Please scream inside your heart

A significant reform followed the fatal police shooting of Michael Brown in Ferguson, Mo.: widespread adoption of body-worn cameras by law enforcement agencies. But have they been the fix so hoped for? Here’s what we know:

• The general consensus from a conference hosted by the National Police Foundation and Arnold Ventures was that there is no consensus. Research hasn't shown cameras to have a consistent impact on officers’ use of force, arrests, and citations, and outcomes and experiences for police departments have been divergent or conflicting.

• The cameras have, however, been found to reduce frivolous complaints against officers. A study supported by Arnold Ventures found that officers in Arlington, Texas wearing body cameras had 38 percent fewer citizen complaints. Similarly, a Milwaukee study found that officers who wore cameras were less likely to receive complaints.

• Cameras are expensive. Data storage, evidence-handling and administration make up the many hidden costs for police departments and communities. At least one small law enforcement agency said it has a box of cameras that officers cannot use because the local government refuses to pay for data storage costs.

Bottom line: More research is needed. Arnold Ventures has supported a new review of existing body-worn camera research to be published later this summer. “After 10 years of using body-worn cameras, we’re starting to realize that it’s not just about looking for the right answers — but also asking the right questions,” says Asheley Van Ness, AV Director of Criminal Justice. “Hopefully, as we build the evidence base, we’ll start to have the practical information that police agencies, municipalities, governments, and citizens need to understand how we can best use this technology.”

Gilead’s pricing structure for its COVID-19 drug remdesivir is raising questions about how drugs are priced in the U.S. and in comparison to the rest of the world. Here’s the price breakdown of who will pay what for a five-day course of remdesivir:

• $3,120: This is the cost for most U.S. patients — those who are covered by commercial insurance and those who are uninsured (at a time when many are losing their jobs and health insurance). It’s 33 percent higher than what Gilead is charging other developed countries.

• $2,340: Government payers such as the Department of Defense and Department of Veterans Affairs (which are empowered to negotiate drug prices) — as well as other developed nations that have the power to negogiate.

• $3,120: Hospital Medicare and Medicaid patients (That’s right — the two largest government payers failed to access the discounted government price.)

How much will Gilead profit? There are still unknowns here, but analysts estimate $525 million in sales this year and $2.1 billion next year. Gilead is developing an inhalable version, which will boost that margin. Some independent researchers have estimated Gilead’s production costs at less than $10 for a course of treatment.

Does it work? It’s been shown in clinical trials to reduce hospital stays but not save lives. Early data seems to suggest remdesivir will have narrow clinical applications, with benefits shown in a small population of patients. 

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Georgia just became the latest state to pass a law protecting its citizens from the predatory practice of surprise billing, at a time when federal efforts to do so have stagnated, thanks in part to an all-out assault by private equity-backed firms seeking to protect their lucrative business model. 

How did they do it? We sat down with professors Kevin Lucia and Jack Hoadley of Georgetown University’s Center on Health Insurance Reforms to learn about the state’s hybrid approach to resolving payment disputes, how a committed group of state leaders worked together in a bipartisan fashion — and what Congress can learn from Georgia’s experience.

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California's Proposition 47 has been shown to narrow racial disparities within the criminal justice system and reduce pretrial detention, a new study by Public Policy Institute of California shows. (It was supported by Arnold Ventures.)
 

What researchers found: The 2014 reform reclassified some California drug and property offenses from felonies to misdemeanors and succeeded at its primary goal of reducing the prison population. A beneficial side effect was a reduction in arrests and bookings across the board — as well as a significant decline in African-American bookings for drug and property felonies. 

The report also looked at impacts of reforms dating to 2009 and found that the overall reduction in the incarceration rate narrowed racial disparities: The gap between African-American and white incarceration rates dropped from about 4.5 percentage points to 2.8 percentage points. 

What’s next: There is still much work to be done, notes Magnus Lofstrom, Policy Director and Senior Fellow at PPIC. “The effects of Prop 47 on racial disparities represent a notable but modest step toward addressing inequities in criminal justice outcomes. Still, there remain sizable and troubling disparities, especially between African-Americans and whites.” And as criminal justice reform dominates the national conversation, other states could dig into their own data to understand how reforms are — or aren’t — helping to create a more just and fair system. 

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By Stuart Buck, Arnold Ventures Vice President of Research

On July 7, 2020, the American Journal of Gastroenterology published a seemingly groundbreaking article claiming that in a study involving over 53,000 people, the ones who take so-called proton pump inhibitors — i.e., drugs like Nexium that treat heartburn and stomach pain — are at a much higher risk of getting COVID-19. This study was reported in the New York Times, Time, MSN, and others.
 

Oddly enough, all of the data came from a survey firm, not from hospital or medical records. That is, people were given a survey about themselves and their medical conditions, with no independent verification or administrative records involved. 

As has been pointed out by a number of Twitter commentators, the initial results should have made the researchers question their data, if not their entire ability to conceive of a research project in the first place. Table 1 of the study claims that while the overall survey respondents were a nationally representative sample — fairly balanced across age, gender, income, race/ethnicity, etc. — there were some surprising imbalances among the survey respondents who got COVID-19:

• 74.5% were between 30 and 39 years old; 

• 64.7% were female; 

• 69.7% were Latina; 

• 69.6% had only a high school education; 

• 63.5% had an income over $200,000 a year; 

• 73% were daily smokers; and 

• 68.5% lived in the South. 

Does anyone believe that in a nationally representative sample of Americans, a huge majority of the COVID-19 cases would be 30-something Latinas who live in the South, smoke every day, have a high school education, but nonetheless make over $200,000 a year? This study shows why the number one rule for researchers should be to take stock of whether the underlying data are believable.