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The Abstract
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> By Stephanie DiCapua Getman, Arnold Ventures
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Dear readers, Welcome back to The Abstract! I hope you had a restful and re-energizing holiday, and if you or yours are personally impacted by the omicron surge, I wish for you good health and a speedy recovery. I am turning this week’s space over to my new colleague Juliana Keeping, communications manager in health care, who is generously sharing her personal experience with our health care system and highlighting some good policy news to ring in the new year.
The day my son was born, I put my hand on the hospital window and watched as he was flown away in a medical helicopter en route to the only children’s hospital in our state equipped to save his life. “Please, God,” I thought. “Protect him.”
Not on my mind was whether the air ambulance ride would be considered in- or out-of-network on my insurance.
The expectation I would ask is absurd to anyone who has ever experienced the powerlessness and trauma of a medical crisis — not to mention an affront to common sense.
A week later, as my newborn recovered from emergency surgery, I received his first-ever medical bill: The helicopter company wanted $25,000.
No one should face financial ruin just because they or their loved ones need health care — yet two-thirds of bankruptcies in America are tied to medical expenses.
So it is very welcome news that at the start of 2022, the bipartisan No Surprises Act became law, protecting millions of Americans who need emergency care — like my son did — from receiving surprise medical bills from an out-of-network hospital or doctor.
Broadly speaking, the law prohibits providers from sending out-of-network bills for air ambulance, emergency care, and certain non-emergency services (e.g., anesthesiology). The No Surprises Act has been a key policy priority of AV’s health care team and grantees, given the impact that out-of-network billing has on health care prices. High health care prices mean high health care costs for consumers, employers, and taxpayers.
The enactment of the No Surprises Act is a win worth celebrating when so much about the world seems pretty bleak. But there are still gaps to be filled. Importantly, the No Surprises Act does not protect against surprise bills from ground ambulance rides, despite the fact that nearly three out of four ground ambulance rides result in a surprise bill.
And the fight over surprise bills didn’t end with the bill’s enactment. Powerful hospital, provider groups, and special interests are already trying to weaken the No Surprises Act in the courts. If these efforts are successful, health care consumers, employers, and taxpayers will not see the savings promised from the bill — and health care costs for everyone could increase even further.
It’s imperative that the No Surprises Act lives up to its promise. AV staff and our partners are working hard to ensure just that.
Nine years have gone by since my son’s air ambulance ride. Eli is a happy kid who loves his family, Minecraft, and cheese pizza. He has a lifelong chronic illness called cystic fibrosis, so I’m glad we don’t have to worry that a future emergency room visit to keep him healthy will devastate my family financially, or saddle him with debt when he grows up.
I’m grateful for this victory, for the Arnold Ventures team, and for the law’s many champions. They are determined to vigorously defend it and my son — as well as the rest of America — from broken health care markets that directly threaten our financial wellbeing and our lives.
— Juliana Keeping, communications manager
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Biden Can Reform Policing
From the Top Down
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By Evan Mintz, communications manager
Even as Congress failed to pass a law better regulating policing in 2021, the White House has an opportunity to reform federal law enforcement agencies in 2022, AV Director of Criminal Justice Marc Krupanski wrote in an op-ed for the San Antonio Express News this week.
The piece highlights the need to address officer misconduct and excessive use of force, and also to pair any new regulations with robust data collection and national standards for decertification. “The Biden administration has all the power it needs to implement policing reforms, increase transparency, and restore public trust in law enforcement institutions,” Krupanski wrote.
Why It Matters: Krupanski notes that the House Committee on Oversight and Reform recently released a report documenting how U.S. Customs and Border Protection agents engaged in racist behavior and general misconduct without facing serious accountability. This wasn’t just a one-time problem but part of a pattern of misbehavior that undermines trust in law enforcement and perpetuates unnecessary violence. “A systemic problem requires a systemic solution, and the White House has the opportunity to enact lasting reforms not only for Customs and Border Protection but for policing nationwide,” Krupanski wrote in the op-ed.
Once enacted at the federal level, these new standards for accountability and transparency can stand as best practices for the 18,000 local law enforcement agencies across the country.
What Else: In addition to accountability and transparency, federal law enforcement should use data to incentivize noncarceral solutions, such as by measuring use of discretionary powers, diversion from arrests and detention, and advancing public health objectives, like decreased overdose rates.
“Prioritizing these metrics — rather than exclusively punitive metrics — would ensure that officers who are genuinely serving their communities receive the promotions and credit they deserve.”
Read the story > |
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A New Year, A New 'NegReg'
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By Torie Ludwin, communications manager
The negotiated rulemaking — or NegReg — committee at the Department of Education has three sessions on the calendar in 2022, and as far as AV Director of Higher Education Kelly McManus is concerned, the priorities are clear.
Why It Matters: The Department of Education disburses $32 billion in federal student aid each year, and the regulations currently being negotiated around how schools access it and what recourse students have when they are cheated by predatory schools is big business.
What’s Next: In the coming months, expect to see discussions on a range of accountability regulations, including the Gainful Employment rule, meant to protect students from debt that far outstrips their earning potential; implementation of the new 90/10 rule protecting veterans from deceptive and fraudulent marketing tactics by for-profit colleges; and the Borrower Defense to Repayment rule to help cheated students get out of debt.
Read the story >
Related: We recently profiled the stories of students who had been victimized by predatory schools, and how via negotiated rulemaking, they could be protected and made whole.
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Insha Rahman of the Vera Institute of Justice, who pushes back against the false claim that bail reform is to blame for the tragedy in Waukesha, which continues to be politicized by anti-reform activists. “Let me be really clear: Bail reform was not the cause for this person being released. He was released because he paid money and he got out. Our cash bail system — the status quo in Waukesha and in courtrooms across the country — is what failed us.” She argues that robust pretrial services — not cash bail — are what’s needed to deliver public safety. “An ideal pretrial system wouldn’t allow for money or profit to drive decisions about release or detention.”
Read the Q&A >
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Criminal Justice
- In a thought-provoking opinion piece, Paul Butler asks in The Washington Post whether prosecutorial tactics used in securing the conviction of former police officer Kimberly Potter could set a dangerous precedent for racial justice. (free link for our readers)
- Decades of mismanagement and dysfunction have led to the current state of violence at Riker’s Island jail, reports The New York Times. (free link for our readers) Here’s a Twitter thread on the piece from our co-founder, John Arnold, who calls it the newspaper’s most important story of the year.
- Reason examines the stagnation of qualified immunity reform in 2021 and highlights the welcome news that thousands of prisoners released on home confinement during the COVID-19 pandemic will be able to complete their sentences from home. “I just want to make sure we find a way to avoid them getting violated over stupid little infractions,” says Kevin Ring of Families Against Mandatory Minimums.
- The reported budget woes of Louisiana's public defender offices are more reason why relying on user fees to fund our courts, public defenders, and other justice agencies is no way to ensure a fair and just criminal justice system.
- The number of children and teenagers killed by gun violence has risen sharply during the coronavirus pandemic, reports The New York Times. (free link for our readers)
- Related: 2021 saw a record number of school shootings, and the Department of Justice just announced new gun safety and storage best practices, via The Crime Report.
- By the numbers: The toll of gun violence in 2021, via The Trace.
- Funding opportunity: The National Collaborative on Gun Violence Research has issued a new request for proposals for research that will provide the public and policymakers with evidence to support development of fair and effective gun policies. Funding is available for one-year dissertation awards and postdoctoral fellowships. Learn more here.
Health
- Big Pharma rings in 2022 with a new round of price hikes on more than 400 prescription drugs. “Patients are counting on Congress and the Biden administration to deliver drug pricing reforms immediately in this new year,” David Mitchell of Patients for Affordable Drugs tells Common Dreams.
Dive Deeper: 90% of voters say it is important for this Congress to take action to reduce health care prices – that includes the skyrocketing price of drugs.
Related: A gallon of milk would cost $13 if its price had risen as fast as brand-name prescription drugs have over 15 years. AARP does the math on how other basic consumer necessities would stack up.
Related: Why drug price controls are critical for patients and small businesses alike, via Dr. Erika Gonzalez writing in The Hill.
- Before paying for the pricey new Alzheimer’s drug Aduhelm, Medicare should learn whether it works by limiting coverage to patients who volunteer for a clinical trial, argue Peter B. Bach and Rita F. Redberg in Bloomberg.
- "The industry will always say if you do anything, it's nuclear winter. But that is often not the case,” AV Executive Vice President of Health Mark Miller tells Modern Healthcare in this piece on the opportunity for Medicare Advantage plans to save money for Americans and taxpayers — and the insurance lobby’s fervent opposition.
- Affordability standards can help stop runaway health care prices, according to a new brief from the National Academy for State Health Policy.
- Will the opioid settlement money actually help people who need it, asks The New Republic?
Higher Education
- The New Yorker outlines the issues with predatory for-profit schools and the importance of the gainful employment rule, for which negotiated rulemaking will begin on Jan. 18..
Democracy
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- The Betty White birthday challenge is going viral. It’s a way to honor the cherished icon by donating to her favorite cause on Jan. 17: a local rescue or animal shelter. Pass it on.
- For all the words nerds: Try this addictive new game, Wordle, which was inspired by love.
- My son got an electronic drum kit for Christmas to foster his newfound talent, so this story touched a nerve: After his drums were destroyed in a house fire, 10-year-old Alijah Lockhart was surprised by his music teacher with a new set. This kid is going places.
- 100 ways to slightly improve your life without really trying, via The Guardian.
- How big is the universe? Watch and have your mind blown.
- This COVID meme is accurate, and brings back childhood memories.
- For all the parents, some much-needed comic relief when it comes to COVID and schools. (Better to laugh than cry, right?)
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Have an evidence-based week,
– Stephanie
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Stephanie DiCapua Getman develops and executes Arnold Ventures' digital communications strategy with a focus on multimedia storytelling and audience engagement and oversees daily editorial operations and design.
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