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04.12 Americans Don't Associate Price with Quality in Health Care

Tuesday, April 12th, 2016 | Allison Rizzolo



Does your insurance company provide a website or other resource for you to look up health care prices? If so, they're part of a growing trend. More and more government agencies, insurance companies and nonprofit organizations have developed tools to help patients navigate the complicated and often opaque health care price system.

As these resources proliferate, some health care experts worry that, if patients assume price is associated with quality, they'll avoid low-price care. After all, it's only reasonable to believe that price and quality are related. Yet while health care prices vary widely throughout the country, there is no evidence that higher prices are associated with higher quality or better health outcomes.

A new analysis of our 2015 survey data on price transparency provides good news for those troubled experts: most Americans do not associate the price of health care with the quality of that care. The analysis, conducted by Public Agenda's David Schleifer and Carolin Hagelskamp together with Kathryn Phillips of the University of California, San Francisco, was published in the April issue of Health Affairs, a top health policy journal.

In the analysis, we found that a majority of Americans (ranging from 58-71 percent depending on how the questions were framed) do not think health care cost and quality are associated. Fewer than one-quarter (21-24 percent) perceive an association, while 8-16 percent are unsure.


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04.08 Engaging Ideas - 4/8

Friday, April 8th, 2016 | Public Agenda





Every week we curate stories and reports on complex issues including democracy, public engagement, opportunity, education and health care.


Democracy

2 political scientists have found a key reason Republicans and Democrats see politics so differently (Vox)

Republicans' distrust of the mainstream media creates an asymmetry in how the parties approach the media. Democrats rely on the mainstream media both to get out their message and to cover events. Republicans generally distrust mainstream outlets and so have set up a parallel ecosystem to get their message out. The result is Republicans rely on a media that is more likely to echo their partisan biases, and Democrats rely on media that does not pick a side and at least claims to be objective and empirical (whether or not it lives up to that promise).


Engagement

No, Wait, Short Conversations Really Can Reduce Prejudice (The Atlantic)

A new study redeems a remarkably successful canvassing approach that was rocked by scientific fraud last year.


K-12 Education

The Testing Bill of Rights (Politico's Morning Education Newsletter)

The Center for American Progress and other groups unveiled a "Testing Bill of Rights" late last month with the goal of collecting 10,000 signatures in a month, but Wednesday CAP announced that it has already collected 11,000 signatures - a third of which stem from New York state, where the opt-out movement is prevalent. The bill of rights is meant to find a middle ground on the issue, denouncing over-testing but advocating that high-quality tests are important for improving instruction and measuring student learning. See the bill here.

Iowa Academic Chief Plays Dual Role (EdWeek)

Jaclyn Zubrzycki writes: In this 1,500-student district between Cedar Rapids and Iowa City, there's typically little delay when someone has an idea about how technology might help improve academics. That's because the district's chief academic officer and chief technology officer are one and the same. And that person is Townsley.


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04.07 Bold Solutions to Housing Affordability in NYC

Thursday, April 7th, 2016 | Allison Rizzolo



Public Agenda is kicking off new work to elevate the public's voice in housing policy


From left to right: Patricia Swann of The New York Community Trust; WNYC Radio Host, Brian Lehrer; Public Agenda President, Will Friedman; NYC Commissioner for Housing Preservation and Development, Vicki Been; and New York University's Steven Pedigo.

If you live in New York, it's easy to believe the sky is falling when it comes to housing costs. You're not alone: 80 percent of New Yorkers say the high cost of housing is a serious problem in the region.

Still, cities across the world look to New York as they struggle with their own housing needs. As the city's Commissioner for Housing Preservation and Development Vicki Been noted this week, she's received "many requests" for information about Mayor de Blasio's ten-year affordable housing plan from cities looking to meet their affordable housing challenges.

Been spoke at a panel discussion Monday evening on solutions to housing affordability in New York, hosted by Public Agenda and moderated by Brian Lehrer. The panel also included New York Community Trust's Patricia Swann and New York University's Steven Pedigo.

While other cities may look to Mayor de Blasio's affordable housing plan for inspiration, Been noted that New York is falling far behind on its housing supply compared to cities of similar density. This shortage, together with other variables that increase housing costs in the city, threatens to erode what the panelists agreed makes New York so great: its intermingling of different types of people. "Economically diverse neighborhoods are healthier neighborhoods," said Been.


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04.05 Building Democratic Skills for City Leaders Through Lessons Learned Post-Katrina

Tuesday, April 5th, 2016 | Nicole Hewitt



City managers have a unique power to shape the future of their municipalities. They are responsible not only for day-to-day administrative operations of their cities, but also for engaging their citizens. In many situations, they essentially run their cities, even more so than the mayor. As cities face opportunities or challenges that drive them to reinvent or rebuild, city managers are crucial liaisons for engaging the public in these efforts.

In February, I delivered a workshop on Democratic Skills for Public Leaders to a group of 50 city and county managers. The workshop was the opening session of the Association for Pennsylvania Municipal Management's Executive Development Conference in Bedford Springs, Pennsylvania. We tailored the workshop to the specific needs of city managers, focusing on tools and techniques they can employ to strengthen the participation infrastructure in their cities.

It can be daunting for a city leader to choose the most effective platform to reach their constituents. City leaders have a vast range of civic engagement tools at their disposal, including phone calls, newsletters, email, town hall meetings, social media and many others.

Many participants were incorporating both technological and face-to-face tools to engage their constituents. During the workshop, I focused on how they could most effectively coordinate and combine face-to-face engagement with civic technology as they design engagement processes for their communities.

We first discussed successful cases where innovators used both face-to-face and technological tools to engage citizens, including Portsmouth Listens and Participatory Budgeting. After, the group broke into small groups to design a comprehensive engagement strategy using a combination of engagement methods. To make the exercise feel more real and grounded, we used an exercise based on past engagement work in the U.S. Gulf Coast.


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04.01 Engaging Ideas - 4/1

Friday, April 1st, 2016 | Public Agenda





Every week we curate stories and reports on complex issues including democracy, public engagement, opportunity, education and health care.


Democracy

Uninformed Voters Are a Problem. This May Be a Solution. (Governing)

A new award-winning website from two Chicago women aims to better educate voters about downballot races, which people often know little (if anything) about.

Do We Actually Want Higher Youth Voter Turnout? (Stanford Social Innovation Review)

Young people can be more engaged in politics, but major institutions must actually want that to happen. Abby Kiesa and Peter Levine write: "We found that about one quarter of high school teachers of civics and government were leery of teaching about the election in 2012 because they feared backlash from local adults. Better preparation for future teachers and professional development for current teachers would help allay their concerns, and, in turn, help them allay public fears."

What I Learned When an Angry Mob Destroyed My Public Meeting (Metroquest)

When things go wrong in public engagement, they can go spectacularly wrong. The result isn’t just frustration for project leaders. It can spell costly delays, failed or overturned planning efforts, or the loss of public support for politicians and government agencies. Introducing the Fiasco Files – a lighthearted opportunity to look back on those times when things went sideways.


Restoring Opportunity

Should Economic Development Focus on People or Places? (Governing)

Cities tend to favor building stadiums and convention centers over investing in education or human services. It's an understandable but troublesome trend.

How America’s Mayors Are Taking the Lead on Income Inequality (Governing)

They're doing what they can on this challenging issue, but they think it's a problem Washington and state governments should solve.


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03.31 To Keep Cities Affordable, Affordable Housing Is One Solution of Many

Thursday, March 31st, 2016 | Allison Rizzolo




Photo: Chris Goldberg | Flickr

Earlier this month, the New York City Council approved two major parts of Mayor Bill de Blasio's plan to build and preserve 200,000 affordable housing units over the next ten years.

Increasing the inventory of housing for lower- and middle-income residents is one very important approach for addressing housing costs in New York and other cities across the country. But such efforts alone will not alleviate the housing affordability problem fully. Nor are they likely to ease the immense anxiety many feel as they ponder, can I afford to live here?

We must expand the conversation on affordable housing and explore additional solutions and approaches that support affordable cities for residents of all incomes. Next Monday, we plan to do just that, during Bold Solutions to Housing Affordability, a free event open to the public.

Our discussion, moderated by WNYC's Brian Lehrer, will include New York City's Commissioner for Housing Preservation and Development Vicki Been, NYU's Steven Pedigo, Director of Creative Cities & Civic Innovation, and New York Community Trust's Patricia Swann, senior program officer for community development.

This event kicks off an effort to better understand: what are the approaches to housing affordability that New York residents are willing to support? While our discussion will be hosted in New York City and focus on solutions for the metro area, like Mayor de Blasio's affordable housing plan, we will examine other approaches to housing affordability that have been tried and implemented around the world. We will also explore how issues like transportation, social mobility and opportunity affect housing affordability.


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03.29 To Address Gender Equity in the Workforce, We Must Look to Higher Education

Tuesday, March 29th, 2016 | Tiffani Williams



Too often, our conversation about gender equity fails to consider the ways in which college-level practices can end up reinforcing gaps and inequalities that persist well into women’s working lives. To boost gender equity in workforce representation and compensation, we need a deeper understanding of the ways colleges create and reproduce barriers to equal labor market opportunities.

Historically, women have been underrepresented in education and the workforce for a majority of the last century. However, current trends indicate that trend is shifting.

Women enroll in college, graduate and pursue advanced degrees at higher rates than men. For example, between 2002 and 2012, college enrollment grew from 16.6 million to over 20 million. Much of this growth is attributed to an increasing number of women enrolling in college. The ratio of college graduates that are women versus those that are men is 3 to 2. And when considering women ages 25-34, studies find that women are over 20 percent more likely to complete a college degree and 48 percent more likely to have completed graduate school than men.

Do these numbers tell the entire story of gender equality? Probably not. Labor market outcomes post-graduation reveal interesting differences between men and women and even suggest that large gender gaps still exist.


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03.23 Wanted: A Vision that Unites and Engages America

Wednesday, March 23rd, 2016 | Will Friedman, Ph.D.



The presidential primaries have a way of putting the extremes at the center. As the candidates mobilize the small number of partisan donors and activists who determine their fate, the political discourse polarizes even more than usual and leaves behind what little common ground and pragmatism remain in our national politics.

This is, in part, the natural outcome of the problematic design of our electoral system. It is also symptomatic of many troubling trends that are dividing the nation and undermining our ability to solve problems. These include:

  1. The growing gap between leaders and the public: Public trust in government and many other societal institutions remain near historic lows.
  2. Increasing partisan polarization in our national politics: Moderates of either party in Congress have disappeared, partisan rhetoric has hardened, and populist movements on the left and right are rising.
  3. Growing inequality and the hollowing out of the economic middle: Our post-industrial economy is splitting into a small sector of high-wage knowledge occupations and a large one of low-wage and insecure service jobs, as the middle class disappears and inequality deepens.
  4. The fracture of the news media: This makes it all too easy to reinforce our own views and avoid hearing from those who disagree.
  5. The stubborn cleavages of racial discrimination, discord and violence: Racism, the most ancient of American failures, continues to challenge each generation.


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03.21 On Health Care Quality, What Does the Public Think?

Monday, March 21st, 2016 | David Schleifer, Ph.D.



Experts have a lot to say about measuring quality in health care. But what qualities matter most to patients like you and me?

What do you think makes for a high-quality doctor? When asked this question, most Americans say they focus on doctor-patient relationships and doctors’ personality, according to a 2014 nationally representative survey from the Associated Press-NORC Center for Public Affairs Research.

But do people think differently about quality when they're faced with a potentially more serious situation such as joint replacement, diabetes or childbirth? People facing such situations may be interested in personality and relationships. However, they may also want to choose doctors and hospitals who are “the best.” But the best at what exactly? And according to whom?

We've seen a lot of progress on ratings systems that measure and communicate the quality of care that doctors and hospitals provide. Organizations like the Leapfrog Group, for example, have for many years reported on hospital quality and safety. They have found that a person on Medicare has a one in four chance of experiencing injury, harm or death when admitted to a hospital.

Several other non-profit organizations, private companies and state governments also now publicly rate the quality of hospitals and physician groups. The Centers for Medicare & Medicaid Services recently released core quality measures for treatment in seven areas of health care. These measures are designed to improve consumer decision-making and facilitate value-based payment, among other goals.


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03.18 Engaging Ideas - 3/18

Friday, March 18th, 2016 | Public Agenda





Every week we curate recent stories and reports on complex issues including democracy, public engagement, opportunity, education and health care.


Democracy

At SXSW, Obama Calls for More Civic Engagement in Digital Age (Tech.co)

Ronald Barba writes: President Barack Obama made his inaugural appearance at this year’s SXSW to discuss the importance of utilizing today’s digital tools and technological advancements to greatly improve and support civic engagement. Sitting with Evan Smith of The Texas Tribune, the President talked over many topics, including the increasing role of government in streamlining the process for aspiring entrepreneurs, how a private-public partnership between The White House and Silicon Valley is helping to solve our nation’s problems, and even touched upon the civil liberties issues surrounding Apple’s privacy case. More relevant to our election season, though, President Obama called for a better process to engage citizens in the electoral process.

Mediating Political Gridlock (WNYC)

Being a political mediator is no easy gig. Just ask seasoned mediator, Mark Gerzon, president of Mediators Foundation and the author of The Reunited States of America: How We Can Bridge the Partisan Divide. He's advised a number of groups, political actors, and corporations on bipartisanship. Listen as Gerzon mediates a conversation between a guns rights enthusiast and an anti-guns skeptic.


Engagement

The Power of Convening for Social Impact (Standford Social Innovation Review)

Bringing people together in an environment that encourages and facilitates idea exchange is one of the most powerful communications strategies for driving change.


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