Cracking and Packing: Why Your Vote May Not Count

By Rhiannon Meyers Collette, communications manager

For decades, pharmaceutical companies have gamed the U.S. patent system and engaged in anticompetitive behaviors to drive up prices, making it increasingly harder for American families to afford life-saving drugs. Those findings, released Friday, were the culmination of three years of Congressional investigation into pharma’s price gouging and anticompetitive business practices.
 
What's Happening: The House Oversight Committee investigation, led by Democrats, relied upon hundreds of pages of internal documents and dozens of hours of Congressional testimony. The investigation found that pharma deploys an intentional strategy to extract profits off the backs of American patients, employers, and taxpayers — raising prices to meet revenue targets, incentivizing executives to hike prices, targeting the U.S. for higher prices while discounting the same exact drugs elsewhere, abusing the patent system to suppress competition and maintain monopoly pricing, and so on. Separately on Friday, Republicans on the Oversight committee issued their own report, laying the blame on pharmacy benefit managers (PBMs) for the dramatic increases in prices and drug spending. Both pharmaceutical companies and PBMs engage in bad behaviors that contribute to rising drug prices — however, independent and nonpartisan research has long demonstrated that PBMs contribute to a much smaller fraction of the problem than large pharmaceutical companies.
 
Why It Matters: The Build Back Better Act would empower Medicare to negotiate drug prices and require drugmakers to reimburse taxpayers when they hike drug prices higher than inflation. The package has been passed by the House and is now awaiting approval in the Senate. Comprehensive drug pricing reform is necessary — and should include measures that address the holistic failures inherent across the system — however, as Americans continue to struggle to afford their prescriptions, Congress has an opportunity now to take action to help lower drug prices while continuing to work in the future to ensure affordability and accessibility.

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Dive Deeper: In Congressional testimony, pharmaceutical executives struggle to explain unsustainable drug prices and answer for anticompetitive tactics.

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By Evan Mintz, communications manager

How can a Black community be expected to trust police officers who joke about lynchings? How can a Jewish community be expected to trust police officers who joke about gas chambers? The community of Torrance, California, is asking itself those questions after the Los Angeles Times reported on a cache of text messages between current and former police officers and recruits exposing not just bigotry, but total disregard for a duty to protect and serve. 
 

One officer even mentioned lying during an investigation into a police shooting. 
 

“What those text messages revealed was an extraordinarily hostile attitude toward people of color, people who are nonbinary, people who have different sexual orientations,” Arnold Ventures Vice President of Criminal Justice Walter Katz told the LA Times.
 

Why It Matters: This reporting has brought into question not only the individual officers’ morality and trustworthiness, but the outcome of hundreds — if not thousands — of cases in which the officers served as witnesses, in addition to cases alleging excessive use of force. “I don’t know that we can take anything they’ve said at face value,” Katz told the Times. 
 

The officers at the core of the scandal have been involved in at least seven serious use-of-force incidents, including three that ended in Black or Latino men being killed. At least 85 criminal cases have already been dismissed.
 

Katz also pointed out that the Torrance police department upheld a shockingly low number of allegations of police misconduct and racial profiling, especially in the context of what we now know about officers’ beliefs and behaviors. These statistics are a sign that officers simply weren’t held accountable for their actions. “If citizen complaints are not taken seriously, it does increase the sense of impunity that officers who are inclined toward misconduct have,” he said.
 

What’s Next: This investigation highlights the need for transparency and accountability in policing. Before California passed Senate Bill 2 earlier this year, these officers would have been able to get jobs at other law enforcement agencies in California. The bill creates a process for decertifying officers who violate the public trust, but all too often legal barriers and data opacity stand in the way of true accountability. In fact, the Department of Justice came under sharp criticism this week for a failure to consistently publish an annual summary about police use of excessive force. Voters this past November demonstrated a real interest in focused civilian oversight of policing. States and the federal government all have roles to play in holding our nation’s 18,000 law enforcement agencies accountable.

Related: Congress Needs to Have a Criminal Justice Data Infrastructure Week

By Alan Greenblatt, Arnold Ventures contributor

Around the country, the idea that voters should pick their politicians and not the other way around has shown to be hugely resonant. Redistricting, which determines what districts elected officials represent based on census data, is a process that used to be considered strictly an insider’s game, but with greater data transparency and an increasingly informed electorate, more citizens are aware of its importance — and they’re speaking up. 

What’s Happening: On Wednesday, the North Carolina Supreme Court delayed the state’s primary elections from March until May so that it can resolve lawsuits claiming that congressional and legislative maps are illegal gerrymanders that discriminate against Black voters. The action came two days after Attorney General Merrick Garland filed a lawsuit against new maps approved in Texas, alleging that they violate the Voting Rights Act and “deny or abridge the rights of Latino and Black voters.”

Why It Matters: With most districts accountable only to voters of one party, most of the real action takes place in primaries, which have smaller turnout and draw more ideologically extreme voters. That leaves the general public with little way of holding Congress or their state legislatures accountable. Redistricting contributes to polarization and, by insulating politicians from real competition, leaves other issues of concern — such as climate, criminal justice reform, and student debt — less likely to be addressed in meaningful ways.

What’s Next: The Justice Department lawsuit is one of many challenges being brought against discriminatory maps across the country. Litigation aside, activists are already plotting ballot initiatives to regulate the process during the next round of redistricting. More immediately, they are pressing Congress to put guardrails in place and end the worst abuses.
 

Related: In the Deep Dive podcast “Cheating Between the Lines,” Laura Arnold explores the legal landscape for gerrymandering and the future of efforts to redraw political maps in a way that supports democracy. 

By Steven Scarborough, communications manager
 

Probation and parole are supposed to be a means to divert people away from jail or prison, but for a quarter-million Americans, community supervision has become a revolving door to the carceral system. One in four people in prison are there because of a supervision violation, but we have a poor understanding of what’s causing probation and parole violations and what we can do to limit them. To bridge these gaps, the CUNY Institute for State and Local Governance partnered with AV to launch the Reducing Revocations Challenge (RRC). RRC worked with supervision departments in 10 jurisdictions across the country and recently published findings from the first phase of the challenge on what’s driving probation violations and how they might be addressed.
 

Why It Matters: The terms of community supervision agreements are often onerous and complex. Half of the prison admissions stemming from probation revocations are for technical violations — acts that do not involve a new crime. They can range from missing a call from a supervision officer to getting stuck in traffic and coming home after curfew. As Leah Bower, a supervisor at Ramsey County Community Corrections, asks, “Do we need jail or incarceration as sanctions, or can we come up with other ways to address behavior to keep people in the community and help them back on course?”
 

What’s Next: Of the 10 jurisdictions participating with the Reducing Revocations Challenge, five have been selected to move to a second phase of the initiative aimed at developing interventions that will improve probation outcomes and reduce violations. These probation departments will be exploring approaches such as issuing probation violations only when a new crime has been committed or enlisting community advocates to ensure individuals maintain contact with their probation officer.
 

Dr. Ishani Ganguli, who recently published a study measuring the use of low-value care —  medical services that range from unnecessary CT scans and lab tests to overprescribing and avoidable surgeries — and exploring its drivers. “I noticed, and was bothered by, tests and treatments my peers and I were ordering not for a compelling clinical reason but instead out of habit,” says Ganguli, a professor at Harvard Medical School. We discuss how findings from her research are laying the groundwork for policymakers, health plans, and employers to curb the use of low-value care, which costs the United States up to $100 billion annually on procedures and treatments that are low value — often because providers have a financial incentive to provide them. “Patients might use publicly reported measures to choose which doctor they see or to start a conversation with their doctor about whether they really need a certain test or treatment. Policymakers can use them to hold systems accountable for reducing low-value care.”

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Criminal Justice

• Politicians should let research — not rhetoric — define the gun debate, AV's Asheley Van Ness writes in the Houston Chronicle.
  
  Related: Here's a helpful thread from Andrew Morral of RAND's Gun Policy in America Project on the data, code, and other resources made publicly available to gun policy researchers. 
   
• The Michigan school shooting has renewed calls for child access prevention laws, which are shown to have a profound impact on gun-related deaths among children, The Washington Post reports. 
   
• From 1980 to 2019, Tennessee's jail incarceration rate increased 319%, according to Vera Institute for Justice. Legal advocacy groups in the state have asked Shelby County Court officials to change their bail and pretrial detention practices or face a lawsuit, reports Public News Service.
   
• In Chicago, thousands of people have been jailed in the past two decades on drug possession charges that police, prosecutors, and judges knew from the beginning would not stick, an investigation by the Chicago Sun-Times and the Better Government Association has found, costing taxpayers millions and those arrested jobs, housing, and freedom.
   
• "Let’s respond to the Waukesha Parade murders by working together to improve bail decisions in a thoughtful, bipartisan way in accord with constitutional rights and decision-making science." Read the op-ed from Stevens Point Journal.
  
  Related: The Waukesha tragedy calls for serious bail reform, not finger-pointing, writes Clarence Page.
   
• How a controversial “21-foot rule” is used to justify police shootings, via Frontline and the Salt Lake Tribune.
   
• How should we tell the story of crime and punishment in America? In a new Square One Project paper, Greisa Martinez of United We Dream and Matthew Desmond of Princeton University argue that reformers must go beyond the easiest cases — the ones that most people find harshly unjust — if we want real, systemic change.
   
• A mother facing the first holiday season without her son urges an end to the use of solitary confinement.
   
• “Mr. Simmons spent 15 years in prison. Since 2014, he’s been a free man — one whose trajectory was dramatically rerouted not once, but twice. As a reader and writer in prison, and then the first graduate — summa cum laude — of the John Jay College of Criminal Justice’s Prison-to-College Pipeline program, he broke free of that dark narrative. In the years since, he’s devoted himself to rewriting it altogether.” Read the interview.

Health

• Hospitals in Wisconsin pursued medical debt collection with lawsuits disproportionately targeting low-income and Black people, The Wall Street Journal reports on an AV-funded analysis from Yale economist Zack Cooper. Medical-bill lawsuits “are not a fait accompli,” Cooper says. “This is very much a choice that these hospitals are making.”
   
• Drugs that come to market through an accelerated approval pathway not only lack proven clinical benefits, they drive up spending in Medicare and Medicaid, according to new findings from Aaron Kesselheim in JAMA. 
   
• America’s drug pricing problem is a patent problem. Tahir Amin and Priti Krishtel make the case for a strengthened U.S. Patent and Trademark Office that will end pharma’s anticompetitive patent tactics, via STAT. 
   

• Critics of the controversial Alzheimer’s drug Aduhelm say its whopping $56,000 a year price tag could tank Medicare’s entire prescription drug model, Salon reports. According to the Institute for Clinical and Economic Review (ICER), the drug should be priced no more than $8,300 per year.  
   

• A new analysis of Washington State’s public option experiment shows the state is making progress toward improving affordability and access, suggesting a roadmap for other states pursuing public options, Georgetown’s CHIRblog reports.
   
• The way payments are set is key to the success of population-based payment models like ACOs. New work from Michael E. Chernew, Jermaine Heath, and J. Michael McWilliams highlights how administrative benchmarks can help policymakers design more effective, equitable models.
   
• “America can’t arrest its way out of a problem caused by the fundamental human need to connect.” Maia Szalavitz writes in a New York Times guest essay about the biology of the opioid crisis.
  
  Dive Deeper: Szalavitz writes for AV about the many different restrictions states place on life-saving medications to treat opioids, and the effort to rethink our inefficient, patchwork system.

Higher Education

• Bloomberg hosts a Q&A with U.S. Under Secretary of Education James Kvaal on student debt and college completion. “We know that 80% of community college students want a four-year degree, but only 14% get them.”
   
• In the Hechinger Report, Student Defense outlines the issues with for-profit colleges, including the rise of enrollment in these colleges, the poor debt-to-earnings ratios, and the possibilities for students to be taken advantage of. 
   
• The Wall Street Journal outlines debt-to-earnings ratio issues among high-cost, low-income graduate and professional degrees, including veterinary medicine, dentistry, and other programs.
   
• The U.S. Department of Education announced the topics for the second table of negotiated rulemaking in January, including the 90/10 rule, gainful employment, and financial responsibility, among others.
   
• Secretary of Education Miguel Cardona and Under Secretary James Kvaal discuss targeted measures of fixing student loan issues at a financial aid professionals conference this week. 

Also...

• “To put it bluntly, the demise of local news poses the kind of danger to our democracy that should have alarm sirens screeching across the land.” The Washington Post’s Margaret Sullivan offers a depressing assessment on the state of local news today, but there is some reason for hope: nonprofit journalism. Explore the issue and the stories in danger of being lost.
   
• Yearslong AV-funded research by the Center for Open Science that aimed to replicate influential cancer experiments hit roadblocks and found problems. But it could incentivize scientists to share more data, Wired reports.

“Lead Me Home” is a short Netflix documentary that offers a fly-on-the-wall glimpse of homelessness in San Francisco, Seattle, and Los Angeles. There are no expert talking heads here, just stunning landscape cinematography and intimate portraits of its subjects and their day-to-day realities. During vulnerability assessments for housing and wraparound services, more details emerge about each person’s unique situation and the circumstances that led to being unsheltered. This film doesn’t purport to have all the answers to solve this growing crisis, but rather aims to bring humanity to the problem and dignity to its subjects.

On the WMNF MidPoint podcast, MacArthur Genius Grant winner and President of the Florida Rights Restoration Coalition Desmond Meade discusses the push to “Ban the Box,” which would eliminate the check-off box to declare a felony conviction on job applications. “These are people who make some of the best employees. These are the people who allow you to get tax breaks. Let’s give them a shot,” Meade tells MidPoint host Janet Scherberger.  “Let’s give a person the opportunity to prove their worth or value to your organization before you automatically discard them because you are requiring them to check a box with a question, ‘Have you ever been convicted or arrested?’ ”

• Take a few minutes of your day to read or listen to an incredible Pearl Harbor love story.
   
• Gen Z is fighting the spread of disinformation with Birds Aren't Real.
   
• I may be a little late to the party, but I am enjoying these memes about the new Beatles documentary, which I think we can all agree proves Yoko Ono is a legend who did not break up the band.
   
• The Natural History Museum in London outfitted its Tyrannosaurus rex in a colorful Christmas sweater. “There is nothing more funny than a jumper fitted for a dinosaur that has the tiniest arms in the world.”
   
• I thought I was using film subtitles because I’m getting older, but apparently movies are just getting harder to hear. Here’s why.
   
• For the kid in all of us, here are the winners of the 2021 comedy pet photography awards. 
   
• Take a look at what Americans Googled in 2021.