Tuesday, August 8th, 2017 | Megan Collado
This blog post originally appeared on Aug 1, 2017 and is reposted with permission from AcademyHealth.
While the future of healthcare reform in the United States remains uncertain, every day consumers continue to make decisions about their health and healthcare, and they are doing so in a rapidly evolving healthcare environment. Some are receiving care in new settings, such as retail clinics or virtual office visits. Many are navigating new health insurance benefit designs, including high deductible health plans that expose consumers to greater cost-sharing in exchange for lower monthly premiums. And some are shopping for doctors and hospitals to provide treatment for a range of “shoppable” conditions.
In response to this evolving landscape, the Robert Wood Johnson Foundation wanted to better understand how consumers are navigating the healthcare system, with a particular focus on their experiences, preferences, and values. Under a funding opportunity managed by AcademyHealth, they awarded 11 research studies in 2015 that sought to generate evidence on what consumers value in different care delivery settings, when they are buying and using insurance, and when they are shopping for healthcare.
These grants are wrapping up this year, and two grantees found unique insights into how patients perceive and value physician and hospital quality. David Schleifer, Ph.D., director of research at Public Agenda, and colleagues explored perspectives on quality among people who have experienced one of three common types of healthcare: type 2 diabetes care, joint replacement surgery and maternity care. They found that across all three groups, people value both interpersonal and clinical qualities of doctors and hospitals. The most common interpersonal quality that people across these three groups say is very important is that the doctor makes time for patients’ questions and concerns.
Interestingly, the researchers found differences between the three groups’ rating of interpersonal and clinical qualities (i.e. as very important, somewhat important, not too important, or not at all important). While most people recently diagnosed with type 2 diabetes and women who recently gave birth rated interpersonal qualities as very important, fewer rated clinical qualities as very important. Most people who recently had a joint replacement rated both interpersonal and clinical qualities as very important. Schleifer and colleagues conclude that it’s important to understand that people value different qualities of care depending on their health needs. The full findings from Public Agenda are detailed in a recently released report.
David Auerbach, Ph.D., director of research at the Massachusetts Health Policy Commission, and colleagues provide some additional insight into consumer perspectives on the value of different care settings (specifically community health systems versus academically-affiliated systems). They conducted focus groups with consumers finding that quality scores for physicians and hospitals mattered more for procedures that patients considered “risky,” such as cancer treatment or surgery. This observation aligns with Schleifer and colleagues’ finding that people who recently had a joint replacement surgery viewed clinical quality as very important, whereas for more routine care that perhaps was perceived as less risky, fewer patients rated clinical qualities as very important. In the case of more routine procedures, Auerbach and colleagues found that patients were more influenced by physician referrals and cost when choosing between community and academic settings.
While both studies found that patients do value clinical quality information about their doctors and hospitals, both also found that more work is needed to educate consumers about what’s included in clinical quality measures as well as how to find this information about doctors and hospitals. Schleifer and colleagues note that while many patients viewed clinical qualities as important, only some knew or tried to find out whether a doctor or hospital had these qualities.
The findings described here are a sneak peek of the full portfolio of grantees that will continue to come out over the next year. As these findings emerge, they will provide important evidence about how consumers are navigating new delivery settings, how they are buying and using health insurance and shopping for care, and how they are using information to make decisions to improve their health. Findings and publications will be posted on the program website.
Friday, August 4th, 2017 | PUBLIC AGENDA
Minnesota Professor Hopes to Overcome Political Divide (US News & World Report)
A University of Minnesota professor is among those on a mission to mend the hostility between supporters and opponents of President Donald Trump.
Millennials aren’t taking over politics just yet (Washington Post)
At some point, the age of the baby boomer in American politics will end. It’s simple demographics: Boomers keep getting older and older, and that means there are fewer and fewer of them. But, contrary to two recent news articles, the boomer political era hasn’t ended yet — and it won’t end next year, either.
Campus Political Fights Come Home for the Summer (New York Times)
College in the summer: Dorms and quads are quiet, and it seems that the whole community is catching its breath. No marches, sit-ins, shout-downs, protesters giving professors whiplash. No arguments over free speech, Black Lives Matter, Israeli boycotts, abortion, Bernie Sanders, Hillary Clinton, President Trump. But the fighting hasn’t stopped. It has just come home for the summer.
Why Are Government Websites So Bad? (Governing)
Years ago, it took days to get our hands on basic government documents. We’d call someone who could send them to us, hope they would follow through and then wait for the U.S. Postal Service to do its job. When they didn’t arrive in a week or so, we’d repeat the process. These days, like many other researchers, journalists, policymakers and citizens, we rely on the troves of reports, budgets, data and plans that state and local governments post on their websites.
Pols. Take Marathon Subway Ride To Hear Commuter Complaints (New York City Patch)
“There should be more communication between officials and the working stiff," a retired iron worker said.
Americans Aren’t Saving Money Like They Used To (Bloomberg)
American households scaled back their pace of savings to the lowest level in nine years at the end of 2016 as the growth of their wages and salaries slowed, updated government figures show.
The Wealth Gap in the U.S. Is Worse Than In Russia or Iran (Fortune)
There's an widening gulf in the United States between the haves and the have-nots. The columnist points to education and metropolitan zoning restrictions as reinforcement for this unequal system, with statistics to support the argument. But how true is it? We asked urbanist, author, and University of Toronto professor Richard Florida to weigh in.
One in four D.C. public schools have had at least three
principals since 2012 (Washington
More than a quarter of D.C. Public Schools have had at least three principals since August 2012, a pattern of upheaval that worries parents and teachers who say constant change in leadership can generate instability, inhibit trust and stall academic progress.
Do vouchers actually expand school choice? Not necessarily —
it depends on how they’re designed (Chalkbeat)
Who benefits most from private school voucher programs: families with few options or the schools themselves? This is a hotly debated question among supporters and critics of school vouchers, and is especially relevant as U.S. Secretary of Education Betsy DeVos has vowed to allow more families to use public dollars to pay for private school tuition. A 2016 study considers this question and comes back with an answer: It depends.
Higher Education & Workforce Development
More Bootcamps Are Quietly Coming to a University Near You (EdSurge)
In the last two years, a surge of nonprofit, four-year institutions have hopped on the bootcamp bandwagon. These programs, often on skills such as software development or data analytics, have arrived in a number of ways—from universities partnering with local for-profit bootcamps, or colleges creating their own intensive training programs completely in-house.
Affirmative Action Battle Has a New Focus: Asian-Americans (New York Times)
Students like Mr. Jia are now the subject of a lawsuit accusing Harvard of discriminating against Asian-Americans in admissions by imposing a penalty for their high achievement and giving preferences to other racial minorities.
Maximizing Mobility (Inside
Leveraging new data can help low-income students climb the economic ladder, writes Michael Lawrence Collins.
We need to treat the causes of high health costs, not the
symptoms (The Hill)
As Senate Republicans failed to repeal and replace the Affordable Care Act, the reality is that no measure that was actually considered would actually lower the costs of healthcare.
How to Repair the Health Law (It’s Tricky but Not Impossible)
(New York Times)
Stabilizing the market, lowering drug prices and expanding access to
coverage would go a long way to easing millions of Americans’ concerns.
Physicians with high-risk patients struggle under value-based
pay model (Modern Healthcare)
Physicians who serve low-income patients with complex conditions are more vulnerable to financial losses in value-based payment models, according to a new study that found these providers, many of them safety-net providers, didn't have the technological infrastructure to report the necessary data.
Texas legislators take aim at high maternal mortality rates (Fierce Healthcare)
Maternal death rates are on the rise in some regions, pushing leaders in several states to investigate the trend and putting hospitals on alert.
Friday, July 28th, 2017 | ANTONIO DIEP
In today’s information-intensive age, we often rely on search engines and websites to gather details with the hope of arriving at an informed decision. I myself do this when deliberating on which new restaurants to try or which cities to visit. Like many others, I am trying to learn about the particular qualities of the establishments and cities that I think are important.
In health care, policy experts and leaders often propose more transparency in quality information, arguing that an informed patient can make smarter decisions about his or her health. Theoretically, such an approach can positively affect a patient’s health outcomes and help with reducing costs. Consumers are increasingly relying on the wisdom of the internet or online tools designed by tech start-ups to search for health information. But do people really want to look for C-section rates and hospital ratings like they do for a new restaurant? When people face a serious medical choice, what kind of information do they look for, whether from the internet or other sources? Do they try to find out about the quality of doctors and hospitals before getting care?
Public Agenda recently surveyed people with three different types of health care needs -- people recently diagnosed with type 2 diabetes, people who recently had joint replacement surgery and women who recently gave birth— to learn more about what qualities of doctors or hospitals they think are important and how, if at all, they try to find information about these qualities. We found that a large majority of people across the three health care situations think that both interpersonal and clinical qualities of doctors and hospitals are important for high-quality care. But does that mean they are looking for information about doctors and hospitals?
In fact, our research shows that more people across these three groups spent time looking for information about the care they needed than spent time looking for information about doctors or hospitals. For instance, 85 percent of women who recently gave birth say they spent a lot of time learning about pregnancy and birth, but only 43 percent say they spent a lot of time finding out everything they could about different OB-GYNs/midwives and hospitals.
This finding raises the question: If people say qualities of doctors and hospitals matter, why don’t they take the time to learn about them? Our findings suggest several potential reasons. For example, we found that few people are aware that quality varies across doctors or across hospitals. Some people don’t think or know if they have much choice among hospitals in particular.
Looking for information about qualities just may not be top of mind for many people: We found that most women who recently gave birth did not know or try to find out about important qualities because it did not occur to them to do so. Only about one quarter to one third of people across the three groups we surveyed say there is not enough information about the quality of doctors or hospitals for their respective type of care.
Information and tools are not necessarily enough to help people arrive at sensible health care decisions, much less produce better outcomes. While searching for information can be great for planning your next dinner or destination, people need support and guidance in making more decisions about health care. Online tools can help unlock information. But simply having access to quality information isn’t enough if people aren’t looking for it or understand it when they find it. This is particularly concerning when it impacts something as consequential as medical care. This is where doctors, insurers, medical experts and leaders can step in to make sure that people are not only well informed but also have support navigating the system before receiving care.
For more insights into what qualities matter in diabetes care, joint replacement surgery and maternity care, check out our report, “Qualities that Matter.”
Friday, July 28th, 2017 | PUBLIC AGENDA
Politicians can’t seem to do it, but these citizens are learning how to
find common ground (Washington Post)
Like so many Americans, most of Donna Murphy’s social circle shared her politics. So when she, a self-described liberal, was tasked with putting together a weekend-long event with an equal number of Democrats and Republicans, she needed to broaden her bubble. To aid in her search, Murphy visited one of the most personally uncomfortable, but almost assuredly conservative places she could think of: Local gun shops.
City Releases Latest Progress on Open Data Plan (Gotham Gazette)
The city released its annual update to its Open Data plan on July 15, detailing the progress by city agencies to release all of their public data by 2018. The initiative, originally launched in 2012 under former Mayor Michael Bloomberg, was expanded by the de Blasio administration two years ago under its Open Data for All plan, which aimed to make the data more accessible to everyday New Yorkers. City agencies periodically add data sets to the portal for public access.
Funders must join forces to defend civil society (@lliance)
Accustomed to being relatively invisible, philanthropy doesn’t just have a role to play in trying to get money to those most in need; it has a role to play in seeking to influence powerful actors, and to help uphold the fundamental values of everything that we do.
Women create fewer online petitions than men — but they’re more
successful (Washington Post)
Hillary Clinton’s candidacy for U.S. president reignited debate about gender inclusiveness in politics and the rate at which women participate. Many studies have shown that women do not participate as much as men in many aspects of offline politics. Yet this may be changing as a result of new technology.
Puerto Rico as a Blueprint for Voter Engagement (Pacific Standard)
Extraordinary efforts to bolster access to voting and participation in civic life have led to a high level of political engagement in Puerto Rico.
Public participation at City Council meetings begins — within limits (Chicago Sun Times)
Chicago residents finally got their individual three minutes of fame today in the City Council chambers, as a flashing digital clock on the wall counted down to zero. At the start of the 30-minute public comment session — a City Council first — George Blakemore boomed: “This is historic — you are now allowed to speak at City Council.” Three minutes later, the clock cut him off.
Getting By, But Not Getting Ahead (Next Avenue)
Despite a growing economy and the lowest U.S. unemployment rate in 16 years, things aren’t looking up for many Americans — financial fragility is especially an issue for people with low incomes and for minorities, according to the new 2017 Prosperity Now Scorecard.
Rural internet can help shrink economic gap (Seattle Times)
Microsoft wants to connect rural areas to better digital service. It’s a welcome initiative from an industry that, aside from locating some data centers in the hinterlands, tends to focus on metro areas. But the economic divide is long-standing and won’t be easily bridged.
One big reason millions are locked out of the American dream (MarketWatch)
Millions of families are living in perpetual financial insecurity. Low-income families are still unable to accrue enough savings to see themselves through a period of joblessness.
A Career Pathway To Educational And Employment Success (Forbes)
How can our schools transform education to make it applicable and adaptable to the future? How can they foster the capacity for lifelong learning that young people entering the workforce today need for future success? Stephen Spahn, chancellor of New York’s preschool-12 Dwight School, has been asking these questions for 50 years.
Please keep this guy away from rousing charter school debate (Washington Post)
Along with many Americans, I enjoy intense arguments about charter schools, the tax-supported institutions independent of school districts. I happily air my biases and skewer the squishy defenses of my foes. People like me have to watch out for Zachary W. Oberfield, an associate professor of political science at Haverford College. He spoils our fun. On the charter school issue he is scholarly, precise and balanced.
How Colorado could see more “blended learning,” combining online courses
and traditional teaching (Chalkbeat)
A new guide released Monday seeks to help Colorado schools successfully introduce blending learning, a growing practice combining traditional classroom instruction with online coursework.
Higher Education & Workforce Development
College Degrees Lead to 'Good Jobs' (Inside Higher Ed)
The college degree has solidified its role as the best ticket to the middle class. With the title “Good Jobs That Pay Without a B.A.,” new research from Georgetown University’s Center on Education and the Workforce would seem to offer some solace for job seekers with only a high school credential. But not much, as the study shows that an increasing share of well-paying jobs have shifted to workers who hold four-year or associate degrees.
For-Profit Graduate Schools Popular With Black Women (Inside Higher Ed)
Graduate student enrollment is declining at for-profit institutions, but the sector continues to resonate with one particular demographic -- black women.
Private colleges play a key role in diversifying America's workforce (The Hill)
What may be surprising is that private colleges serve a higher proportion of first-generation and low-income students than public and private doctoral universities. At private nonprofit colleges 17 percent are first generation, and at private doctoral-granting universities, 11 percent are first generation.
What Makes a Good Free College Plan? (Inside Higher Ed)
We have recently witnessed the introduction of a growing number of diverse plans for free public college. But what we’ve not seen -- and what must be done -- is to determine a set of criteria to judge the effectiveness and the viability of these various financial aid models.
What do patients value in healthcare? (Modern Healthcare Executive)
When defining quality, it is important to understand that patients value different qualities of care depending on their health needs, according to a new survey from Public Agenda, supported by the Robert Wood Johnson Foundation.
Universal Health Insurance? Why? (Health Affairs)
The Congressional health care debate has become a war between two seemingly irreconcilable extremes, coverage versus budget control. Health care is a right, thunders Bernie Sanders (I-VT). There’s no free lunch, roars back Rand Paul (R-KY). We think both sides miss the boat.
Which Metrics on Hospital Quality Should Patients Pay Attention To? (The Upshot)
The relatively recent movements toward transparency and quality in health care have collided to produce dozens of publicly available hospital quality metrics. You might consider studying them in advance of your next hospital visit. But how do you know if the metrics actually mean anything?
Tuesday, July 25th, 2017 | MATT LEIGHNINGER
How can public engagement evolve in order to meet the challenges and conditions of 2017? In my first post of this multi-blog series, I shared a list of promising directions for innovation in the field. Now, in Part 2 of the series, we'll explore in more detail the first item on that list: making engagement more social and versatile, so that it is more common, convenient and fun.
This first direction for innovation is not terribly daunting or difficult: it just flies in the face of how people usually think about public engagement. Especially in North America, we tend to treat engagement as a legal requirement (something governments must do in order to ‘check the box’ and comply with an open-meetings law) or a matter of civic duty (something people must do in order to think of themselves as “good citizens”). Both of these assumptions treat engagement like a bad-tasting cough medicine.
Engagement can, however, be enjoyable. In fact, when you look at some of the best examples of sustained engagement, it becomes clear that these models work because people find them convenient and fun. The City of Decatur, Georgia, hosts “Budgets and Beer” nights at a downtown bar where city employees bring poster boards to help explain public finance issues and surveys to gather citizen input. “Meet and Eat,” a weekly lunch in Buckhannon, West Virginia, has helped citizens plan and establish a new farmer’s market and new bike trails. The residents and employees of Jun, Spain, use Twitter to communicate about everything from replacing streetlights to matters of EU policy – along with advertising social events, booking doctor’s appointments and finding lost cats. On the Table, an initiative in Chicago which brings people together to discuss public issues over dinner, engaged over 50,000 people and is expanding to ten other cities.
In these regular settings for engagement, people keep coming back, not only because the experience gives them a chance to give input on policy decisions, but because of some more down-to-earth incentives: friends, food and lost cats.
Following this line of innovation can be very simple – just follow the advice of Gloria Rubio-Cortes, former president of the National Civic League, who said “Sometimes you need a meeting that is also a party, and sometimes you need a party that is also a meeting.”
As a variation on this theme, many engagement leaders have used “meetings in a box” as a way to bring the more serious elements of engagement, such as discussion questions, information on different policy options and forms for providing input, into settings where people are already gathering. Examples include meetings of neighborhood associations, Rotary Clubs and Parent-Teacher Associations.
The development of SMS-enabled discussion presents a whole new set of possibilities. Digital platforms that use Short Message Service (otherwise known as texting or SMS) can structure and connect face-to-face discussions among 3-4 participants, allowing people to contribute ideas, find information and answer questions no matter where or when they decided to get together. The potential of this format has been demonstrated by “Text, Talk, Act,” which over the last three years has involved over 50,000 people in productive deliberation on mental health issues.
We need to offer more of these kinds of versatile and convenient engagement opportunities that don’t need to take place at a community center or a meeting room in city hall. Given that an SMS-enabled process only requires a handful of people in each setting that don’t need to be sitting at tables, the engagement can happen in a wide variety of ways and places – people can participate in a classroom, during a protest march, in a church basement, on a bus or at a festival.
Democracy can’t survive on bad-tasting cough medicine. Using old ideas like the neighborhood potluck and new technologies like SMS platforms, we can support “anytime, anywhere” engagement that fits better into the rhythm of everyday life – and that offers a broader array of incentives to participate.
Keep an eye out on social media or check our website often for the next blog in this series. Meanwhile, don’t forget to register for our Public Engagement Strategy workshop taking place in New York City next Monday and Tuesday.
Friday, July 21st, 2017 | PUBLIC AGENDA
Despite Political Differences, Two High School Teachers Find Common
Ground (KQED News)
Two teachers — Brandon Johnson and Ysidro Valenzuela — talk about the intersection of politics and education.
At end of NRA protest march, a bit of common ground (Washington Post)
Men sported National Rifle Association hats and signs declaring “free speech is under attack” and “no jihad against our freedoms.” Then, for a few minutes at least, the median became common ground. Paul Jutte, who attended the Women’s March with his girlfriend, crossed Pennsylvania Avenue to join the counterprotesters.
The End of the Grand Bargain (National
The spirit of bipartisan compromise, never strong in recent years, has vanished completely on Capitol Hill.
There's a large group of Americans missing out on the American dream (Business Insider)
While education continues to be an important determinant of whether one can climb the economic ladder, sizable differences in economic outcomes across race and ethnicity remain even after controlling for educational attainment.
Which countries are the most (and least) committed to reducing
inequality? (The Guardian)
The UK’s lack of investment in education and low tax rates put it 17th in a new Oxfam inequality index – which ranks Sweden top out of 152 countries, and Nigeria bottom
In Parts Of Connecticut, Interest In Running For Local Office On The
Decline (Hartford Courant)
As Republicans and Democrats hold local caucuses to select candidates for the November municipal elections, some cities and towns report a surge of interest in response to the election of Donald Trump as president. But others say the nasty nature of national politics, and Connecticut's budget woes, are turning people off.
Why Civic Engagement Matters (National
Where there is inclusive civic engagement, in which everyone has a place at the table to define, direct and implement public services and amenities, there is greater civic pride and responsibility, which then lead to sustained community wellbeing.
Are Loath to Give Teachers Bad Ratings (Education Week)
Principals continue to rate nearly all teachers as “effective,” despite states’ efforts in recent years to make evaluations tougher, two new studies show.
testing may push struggling teachers to younger grades, hurting students (Chalkbeat)
Kindergarten, first grade, and second grade are often free of the high-stakes testing common in later grades — but those years are still high-stakes for students’ learning and development. That means it’s a big problem when schools encourage their least effective teachers to work with their youngest students. And a new study says that the pressure of school accountability systems may be encouraging exactly that.
Higher Education & Workforce Development
New rankings measuring the outcome of college (Sante Fe New Mexican)
What parents and students really want to know is how to differentiate the outcomes of the thousands of other colleges that are not among the top schools in the U.S. News rankings. A spate of new rankings and other studies have emerged in recent years attempting to answer that question by looking more closely at the employment and earnings record of college graduates and weighing that against the cost of attending college and chances of graduating on time.
The Trouble With Trade School (New York
Across the political spectrum, just about everyone seems to be in favor of expanding vocational education. The idea makes a lot of sense, too. But I’m worried that the idea of vocational education has become so popular — backed by Presidents Trump and Obama — that its advocates have not thought through the potential downsides.
As academic hospitals lower mortality rates, should insurers reconsider
excluding them? (San Francisco Chronicle)
A comprehensive new study has found that major teaching hospitals in the United States outperformed non-teaching hospitals in the most important of all health care outcomes: reducing mortality rates. Using a traditional measure of surgical quality, the study analyzed mortality rates for 21 million Medicare patients who were hospitalized with one of the 15 most common medical diagnoses or who underwent one of the six most common surgical procedures.
Mirror, Mirror 2017:International Comparison Reflects Flaws and
Opportunities for Better U.S. Health Care (Commonwealth Fund)
Poor access to primary care has contributed to inadequate prevention and management of chronic diseases, delayed diagnoses, incomplete adherence to treatments, wasteful overuse of drugs and technologies, and coordination and safety problems.
Thursday, July 20th, 2017 | MATT LEIGHNINGER
On all kinds of issues, people want more choices, more information and more of a say. Whether the topic is how schools should work, what should be in the local budget or what Congress should do about health care, citizens want their voices to be heard. “We are in the midst of a profound global Great Push Back against concentrated, monopolized, hoarded power,” writes Eric Liu.
When they’re given productive, well-structured ways to participate, citizens have a lot to contribute: they can not only provide reasonable input and interesting ideas to public officials and staff, they can also devote their own time, energy and skills to solving public problems.
Most official opportunities for public engagement are not productive or well-structured, however. The main official avenues are the same ones we’ve had for over fifty years: writing to your elected officials, signing a petition or taking the time to attend a long, laborious public meeting in which you may have three minutes at the microphone to make your statement. As Jane Jacobs famously remarked, “There is no hearing at public hearings.”
The irresistible force of citizen pressure has met the immovable object of official engagement: the result is a great deal of heat. In this crucible, all kinds of leaders – from public officials and staff to community organizers and civic technologists – have invented new processes, platforms, tools and apps for engagement. Many of these innovations work well, but even when they are brilliantly successful, they are usually deployed as isolated projects or temporary workarounds to avoid the worst bottlenecks of conventional engagement. They are rarely sustained or incorporated into the official systems of democratic governance.
Then there are the less successful attempts to give citizens more say. With Brexit, for example, a government allowed citizens to vote on an issue without providing ample opportunities for people to learn the key facts, deliberate with one another and weigh the trade-offs inherent in the decision.
So for public officials wondering what do about the citizen pressure they face in the Great Push Back, there is one obvious answer: engage the public more productively, on a more regular basis and in ways that augment the tired official venues rather than working around them.
But what else needs to happen? How can public engagement change in order to meet the challenges and conditions of 2017?
There are a number of promising directions for new innovations:
- Making engagement more social and versatile so that it is more common, convenient and fun
- Finding new ways to ‘scale up’ engagement so that people can be heard on state and federal issues, not just local ones
- Giving engagement opportunities more authority so that people are clear on how their voices will be heard and confident that it will make a difference
- Helping public institutions collaborate in their efforts to support engagement so that it becomes more efficient, systemic and sustained
- Finding better ways to measure the perceptions, processes, and outcomes of engagement, so that people know how to continually improve it
In the next few weeks I’ll explore each of these directions for innovation in greater depth. Meanwhile, there is still time to register for our Public Engagement Strategy workshop taking place in New York City on July 31 and Aug 1. I hope to see you there!
Friday, July 14th, 2017 | PUBLIC AGENDA
A Bipartisan Congress That Works? Veterans Committees Show
How It’s Done (New York Times)
Magnanimous hearings. Bipartisan votes. Substantial legislation on its way to becoming law. This is Congress? Something strange is happening in the staid hearing rooms of the House and Senate Veterans’ Affairs Committees here this summer, though few have taken notice.
AP-NORC Poll: Three-quarters in US say they lack influence (Associated Press)
Three-quarters of Americans agree that people like themselves have too little influence in Washington, rare unanimity across political, economic, racial and geographical lines and including both those who approve and disapprove of President Donald Trump, according to a new poll by The Associated Press-NORC Center for Public Affairs Research.
Why The Trend Around Politics And Cocktails Is Exploding (Huffington Post)
Healthcare sit-ins on Capitol Hill. Alleged Russian interaction previous to the presidential election. Previous generations may have been taught that conversation about such topics as religion or politics while socializing were definitely taboo, but it seems that the new trend toward frank discussion and exchange around all things statecraft is not only smashing all previous etiquette norms but also shows no signs of slowing down.
How Income Inequality Makes Economic Downturns Worse (CityLab)
Urban counties in the United States were more likely to enter the Great Recession earlier when they had a larger gap between the rich and the poor.
The huge gap between America's rich and superrich exposes a
fundamental misunderstanding about inequality (Business Insider)
While America's enormous gap between rich and poor and the sorry state of its middle class are well-documented, a less prominent trend tells an equally important story about the American economy: the divide between the well-off and the stratospherically rich.
Why Can’t Americans Get a Raise? (Slate)
Companies have forgotten how to compensate workers fairly—and workers have forgotten what they deserve.
Turning down the temperature on town halls (Christian Science Monitor)
Town halls are a crucial tool in creating connections between citizens and their lawmakers. But how do you mix civility with passion? There are ways.
This Might Be the Best Idea for Turning Out More Voters in
U.S. Elections (New York Magazine)
Presidential election years bring out more voters, of course, but even the 2016 national election — featuring a reality TV star and the first woman to win a major-party nomination — drew only slightly more than half of voting-age Americans to the polls. So what changed? A professor of political science at Columbia University thinks part of the problem is that voting isn’t as fun as it once was.
Improve Professional Learning for Teachers, We Can’t Forget Principals (New
Roxanne Garza discusses a recent report from the Aspen Institute regarding how state and district leaders can support teachers by adapting to new standards.
The two standard college admission tests — the SAT and the ACT — could be administered universally and free of charge to students. That would reduce the administrative barriers to applying to college, help identify talented disadvantaged children, and increase the likelihood they will attend a college that matches their skills.
Higher Education & Workforce Development
Deep Partisan Divide on Higher Education (Inside Higher Ed)
In dramatic shift, more than half of Republicans now say colleges have a negative impact on the U.S., with wealthier, older and more educated Republicans being least positive.
Find Out If Your Job Will Be Automated (Bloomberg)
Wondering how vulnerable your job might be? Type your occupation into the chart to see what the researchers think is the probability of your job being automated.
How 3 patient groups view healthcare quality: 6 things to
know (Becker's Hospital Review)
The nonpartisan Public Agenda conducted a study to gauge how three groups — people recently diagnosed with type 2 diabetes, people who recently had a joint replacement and women who recently gave birth — view healthcare quality and value.
Health Plans That Nudge Patients to Do the Right Thing (New York Times)
As health care costs rise, Americans are increasingly on the hook to pay more for their care. This trend is more than just annoying — asking consumers to pay more for everything deters many from getting the care they need. What would happen if, instead, health plans offered more generous coverage of high-value care, but less generous coverage of those services that provide little or no health benefit?
Friday, July 14th, 2017 | ANTONIO DIEP
If today’s ongoing health care debate on Capitol Hill has taught us anything, it’s that health care is a complex and divisive issue. While that debate has focused largely on finding ways to provide Americans with health insurance, one has to wonder: What is health care without quality?
Experts measure health care quality in many ways, and the amounts of money that hospitals are paid by insurers are beginning to be based on quality. But what do people like you and me have to say about quality? What do people think make for high-quality doctors or hospitals? Do people know that doctors or that hospitals can vary in the quality of care they provide?
To answer these and other questions, Public Agenda, with support from the Robert Wood Johnson Foundation, has released new research about how patients view and experience health care quality. We specifically explored the perspectives of people in three health care situations—people recently diagnosed with type 2 diabetes, people who recently had joint replacement surgery, and women who recently gave birth.
We learned that a majority of people think that both interpersonal and clinical qualities of doctors and hospitals are important for high-quality health care. Yet people still rated certain qualities differently.
The most common interpersonal quality that people across these three groups say is very important for high-quality care is that a doctor make time for patients’ questions and concerns. But we found that people rate the importance of clinical qualities differently depending on their health needs. For instance, 83 percent of people who recently had joint replacement surgery rate the clinical qualities of doctors as very important, while only 43 percent of women who recently gave birth and 41 percent of people who were recently diagnosed with type 2 diabetes rate clinical qualities of doctors as very important. Regarding interpersonal qualities, one recent mother from our New York City focus group said her doctor “was really personable” and “available,” which was especially important to her since she was giving birth for the first time. But a woman in Florida who recently had a joint replacement said, “I think you really need to do your homework and get a doctor that really knows what he’s doing.” This suggests that people’s priorities vary depending on the type of care they need.
Although experts know that quality can vary significantly, we found that across the three groups, awareness of quality variation is limited. This was especially the case for clinical qualities, with fewer people being aware that those formally measured qualities vary across doctors or hospitals.
Any conversation about health care quality should not just focus on providing people with information to make better choices, but also on improving health care quality across the board. Low-quality care can have serious medical consequences and can be financially ruinous for patients and their families. It can be costly to employers and insurers, including Medicare and Medicaid. This makes it all the more important to know what qualities matter to people who need care, so that leaders can continue focusing on improving the quality of care for everyone.
For more insights into what qualities matter in diabetes care, joint replacement surgery and maternity care, check out our report, “Qualities that Matter.”
Thursday, July 13th, 2017 | WILL FRIEDMAN, PH.D.
This May, I told you about two intertwined themes that Public Agenda has been focusing on lately: Renewing Democracy and Reinventing Opportunity. We launched the Yankelovich Center for Public Judgment in 2015 with the former in mind. More specifically, to understand the public's role in an effective and just democracy, including how people come to judgment on critical problems and the conditions that make public judgment more or less likely.
As part of this work, we seek to study the things that separate and the things that unite Americans. Because the former tends to get the most attention, we're excited to announce the kickoff of our new Hidden Common Ground initiative, which will explore the hypothesis that there are many problems and, importantly, solutions that the public agrees on, despite the political gridlock and media noise to the contrary. To that end, we will soon collaborate with our friends at the Kettering Foundation to launch the inaugural Hidden Common Ground research project that will test and potentially challenge the increasingly dominant narrative of a deeply, even hopelessly, divided America--a narrative that we fear could become self-fulfilling to the detriment of democracy. I look forward to sharing more updates with you as we embark on that journey.
Meanwhile, our Public Engagement team is helping local leaders create better conditions for identifying common ground and supporting public judgment in order to better address local problems. Today and tomorrow, they are hosting a Public Engagement Strategy workshop in New York City designed to help leaders in their efforts to engage the people they serve.
Please be in touch if you'd like to hear about upcoming public engagement workshops and trainings.