A Chilling End to Our ​‘Hot-Vax Summer’

By Evan Mintz, Communications Manager
 

For nearly a year, Kenneth Humphrey sat in a jail cell as an innocent man. Not yet convicted of a crime, Humphrey — a 66-year-old Black man from San Francisco — was unable to afford his unreasonably high bail of $350,000 to buy his freedom. But four years after he was charged with robbing a neighbor of a $5 bottle of cologne, Humphrey's case was successfully appealed to the California Supreme Court and led to a unanimous decision reforming the state's pretrial practices.
 

Why it Matters: Before the court took up Humphrey's case, Californians would routinely be held behind bars before trial simply because they couldn't afford cash bail. Writing unanimously for the court, Justice Mariano-Florentino Cuéllar ended this unjust practice by noting that “the common practice of conditioning freedom solely on whether an arrestee can afford bail is unconstitutional.”
 

What's Next: Kenneth Humphrey is still waiting for his day in court, though he’s no longer confined to a jail cell. Meanwhile, California lawmakers are working to pass new legislation to codify the end to wealth-based detention. 
 

By Rhiannon Meyers Collette, Communications Manager

From insulin pumps to pacemakers to CPAP machines to treat sleep apnea, you either know someone who relies on a medical device or may even use one yourself. Medical devices are ubiquitous in the U.S., and while many are classified as low-risk (think tongue depressors and bandages) others carry a great deal of risk that’s often not fully understood by those who are using them.

Take for example the HeartWare Ventricular Assist Device, or HVAD, an implantable heart pump that helps keep patients alive until they can get heart transplants. In a bombshell story, ProPublica found that more than 19,000 patients have been implanted with this device despite red flags waved by federal regulators at the U.S. Food and Drug Administration as far back as 2014 that the HVAD failed to meet federal standards. The agency has received at least 3,000 reports of patients who died. How does something like this happen? Short answer: The FDA’s system for regulating devices is deeply flawed and has allowed some to come to market that are ineffective at best, and harmful at worst.

Dive Deeper: As my colleague Rhiannon Euhus has written, the FDA’s approval process “is rife with low evidence standards and loopholes for device-makers to gain market approval.” One glaring problem: Manufacturers trying to gain approval through certain pathways only have to prove that their device is “substantially equivalent” to an existing device already on the market. This creates a system where new devices are marketed to patients without first undergoing rigorous scrutiny of their safety or effectiveness.   

Further complicating the problem, device makers aggressively market their technologies, embedding sales reps in operating rooms alongside surgeons to offer “technical guidance” during procedures and paying surgeons to tout their devices — practices that Kaiser Health News found contributed to “serious patient harm in thousands of medical malpractice, product liability and whistleblower lawsuits filed over the past decade.”

Bottom Line: The medical device system should be reformed to create higher evidence standards for coverage and payment. Low-value medical devices increase health care costs — a federal report found that Medicare spent $1.5 billion on services and procedures associated with just seven recalled or failed cardiac devices over 10 years. Medicare beneficiaries spent another $140 million in copayments and deductibles related to these same devices. They also pose potential risks to patients’ safety and quality of life. 
 

By Evan Mintz, Communications Manager

Last week media outlets across the country ran a story about a San Diego sheriff’s deputy accidentally overdosing on fentanyl after being exposed on the job. But experts quickly raised a skeptical eyebrow at the reports. As the Los Angeles Times noted in its follow-up correction, the risks of incidental contact with fentanyl are vastly exaggerated by law enforcement and media alike. In fact, this problem was documented in a recent report by RTI International, supported by Arnold Ventures:

“Although toxicologists, medical professionals, and service providers have determined that the risk of overdose from fentanyl exposure is extremely low for law enforcement and other first responders, hundreds of media and social media accounts contradict these facts, making these civil servants unnecessarily concerned about such occupational hazards.”

Why it Matters: Police officers need to have a factual understanding of the issues they face in their jobs. Misplaced fears can undermine the psychological well-being of individual officers and make it harder to respond effectively. “There is more of a PTSD-like fear of this drug when, in reality, it’s not warranted,” Dr. Lewis Nelson, chairman of the Department of Emergency Medicine at Rutgers New Jersey Medical School, said about fentanyl in the LA Times. “There is no risk of poisoning from such an exposure. And I fear people won’t rescue those who have overdosed because of the fear of being exposed.”

What’s Next: While RTI International recommends that law enforcement agencies take steps to educate officers about fentanyl, media also has a responsibility to fact-check claims made by the police and not simply treat criminal justice as a one-sided issue. Journalists are starting to face up to this challenge. Gannett has announced a company-wide effort to reimagine the way its newspapers cover crime. “The goal is to move beyond coverage that lacks context and relies on police narratives to the detriment of marginalized communities,” Poynter reported.

It's been clear for a long time that Medicare is on an unsustainable path: Rising health care costs and the growing generation of baby boomers aging into the system are straining Medicare's resources. This week, AV launched a new initiative to ensure the long-term stability of Medicare. Our approach: The Medicare program provides health insurance to more than 62 million Americans, but it faces serious fiscal challenges. We believe that an effective, long-term solution must adopt a balanced approach that includes slowing the growth of Medicare spending while increasing revenue to the program. AV will focus on developing research, policy proposals, and technical assistance to aid federal policymakers in enacting reforms to Medicare.

Learn more >

Related: A coming report is expected to highlight the fiscal and policy challenges facing Medicare. Here are five things to watch for.

• The Atlantic explains why “defund the police” is such a problematic slogan, citing journalist Jill Leovy’s book on homicide in America. “Ghettoside’s great insight is that a community can be over-policed and under-policed at the same time –– and that reformers can advocate for an end to over-policing while also championing the proposition that more police resources are required to solve more violent crimes. Defund the war on drugs. Defund stop-and-frisk. But also, fund the homicide bureau and the processing of rape kits and the community-policing initiatives that help people of all classes to feel as safe in their neighborhoods as wealthy Americans do in theirs.”
   
• Praise for slain Chicago police Officer Ella French pours in as her death continues to roil the city, The Chicago Tribune reports. “She really cared about her community; that’s why I’m glad to say I actually saw her hands-on. She was really kindhearted. She had a great spirit.”
   
• Houston becomes the latest city to propose sending social workers and mental health professionals, rather than police, to respond to 911 mental health emergencies, the Houston Chronicle reports.
   
• Learn how communities across the country are tapping American Rescue Plan dollars to fund gun violence prevention, via The Trace.
   

• Two experts debunk myths about firearm suicide and explain what can be done to decrease these deaths, via Crosscut.
   

• The deaths of two Safe Streets workers dedicated to ending the cycle of violence in their communities should not lead us to abandon this important work, writes Johnny Rice II of Coppin State University in The Crime Report. 
   
• “Prisons tend to rinse away the parts that make us human.” Atrocious conditions in America’s prisons make us all less safe and thwart a successful return to society, writes Shon Hopwood of Georgetown University Law Center. It’s part of the Brennan Center’s series examining the punitive excess that has come to define America’s criminal legal system.
   

• President Biden this week outlined his blueprint for lowering drug prices and called on Congress to take the next steps to enact policies that would allow Medicare to negotiate drug prices and implement an inflation rebate for pharmaceutical manufacturers who hike their prices above inflation. “There aren’t a lot of things that almost every American could agree on,” Biden said. “But I think it is safe to say that all of us, whatever our background or our age and where we live, could agree that prescription drug prices are outrageously expensive in America.”
   
• Meanwhile, the Washington Post debunks PhRMA’s “Mediscare” ads and awards the lobbying group “three pinocchios” for their misleading description of Medicare drug-price legislation.
   
• Medical debt is leaving too many Americans indefinitely impoverished — and leading to higher rates for those with insurance, writes Chris Tomlinson in the Houston Chronicle. And the burden of medical debt is not equally shared, impacting communities of color disproportionately. 
   
• Health Affairs published an analysis from AV grantees using newly disclosed pricing information on colonoscopies — available under the new transparency rule — to examine where the high-price hospitals are. (Spoiler alert: They are everywhere.) 
   
• In response to a request for information on designing a public option, AV's Health Care team makes the case that any reform should contain health care costs by addressing a key cost driver: excessive prices dominant providers charge for care. 
   
• On our radar: A new memoir from Leana Wen, “Lifelines: A Doctor's Journey in the Fight for Public Health,” that chronicles her work in Baltimore to tackle the opioid epidemic, improve maternal and child health, and address violence as a public health issue. She also shares her family's immigration story and how it shaped her work in public health, as well as her personal experience with postpartum depression. 
   
• The First Step Act required the Bureau of Prisons to make medication-assisted treatments for opioid addiction more widely available to incarcerated people, but few are getting them, The Marshall Project reports.
   

• This excellent piece from FiveThirtyEight highlights the importance of conducting high-quality randomized controlled trials to identify what works in medicine, a lesson our Evidence-Based Policy teams says is equally applicable to social policy. 
   
• It’s become harder than ever to be a practicing journalist (spoken as a former journalist myself), but I was inspired by CNN journalist Jen Christensen poignant writing about the importance of field reporting to capture on-the-ground realities of the people she is writing about in this piece for the Center for Health Journalism. Shoe leather reporting lives.
   
• The bipartisan Energy Sector Innovation Credit Act offers an "opportunity to establish the next generation of clean energy tax incentives and equip our energy industry with the tools needed to meet our ambitious climate goals," write Jeremy Harrell of ClearPath Action and Quill Robinson of the American Conservation Coalition in The Hill.
   
• Bring out the maps: This week’s release of Census data will prompt a flurry of redistricting activity, FiveThirtyEight reports. The site is tracking the proposed maps in real time.

Hulu's “Homeroom,” a beautiful film about the dreams, challenges, and burgeoning political activism of the senior class of Oakland High School. It’s the first day of school in 2019 — a nostalgic view of the world without masks — and some in the class of 2020 have taken on a bold mission: getting police out of their schools. They’re also navigating college applications, displacement from gentrification, a presidential impeachment, prom, a global pandemic, virtual graduation, newsmaking violence, and a summer of protest. This is a story told solely through the teens’ eyes — and their phones and computer screens. COVID-19 cuts them off from their senior journey just as they’re about to crescendo, an experience illustrated with an eerie montage of empty classrooms and halted plans. These teenagers adapt.
 

Also: Our Co-Founder John Arnold talks to Robert Frank on CNBC’s “The Exchange” about the need to reform charitable giving so that money gets to those in need faster. Today, money “earmarked” for charity is sitting in donor-advised funds — sometimes for decades — generating tax benefits for wealthy donors. "That money can sit there in a wealth warehousing vehicle forever. It’s received the tax benefit on Day 1, but that money never has to go to the community.” 

• RCT Training Opportunity: Register by Sept. 1 for discounted access to J-PAL North America’s Research Staff Training, a four-week virtual course that will run from Oct. 18 to Nov. 12.  It’s designed for research staff working on randomized controlled trials and provides an opportunity for participants to develop practical skills necessary for their work, refine technical skills, and meet other research staff working on RCTs around the world. Register here. 
   
• Police Reform Panel: The free, virtual 20th Annual State Criminal Justice Network Conference runs from Aug. 18-20 and includes a panel on the “Year in Police reform,” with AV’s Vice President of Criminal Justice Walter Katz, DeRay McKesson, co-founder of Campaign Zero, and  Kami Chavis, professor of law and director of the criminal justice program at Wake Forest University School of Law. It’s moderated by ACLU’s Paige Fernandez. Learn more and register here.

• I read a compelling New York Times op-ed that gave me a view into the unvaccinated that I hadn’t considered enough. “No, the Unvaccinated Aren’t All Just Being Difficult” argues that lagging vaccination rates are not all the result of ideology or misinformation, but rather access, and that time spent shaming the unvaccinated may be better spent addressing the barriers to getting a shot: child care, transportation, work obligations. For those who are facing such obstacles or just hesitant, one Alabama resident is pursuing a revolutionary solution: kindness. “The Panola Project” is a refreshing short documentary about Dorothy Oliver, a force of a woman who is using gentle persuasion — and her infectious laughter — to get as many people as possible vaccinated against COVID-19 in her 400-count hamlet of Panola, Alabama. “I just felt like I had to do it because the government, nobody does enough in this area,” Oliver says. “This area here is majority Black. Kind of puts you on the back burner.” Access to a vaccine is 39 miles one way, and a lot of people don’t have cars, so she just has to persuade 40 people to sign up to get a clinic to come to them. Oliver exudes compassion and understanding in her door-to-door mission, counts every shot as a win, and never judges her neighbors. She is an inspiration. 
  
  
   
• Orion Jean, a 10-year-old from Fort Worth, Texas, has made it his mission to get 500,000 books into the hands of children. He’s 120,000 books closer to his goal, and seeking more donations. “They can give that book away to another child who may need it, and it causes a ripple effect. And that’s what it’s all about.” Here’s how to help.
   
• “Welcome to America,” a posthumously released concept album from Prince, is composed of previously unreleased 2010 material but has a point of view that rings very relevant in 2021.