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October 9, 2020
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The Abstract
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> By Stephanie DiCapua Getman, Arnold Ventures
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This week’s vice-presidential debate didn’t do much more to shed light on the problems and policies Americans care about than the disastrous first presidential debate. There was no discussion about the irrationality of high drug prices or how unaffordable health care is for families, employers, and taxpayers — issues voters have demanded action on. We should be talking about this. There was no discussion of how to make higher education affordable and accountable for its outcomes — especially critical at a time when so much learning has moved online. We should be talking about this. And there was not a word about our other public health crisis — the opioid epidemic — at a time when COVID-19 is limiting access to evidence-based treatment and driving up overdose deaths. We should be talking about this.
While there was a truncated conversation on criminal justice reform, it included outright denial from one side that implicit bias and racism are endemic — even though we see devastating reminders of this fact every day. Look at the recent case of Jonathan Price, yet another Black American violently killed at the hands of a police officer. Policing — like much of our criminal justice system — is deeply troubled. Amid our extreme partisan divide, it might be worth remembering that it was left and right uniting that led to the biggest piece of criminal justice reform legislation in a generation.
The most memorable parts of this debate will be Harris's history-making turn as the first woman of color to appear on this stage — a balancing act in itself —and the memes it generated. (I know I'll always be teaching my daughter when to say "I'm speaking.")
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Big Bailouts, Little Oversight
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By Rhiannon Meyers Collette, Communications Manager
The federal government has provided hundreds of billions of dollars to help hospitals weather the COVID-19 pandemic, but there’s been little transparency and accountability around this funding, despite the possible implications for our health care system, Medicare, and the deficit, write my health care colleagues Mark Miller and Erica Socker. Providers do need federal support right now, but not all hospitals and physicians are in the same financial boat. Some hospitals have enough cash reserves to continue paying their expenses for five months or more, without any additional revenue coming in. Unfortunately, the government’s approach to disbursing the relief funds has at times failed to account for these differences.
Why it matters: Hundreds of billions of taxpayer dollars are being spent with little transparency or oversight — and for the provider loans in particular, the potential impact on the Medicare program is worrisome. Pre-pandemic, the Medicare hospital insurance trust fund was careening toward insolvency by 2026 — the pandemic and economic crisis have hastened that timeline to as early as 2024. If providers are granted their requests for loan forgiveness, this could leave holes in the trust funds with negative consequences for the Medicare program and beneficiaries.
What’s next: “Congress should resist calls for loan forgiveness,” Mark and Erica write. If Congress does consider loan forgiveness or additional financial support, the aid should go to the subset of providers who need it most.
Read the story >
Related: In Health Affairs, Mark, Erica, and our colleague Alex Spratt explain the shortcomings in the distribution of the federal relief funding and sketch out a roadmap on where we should go from here.
Related: Speaking of hospital finances, my colleague Alex Spratt examines a new report from the RAND Corporation that, once again, reinforces the reason health care is expensive: because hospitals charge excessively high prices. Big hospital bills don’t just hurt those needing care; they drive up premiums for people with private insurance and increase the amount people pay out-of-pocket.
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By Evan Mintz, Communications Manager
Early voting began in California on Monday, and while the presidential race may be a foregone conclusion in the solid-blue state, there are still heated contests further down the ballot. With Proposition 25, voters are facing perhaps the largest singular criminal justice reform effort ever put up for popular vote. If it passes, the referendum will eliminate the discriminatory and outdated system of cash bail.
Why it matters: Legislators, judges, sheriffs, district attorneys and activists from across the political spectrum are leading a nationwide movement away from cash bail — and California voters will determine whether the momentum continues to build or comes to a sudden halt. Pretrial reforms in places like the state of New Jersey, Mecklenburg County, N.C., and Bernalillo County, N.M., stand as successful examples that should inspire Californians to vote yes on Prop. 25.
What’s next: If it passes, 39 million Californians will no longer have to worry about being stuck behind bars simply because they can’t pay for bail. The for-profit cash bail industry, which opposes a litany of criminal justice reforms across the country, will be dealt a major blow. Meanwhile, criminal justice advocates are already working to further improve SB 10 — the bill underlying Prop. 25 — in the next legislative session.
If it fails? The reform movement suffers a critical setback.
Read the story >
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Hydroxychloroquine’s
Lesson for Social Policy
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By Adrienne Faraci, Communications Manager
The evidence was in on hydroxychloroquine: High-quality randomized controlled trials (RCTs) “indicate no therapeutic efficacy” against COVID-19, in the words of Dr. Anthony S. Fauci. However, that didn't stop policymakers from putting time and money behind hydroxychloroquine based on less rigorous studies.
Why it matters: This classic case of medical reversal illustrates the importance of high quality randomized control trials as applied to social policy, says Jon Baron, Arnold Ventures’ Vice President of Evidence-Based Policy. We have seen public officials and researchers routinely rely on less rigorous studies and their findings when championing and funding programs and policies, sometimes even in the face of contrary RCT evidence.
What’s next: We’ve been fighting major problems like educational failures, stagnant wages, poverty, crime, and opioid use disorder for years with unproven strategies — or even strategies already found to produce disappointing results. While RCTs are far less common in social policy than in medicine, they have shown the same ability to identify exceptional programs that produce important improvements in people’s lives. If we hope to make progress on the nation’s social problems, we must deploy RCTs on a much larger scale.
Read the story >
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Few people are able to connect the injustices of our past with our current reckoning as effectively and devastatingly as Sebastian Johnson, AV’s Advocacy Chief of Staff. (Case in point: “Why Would They Kill Me for Something I Didn’t Do?” — our most-read story ever.) He does so again in a reflection on the fourth Square One roundtable, examining the insistence on “white innocence” implicit in our news cycle and laying bare the threads of our nation’s tattered social contract.
“America is in a season of furious discontent. A cascading series of crises — economic, ecological, existential — threaten to overwhelm the nation’s ability to respond. These unprecedented challenges could not have come at a worse time, or under worse leadership. People are deeply divided, fearful, distrustful of our common institutions and disdainful of whatever ties still bind us. The future of our Republic is in peril, by no means assured; this may, in fact, be its moment of maximum danger.
The mass uprisings against police brutality, and for racial equality — the largest demonstrations of their kind in our nation’s history, spread across many countries, creeds and colors — have sparked hopes for a renewed Civil Rights movement. But another mobilization, happening concurrently, should give us pause. Armed white citizens storming state capitol buildings to protest pandemic-related restrictions. Armed white citizens convoying into cities across the country to confront protesters, sometimes violently. White citizens whipped into mass hysteria, deploying conspiracies about pedophilic cabals and Antifa arsonists to justify the increasingly authoritarian actions of the state.” Read “To Ourselves and Our Posterity: Reflections on the Fourth Square One Roundtable” by Sebastian Johnson.
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News of the nearly $3 million in new grants awarded by the National Collaborative on Gun Violence Research. Projects will examine attitudes toward gun ownership, possession, and usage by urban youth; the nature, structure and dynamics of California’s crime gun markets and the sources of firearms used in crime; and the factors that determine the approval or denial of extreme risk protection orders across six states.
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Why it’s time to bring higher education out of the data Dark Ages, in an op-ed from Tamara Hiler of Third Way and Andrew Gillen of the Texas Public Policy Foundation’s Center for Innovation in Education. (Consumers can learn more about a car they might buy than they can about a costly education.)
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The Marshall Project writing about the widespread denials of compassionate release requests from sick federal prisoners.
Related: “If Prison Walls Could Talk,” personal stories about COVID-19 and incarceration from the Vera Institute for Justice.
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An interactive look from The Upshot at how the pandemic has hindered efforts to reduce violence in our cities. Most every category of crime has declined this year, with the exception of shootings and homicides. “But at least part of the puzzle may lie in sources that are harder to see (and politicize): The pandemic has frayed all kinds of institutions and infrastructure that hold communities together, that watch over streets, that mediate conflicts, that simply give young people something to do.”
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Democrat Andrew Yang and Republican former Massachusetts Gov. Bill Weld writing in USA Today in support of ranked choice voting. “This promising non-partisan electoral reform would give voters more voice, choice and power in the primary process.”
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Insight from Portugal on how the United States can fight addiction, including the country’s policy of expanding substance-use disorder treatment through things like medically assisted treatment for opioid use disorder.
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Why pharmacist-prescribed birth control is safe, increases access for many, and is cost-effective, in a new guide for legislators from R Street Institute.
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News that the Nobel prize in medicine went to three scientists who discovered hepatitis C, leading to blood tests and the development of medicines that have saved millions of lives — but are expensive. With the help of AV, Louisiana last year pioneered an innovative subscription-based payment model to make treatments available to the state’s most vulnerable populations.
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Peter Bach of the Drug Pricing Lab at Memorial Sloan Kettering Cancer Center weighing in on the impact of Trump’s drug pricing actions: “...the strategies the White House has concocted, if carried through, would only enrich the pharmaceutical industry, and raise costs for U.S. taxpayers.”
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One of the populations most harmed by COVID-19 are the so-called dual-eligible beneficiaries, a group of people who qualify for both Medicare and Medicaid. In a new blog post, ATI Advisory makes the persuasive argument that the pandemic has made it imperative for policymakers to find solutions to create more integrated care.
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This profile of economist Emily Oster (a grantee), who’s racking up fans and bylines thanks to her data-driven approach to parenting in a pandemic.
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This Nightline report on the wave of progressive prosecutors working to reform the criminal justice system from within. You’ll hear from Jamila Hodge of the Vera Institute for Justice, St. Louis Circuit Attorney Kim Gardner, and Suffolk County District Attorney Rachael Rollins, who says her run for office was prompted by the all-too familiar pattern of Black men losing their lives after a police interaction: “I just one day said I’m gonna stop yelling at my television, and I’m gonna change the system from the inside.” Their goals: Confront racial disparities, bring more transparency to prosecutors' offices, and end mass incarceration by addressing nonviolent, societal problems without using jail as a remedy. Naysayers are here as well, calling the approach “soft on crime.” Rollins’ response? “Change is never easy, but for the people that are not happy with what we’re doing, they are deeply invested in the system working exactly the way that it does.”
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“The Redaction Project” from Art for Justice and the Civil Rights Corp. It’s a marriage of art and poetry by Titus Kaphar and Reginald Dwayne Betts that’s focused on abuses of the criminal justice system — specifically money bail and fines and fees. Alec Karakatsanis of Civil Rights Corp puts it plainy: “The existence of the criminal punishment bureaucracy and all of its horror is allowed to exist in part because so few people know about it.” This visual project aims to tell those stories using redacted legal documents from cases in Texas, Ferguson, Mo., and California to uplift the visages and voices of those caught in the cycle of debt and incarceration. “What we wanted to do was to take something that was essentially used to demean people, used to signal that a person was less, and we wanted to turn that whole thing into a way to say that a person was more," says Betts, an attorney and Civil Rights Corp Board Member. It’s a revolutionary way to start a conversation.

Also:
- The 13-minute guitar solo that made Eddie Van Halen a legend. You never saw the man without a smile on his face. He died this week at 65.
- Work, float, eat, dream: first-person accounts of life on the International Space Station. (Sounds like a great getaway right about now.)
- If you need a laugh, this musical TikTok collaboration about a fight in a grocery store is it. Please scroll to the soup can at least. (h/t Julie James)
- I am very excited about the coming Selena series on Netflix. For the uninitiated, here's “Como La Flor,” from her iconic, record-smashing 1995 rodeo concert at Houston’s Astrodome. (It was a pleasure to see Kacey Musgraves recreate this at last year’s rodeo — really missing live music right now.)
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The Criminal Justice and Evidence-Based Policy teams at Arnold Ventures are teaming up to learn more about what works in criminal justice reform in an ongoing request for proposals for randomized controlled trials (RCTs) that will test programs and practices. There is no deadline for submissions.
The Evidence-Based Policy team invites grant applications to conduct randomized controlled trials (RCTs) of social programs in any area of U.S. policy. Details are here.
View all RFPs here.
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Have an evidence-based week,
- Stephanie
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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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