Author Archives: Sheila

A Better Approach?

In my continuing effort to find positive aspects of our gloomy socio-political landscape, I came across a very interesting experiment in public safety being conducted in Albuquerque, New Mexico.

The city has established what has been named the “Albuquerque Community Safety (ACS) department.”

Launched in September, the agency is intended to complement the city’s police and fire departments by having teams of behavioral health specialists patrol and respond to low-level, nonviolent 911 calls.

While it is modeled after programs in a few other cities, ACS is the first stand-alone department of its kind in the country. The initiative is still nascent – Mr. Adams and Ms. White are one of just two responder teams at the moment. But authorities here hope it will defuse the kinds of tensions between police and residents that have surfaced in cities across the country and help reinvent 911 emergency response systems, which many believe have become antiquated.

As slogans go, “Reinvent policing” or “Promote Community Safety” are certainly less off-putting than “Defund the Police,” but the premises are similar; the idea is to relieve police from the need to respond to  situations that don’t pose an immediate threat to public safety and that can be better handled by social workers or mental health practitioners who have the often-specialized skills to handle certain interventions.

Most police interviewed about such approaches are enthusiastic, not defensive.

“What Albuquerque is doing is really exciting and innovative,” says Nancy La Vigne, executive director of the Task Force on Policing at the Council on Criminal Justice, a think tank based in Washington, D.C. Police chiefs “almost universally say we’d love to offload these calls to other people. We need these types of models to be developed and implemented, so we can learn from them.”

Even before the police killing of George Floyd sparked massive demonstrations, a number of cities were debating how to reduce the use of lethal force, how  to increase meaningful accountability, and how chronically understaffed departments might reduce the need to send uniformed officers to deal with issues that aren’t, strictly speaking, posing a public safety threat.

In Albuquerque, those discussions were made more urgent by the city’s experience; between 2010 to 2014, “members of the Albuquerque Police Department shot and killed 27 people.”

One of them, in March 2014, was James Boyd, a homeless man diagnosed with schizophrenia. An investigation by the U.S. Department of Justice concluded a month later that APD “too often uses deadly force in an unconstitutional manner,” including against “individuals who posed a threat only to themselves.” The police entered into a court-approved agreement with DOJ that October, which the department has been operating under ever since.

Initially, police shootings in the city decreased for several years. But more recently they have begun to rise again. From 2015 to this year, Albuquerque had the second-highest rate of fatal police shootings in the country among big cities.

If that wasn’t worrisome enough, the state’s behavioral health system was disintigrating.  A criminal investigation into whether 15 of New Mexico’s largest mental health providers had been defrauding Medicare led to the state freezing their funding. They were subsequently cleared of the the allegations, but according to the report, the state’s mental health system has never fully recovered.

Albuquerque’s aim with its new initiative was thus aimed at revamping its entire emergency response system, and not simply to reform policing.

About 1 in 4 people killed by police since 2015 had mental illnesses, according to a Washington Post database. Many of those killings occurred after the families of those people called the police for help.

“The default response is to send police to a scene and hope they solve whatever is happening,” says Dr. Neusteter. That’s “really not in anyone’s interests.”

“By and large [ACS] is a positive move” for policing in the city, says Peter Simonson, executive director of the American Civil Liberties Union of New Mexico. “It holds the promise that perhaps someday we will see fewer armed officers interacting with people in mental health crisis.”

The effort in Albuquerque is still in its early stages, and police organizations and community groups will be watching to see how it works. The early indications are positive.

Wouldn’t it be great if the Left could stop having to defend clumsy language and the Right would admit that American cities need to handle public safety more effectively and with fewer tragic outcomes–if we could all just put our ongoing culture wars on hold, and instead work collaboratively to use emerging information and expertise to make our communities safer?

I guess I’m just a dreamer……

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Research & Development

Let’s talk about drug prices.

Years ago, I was persuaded by arguments from friends who worked at Eli Lilly, Indianapolis’ own “big Pharma” company, who explained the considerable expense entailed by the development of new drugs–including losses incurred when, after the expenditure of millions of dollars, efforts to produce a new medication failed–the drug ended up being shelved. If the government imposed caps on what could be charged for the medications that did emerge, there would be little incentive to spend the zillions necessary, and we would all suffer.

That seemed reasonable, because I didn’t understand how the production of these medications actually worked, and what profits were actually incentivizing.

What initially triggered my deeper investigation was the overwhelming amount of advertising by big Pharma. (Take the purple pill!!) Companies were spending enormous amounts to “incentivize” patients to demand prescriptions from their doctors. (I don’t know about other doctors, but mine absolutely hated these ads, which required him to explain to his patients why pill X or elixir Y was inappropriate for them.)

My preliminary research (granted, a few years ago) revealed that big Pharma was spending more on advertising than on research and development.

Then there was the data showing how much those companies spent on lobbying…

Then there were the reports showing that efforts to produce new medications seldom if ever addressed so-called “orphan” maladies–that is, severe illnesses from which relatively few people suffer–since the markets weren’t attractive. They did spend generously, however, to produce slightly different versions of already-successful products.

But the most revelatory information came when I joined academia and kibitzed with colleagues on the medical faculty. Until then, I hadn’t realized how much pharmaceutical research and development is funded by government. Taxpayers pay, and drug companies profit.

A recent report from Inequality.org highlighted an example from the recent COVID pandemic.

Moderna, the world’s hottest new Big Pharma giant, now has four of its top players sitting on the annual Forbes list of America’s 400 richest. In early 2020, Moderna had none.

Moderna’s Forbes 400 billionaire quartet owes its current good fortune completely to the company’s Covid-19 vaccine. And who made that vaccine possible? U.S. taxpayers. Moderna’s Covid vaccine, as Public Citizen research director Zain Rivzi puts it, “would not exist without the massive contribution of the federal government at every step of the way.”

The Biden administration’s chief science officer for the Covid response, David Kessler, calculates that the federal tax dollars handed to Moderna for vaccine development, testing, and initial manufacture total about $10 billion. And that figure doesn’t include the brainpower of the scientists at the U.S. National Institutes of Health who spent four years actively collaborating with Moderna’s researchers.

Moderna has now filed for a patent on the key vaccine breakthrough these scientists helped produce. The company’s patent application makes no mention of the NIH scientists, a snub that could, notes a Wired analysis, have “major ramifications.”

What are those ramifications? Well, evidently, if a patent gives federal scientists the credit they deserve, the government can license the technology for Moderna’s vaccine to developing countries where vaccination rates remain low.

But if Moderna gets its way — gets approval for a crucial patent that denies credit to federal NIH scientists — the company’s billionaires would have “sole control” over the Covid vaccine technology that U.S. scientists and tax dollars did so much to create. That control would enable Moderna to continue placing profits ahead of people. Way ahead of people.

Over the course of this year’s first six months alone, Michael Hiltzik of the Los Angeles Times points out, Moderna “pocketed $4 billion in profits on $5.9 billion in revenue, almost entirely from its Covid vaccine, its only product.”

Meanwhile, according to the Mayo Clinic, the most commonly used forms of insulin cost 10 times more in the United States than in any other developed country. Other medications Americans rely upon to survive are also disproportionately expensive here.

According to the Commonwealth Fund

Drug spending in the United States is at an all-time high and still rising. Studies have repeatedly shown that the U.S. pays far more for the same prescription drugs than other high- and middle-income countries. Patients in the U.S. are more likely to report that they can’t afford their medications; half of all of adults with lower incomes go without care because of cost.

Commonwealth also debunks that argument that once seemed reasonable, opining that it “is an overreaction to say that any efforts to address drug pricing will stifle innovation,” since–among other things–the pharmaceutical industry has the largest profit margins of any sector among publicly traded companies.

And since U.S. taxpayers will continue to bear a substantial portion of R & D costs.

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Can Conservatives With Integrity Save Us?

Many thanks to all the readers who posted kind thoughts yesterday. They are much appreciated!

Among the regular readers of this blog are several people I came to know through Republican politics. Even then–“back in the day”–I had philosophical differences with a couple of them. (I generally described myself as a fiscal conservative and a social liberal, but even in my politically-active days, I defined “fiscal conservatism” as prudence, as “pay as you go”–not as ignoring the needs of the poor while being generous to wealthy purported “job creators.”)

The thing is, philosophical differences are philosophical. Rational adults can discuss them, agree or disagree about what the evidence tells us, and even find middle ground. As anyone who is following today’s political environment can attest, today’s GOP is neither rational nor philosophical. Its members bear virtually no resemblance to the center-right, generally Conservative party of which I was once a part.

The liberals and Democrats who dismiss help from the so-called Never Trumpers point out that many of them actively worked for the GOP for years and continue to hold very conservative political views. True–and that is their strategic virtue. The crazies who currently control the GOP and its various propaganda arms certainly aren’t going to listen to people like me; they most definitely aren’t going to listen to AOC and think, “you know, she has a point.” When the New York Times or the Washington Post reports that something from Fox News is false, they aren’t going to believe it.

However, when people who are known to be principled conservatives refuse to engage in the propaganda, some who are not entirely lost to the cult may pay attention. So when longtime commentators resign from Fox in protest, it is a hopeful sign.Steve Hayes and Jonah Goldberg just did that very thing.

We joined Fox News as contributors in early 2009. Combined, that’s more than 20 years of experience, relationships, and friendships. For most of that time, we were proud to be associated with the network, if not necessarily with every program, opinion, or scandal that aroused controversy. We believed, sincerely, that the country needed Fox News. Whether you call it liberal media bias or simply a form of groupthink around certain narratives, having a news network that brought different assumptions and asked different questions—while still providing real reporting and insightful conservative analysis and opinion—was good for the country and journalism.

Fox News still does real reporting, and there are still responsible conservatives providing valuable opinion and analysis. But the voices of the responsible are being drowned out by the irresponsible.

A case in point: Patriot Purge, a three-part series hosted by Tucker Carlson.

As they write, the Carlson piece is not the “hard-hitting expose” Fox is promoting.

it is a collection of incoherent conspiracy-mongering, riddled with factual inaccuracies, half-truths, deceptive imagery, and damning omissions. And its message is clear: The U.S. government is targeting patriotic Americans in the same manner —and with the same tools—that it used to target al Qaeda….

This is not happening. And we think it’s dangerous to pretend it is. If a person with such a platform shares such misinformation loud enough and long enough, there are Americans who will believe—and act upon—it.

This isn’t theoretical. This is what actually happened on January 6, 2021.

The two of them defend the news programming on Fox, which they say “routinely does what it is supposed to do.” If one only turned Fox on for the news, they’d be told that COVID-19 is deadly, vaccines work, Joe Biden won Arizona, the election wasn’t stolen, and January 6 wasn’t a “false flag” operation. But the news side of Fox has been buried by commentary masquerading as reporting, and they’ve had enough.

As they conclude:

With the release of Patriot Purge, we felt we could no longer “do right as we see it” and remain at Fox News. So we resigned.

We remain grateful for the opportunities we’ve had at Fox and we continue to admire many of the hard-working journalists who work there. This is our last recourse. We do not regret our decision, even if we find it regrettably necessary.

We often hear people bemoan the GOP’s “move to the right.” That isn’t really accurate. I don’t know where insanity falls on the political spectrum, but a collection of conspiracy theories and racial and religious animosities are not a political philosophy. Genuine conservatives with integrity understand that the Republican Party is no longer home to people holding genuinely conservative beliefs.Just ask Liz Cheney.

Ultimately, whether our “backsliding democracy” survives may depend on how many principled conservatives are willing to join Cheney, Goldberg, et al. and draw a line in the sand.

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Happy Thanksgiving!

On Thanksgivings past, my kids would call me the “gratitude gestapo” because I insisted on going around our bountiful table and making everyone say what they were thankful for.

I’m not sorry.

I’m aware that I am incredibly lucky to buffered against many of the very real problems that others face–problems that are so often the subject of discussion and concern here.

So I’m going to spend today being grateful–for my health, my endlessly supportive husband and our wonderful children and children-in-laws, for our extended family, and for all of you who are kind enough to visit this blog read my daily diatribes.

Happy Thanksgiving! (I’ll be back to my grumpy self tomorrow…)

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Speaking Of Structural Racism…

Discussions of Critical Race Theory are worse than useless, since most of the people arguing about CRT have absolutely no idea what it is. It has simply become the most recent wedge issue employed by the portion of America’s population intent upon protecting White privilege.

In other words, a distraction.

Why–you might well ask–do these angry people need a distraction? Since I’m not a psychiatrist (nor do I play one on TV), I can’t provide a truly satisfactory answer to that question. But as Americans continue to confront–or refuse to recognize– elements of our social landscape that document how inequitable that landscape truly is, a recent paper issued by The Brookings Institution may prove instructive.

It’s one thing to talk– as we academic types tend to do–about abstractions like “systemic racism.” Those abstractions are frequently dismissed by the people who become defensive in any discussion of unfairness based upon race. The Brookings study is more concrete; rather than talking in abstract terms, it paints a picture of what systemic racism is and does.

In September, Freddie Mac released a groundbreaking analysis of the U.S. home appraisal industry. Consistent with concerns raised by critics, they found that homes in Black and Latino or Hispanic neighborhoods are much more likely than homes in white neighborhoods to be valued below what a buyer has offered to pay.

A homeowner here in Indianapolis recently documented that appraisal bias.

The Brookings researchers found that Black neighborhoods were associated with much lower property values, and that only a relatively small portion of that effect could be explained by physical characteristics and neighborhood amenities.

Median home values in majority Black census tracts are 55% lower than median home values in non-Latino or Hispanic white census tracts. Part of this difference is attributable to quality differences between the housing stock. Lower wealth in Black communities means that homes in majority Black neighborhoods tend to be older, smaller, and more likely to be attached than homes in neighborhoods with few or no Black people. Lower wealth and lower home values further hinder the ability of Black homeowners to pay for structural improvements to the home and access mortgage refinancing to pay for renovations.

There are also differences in neighborhood quality that show up in housing price differences. Local schools are often less desirable—at least as measured by publicly available test scores accessible to home buyers—in majority Black neighborhoods than in non-Black neighborhoods. Some other characteristics of Black neighborhoods are more desirable, such as access to public transportation and proximity to local stores, but on average, they do not make up for the less desirable features. These structural and neighborhood characteristics explain some of the value penalty to housing in Black neighborhoods, which shrinks to 23% from 55% after adjusting for these factors.

That still leaves a lot of lost value. We estimate that losses amount to $48,000 per home and $156 billion cumulatively in majority Black neighborhoods.

The question is: What explains this?

In the linked paper, the scholars consider–and carefully rebut–criticisms of their research methodology. Interestingly, they also show that White-only neighborhoods are over-valued relative to Black neighborhoods.

Later in the paper, they return to that Freddie Mac study.

A team of economists and data scientists at Freddie Mac analyzed more than 12 million appraisals for purchase transactions submitted to Freddie Mac from January 1, 2015, to December 31, 2020 through the Uniform Collateral Data Portal (UCDP). Freddie Mac is a government-sponsored enterprise chartered to buy mortgages from banks in order to lower the cost and increase the supply of residential loans. In practice, their strict standards set the industry norm for what qualifies as an acceptable loan, and they have access to uniquely detailed data on mortgages submitted by banks.

The research team’s main finding is that homes located in majority Black neighborhoods and majority Latino or Hispanic neighborhoods are significantly more likely to have appraisals submitted to Freddie Mac that are below the contract price when compared to homes in majority white (not Latino or Hispanic) neighborhoods.

The research finds “strong evidence that appraisers discriminate against majority Black and majority Latino or Hispanic neighborhoods. They note in passing that their conclusions track with other other studies, including those showing that Black people are around 36% less likely to be called back for a job than white people with identical resumes.

This is what we mean when we talk about “systemic” racism.

No one is burning a cross on a Black person’s lawn, but the effects are–if anything–more detrimental.

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