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The Abstract
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> By Stephanie DiCapua Getman, Arnold Ventures
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AV Journalism Manager Rhiannon Meyers Collette writes this week about rising drug prices — and what can be done:
Flip on the radio, drive past a gas station, stop at a grocery store — from bread, to fuel, to the daily headlines, there are signals of deepening financial hardship everywhere you look. Inflation has reached its highest level since 1981. It costs more today than it has in years to fill up a gas tank, put food on the table, and pay bills.
Big Pharma's response to the harsh economic realities straining Americans' budgets? Make it even harder for people to afford the lifesaving medicines they rely on.
A new report by Patients for Affordable Drugs found that hundreds of pharmaceutical companies collectively raised prices on prescription medications 1,186 times this year so far, exceeding the number of price hikes from the same period last year. Among those drugs with a bigger price tag? Enbrel, a drug used to treat autoimmune disease, which has increased in price by 9.4% this year alone, outpacing even the dramatic rise in inflation.
“Americans are struggling with record inflation and the continued challenges of a pandemic. Yet Big Pharma continues to raise drug prices with no regard for the health and financial well-being of Americans,” David Mitchell, a patient with incurable blood cancer whose drugs carry a list price of more than $900,000 per year, and founder of Patients For Affordable Drugs, says in the analysis.
Pharma was raising prices long before inflation became a top headline. The industry has long argued that these soaring price tags for drugs are necessary to fund innovation — yet new salary data underscores just how much money companies instead spend on exorbitant salaries for their top executives. The CEOs of the nation's health care companies collectively earned $4.5 billion last year, with biotech and pharma CEOs leading the list of lavishly paid executives, STAT reports. (One pharma CEO reportedly earned $453 million, according to STAT). These salaries — which dwarf those of their own employees, some who are making minimum wage — come at a time when medical debt is soaring because average Americans simply can no longer afford their medicines or their health care.
Lowering drug prices is one step toward alleviating the economic pain inflicted on families across the United States. The good news is that Congress has legislation under consideration now that would lower drug prices by giving Medicare the ability to negotiate and by penalizing drug companies when they hike prices higher than inflation. These negotiations would result in cost reductions and lower Medicare premiums.
"It is a historic step. Actual legislation that takes money out of pharma is a huge step," AV’s Executive Vice President of Health Care Mark E. Miller tells CNN.
As the legislative proposals wind their way through the bureaucratic process, this new report from P4AD is just the latest evidence that Americans need relief from crushing drug prices. We simply can't afford to wait much longer.
— Rhiannon Meyers Collette, journalism manager
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The Fraught, Costly Cycle
of Drug Testing
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Almost everyone on probation and parole is required to submit to — and pass — random drug testing as a condition of their supervised release.
What's Happening: It's an inconvenient, unwieldy, and expensive process for the person being tested, who is on the hook for the cost of the test; must check in daily to find out if their number has been called; and must travel to the testing facility, which is usually only open during business hours. If someone misses a test for any reason, they can have their probation or parole revoked and go to jail.
“On the technical side, drug testing is probably the number one pathway back into incarceration,” says Brian Lovins, president of the American Probation and Parole Association.
Why it Matters: Increasingly, data suggests technical violations stemming from missteps in that process contribute to revocations. This cycle widens the net of the carceral system rather than supporting recovery, rehabilitation, and community safety.
What's Next: The Reducing Revocations Challenge matches probation departments with researchers to better understand what drives revocations. In one location, 62% of people who had their probation revoked due to technical violations had missed at least one test. Reforms in some counties may offer a better path forward than what William is experiencing: “Each test costs me at least $40 and takes three hours of my day,” says the catering company cook. (AV isn't using his last name to protect his privacy.)
“We’re pushing for a fundamental shift in supervision policies from catching or enabling failure to facilitating and promoting success,” says Alexa Herzog, criminal justice manager at Arnold Ventures. “Broad, mandated, and punitive drug testing seems to fall into that first bucket.”
Read the story >
Related: Read the Fact Sheet: Drug Testing on Supervision |
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North Carolina Takes On
Integrated Care
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North Carolina is weighing options for integrated Medicare-Medicaid programs for low-income older adults and people with disabilities.
What’s Happening: Today, fewer than 50% of dual-eligible individuals — people who qualify for both Medicare and Medicaid — live in an area where an integrated model is even available to them, which means millions of Americans experience fragmented care and poor health outcomes. But North Carolina is under a deadline for establishing a program to integrate care for its 300,000 dually eligible residents. The Duke-Margolis Center has conducted data analysis and extensive stakeholder engagement to develop recommendations for how the state can do so.
Why it Matters: When people have to navigate getting their health care in two separate programs that don't work together, it's confusing and often dangerous. Some states have invested in reforms to improve care for this population. Yet, other states need a push.
What’s Next: Recent bipartisan legislation, the AIM Act (S.4264), will require every state to develop a plan for integrating care for their dual-eligible population to address this lack of access issue. Passage of this legislation will open up new opportunities to improve the way care is coordinated and delivered and also save Medicare and Medicaid dollars in the long run. Meanwhile, states like North Carolina will continue to be at the forefront of change, setting an example for how states can integrate these two large government programs.
“We call on Congress to pass the AIM Act this year. We’ve allowed low-income older adults and people with disabilities to get lost in this bewildering maze of coverage for far too long, and they deserve better,” says Arielle Mir, AV vice president of health care.
Read the story > |
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A Bipartisan Call
for Charitable Giving Reform
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A new Ipsos poll by the Institute for Policy Studies exposes the need — and support for — reforms to charitable giving. Wealth is being warehoused despite the wealthy getting the tax benefits of potential future philanthropic giving. But the poll shows a broad, bipartisan majority wants donors to move funds quickly to charities on the ground.
What’s Happening: More than $1.2 trillion sits in foundation and donor-advised funds (DAFs), not reaching the neediest people and the nonprofits that serve them. But large majorities across the political spectrum believe money should flow to charities faster, according to the poll released Thursday.
Across parties, people polled support higher annual payout requirements and no taxpayer subsidies for money housed in private foundations. “By very large margins, Americans do not want the U.S. tax code subsidizing wealthy donors to create perpetual private foundations and warehouse wealth in DAFs. And, a broad, bipartisan majority wants donors who are receiving preferable tax treatment for their charitable contributions to move funds quickly to active charities on the ground,” the report's authors say.
Why it Matters: The survey demonstrates that the better the public understands these issues, the more intensely they support reforms that would move more money — and move it more quickly — to charities: 74% of liberals and 70% of conservatives favor increasing foundation and DAF payouts to 10%, even if it would reduce foundation assets in the future.
What's Next: There continues to be bipartisan, bicameral recognition of the need to reform America’s charitable tax code to ensure that charitable donations are actually reaching the charities for which they were intended. Conversations among members of Congress and within the sector about specific proposals are ongoing with the goal of including elements of the proposal in a possible year-end legislative package.
Read the report >
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Criminal Justice
- The Council on Criminal Justice's Task Force on Long Sentences released a statistical portrait of the nation's use of long prison sentences. More than half of people in state prison are serving sentences of more than 10 years, and the share of those people who are 55 or older has more than doubled from 2005 to 2019.
- The Crime Report covers a new RAND Corporation study that shows gun homicides increased each year from 2014 to 2019 and that the increases only further exacerbated existing geographic and racial disparities.
- President Biden was set to unveil his Safer America Plan to reduce violence before testing positive for COVID-19 on Thursday. Read details of the plan in this White House fact sheet.
- The Supreme Court’s ruling in Bruen and the Bipartisan Safer Communities Act both show how we can navigate a middle ground on guns, writes Marc Levin of the Council on Criminal Justice in The Crime Report.
- ProPublica examines the impact of court closures during the pandemic on violent crime, looking at two cities — Albuquerque and Wichita — that took different approaches with different results.
- Congressional action on gun violence would never have happened without philanthropy-backed evidence, writes The Joyce Foundation’s Ellen S. Alberding in The Chronicle of Philanthropy, citing research by the AV-supported National Collaborative on Gun Violence Research and other organizations that stepped up to fill the void in gun research.
- Driver’s license suspensions for unpaid debt are counterproductive and only serve to punish poverty, writes Vera Institute for Justice.
Health Care
- A new study by the Commonwealth Fund finds that nearly half of American men have problems paying their medical bills. High health care costs prevent people from accessing needed care, therefore it's no surprise that American men also have the highest rates of avoidable deaths among wealthy nations.
- The Federal Trade Commission appears poised to more aggressively fight back against hospital consolidation amid growing reports that mergers drive up costs, giving some systems monopolistic power over prices, Kaiser Health News reports.
- Businesswire reports on the formation of a national consortium of organ procurement organizations (OPOs) committed to supporting legislation and regulations to address health disparities and to save more lives via organ donation and transplantation.
- Nearly 44% of people eligible for both Medicare and Medicaid identify as a member of a racial/ethnic minority. The latest installment of a Health Affairs Forefront major series on Medicare and Medicaid integration argues equity and access should be a central consideration when designing programs to serve people who are dually eligible for these programs. (The series will run through August 30, 2022; submissions are accepted on a rolling basis).
Contraceptive Choice and Access
- The House passes legislation to enshrine a right to contraception in federal law, via NBC News.
- According to a nationwide survey of 1,000 likely Republican primary voters conducted in early July, 84% support safe access to contraceptives, as reported in UPI.
Higher Education
- The Century Foundation releases a report on the dark side of cosmetology programs. The report outlines cosmetology’s risk to both students and taxpayers, including graduates’ near-poverty-level wages and the billions received in federal funding.
- The Urban Institute looks at inflation and student loan limits in its newest report and makes recommendations on increasing those limits, such as connecting loans to consumer price inflation.
- In Inside Higher Ed, two for-profit institutions oppose the federal government’s forgiveness of $6 billion in student loans, arguing that the settlement would harm their reputations and violate current borrower defense regulations. Notably, the firm representing the schools framed the debt cancellation issue as a “major question,” citing the U.S. Supreme Court’s recent West Virginia v. EPA ruling.
Climate & Clean Energy
- ClearPath issued a report that analyzes how local wind restrictions create challenges for achieving net-zero goals using renewable energy, using Iowa as a case study.
Evidence-Based Policy
Journalism
- A deeply reported story by AV grantee Capital B chronicles the longtime discrimination against Black farmers by the federal government that has created a vicious cycle of distrust and disadvantage and left these farmers in deeper debt.
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“Aftershock,” a new documentary on Hulu, shines a much-needed spotlight on the crisis of Black maternal deaths in this country. The film follows two families who lost loved ones to very preventable childbirth complications — had the health care system only listened. In the case of Shamony Gibson, troubling symptoms raised postpartum were either downplayed by medical staff or met with questions about whether the new mother was "on drugs." The hospital where she spent her last hours was inadequately resourced, her family says, and Gibson died 12 hours after arriving there, leaving behind two young children and partner Omari Maynard, now a single father struggling to make sense of such a senseless loss.
The grief running through this film is palpable, and the families use it to activate a movement. The fathers left behind turn their pain into power by working to highlight and eliminate the racial disparities in our health care system that lead to Black women dying at a rate four times that of their white counterparts with the same symptoms. The U.S. has the highest rate of maternal mortality among all industrialized nations, and the film delves into why: a historical campaign against midwives, inexperience of some caregivers, perverse incentives in hospitals, racism baked into the system. Says one expectant mother: “A Black woman having a baby is like a Black man in a traffic stop with the police.”
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On the latest episode of Shades of Freedom, a podcast hosted by the Aspen Institute Criminal Justice Reform Initiative, AV grantee Sheena Meade of the Clean Slate Initiative (CSI), talks about her beginnings in labor organizing and her role co-leading the successful fight to restore voting rights in Florida — and how that has led to a push to automate the clearing of records. She also discusses new collaborations, such as Next Chapter, to change employer approaches to hiring returned citizens.
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- Join AV Vice President of Health Care Arielle Mir and Center for Health Care Strategies for a webinar on July 28 and hear from the experts on the latest in Medicare-Medicaid integration and new opportunities and tools available to states. Register here.
- Our Co-Founder and Co-Chair Laura Arnold will be among the growing list of speakers shaping the future of politics, driving innovation, and pushing policy forward at this year's TribFest, Sept. 22-24 in downtown Austin. Arnold Ventures is a proud sponsor of this event. See the full speaker lineup announced so far and get your tickets.
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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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