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The Abstract
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> By Stephanie DiCapua Getman, Arnold Ventures
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To say that fixing our country’s broken drug pricing system is important to Arnold Ventures would be an understatement.
When Laura Arnold launched her Deep Dive podcast more than two years ago, the absurdity of drug prices was the inaugural episode. John Arnold has spoken urgently and often about the need to rein in pharma. Our EVP of Health Care Mark Miller has testified on the issue multiple times before Congress and leads a drug pricing team that has worked tirelessly to push for evidence-based reform.
We’ve written extensively on the Congressional grillings and bad behavior of pharmaceutical executives, the desperate measures patients have taken to survive when they can’t afford their medications, and how states have stepped up where the federal government has failed to act.
“This isn't capitalism. This is a form of oppression,” our co-founders told NBC Nightly News in 2019 about a pharmaceutical industry that continues unfettered to co-opt the political process for its own benefit.
So you will understand when I say we are beyond disappointed — and dismayed — that wildly popular and evidence-based drug pricing reform was omitted from the Build Back Better framework presented Thursday by the White House. As our President and CEO Kelli Rhee, who launched AV's drug pricing portfolio more than eight years ago, writes in this no-holds-barred op-ed in The Hill today, “Failure to implement drug pricing reform will be a political and policy failure on a historic scale.”
Democrats ran on the promise of lowering drug prices for Americans, who pay four times what people in other wealthy nations do for the same medications. Nearly 90% of voters — Republicans and Democrats alike — support reform. It would save taxpayers $500 billion over 10 years.
But most importantly, for the millions of Americans who skip doses or leave prescriptions unfilled because they are too expensive, it’s a matter of life and death.
The president and Congress choosing to appease pharma over the voters who put them in office on the promise of drug price relief is a failure of democracy and an affront to the American people.
“It is an indictment of our entire political system that a handful of members of Congress who are working on behalf of Big Pharma have so far blocked reform,” said AV grantee David Mitchell of Patients for Affordable Drugs after the news broke Thursday. Mitchell is also a cancer patient, and the medicine needed to keep him alive costs more than $900,000 a year.
Big Pharma has pulled out all the stops to kill drug pricing reform — their campaign of lies and lobbying cannot be rewarded.
Congress and the White House must put drug pricing reform back on the table and send a clear message from their constituents to Big Pharma: Americans’ lives matter more than your profits.
Related: Read today's op-ed in The Hill from our President and CEO Kelli Rhee: “Without drug pricing reform, BBB will stand for 'Biden's Big Blunder' ”
Related: Read AV's full statement on drug pricing and the Build Back Better framework. |
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Who's Maximizing Opportunity
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By Torie Ludwin, Communications Manager
When Rich Pierre realized he wasn’t heading to the NBA after high school, he had to figure out what was next. He connected with Boston-area student advising program Bottom Line, and to this day, he’s grateful. His mentor helped him through the college choice, application, financial aid, and preparation processes. Once he got in, they stayed in touch, and Pierre graduated on time.
What’s Happening: Bottom Line realized it wanted to scale up, and to do so, it had to measure its effectiveness. So the organization submitted to a large, randomized controlled trial (RCT) of more than 2,400 students at three of Bottom Line’s sites. Interim results show that Bottom Line students were much more likely to earn a bachelor's degree within five years of high school graduation compared to a control group. In fact, there was a statistically significant 8 percentage point increase in bachelor’s degree completion for the Bottom Line group compared to the control group.
Why it Matters: An impact of this magnitude on bachelor’s degree receipt has never been observed before in a well-conducted study of college prep programs, making Bottom Line the first to achieve this remarkable distinction.
What's Next: Bottom Line is exactly the type of program that education advocates in Washington, D.C., say the federal government should invest in. And they might soon see that happen, notes Kelly McManus, AV’s director of higher education. The White House recently released its framework for the Build Back Better Act, including the College Completion Fund, which invests in evidence-based programs that help students graduate.
Federal investments in programs like Bottom Line through the College Completion Fund would signal an important shift in federal higher education policy — not just focusing on access, but also focusing on success.
Read the story >
Related: New polling from Third Way indicates that voters across the political spectrum think Congress should increase investment in higher education as part of the Build Back Better Act. Eighty-eight percent support investing in college programs that have been proven to prepare students to graduate and enter the workforce, large components of the College Completion Fund.
Related: Nine ways the College Completion Fund can support students who need it most and get them across the finish line.
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Shining a Light
on District Attorney Offices
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Brooklyn District Attorney Eric Gonzalez. (Getty Images)
This week the CUNY Institute for State & Local Governance (ISLG) released the findings of a multi-year study analyzing racial and ethnic disparities in outcomes at key points in the Brooklyn District Attorney’s Office’s decision-making process. The research found that while disparities existed at specific decision points and for certain crimes, outcomes were not universally worse for Black and Hispanic people, and better for white and Asian people, across all stages.
Why it Matters: This research begins to shine a light on the black box of district attorney offices. Prosecutors have vast discretion in how they run their offices, and this decision-making power makes them one of the most powerful actors in the criminal justice system. However, we have little data about how these offices operate and what the outcomes are for impacted individuals.
“For too long, prosecutors have processed people through the criminal justice system without considering the consequences of their decisions, especially possible racial disparities in the exercise of prosecutorial discretion,” said Jeremy Travis, AV’s executive vice president of Criminal Justice. “This report helps to build the much-needed evidence base that can support a new model of evidence-based prosecution — one focused on best practices, transparency, and accountability.”
What’s Next: For the Brooklyn DA’s office, this report is a first step toward building a more holistic understanding of how racial and ethnic disparities develop and how these gaps can be closed. As part of his Justice 2020 program, Brooklyn DA Eric Gonzalez has issued 17 specific recommendations to transform the office into a model of progressive prosecution.
“The comprehensive data analysis performed by ISLG is particularly instructive as we continuously strive to lessen racial inequities in the justice system because it points to areas of successful reforms and provides a roadmap to aspects that require additional efforts,” Gonzalez said.
Beyond the immediate site, this research stands as an example of how prosecutors can and should open their offices to research and scrutiny in order to ensure that their policies and decisions truly promote justice and community safety.
Read more > |
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An Early Release Program
at Rikers Shows Promise
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We’ve talked extensively in this newsletter about the deteriorating and inhumane conditions at Rikers Island and a pathway to closing the notorious jail. A majority of people detained there have not been convicted of a crime but are awaiting trial — often for nonviolent offenses. The Center for Court Innovation recently released a noteworthy report that shows a city-backed early release program from Rikers has largely been a success.
What’s Happening: The program, known as Early Release 6A, was modeled after a 2009 Supervised Release Program that worked in collaboration with the state’s court system to provide an alternative to money bail as a condition to release. More than half of the people released under 6A were charged with a low-level felony; the others were charged with misdemeanors ranging from petit larceny, assault, or possession of a weapon. As part of their release, they had to agree to remote check-ins daily, which included wellness checks and information about counseling services, housing, and food assistance.
The Results: In the six months after the participants’ release, more than 20,000 check-ins were made. At the time, 78% had complied with the conditions of their release, and only 29 of the nearly 300 remained under supervision. There were also 400 referrals made to community-based supportive services, which include addressing employment and housing issues. CCI will release a report next spring that details the overall effectiveness of the program.
Read the story >
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'I Had to Look at My Wife and Tell Her They Just Took Our Home'
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By Torie Ludwin, Communications Manager
Veteran Kendrick Harrison didn’t know that his G.I. Bill was such a desirable asset to predatory schools like Argosy University. He enrolled there planning to complete his bachelor’s degree while supporting his family on stipends from the school. When the stipends stopped coming, Argosy didn’t get back to him; when the school went into court receivership, Harrison lost his home.
What’s Happening: This week, the U.S. Department of Education held hearings on the 90/10 rule, which states that for-profit institutions of higher education must get no more than 90% of funding per student from the federal government. Thanks to a loophole in the rule, the G.I. Bill — an education benefit for veterans — is not considered federal aid. This exemption has made veterans like Harrison highly lucrative sources of money to predatory colleges.
What’s Next: The hearings this week are part of the Department of Education’s monthslong negotiated rulemaking sessions, a process where a committee will make the rules on how federal student loans are accessed. Arnold Ventures is publishing a series of stories produced by Student Defense and filmmaker/photographer Alexander Shebanow that illustrate the impact these student loan disbursement rules, like the 90/10 rule, have on students around the country.
Read the story >
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Rethinking How the FBI
Measures Gun Violence
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By Evan Mintz, Communications Manager
Since 1930, the Federal Bureau of Investigation has collected and published national crime statistics in the annual Uniform Crime Reporting Program. But a lot has changed in the United States over the past 90 years, and it is becoming increasingly clear that our nation needs more than what the UCR can provide if we want to collect the data necessary to help policymakers reduce violence and save lives.
This insight was one of the technical yet groundbreaking ideas discussed last week at the virtual event, “ Improving Data Infrastructure to Reduce Firearms Violence,” which was hosted by Arnold Ventures, NORC at the University of Chicago, the Data Foundation, and the National Prevention Science Coalition.
Why It Matters: Data about gun violence in the United States is “limited, opaque and inaccessible,” AV’s Vice President of Criminal Justice Walter Katz said. This not only undermines research, but makes it difficult to overcome partisan divides. NORC’s John Roman pointed out that any debate about gun violence requires a “shared set of facts” and emphasized the need to “think about firearms data infrastructure, rather than beginning with policy recommendations.”
What’s Next: The FBI’s UCR program tracks firearm crimes but does not include details about victims, the type of gun, or resulting injuries, which is vital information for future policymaking. This data is included in the FBI’s National Incident-Based Reporting System (NIBRS), but the largest police departments in the United States — such as in Chicago, New York City, and Los Angeles, as well as the Los Angeles Sheriff’s Department — do not participate, severely limiting the data’s utility. Ultimately, panelists recommended that the federal government fully fund the Bureau of Justice Statistics to ensure this critical data is collected.
Read the story >
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By Juliana Keeping, Communications Manager
330%
Payment rates, charged by anesthesiologists to commercial payers, relative to what they charge Medicare for the same service.
We’ve long known that providers are paid higher prices from commercial payers than Medicare for the exact same services. A new analysis from AV grantee Urban Institute finds that certain types of specialties are able to extract higher prices compared to Medicare than others.
Prices for primary care and family medicine doctors are closer to Medicare, while anesthesiologists are paid 330% of Medicare, followed by ER doctors at 250%. (These high-priced doctors are also the driving force behind surprise medical billing).
High-priced specialties also have the most generous compensation packages in health care, from $350,000 per year for emergency physicians to $800,000 for neurosurgeons.
Banning surprise billing was a good start to putting downward pressure on these high prices, but policymakers should also consider capping physician prices as a percent of Medicare.
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Criminal Justice
- With its ruling on qualified immunity, the Supreme Court has abdicated its responsibility to regulate police behavior, this New York Times op-ed argues. Legislators must now step up. (free link for newsletter readers)
- Dozens of current and former Louisiana State Police troopers describe “a culture of impunity, nepotism and in some cases outright racism,” this Associated Press investigation reveals.
- We love to see the principle of parsimony invoked in this New York Times essay supporting sensible reforms to reduce prison populations: “Let the Punishment Fit the Crime.” (free link for newsletter readers)
- “Tough-on-crime” policies are making us all less safe and costing taxpayers exorbitantly, write three former prosecutors in a Los Angeles Times op-ed supporting evidence-based sentencing reform in California.
- Debunked: Five common myths about recently released FBI data showing a rise in homicides across the United States.
- Carolina Public Press looks at how some counties are basing decisions on whether to build bigger jails on advice from the very firms poised to profit from more incarceration. It’s part of a four-part investigative series, “Raising Jails.”
- The Nation speaks to incarcerated people in New York who say they have faced discipline and humiliation in prison because of their disabilities.
- San Francisco is home to a novel transitional housing program for survivors of domestic abuse or trafficking who have served time in prison after committing offenses against their abusers. “It’s a population that has long been overlooked or ignored — in part because the entire criminal justice system has always been designed with men in mind, even as the number of women in prison has soared in recent decades.”
- Baltimore will invest $50 million of American Rescue Plan funding into violence prevention and re-entry support for people returning from prison, WYPR reports.
- Medical parole is sorely underutilized in the New York carceral system, leading to countless unnecessary deaths, writes CUNY School of Law professor Steve Zeidman, citing this report from the Vera Institute of Justice.
- Good news for the EQUAL Act, which aims to reverse decades of racist sentencing laws.
- Good news for the the federal Driving for Opportunity Act, which would end counterproductive debt-based driver’s license suspensions.
- Before Rosa Parks, Claudette Colvin refused to give up her seat on a bus. She’s still on probation and is petitioning for her record to be cleared, The Washington Post reports. (free link for newsletter readers)
Health
- The drug industry gave generously to members of Congress in the first half of 2021, according to new data from KHN’s Pharma Cash to Congress database.
- Kaiser Health News Editor in Chief Elisabeth Rosenthal explains how it’s entirely possible to receive excellent health care at a reasonable price. Maryland, the only state in the U.S. that controls what hospitals can charge for services, can show policymakers a path forward.
- A stunning rise in drug overdose deaths is prompting first responders to develop new strategies on the job, such as providing mental health resources and follow-up visits, The Hill reports.
- The price for lifesaving naloxone, which reverses opioid overdoses, has soared due to Pfizer manufacturing problems, The Guardian reports. “The experts wonder why other naloxone producers don’t drop their prices, even temporarily, to cover the gaps.”
- The next FDA Commissioner will play a critical role in advocating for evidence-based science and advancing contraceptive access, writes Raegan McDonald-Mosley of Power to Decide in The Hill.
Higher Education
- Students’ economic return on investment from college can vary dramatically by the programs they attend, according to a substantial new paper from The Foundation for Research on Equal Opportunity — 28% of all programs provide no ROI at all, while some are disproportionately low-value.
- AV partner David Halperin exposes a deeply concerning development in California: The California Community Colleges system has announced a new transfer deal with the problematic for-profit chain American Public University System.
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ABC News examines the epidemic of firearm deaths in this country in the extensive multimedia series "Rethinking Gun Violence." Start with this 11-minute Vox-style primer on the scope of the problem: the research blackout prompted by the Dickey amendment, what the data we do have says about gun violence (and why we need more of it), and a political path forward that balances the right of gun ownership with saving lives. “Our politics is just not being incentivized to pay attention to the things that would actually reduce gun violence.”
Related: Reveal takes a deep and devastating look at how America’s gun laws are failing domestic violence victims.
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- The majority of people sitting in American jails are there awaiting trial because they couldn’t afford cash bail — often on low-level charges like minor drug possession or driving with a suspended license. The Lawyer Up! Podcast talks to Micah Derry, AV’s bail reform campaign director, about the implications of this unjust system, which can lead to people losing their jobs, homes, and even children. He discusses what the evidence tells us about monetary bond and why Ohio should pass SB 182, bipartisan legislation that would overhaul the state’s bail system.
Dive Deeper: Bail reform is a bipartisan issue, Derry says. He outlines AV’s blueprint to eliminate the injustices of money bail in this Q&A.
- Also: Robert Davis did everything right on parole, followed the rules, and was looking forward to his supervision ending. But deep-rooted problems within the U.S. Parole Commission delayed his full freedom for the better part of a year. It’s a case that underscores the many barriers in place for people within the criminal justice system. "I think returning citizens are really viewed like, 'OK, come home, get yourself together,' " Davis tells NPR. "And it's like, you just said this so easily. That is like the hardest thing in the world."
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- Writer’s block? Some kittens may help. (h/t to my colleague Arielle)
- She’s won multiple Grammys, toured, and landed major endorsements — all in one year. Now Megan Thee Stallion is preparing to graduate from college. "I want my big mama to be proud. She saw me going to school before she passed," the Houston rapper tells People.
- A Louisiana school replaced campus police officers with a group of fathers who call themselves “Dads on Duty.”
- For Halloween, I'll be checking out the Vox-recommended podcast "Knifepoint Horror," described as "brilliant" collection of minimalist campfire ghost stories.
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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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