bargaining power relative to employees began gaining favor. Congress responded by passing a series of laws allowing the formation of worker cartels called labor unions, which replaced individual employment agreements with collective bargaining. Congress imposed the Davis–Bacon Act of 1931, the Norris–LaGuardia Act of 1932, and the National Labor Relations Act (NLRA) of 1935 on the private sector workforce. The laws created rules for exclusive representation, mandatory union dues, and other labor force restrictions. These labor laws are still on the books, and they are deeply flawed. They damage the economy and violate individual rights, particularly the freedom of association. This study describes the 1930s labor laws and discusses why they should be repealed to allow greater freedom for workers and employers.
Topic:
Law, Reform, Private Sector, and Labor Market
Political Geography:
North America and United States of America

3144. Aimless Rivalry The Futility of US–China Competition in the Middle East

Author:
Jon Hoffman
Publication Date:
07-2025
Content Type:
Policy Brief
Institution:
The Cato Institute
Abstract:
Fear in Washington over China’s expanding regional presence is quickly becoming a new rationale for an expansive US foreign policy in the Middle East. But China remains an opportunistic actor in the Middle East, driven by practical needs, not by aspirations to dominate the region. Beijing lacks the ability and desire to assume a dominant position in the Middle East, and its ability to jeopardize US regional interests is limited. Centering US Middle East policy on competition with China is a recipe for disaster. It is an aimless rivalry divorced from concrete US interests. The United States has little to fear from China in the Middle East. By viewing every development in the Middle East through the framework of zero-sum competition with China, Washington is operating on faulty assumptions that will result in counterproductive policies. If navigated correctly, the return of multipolarity to the Middle East can be a net benefit for the United States, allowing Washington to disentangle itself from the region.
Topic:
Foreign Policy, Bilateral Relations, Strategic Competition, and Rivalry
Political Geography:
China, Middle East, Asia, North America, and United States of America

3145. Better Long-Term Care for Billions Less

Author:
Stephen A. Moses
Publication Date:
11-2025
Content Type:
Policy Brief
Institution:
The Cato Institute
Abstract:
Medicaid is a means-tested government health and long-term care program that states operate largely with funds from the federal government. In 2025, Medicaid will spend nearly $1 trillion on behalf of 84 million enrollees, or nearly $12,000 per enrollee. Medicaid is the largest purchaser of long-term care (LTC) in the United States, covering nursing home, memory, personal, and other forms of care for qualifying persons. In 2025, Medicaid will spend roughly $80,000 per enrollee receiving Medicaid LTC subsidies, which account for more than one-third of Medicaid spending and nearly half of total LTC spending. Yet, Medicaid subsidies reduce LTC quality, strain state budgets, and contribute to a federal debt that has surged past 100 percent of US gross domestic product. Counterintuitively, Medicaid subsidizes LTC for middle-class and affluent individuals, who do not need government assistance. Middle-class people easily qualify for Medicaid under the basic financial eligibility rules. Some individuals with significant assets artificially impoverish themselves to become eligible for and receive Medicaid LTC subsidies. Eliminating Medicaid LTC subsidies for individuals who could meet or could have planned to meet their own LTC needs would improve LTC quality and reduce the burdens Medicaid imposes on taxpayers. Middle-class and affluent seniors could draw on their assets and private LTC insurance, saving Medicaid as much as $100 billion per year without impairing its ability to serve those who truly need assistance.
Topic:
Economy, Medicaid, Subsidies, Public Spending, and Healthcare System
Political Geography:
North America and United States of America

3146. Protection for Whom? The Origins of Protective Labor Laws for Women

Author:
Matthias Doepke, Hanno Foerster, Anne Hannusch, and Michèle Tertilt
Publication Date:
09-2025
Content Type:
Policy Brief
Institution:
The Cato Institute
Abstract:
Over the past two centuries, the movement for women’s rights and gender equality in the United States has achieved remarkable milestones: Property and economic rights were granted to married women in the 1800s, women gained the right to vote in 1920, and sweeping civil rights reforms were implemented in the second half of the 20th century. Given these developments, progress has appeared to be steady. Yet, this process has not been a story of ever-expanding rights. We can gain insight into the complex political and economic forces that have shaped women’s labor rights by examining a striking historical reversal in the United States: the rise and fall of gender-specific, so-called protective labor laws between the late 19th and mid-20th centuries.
Topic:
Women, Employment, Economy, Protection, and Labor Law
Political Geography:
North America and United States of America

3147. Neoliberalism and Globalization Are Not Undermining Democracy

Author:
Stefani Branilović and Tibor Rutar
Publication Date:
09-2025
Content Type:
Policy Brief
Institution:
The Cato Institute
Abstract:
Neoliberalism and globalization are two distinct yet interrelated processes that began to spread across the world in the 1970s and 1980s. Neoliberalism mainly aims to limit the role of the government in the economy through corporate deregulation, cuts to social benefits, privatization of public assets, and tax cuts for corporations and the investing class. It promotes the free movement of goods, services, capital, and money within countries and throughout the world. Neoliberalism advocates a free-market economy in which governments exist only to maximize the efficiency of global markets, such as by securing property rights. Meanwhile, globalization is the process that promotes the integration of markets worldwide and intensifies economic, political, social, and cultural relations. In other words, globalization creates an interconnected world and removes barriers between countries.
Topic:
Globalization, Democracy, Economy, and Neoliberalism
Political Geography:
Global Focus

3148. What Are the Costs of Weakening Shareholder Primacy?

Author:
Benjamin Bennett, René M. Stulz, and Zexi Wang
Publication Date:
09-2025
Content Type:
Policy Brief
Institution:
The Cato Institute
Abstract:
The mainstream theory of corporate governance in the United States holds that the primary responsibility of the board of directors and management is to maximize the wealth of shareholders. This is the theory of shareholder primacy. If directors and officers stray from their duty, shareholders can constrain or remove them. An alternative theory is that directors and management should consider all stakeholders, including employees, customers, and communities. This theory offers limited guidance when decisions affect stakeholders differently, so it gives much more discretion to directors and officers than the shareholder primacy theory. As a result, the stakeholder theory enables insiders to pursue their own interests and find excuses for underperformance.
Topic:
Environment, Economy, Corporate Governance, and Shareholder Value
Political Geography:
North America, United States of America, and Nevada

3149. The Impacts of Grade Retention Policy with Minimal Retention

Author:
Jordan S. Berne, Brian A. Jacob, Christina Weiland, and Katharine O. Strunk
Publication Date:
10-2025
Content Type:
Policy Brief
Institution:
The Cato Institute
Abstract:
Strong early literacy skills are crucial for children’s school and life success. However, the latest results from the National Assessment of Educational Progress reveal that only about a third of American fourth graders read at a proficient level, with children from historically marginalized backgrounds trailing behind their peers. As educators work to improve reading outcomes, requiring students to repeat a grade—known as retention—has become a common, though controversial, component of state policy reforms, with mixed evidence on student outcomes.
Topic:
Education, Literacy, and Reading
Political Geography:
North America and United States of America

3150. The Impact of Deregulation on Long-Term Acute Care Hospitals

Author:
Markus Bjoerkheim and Ali Melad
Publication Date:
10-2025
Content Type:
Policy Brief
Institution:
The Cato Institute
Abstract:
Acentury ago, only 5 percent of Americans were 65 or older. Today, that figure is about 17 percent, and it is projected to reach 23 percent by 2050. This demographic shift poses a two-headed challenge: How can our society provide health care access to a rapidly growing population of seniors with extensive and increasingly specialized health care needs without further straining an already unsustainable federal budget? Regulations pose many barriers. For example, certificate-of-need (CON) laws restrict the entry and expansion of health care facilities in 35 states. Since the 1980s, 15 states have either completely or partially eliminated their CON laws. However, CON laws for long-term care services have largely been kept in place, making it difficult for researchers to estimate the effects of these laws on long-term health care services and access to care.
Topic:
Aging, Public Health, Hospitals, and Deregulation
Political Geography:
North America and United States of America

3151. Drug Trafficking and the Homicide Epidemic in the Caribbean Basin

Author:
Brian Marein
Publication Date:
11-2025
Content Type:
Policy Brief
Institution:
The Cato Institute
Abstract:
Most of the highest homicide rates in the world are found in the Caribbean basin, a region that includes Central America, the islands of the Caribbean Sea, and the northern coast of South America. This region encompasses countries with the top 6 homicide rates in the world and 23 of the top 30, according to data from 2006 to 2021. In extreme cases, such as El Salvador, annual homicide rates have at times been comparable to the carnage of civil war. European overseas territories, American unincorporated territories, and independent republics, regardless of their income levels, are experiencing violence that has reached epidemic proportions. For comparison, the average homicide rate in the United States was 5.4 per 100,000 people between 2007 and 2021, while the median rate was 20.3 among Caribbean countries and territories.
Topic:
Crime, Public Health, Drug Trafficking, and Homicide
Political Geography:
Caribbean and Puerto Rico

3152. Immigration and Inequality in the Next Generation

Author:
Mark Borgschulte, Heepyung Cho, and Darren Lubotsky
Publication Date:
12-2025
Content Type:
Policy Brief
Institution:
The Cato Institute
Abstract:
The United States experienced historic levels of immigration during the latter part of the 20th century. A generation later, immigration remains one of the most contentious social, political, and economic issues in the United States. Scholars still disagree about the impact of immigration on the economy, inequality, and the many choices families must make. Some of the most foundational questions, such as the long-term effects of immigration on the modern economy, remain unanswered due to a lack of data. Given the declining birth rates and shrinking populations in the wealthiest parts of the world, determining the long-term effects of immigration on the receiving population will only become more important.
Topic:
Immigration, Inequality, Social Mobility, and Income
Political Geography:
North America and United States of America

3153. The Effects of the 1942 Japanese Exclusion on US Agriculture

Author:
Peter Zhixian Lin and Giovanni Peri
Publication Date:
11-2025
Content Type:
Policy Brief
Institution:
The Cato Institute
Abstract:
The history of US agriculture from 1940 to the end of the 20th century is characterized by remarkable gains in productivity, increased specialization in high-value crops, and rapid technological advancements, particularly in mechanization and automation. These developments significantly reduced the need for manual labor in farming, accelerated the reallocation of workers from agriculture to industry and services, and contributed to substantial growth in income per capita.
Topic:
Agriculture, History, Economy, Displacement, and Farming
Political Geography:
North America and United States of America

3154. Social Security and Trends in Wealth Inequality

Author:
Sylvain Catherine, Max Miller, and Natasha Sarin
Publication Date:
10-2025
Content Type:
Policy Brief
Institution:
The Cato Institute
Abstract:
Recent studies have shown that wealth inequality in the United States has risen in the past several decades. However, our research finds that when Social Security benefits are included, the wealth share of the top 1 percent rose from 22 percent in 1989 to slightly under 24 percent in 2019—a much smaller increase than conventional measures suggest. Wealth remains highly concentrated at the top, but not substantially more than in 1989.
Topic:
Economic Inequality, Social Security, and Wealth
Political Geography:
North America and United States of America

3155. Climate-Nature Synergies: From local to global

Author:
Igarapé Institute
Publication Date:
11-2025
Content Type:
Working Paper
Institution:
Igarapé Institute
Abstract:
Climate change and biodiversity loss are distinct phenomena, yet deeply interconnected, with mutual impacts. The Amazon Basin is a powerful example of this interdependence, increasingly threatened by deforestation and the direct effects of environmental degradation. The symbiotic relationship between the climate and biodiversity crises affects not only the Amazon but also other regions of the planet, revealing that their impacts — and, above all, their solutions — are inseparable. Addressing both crises requires integrated, coordinated, and systemic measures. It is in this context that the Climate–Nature Synergies Agenda emerges — an effort to promote greater coherence between actions to confront the climate crisis and protect biodiversity, ensuring ecosystem integrity, maximizing benefits, and minimizing trade-offs. This effort is, by definition, multilevel and multidimensional, aimed at protecting people, climate, and nature across different scales — from local to global. In Climate–Nature Synergies: From Local to Global, the Igarapé Institute draws on the Brazilian context and the Amazon Basin to explore the opportunities and challenges of fostering dialogue between the climate and nature agendas. The study maps ongoing programs and policies that already demonstrate integrated approaches to climate and biodiversity, both in Brazil and in other Amazon countries. By mapping these initiatives, we highlight the importance of strengthening synergies at multiple levels — national, regional, and global. We also show how existing efforts can catalyze new technical, political, and financial partnerships, enhancing the robustness of solutions being tested in Brazil and across the Amazon Basin, while promoting the exchange of experiences among Amazonian countries and across basins, amid a growing global mobilization for the conservation of tropical forests.
Topic:
Climate Change, Environment, International Cooperation, Governance, Conservation, Nature, Biodiversity, and Deforestation
Political Geography:
Brazil, South America, and Amazon Basin

3156. A Pacific Eyes intelligence-sharing agreement

Author:
Mihai Sora
Publication Date:
10-2025
Content Type:
Policy Brief
Institution:
Lowy Institute for International Policy
Abstract:
The Pacific Islands face converging transnational and geopolitical threats that exceed the capacity of any single country to address. Organised crime, illegal fishing, cyberattacks, political instability, and climate shocks are compounding and being increasingly exploited by external powers, creating systemic vulnerabilities across the region. Existing intelligence exchanges are fragmented and inadequate to meet the scale of these challenges. Current bilateral channels and ad hoc networks leave critical blind spots in regional awareness, undermining the ability of Pacific Island governments, and Australia and New Zealand as principal partners, to anticipate and respond to “strategic surprises”. A dedicated intelligence-sharing framework — a “Pacific Eyes” agreement — would transform regional security cooperation. By embedding structured, continuous intelligence collaboration between Australia, New Zealand, Papua New Guinea, and Fiji, the initiative would build capacity, deepen trust, and lay the foundations for a resilient Pacific Islands security community.
Topic:
Regional Cooperation, Geopolitics, Regional Security, and Transnational Threats
Political Geography:
Australia, New Zealand, Papua New Guinea, Fiji, and Pacific Islands

3157. How to scale up Australia’s investment in Pacific climate adaptation

Author:
Roland Rajah, Riley Duke, and Georgia Hammersley
Publication Date:
08-2025
Content Type:
Policy Brief
Institution:
Lowy Institute for International Policy
Abstract:
Pacific Island countries are among the most climate vulnerable in the world and require substantial additional adaptation investment. It is in Australia’s interest to help meet this need. Australian investment in Pacific adaptation infrastructure is scaling up but has almost run out of concessional financing firepower. Directing more of Australia’s aid to this is smart development and smart diplomacy. Australia can fund this most effectively by reducing some of its current heavy use of technical advisers, shifting its aid to enable increased adaptation infrastructure investment, and linking this to partner country governance and reforms. Doing so could dramatically increase Australia’s adaptation infrastructure investment in the Pacific to almost half a billion dollars annually and form the basis for a major new initiative.
Topic:
Climate Change, Infrastructure, Investment, and Adaptation
Political Geography:
Australia and Pacific Islands

3158. Bougainville’s future: A roadmap for development

Author:
Oliver Nobetau
Publication Date:
09-2025
Content Type:
Policy Brief
Institution:
Lowy Institute for International Policy
Abstract:
The Bougainville Peace Agreement established a roadmap towards autonomy and independence. Now, a new agreement is needed to guide socio-economic development and redefine the relationship between the Autonomous Bougainville Government and the Papua New Guinea Government. The Autonomous Bougainville Government should consider establishing a special independent authority responsible for implementing development projects. Capacity-building must take place within the Bougainville Public Service. The Bougainville and PNG governments need to further prescribe the process for the transfer of powers to clarify their roles in the partnership.
Topic:
Development, Politics, Autonomy, and Independence
Political Geography:
Australia/Pacific, Papua New Guinea, and Bougainville

3159. African Transitions Tracker

Author:
Bobuin Jr. Valery and Gemandze Oben
Publication Date:
12-2025
Content Type:
Special Report
Institution:
Centre for the Study of Violence and Reconciliation (CSVR)
Abstract:
Since the beginning of 2025, African political discourse has increasingly centred on militarism, especially among the youth and across diverse social media platforms. The reference point of conversation has been Captain Ibrahim Traoré, President of the Patriotic Movement for Safeguard and Restoration, the military coalition that has been leading Burkina Faso since 2022. His popularity has risen considerably, helped by a surge in popular social media accounts reporting on numerous 'massive developmental projects' and 'rapid socio-economic transformation' under his guidance, amid other reports of the country attaining self-sufficiency and rejecting all foreign aid. However, these reports have mostly been false, and it is unclear what the motive for this recent surge is or where these reports originate. Nonetheless, be they disinformation or misinformation, they highlight the impact of social media in changing public perceptions about military governments, with many African youth hoping for the continuity of the post-2022 governance transition and the spread of militarism. These sentiments reflect the gradual decline of democracy as the favoured model of governance. In a similar vein, Burkina Faso, Mali and Niger formally withdrew from the Economic Community of West African States (ECOWAS) as they officialised their confederation, the Alliance of Sahel States (AES). Significant developments were recently witnessed in Gabon, which ended its governance transition following recent military takeovers by holding presidential elections on 12 April 2025, ushering in a new civilian government. Transition leader General Brice Oligui Nguema secured an overwhelming victory with an absolute majority of the votes. The elections came at a time when some states under transition governments like Burkina Faso, Guinea and Mali continue to postpone elections. Meanwhile, Sudan's civil war rages on amid a worsening humanitarian crisis that has seen nearly 13 million people displaced and 24.6 million people (which is almost half of the country's population) without enough food. This is the largest humanitarian crisis in the world. In neighbouring South Sudan, tensions have been rising following the arrest of Vice President Riek Machar as ordered by President Salva Kiir Mayardit. The official response was that the arrest was made to stall attacks on government infrastructure and to safeguard the Revitalised Agreement on the Resolution of the Conflict in the Republic of South Sudan (R-ARCSS).
Topic:
Civil War, Politics, Governance, Coup, Humanitarian Crisis, and Political Transition
Political Geography:
Africa, Sudan, Mali, South Sudan, Niger, Gabon, and Burkina Faso

3160. Active Public Participation: The Key to Effective Climate Action at the Municipal Level

Author:
Jasmina Brankovic
Publication Date:
11-2025
Content Type:
Policy Brief
Institution:
Centre for the Study of Violence and Reconciliation (CSVR)
Abstract:
The people most affected by climate change are the ones who best understand the problems they face. They see solutions that experts living outside their communities might not – what will work, what will not, and why. At the municipal level, affected communities are essential to developing effective policies and actions to deal with climate impacts. Their active participation in mapping the local situation and designing, planning, implementing and monitoring the response leads to more effective climate action. This brief recommends structures and procedures that municipal councils and administrations can adopt to ensure a participatory approach to climate change responses in South Africa. They include, among others, collaborative assessments, establishment of representative advisory councils and community-based committees, participatory design and budgeting, and capacity building measures. Municipalities that ensure active participation can benefit not only from the expertise of local communities but also from their increased buy-in and support.
Topic:
Climate Change, Municipalities, and Public Participation
Political Geography:
Global Focus