My colleague Kelli Rhee (who also happens to be the President and CEO of Arnold Ventures) is among those who’ve inspired me to look for silver linings amid this pandemic (see previous newsletter). She also recommended reading this eye-opening essay by venture capitalist Marc Andreessen: “It’s Time to Build.” I’m among those who have been rattled by America’s lack of preparedness for this pandemic — we lack medical equipment, tests, therapies, and even a way to get stimulus in the hands of those who need it — and Andreessen argues it’s because we as a society haven’t been “building.” And the implications of not building have been far-reaching, leaving us with systemic failures in health care, education, housing, and manufacturing that we’ve accepted as the status quo for too long. While it’s a depressing look at the current state of affairs, I see a silver lining: We still have time to wake up from our complacency and get to work (as soon as it's deemed safe, of course).
Who's Minimizing Injustice
Here’s a story that will make your blood boil. After leaving the military, veterans Tasha Berkhalter and Jarrod Thoma both tried to realize their career dreams with the help of the GI Bill, but both were targeted by predatory, for-profit colleges that made false promises and left them with debt and worthless degrees. “I had an extreme amount of debt, and I didn’t know my options…That school completely smashed my dreams,” Berkhalter said.
Now, groups like Veterans Education Success, the Project on Predatory Student Lending, and American Legion are helping to pick up the pieces and fighting hard to protect others from the same fate.
Predatory colleges and institutions that exploit GI Bill dollars benefit from the “90-10 loophole.” They’re required to get no more than 90 percent of their revenue from federal dollars, but thanks to their aggressive lobbying, GI Bill money is excluded from that 90 percent.
There are signs that a bipartisan consensus is emerging in Congress to close the loophole as more people learn about the plights of veterans like Berkhalter and Thoma. “More veterans are coming forward and telling their personal stories,” says my colleague Kelly McManus, Arnold Ventures Director of Higher Education. “That has made all of the difference.”
Carrie Wofford, who is fighting to protect veterans from the predatory, for-profit colleges mentioned above. The founder of Veterans Education Success and her staff are busier than ever, providing free legal services and college and career counseling to veterans and military members, and they’re working with Congress and the Department of Veterans Affairs to fight against institutions looking to make a profit off those who served their country. “They’ll lie about the course offerings, lie about the quality of the faculty and the teaching, lie about everything,” Wofford says. More disturbingly, she highlights the well-established tactic of “pain-based recruiting,” when for-profits “manipulate prospective students’ emotional pain to get them to enroll.” She’s also concerned the pandemic will exacerbate scams targeting veterans. When she’s not worrying about veterans, Wofford’s mind is on her team. Zoom is her favorite tech toy right now because of the face-to-face time she gets with staff. “We talk about ways to handle stress and that it’s normal to feel stressed; it’s a stressful time.” (But Zoom fatigue is real, y’all.)
The same week that Arnold Ventures implemented a work-from-home policy in the face of the pandemic, I had taken my daughter to our pediatrician for an (unrelated) respiratory infection. She has asthma, so the first thing I did when we got home was order a refill of her inhaler. It went through my mind that her medication might be difficult to come by in the coming weeks, and with coronavirus looming, I didn’t want to take any chances.
Apparently my instincts were right. As Charles Lyons reports in this piece for our website, there are countless stories of panicked patients (including his own father, in search of statin medication) confronting shortages of the drugs they need from neighborhood pharmacies and hospitals, yet another way COVID-19 has upended our lives. “In short,” he writes, “the pandemic has laid bare fundamental flaws that have long existed — but have never been fully exposed — in the way the United States sources, manufactures, and distributes drugs.” His piece covers the first signs of distress and why generics are those most at risk of experiencing a “stock out.” (Spoiler alert: Charles’ father did get his prescription filled, eventually.)
Eric Pachman, co-founder of Ohio nonprofit 46brooklyn Research, sums it up in a way I appreciate: “You know considerably more about where your craft coffee or beer is made than where your drugs are made.”
Related: Pachman’s 46brooklyn Research released two dashboards that serve as an “early warning system” of potential problems in the U.S. drug supply chain.
Related: Kaiser Health News reports that the FDA is increasing seizures of cheaper prescription drugs being sent to Americans from pharmacies in Canada and other countries.
Research in Action
RAND Corporation’s Gun Policy in America initiative continues to fill major gaps in evidence about what works in gun policy with its second edition of the Science on Gun Policy report. As RAND’s Andrew Morral, who leads the initiative, says, “Getting this right has life-or-death implications.”
How it was done: The report reviews gun policies that regulate who may legally own, purchase, or possess firearms; firearm sales and transfers; and legal use, storage, or carrying of firearms, and examines how they affect outcomes such as mass shootings, domestic violence, or suicides. Findings were assigned one of four evidence “strengths” ranging from inconclusive through limited and moderate and up to supportive.
The findings: Researchers found supportive evidence that stand-your-ground laws cause increases in firearms homicides. They also found (as they did in 2018) supportive evidence that child access prevention laws reduced deaths and injuries among children.
Other areas were assigned new evidence ratings: Moderate evidence — the second highest rating — shows that waiting period laws reduce total homicides and firearm suicides. Limited evidence — the weakest rating short of “inconclusive” — shows that permit-to-purchase laws reduce firearms suicides among adults. There was inconclusive evidence for the effects of background checks on total and firearm-related suicide.
Read more: Morral discusses the report and what gun regulations work — and which ones don’t — in this Q&A.
Who's Maximizing Opportunity
Colleges implementing the ASAP (Accelerated Study in Associate Programs) model for low-income students. Arnold Ventures’ Evidence-Based Policy team funds randomized controlled trials (RCTs) of programs spanning U.S. social policy, and we have a page dedicated to short, plain-language summaries of RCTs that have reported results. (A list of all RCTs underway can be found here.) The team’s latest summary looks at an MDRC study published in January of how ASAP performed at three Ohio community colleges and concludes the study was well-conducted and produced valid findings. (This is what I would tell my now-home-schooled children is “checking your work.”)
We’ve reported previously on the success of the ASAP program, which provides academic, personal, and financial support to low-income students. It was pioneered 12 years ago by City University of New York and was an astounding success — we just didn’t know if it could be replicated in a setting thousands of miles away.
Related: The Evidence-Based Policy team produced a second summary this week of the well-conducted RCT from the Rector and Visitors of the University of Virginia that found communications 'nudges' to increase financial aid applications and attendance of low-income and first-generation students had no statistically significant effects on students’ persistence into their second year of college.
A Star-Studded Call
for Corrections Reform
We’ll continue our drumbeat on the reduction of corrections populations with this CBS News piece from Ted Koppel that brings you inside San Quentin to see why social distancing is impossible and the crisis in prisons and jails is severe. Advocates Piper Kerman (whose memoir was the inspiration for the Netflix series “Orange is the New Black”), Ear Hustle podcast host Earlonne Woods and Adnan Khan, Executive Director of Re:Store Justice, bring their lived experiences to the report, which includes this startling fact: Of those testing positive for COVID-19 in New York City's prisons and jails, Department of Corrections staff outnumber inmates almost 2 to 1. And while cases in New York City and elsewhere in the state are plateauing, The City reports that New York state prison cases of COVID-19 are on the rise.
On the federal level, the Fort Worth Star-Telegram recently profiled life inside a women’s federal medical prison, where many of the women have severe illnesses and underlying health conditions and two (including a pregnant woman) have tested positive for the coronavirus. “If there was ever a time to show mercy and compassion, this is it,” several women wrote in a letter to the warden. Advocates say roughly 50,000 federal inmates meet criteria for release to home confinement based on the CARES Act, the Washington Examiner reports, but the Bureau of Prisons has been slow to act.
Related: How the coronavirus threatens to overwhelm already underfunded and understaffed prisons and jails in the deep south, or “America’s incarceration center,” as The Guardian calls it.
This op-ed from the Los Angeles Times on why a $0 bail for Californians accused of nonviolent crimes is exactly the right amount. Detaining people simply because they can’t afford bail "is manifestly unjust in normal times but now is potentially fatal."
Kaiser Family Foundation’s finding that hospitals charge private insurers nearly double Medicare rates for all hospital services — a result of market power and, well, because they can.
New findings from Straight Talk on Evidence that a reemployment program in Nevada produced earnings gains of 15 percent over three years and net government savings. Policymakers may want to take note as the nation grapples with massive unemployment due to COVID-19.
ProPublica reporting that medical staffing companies backed by private equity are cutting the pay of ER doctors and other medical workers while at the same time funneling millions of dollars into a political ad campaign against legislation to protect patients from surprise billing. (ICYMI in the last newsletter, here are some of the myths they’re pushing.)
Stat’s opinion on what pharma might want in return for a vaccine. (TLDR: A lifetime of zero controls on drug pricing)
The formula used to distribute stimulus funding in higher education that favors institutions with full-time enrollment, leaving behind some that serve the most vulnerable students, Inside Higher Ed reports.
How the pandemic has opened up online treatment options and prescribing to those struggling with opioid use, something experts have long been calling for, reports Kaiser Health News.
A new study in JAMA that shows removing barriers to medications for treatment of opioid use disorder is important not only from a public health perspective, but also an economic one, via the Legal Action Center.
This poignant speech from Oklahoma City Mayor David Holt commemorating Sunday’s 25th anniversary of the Oklahoma City bombing, when 168 people — including 19 children — lost their lives. He draws lessons from that tragic event to today's response to the coronavirus pandemic.
Isolation advice from those living on the one continent that hasn’t seen a case of COVID-19: Antarctica. The Wall Street Journal talks to the crew of Troll station. Apparently they’ve all seen an uptick in their social lives now that friends and family on lockdown are eager to connect virtually.
Some “oddly satisfying content” from one of the best accounts on Instagram. Swipe to see Refinery29’s stress-reducing video clips. You can thank me later. (And anyone who until a few weeks ago worked with me in the office knows I need that lint roller.)
This heart-warming New York Times story (with videos!) about the "songs of hope" hospitals are playing as coronavirus patients are discharged. (I'd definitely pick "Here Comes the Sun.")
What We're Listening To
John Arnold’s Twitter feed pointed us to this conversation between oncologist, author, and podcaster (and grantee) Vinay Prasad and EconTalk podcast host Russ Roberts, who discuss how policies "incentivize the pursuit of marginal or unproven therapies at lofty and unsustainable prices."
By Stuart Buck, Arnold Ventures Vice President of Research
Another week, another round of terrible COVID-19 studies. For the sake of time, I’ll focus on one that caught the eye of national journalists.
One of the most important questions is how many people have had COVID-19. Yet we don’t know that basic fact. Most of the people who get tested are those with symptoms so serious that they go to the hospital. Thus, some have argued that a much larger number of people may have been infected with only mild symptoms or with no symptoms at all, which means that the true death rate could be much lower and the path to herd immunity much quicker.
Thus, this week’s study: researchers at Stanford and USC tested 3,330 residents of Santa Clara county for antibodies to COVID-19, and found that about 1.5% were positive (meaning they had been infected at some point). But then they made some statistical adjustments and announced that the actual rate of infection was between 2.5% and 4.1% — between 50 and 85 times more than the number of reported cases!
Striking news. But was it true?
Almost certainly not. One critic pointed out that given the accuracy of the antibody test, nearly all of the 1.5% could have been false positives. A stats professor pointed out that the study made basic mathematical errors. And numerous critics (here’s one) noted that the study didn’t come anywhere near a random sample of Santa Clara County (if people who suspected they had COVID symptoms were more likely to sign up for the study, then the study’s rate of positive results is absolutely nothing like the true rate).
On top of that, if the Santa Clara estimates were true, then the number of infections in New York would be higher than the total population! If a study leads to logically impossible conclusions, something is wrong with the study. The bright side is that with today’s rapid-response from Twitter and blogs, everyone can find out about a study’s faults in quick order.
Some Final Inspiration
I have gone down some musical rabbit holes in lockdown, and one took me to 1996, which was a great year for albums: Quintessential works came out from Beck, R.E.M., Tool, 2Pac, Tori Amos, Jay-Z, The Fugees, OutKast, Sublime, and more. (Don’t @ me. “New Adventures in Hi-Fi” was the last album where R.E.M. was whole, okay?) It was also the year of Fiona Apple’s debut album, “Tidal,” which was essential listening for a 16-year-old rebel girl. So it’s fitting that I just discovered her new album, which comes with a title we can all relate to right now: “Fetch the Bolt Cutters.” Critics have been raving, as well as making connections to the time of coronavirus we all live in. (Apple was a bit of a recluse before all this began.) This album may not be for everyone, but last week I gave you opera, so…. (And I promise this will not become a music column.) I’ve noticed a lot of people are reconnecting with music right now. Ask your friends what they’re listening to.
Stephanie 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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