Yesterday’s news that Congress once again failed to move forward a coronavirus relief bill — leaving millions of unemployed Americans in the lurch — made me think immediately of my younger brother and sister. Especially this line from one senator responding to the inaction: “Very unfortunate, but it is what it is.”
On behalf of my siblings, who are part of that “unlucky cohort” of young people who hit the job market at a terrible time, I don’t accept that. My brother is an essential worker, dodging un-masked patrons six days a week at a grocery store for little more than minimum wage. My sister has been unemployed for months, and is terrified by both the job market and the unemployment system. They — and everyone else in their situations — deserve better than a disaffected shoulder shrug.
At Arnold Ventures, since the start of the pandemic, we’ve been working to help a long list of people and organizations who are under threat: Our Criminal Justice team and grantees are calling on lawmakers — at every level — to release people from jails and prisons, and has so far given $7.8 million in COVID-related criminal justice grants. Our Contraceptive Choice and Access team supported a study into pharmacist-prescribed birth control, demonstrating it can help women without access to doctors. Our Public Finance team is supporting assistance to states facing fiscal crises. And our Health Care team is standing up for patients against surprise medical bills and exploitation by private equity, which you’ll read about in this newsletter.
Our efforts make up only a small portion of the larger work underway by fellow philanthropists, nonprofits, activists, private businesses, and private citizens to help mitigate harm to those who are suffering. In this newsletter, I hope you’ll see a lot of evidence that we, as an organization, won’t accept “It is what it is” as an answer.
Health Care, Brought
to You by Private Equity
By Rhiannon Collette, Communications Manager
Higher costs for patients. A growing prevalence of predatory billing practices. Widespread cuts to staffing and resources. Early evidence shows that the private equity model of health care seems to value profits over patients, exploiting loopholes to make money. We take a deep dive into the impacts of private equity on the health industry in this three-part series:
Private equity’s expansion into sectors such as hospitals, physician practices, and nursing homes often comes with the promise of increased efficiencies and improved care — but evidence supporting these claims is limited, and some research suggests the opposite is true: higher costs for patients, predatory surprise medical billing, and disinvestments in health care infrastructure. Read Part 1 >
Nursing homes — hotspots for COVID-19 deaths — have long been targeted and gutted by private equity. Pre-pandemic, private equity-owned long-term care facilities were short-staffed and provided a lower quality of care. The disproportionate toll of the coronavirus on these facilities exposes the need for better policies to care for individuals with complex care needs. Read Part 2 >
Private equity has aggressively worked to limit patient protections against surprise medical billing, one of its most egregious money-making tactics. As legislation languishes amid a pandemic, expensive surprise medical bills keep rolling in. Read Part 3 >
Bottom line: As Congress seeks to offer families protection from financial harm during the pandemic and economic crisis, they could start with surprise medical billing legislation. “Action on their part is overdue,” says Mark Miller, AV's Executive Vice President of Health Care. “They can act now and close this loophole that has been exploited by private equity — that saddles families with debt and raises the cost of health care for everyone.”
Defund the Police?
There Might Be a Model for That
A 2003 paper by Susan Tucker and Eric Cadora studied the then-$54 billion the United States spent annually on prisons, and argued that our country’s public safety goals could be better served by funding areas like education, housing, health care, and jobs — all of which have a direct impact on crime rates — rather than expanding incarceration.
By 2007, a public-private partnership called the Justice Reinvestment Initiative was established to help state governments assess their public safety policies and spending and come up with more effective ways to improve recidivism rates and overall public safety. The majority of the eventual 35 participating states moved portions of their funding away from corrections and into community-based services and support.
The results? The Urban Institute reported that, between 2010 and 2016, 28 states saved or averted a total of $1.1 billion in costs attributable to reforms; the total incarceration rate among the 35 JRI states has dropped by 11 percent, and recidivism has declined.
Why it matters: At a moment when protestors nationwide are demanding that public officials rethink how we approach public safety — forcing policymakers from New York to Minneapolis to Seattle to grapple in particular with the idea of diverting police budgets to programs that better serve communities of color — the experience of justice reinvestment is worth revisiting.
Bottom line: The successes and shortcomings of the Justice Reinvestment Initiative offer important lessons for those who wish to see criminal justice funding redirected toward community groups and hard-hit neighborhoods.
Like mine, your social feeds were probably flooded with eerie, orange photos of the West Coast this week. These images show the impact of devastating wildfires plaguing Washington, Oregon, and California. So far, the fires have taken seven lives and destroyed thousands of homes. Now 500,000 Oregonians have been ordered to evacuate. Please stay safe, West Coast colleagues and friends.
Newsday reports on today’s somber anniversary: It’s been 19 years since so many tragically lost their lives in the Sept. 11 attacks, and the pandemic poses a new threat for 9/11’s frontline responders. “First the firefighters, police officers, EMS and construction workers who toiled for weeks at Ground Zero, inhaling toxic fumes and dust, contracted serious respiratory illnesses or cancers. And now, many of those same first responders, burdened with weakened immune systems and comorbid conditions, contracted COVID-19 and were unable to fend off the virus."
What We're Reading
In its list of the most wealthy Americans, Forbes has revised the way it ranks philanthropy. We’re proud that our Co-Founders, Laura and John Arnold, are in a group of just 10 that have given away at least 20 percent of their wealth. These individuals are not parking money in donor-advised funds, but getting it out the door. (Related: Read John Arnold’s critique of donor-advised funds here.)
Claims of lower drug prices by President Trump mask the truth that some consumers are paying more, and the uninsured haven’t gotten much help at all, writes Roll Call.
CityLab urging an end to blaming police protests for gun violence spikes in U.S. cities, drawing from a study by University of Missouri-St. Louis criminologist Richard Rosenfeld and Thomas Abt, a senior fellow for the Council on Criminal Justice, for Arnold Ventures.
New polling from Third Way and New America on the educational challenges and enrollment decisions current and future college students are making due to the coronavirus pandemic. The bad news: “Roughly half of college students feel higher education is no longer worth the cost anymore, and four-in-ten believe it is a bad deal now that it has moved online.”
Our Vice President of Research Stuart Buck writing in Inside Philanthropy about ways that philanthropy can embrace more high-risk, high-reward projects.
STAT reporting that COVID-19 is creating a crisis for Medicare, with the Congressional Budget Office projecting that by 2024, there won't be enough money in Medicare's trust fund to fully pay hospitals, doctors, and nursing homes for the care they provide to Medicare beneficiaries.
The Guardian urging lawmakers to act now to release more people from jails and prisons, after July and August saw the worst months yet for COVID in correctional settings.
This piece from The New York Times on what deadlock in Washington over COVID relief packages means for states facing dire fiscal crises.
The Wall Street Journal reporting yet another unprecedented reality (aren’t we getting tired of those?): The U.S. debt is predicted to exceed the size of the economy next year, which hasn’t happened since World War II.
The Economist on how a faction of Republicans and a band of lobbyists are campaigning to overturn redistricting reform and bring back gerrymandering in Missouri — thus overturning the will of the people. "That looks like rigging rules to help one side. Two years ago voters appeared to reject that sort of thing. They might again."
What We're Watching
“The New York Times Presents: The Killing of Breonna Taylor,” a bone-chilling look at what happened the night police burst into the Louisville, Kentucky apartment of Breonna Taylor’s boyfriend, exchanged gunfire, and killed the 26-year-old EMT. This documentary draws on a wealth of resources — including 911 calls and over 1,500 pages of police records — to investigate what happened and why. Warning: This is difficult to watch, so take care of yourself and make the viewing decisions that are right for you.
Lies, Damned Lies, and Statistics
By Stuart Buck, Vice President of Research
Taking a break from the overwhelming wave of bad COVID-19 research, this week I’d like to mention a new study on contraceptives. The study claims to have discovered brain alterations in women who started using oral contraception as a teenager that would help explain “the increased vulnerability to mood-related mental illness in women.”
It does no such thing.
The study involved two groups of college-age women: 75 who had a brain MRI (27 were oral contraceptive users, and 12 of those started as a teen), and 140 who did a stress test (58 were oral contraceptive users, and 26 of those started as a teen).
Already we can see that this isn’t a large sample of women who use contraceptives at all, let alone those who started as teenagers.
Worse, this wasn’t a random assignment study or anything close to it: Women weren’t randomly assigned to use contraceptives or when to start. Women who make radically different choices might already be somewhat different. Indeed, if you look at the table of descriptive statistics, the two groups of women (users and non-users) were very different from the outset. For example, 80-85% of the users were white, compared to only 35% of the non-users (who were mostly Black and Asian). We don’t know how different the teenage users were, because the researchers don’t bother to say.
Even worse, the researchers took too many measurements to list: hormones in saliva, memory tests, stress tests, and activity in literally every area of the brain. They then report a staggering number of correlations that overwhelm the reader.
For example, while there were no differences in estrogen or cortisol levels, non-users “in the luteal phase of the menstrual cycle showed higher salivary progesterone levels” compared to users. Also, users’ brains had more white matter volume in the left parahippocampal gyrus (whatever that is). The study goes on like this for several pages.
At least the researchers told the reader about many of these (likely meaningless) correlations, but then they made a fateful choice: to selectively highlight a few of them.
That is, among all the possible correlations, the researchers “found” that within users, there was a “blunted cortisol response” after the stress test in women who began using contraceptives as a teen, which they take to mean that “there may be long-term effects” that can “be a risk factor for depression.”
That stark conclusion isn’t justified at all. Among the relative handful of college students who responded to participate in this study in the first place, there’s no telling why a particular subset of them might have different hormonal or brain response to stress tests.
It makes a good headline, though: Teenage use of contraception leads to depression. Never mind if it’s true.
Some Final Inspiration
Say goodbye to the Kardashian clan, who announced their long-running series “Keeping Up with the Kardashians” will come to a close. My fingers are crossed this means Kim will have even more time to devote to criminal justice reform.
My husband is a NASA engineer, and we have to rush out to look at the International Space Station zooming overhead in the night sky a lot. My curiosity about what’s going on inside the ISS brought me to NASA’s Space Station blog, where the latest post is about the autonomous robot Astrobee. Cute, I said. Tricky to design, my husband corrected.
I’m a cat person, but that doesn’t mean I don’t appreciate the efforts of the adorable golden retriever Kerith, who is comforting firefighters on the front line in Marin County, California.
Speaking of the wildfires, there’s good news: the AP and NBC News report that the 2,000-year-old redwood trees in one of California’s state parks — including the famous Mother of the Forest (yes, some trees are famous) — survived a brush with the flames.
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