NegReg, Worthless Degrees, and a Chance to Make it Right

A 2019 executive order put into motion direly needed reforms for our nation’s deeply flawed organ donation system, which allows thousands of potentially life-saving organs to go unrecovered across the country every year. But the reforms don't take effect until 2026. 

What's Happening: The organ donation system is operated by a network of organ procurement organizations, or OPOs, that have demonstrated a "horrifying mix of greed and incompetence." A delay in reforms would mean the lavish CEO salaries and unethical side hustles of OPOs could continue for five more years — and people waiting on organ transplant lists have no time to waste. LaQuavia Goldring, pictured above, has already been waiting for a new kidney for seven years; she is on dialysis 10 hours a day.
 

Why it Matters: More than 100,000 patients are on organ replacement waiting lists. The opportunity to arrange more than 28,000 additional organ transplants is wasted each year due to inefficiency and mismanagement of the organ donation system. And as many as 60,000 people may die needlessly if Congress doesn't accelerate the new standards. 

Hillary Blout, executive director of For The People, which is working directly with prosecutors in California to free people who have faced overly punitive sentences. Blout’s organization helped pass Assembly Bill 2942, which allows district attorneys in California to decide whether a draconian sentence “is no longer in the interest of justice.” She talks to the National Partnership for Pretrial Justice about her work as a prosecutor in the reform-minded San Francisco District Attorney’s office, her founding of For The People, and its work passing the first-of-its kind legislation. “Call it a rescue mission, call it back-end reform, but we have to go back and get people out that are serving sentences that we now as a society feel are extreme.”

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83%

Percentage of Americans who favor allowing the government to negotiate drug prices for people on Medicare and private insurance.

82%

Percentage of Americans who maintained their favorable view of Medicare negotiation, even after they were exposed to arguments against the proposal.
 

The new polling from Kaiser Family Foundation shows that Americans' views on drug pricing reform aren't swayed by fear-mongering and misleading talking points from Big Pharma, which has falsely claimed that attempts to create more affordable medicines would curtail innovation and hamper access.

"The truth is, if Congress passes legislation to give Medicare negotiating power to make drugs more affordable, we will still have robust innovation," writes Ezekiel Emanuel, an oncologist and the chair of the department of medical ethics and health policy at the University of Pennsylvania in an op-ed for Politico. He points to a report by the nonpartisan Congressional Budget Office, which found that the kind of drug pricing regulation under consideration by Congress would prevent just 1% of all new drugs from coming to market.

All that to say, new drugs don't necessarily equal innovation. Emanuel points to a Deloitte study that found only seven of 35 drugs categorized as innovative represented a new approach to fighting disease, and another study of 46 new drugs that found 37% of them offered small, if any, clinical benefits compared to existing drugs. 
 

The current reality for most Americans is that drugs don't work if you can't afford them. Put a different way, most adults, regardless of their political stripes, believe that even if U.S. drug prices were lower, “drug companies would still make enough money to invest in the research needed to develop new drugs," according to the KFF poll. Congress should take heed.
 

ICYMI: Mark Miller, EVP of Health Care at Arnold Ventures, teamed up with The Commonwealth Fund's David Blumenthal and Lovisa Gustafsson to make the case that the U.S. can lower drug prices, making needed medicines more affordable and accessible, without sacrificing innovation. 

Criminal Justice

• “All four girls were Black. There was a sixth grader, two fourth graders and a third grader. The youngest was 8. On this sunny Friday afternoon in spring, she wore her hair in pigtails.” This  ProPublica investigation reveals an appalling juvenile justice system in Rutherford County, Tennessee with a “staggering history of jailing children.”  
  
  Related: The Justice Department is investigating abuse and mistreatment at Texas’ long-troubled juvenile facilities, the Texas Tribune reports.
   
• Gun violence is claiming the lives of more teens and children, The Associated Press reports.
   
• The Houston Chronicle exposes how the for-profit cash bail industry has been undermining judicial settings for pretrial detention and putting community safety at risk.
  
  Related: The data continues to show that bail reform is working in New Jersey, The New Jersey Monitor reports. And here’s the backstory on how New Jersey got bail reform done.
   
• The Trace examines how New York City’s community violence intervention programs would fare under an Eric Adams administration. 
   
• A toolkit for decarceration from the Vera Institute of Justice offers communities a step-by-step guide and resources to better understand local jail systems and enact changes to the criminal legal system locally.
   
• COVID-19 is by far the most common cause of duty-related deaths for police officers, The New York Times reports. More than four times as many officers have died from Covid-19 as from gunfire since the start of the pandemic. (free link for Abstract readers)
   

• Philadelphia is the first big city to bar police officers from pulling over drivers for low-level motor vehicle offenses that have disproportionately targeted Black drivers, The Philadelphia Inquirer reports.
  
  Related: A new report by the Public Policy Institute of California explores how racial disparities in traffic stops lead to inequities throughout the criminal justice system. 
   

• AV grantee Greg Jackson Jr. has been working to address gun violence since he was shot in 2013. But as he recounts in this Time piece, he almost didn’t survive. Jackson was greeted in the ER not by doctors and nurses, but by police officers. “I’ll just never forget knowing that I could have died while being interrogated.”

Health

• Amid private equity's rapid expansion into health care — which has raised questions about its impact on higher prices and spending — AV grantees at the Brookings Institute outline policy recommendations to protect consumers and taxpayers from private equity's potential harms and level the playing field for all investments. Loren Adler breaks it all down in a segment on Yahoo Finance.
   
• Health plans that serve people with Medicare and Medicaid, called Dual Eligible Special Needs Plans, or D-SNPs, have an untapped potential to help expand home- and community-based services — if states lean on them to do so. Read more from my colleagues Arielle Mir and Amy Abdnor and ATI Advisory's Brie Ensslin Janoski.
   
• Prices for COVID-19 tests are all over the place, Marketplace reports, and even at-home tests cost far more than they should given taxpayer subsidies, experts say.
   
• The Affordable Care Act was supposed to ensure that birth control was fully covered for women, but many still struggle to access the contraception prescribed to them, Axios explains. Last week, the chairs of the most powerful House committees penned a letter to Health and Human Services, the Labor Department, and the Treasury Department urging them to make sure that women have a full access to the full range of FDA-approved contraceptives, as required by law.
   
• A lawsuit filed by the family of Henrietta Lacks against Thermo Fisher Scientific accuses the company of continuing to unfairly profit from the sale and use of her cells. It is “the culmination of a decades long effort on behalf of the Lacks family to seek justice and shed light on racism within the medical field,” writes MSNBC’s Keisha N. Blain in this powerful column.

Also...

• Americans are giving away more money than ever, but charities still can’t make ends meet. That’s why lawmakers should support the ACE Act and restore “the balance between charitable tax breaks for donors and the actual benefits to charities and the people they serve,” writes Kat Taylor in Fortune.
   
• The baby boomer generation is in the midst of planning the largest generational transfer of wealth in history, says Bill Graves of the Graves Foundation, some of which will be set aside for charitable giving. But policy changes are needed to ensure those funds get to working charities more quickly, he writes in Philanthropy News Digest. 

I have already binged the first three episodes of Hulu’s “Dopesick,” a dramatic retelling of the role the Sackler family and their company Purdue Pharma played in seeding and fomenting the nation’s opioid epidemic. (The Sacklers have denied wrongdoing and are protected by a settlement that dissolved Purdue.) Based on the 2018 book by journalist Beth Macy, “Dopesick” details Purdue’s deceptive marketing of OxyContin, including its pitch to doctors that less than 1% of patients would become addicted, and exposes the flawed FDA approval and labeling process that allowed such a dangerous narcotic to be prescribed so freely. The story is told in shifting timelines and places: Purdue’s boardroom meetings and aggressive sales training sessions; the Sackler family’s lavish homes and art wings; and the U.S. attorneys’ office investigation into the company’s misleading claims. But most compelling is how the crisis unfolds in an Appalachian coal-mining community, where a well-meaning doctor played by Michael Keaton starts prescribing the drug to his patients after a Purdue rep convinces him it will take their pain away safely. We all know how this story ends — with more than half a million deaths and countless lives destroyed — so it’s hard not to watch the deception unfold without a sickening feeling gripping your stomach. But it also humanizes the victims and, as show creator Danny Strong tells The New York Times, aims to destigmatize treatment for opioid use disorder. 

The Daily podcast is a must-listen on the deteriorating situation inside the Rikers Island jail complex. Host Astead W. Herndon talks to Jan Ransom, an investigative reporter for The New York Times who covers the jail, and Richard Brown, a man detained there. Brown recounts fighting for food and dignity, witnessing constant assaults and beatings (and experiencing one), and being denied basic health care. It’s a place where control of some units has been ceded completely to those detained there. Rikers has always had a notorious reputation, but Ransom explains why this crisis is different. 

Related: Read a Times investigation on the extraordinary levels of violence and lawlessness inside Rikers. (free link for Abstract readers)

Dive Deeper: How New York City can close Rikers and continue to reduce the jail population.

Also: Bryan Stevenson, founder of the Equal Justice Initiative and author of "Just Mercy," talks to Vox Conversations about the newly expanded Legacy Museum, which traces the Black experience in America from slavery to mass incarceration. He discusses why the museum needed to expand, its ties to his work on behalf of the wrongfully convicted, and the backlash against confronting our true American history.

• William Shatner’s spaceflight demonstrated what researchers already knew: Yes, a nonagenarian can be an astronaut.
   
• Here are the 2021 Wildlife Photographer of the Year winners. (That spider and her babies are still giving me nightmares.)
   
• A group of church deacons deploy the church’s vans, unused during weekdays, to help Clevelanders get rides to work.
   
• Formerly incarcerated women in North Carolina have found safe housing at Benevolence Farm, an organic farm that offers a transitional residential and employment program — and a path forward after prison.
   
• Megan Thee Stallion — who hails from our hometown of Houston — has released a new sauce exclusive to Popeyes, aptly named Hottie Sauce. What's even hotter? The collaboration includes a six-figure donation to nonprofit Houston Random Acts of Kindness.