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.
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.
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.
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.
Thursday, March 17th, 2016 | Chloe Rinehart
Photo: Costa Constantinides.
Next week, tens of thousands of New York City residents across 28 neighborhoods will have a voice in improving their community. Starting Saturday, March 26th, residents will go to the voting booths for the city's fifth year of participatory budgeting (PB), a process by which community members have direct decision-making power over local budget decisions.
Voting week is the culmination of many months of hard work, time and collaboration from community volunteers, city and district staff, and community-based organizations. Residents gather at a series of community meetings to present, listen to and collect ideas. Volunteers and city agency staff develop and vet projects. Finally, volunteers design and draft concrete project proposals.
During voting week, NYC residents who live or work in a PB-participating community can choose their preferred projects at a number of different voting stations located throughout their area, including libraries, schools, their council member’s offices and even beer gardens. Residents might also come across a “pop-up” voting table on a busy street corner.
Each voting location has ballots that describe the PB projects proposed for that particular community, with a brief description and cost for each project. Ballots are translated into languages other than English that are typically spoken in the community.
Many NYC residents are eligible to cast their PB vote even if they would not be eligible to vote in municipal elections. Residents as young as 16 (and in some cases 14), residents who were formerly incarcerated, and residents who lack citizenship status are all welcome and encouraged to participate in the vote.
How Research Helped Expand PB in NYC
As we have written previously, PB has expanded exponentially in the U.S. and Canada the past few years. New York City has driven much of that growth, where PB has expanded from 4 participating communities to 28 in 5 years.
The growth and expansion of PB in NYC has not happened in a silo. Research and evaluation led by Alexa Kasdan and Erin Markman of the Community Development Project (CDP) at the Urban Justice Center has played an integral role in development and expansion of PB in NYC.
Tuesday, March 15th, 2016 | Alison Kadlec, Ph.D.
Few issues enjoy the same widespread bipartisan agreement that higher education does, even amidst the unparalleled polarization we are seeing in this year's election season. Regardless of party affiliation or ideological orientation, a vast majority of leaders in this country agree that we need a more educated population and significantly more people with high-quality postsecondary credentials.
Despite the encouraging (and probably short-lived) cross-partisan agreement among policymakers of every stripe, conversations on college campuses—where the real work must be done—are rife with hostile, polarizing and often ideological rhetoric.
03.10 Engaging Ideas - 3/10
Thursday, March 10th, 2016 | Public Agenda
A collection of recent stories and reports that sparked consideration on ways to make progress on divisive issues.
Mark Funkhouser writes: Those who want greater turnout in elections, more successful women and minority candidates, less gerrymandering, less ideological extremism and more pragmatic policymaking have a ready tool: Take the electoral machinery back from the private organizations that have given us the broken system of governance we have now.
The End of American Idealism (The New York Times)
Charles Blow writes: There is palpable discontent in this country among those who feel left out and left behind in the bounty of America’s prosperity. How long can the center hold? How long can the illusion be sustained? How long before we start to call this the post-American idealism era?
The Risk I Will Not Take (Bloomberg View)
Michael Bloomberg writes: “We cannot “make America great again” by turning our backs on the values that made us the world’s greatest nation in the first place. I love our country too much to play a role in electing a candidate who would weaken our unity and darken our future -- and so I will not enter the race for president of the United States. However, nor will I stay silent about the threat that partisan extremism poses to our nation. I am not ready to endorse any candidate, but I will continue urging all voters to reject divisive appeals and demanding that candidates offer intelligent, specific and realistic ideas for bridging divides, solving problems, and giving us the honest and capable government we deserve.”
What's the Answer to Political Polarization in the U.S.? (The Atlantic)
From partisan gerrymandering to exclusionary party primaries, a breakdown of the factors behind our polarized politics, and common proposals to fix it in a Jeopardy-style Q&A.
Wednesday, March 9th, 2016 | Erin Knepler
Earlier this month, I examined a tax-credit initiative designed to support community college graduates in President Obama's FY 2017 budget. In this post, I continue my examination of the higher education proposals in that budget. While the Obama budget has little chance of passing, I enjoy exploring commitments signaled by the budget and believe placing those commitments within the broader context of higher education to be a worthwhile effort.
Photo by Isabelle Saldana
A growing body of research suggests that diversity in groups bolsters their ability to solve problems. Increased diversity on college campuses has the potential to enhance students’ advanced thinking and leadership skills. In the workplace, it can improve innovation and strengthen the bottom line.
Expanding diversity in science, technology, engineering and mathematics (STEM) has been a major focus of President Obama throughout his administration. This commitment is mirrored by the American public, who are convinced that math and science skills are crucial for the future. Strong majorities of Americans say there will be more jobs and college opportunities for students with those skills. It is also mirrored by the efforts of many organizations, including AAAS, which recently focused on the power of mentoring to boost diversity in STEM.
Monday, March 7th, 2016 | Allison Rizzolo
A Public Agenda Event Will Explore Approaches to Housing Affordability in NYC
Even as The New York Times today declared that New York City has "rarely been in better financial shape," residents are deeply anxious about their ability to afford living here.
Eighty-six percent of people living in New York City and surrounding communities say the high cost of living is a serious problem; 80 percent say the high cost of housing is a serious problem.
Residents of the five boroughs are especially worried about these issues, with 93 percent saying the high cost of living and 90 percent saying the high cost of housing are serious problems.
Can we afford to live here? What strategies could we pursue to make housing in our region affordable again? What are the trade-offs of those strategies, and which are residents most likely to embrace?
03.04 Engaging Ideas - 3/4
Friday, March 4th, 2016 | Public Agenda
A collection of recent stories and reports that sparked consideration on ways to make progress on divisive issues.
The Seven Habits of Highly Depolarizing People (The American Interest)
David Blankenhorn, the founder and president of the Institute for American Values, writes: If polarization is all around us, familiar as an old coat, what about its opposite? What would depolarization look and sound like? Would we know it if we saw it, in others or in ourselves? Perhaps most importantly, what are the mental habits that encourage it?
On Super Tuesday We Polarize. On Wednesday We Need To Start Listening to WHY. (Ben Berkowitz on Medium)
The CEO at SeeClickFix writes: In trying to listen to the other side I have only come to one tactic that works: Hear what the other side is saying, but listen to why they are saying it. In the current election cycle this empathy technique leads to a conclusion that we will be fighting each other to satisfy the same need at our core: Safety. Maslow placed Personal security, Financial security, Health and well-being, and Safety net against accidents/illness and their adverse impacts all under the ‘safety’ slice of his primal pyramid. Look at the movements that have fueled Bernie Sanders’ AND Donald Trump’s campaigns and you will find politicians playing on these insecurities in an attempt to divide us.
“The insights from behavioral economics are beautiful from a research perspective,” said Eldar Shafir, a professor of psychology at Princeton who is an expert on decision-making and a leading proponent of the behavioral approach to economics. “But its popularity no doubt comes from a combination of lack of funds and political helplessness.” Given Washington’s political paralysis, it’s no surprise that “nudges” like these are all the rage in the Obama administration, which has brought in some leading behavioral experts.
Thursday, March 3rd, 2016 | David Schleifer, Ph.D. and Allison Rizzolo
A Supreme Court decision earlier this week was a setback for advocates of greater price transparency in health care. In a 6-2 decision in the case Gobeille v. Liberty Mutual, the Court ruled that state officials cannot require certain insurers to submit information showing how much they pay for health care services to a database.
This move greatly complicates efforts to understand health care price variation and trends in how much doctors and hospitals get paid. It also affects public access to robust information about health care prices and value.
Some advocates of price transparency argue that the public, if armed with information about health care price and quality, will shop for better quality care, driving down the cost of health care generally. While we are cautious about overstating the potential scale and impact of consumer shopping, the court’s decision leaves us disappointed.
Last year, we dug deep into public behaviors and attitudes related to health care prices with funding from the Robert Wood Johnson Foundation. Our findings suggest that the Supreme Court’s decision runs counter to the beliefs of the majority of Americans, 69 percent of whom say insurers should be required to make public how much they pay doctors.
Tuesday, March 1st, 2016 | Carolin Hagelskamp, Ph.D.
Back in 2009, one solitary community in Chicago was the first in the U.S. to pilot participatory budgeting, a process for engaging residents in local budget decisions. A large public housing authority in Toronto had been engaging its residents through participatory budgeting since 2001, but with few American or even Canadian cities noticing.
Over the past seven years, participatory budgeting (or PB) has expanded exponentially in the United States and Canada. Last year alone, 46 communities in 13 cities across the two countries used participatory budgeting to decide how to use nearly $50 million (US).
Participatory budgeting has even been endorsed by the White House, whose Open Government Plan highlights PB as a best practice for American democracy.
PB holds great promise for American democracy. It transforms local governance by getting residents directly involved in budgeting and giving them real decision-making power. PB thus has the potential to empower individuals, build stronger civic infrastructure, raise public concerns and needs that officials alone could not see, lead to more equitable distribution of resources, build trust in government and make government more efficient.
But how and when will we know whether PB indeed fulfills its potential in American and Canadian communities? How long are we willing to wait to see these results? And what resources are we willing to expend to see them?