This week, we discuss how Medicare for All might affect national health care spending; what “principal pipelines” are and how they can improve student achievement; whether graphic warning labels can stop smokers from buying cigarettes; the latest challenges facing Syria; preventing suicides after a mass shooting; and lessons about the opioid crisis from Grey's Anatomy.

Supporters of a “Medicare for All” plan gather on Capitol Hill in Washington, D.C., September 13, 2017
Photo by Yuri Gripas/Reuters
How Might Medicare for All Affect Spending?
The New York Times recently asked RAND researchers and other experts to estimate how a national single-payer health care plan could affect spending. We estimate that total health expenditures would be 1.8 percent higher in 2019, relative to the status quo. This is a relatively small change. But federal health care spending would spike, rising by an estimated 221 percent.
Principal Pipelines Benefit Students, Reduce Turnover
From 2011 to 2016, six large urban school districts implemented “principal pipelines” to hire, evaluate, and support school leaders. According to a new RAND report, building these pipelines is an affordable and effective way to improve schools. Specifically, the strategy boosted student achievement in both reading and math. It also helped improve principal retention.
Can Graphic Warning Labels Stop Smokers from Buying Cigarettes?
A new RAND study finds that graphic warning labels can deter some smokers from buying cigarettes. Notably, how effective these warnings are may depend on how addicted a smoker is. Smokers with lower nicotine dependence were less likely to purchase cigarettes with graphic labels. On the other hand, those with a heavy nicotine dependence were not deterred by the labels.

Men work on a damaged building in the northwestern province of Idlib, Syria, December 27, 2014
Photo by Mahmoud Hebbo/Reuters
What Syria Faces After ISIS
ISIS has been driven from its final patch of territory in Syria. But there's an even bigger challenge ahead, says RAND's Howard Shatz: ending the civil war and rebuilding the country. This will require creating a state that can provide safety, security, and opportunity for millions of displaced people. A reconstructed Syria must also be able to prevent further rebellion and devastation. Unfortunately, as long as Bashar al-Assad is in control, this seems unlikely.

Suzanne Devine Clark at a memorial one year after the shooting at Marjory Stoneman Douglas High School in Parkland, Florida, February 14, 2019
Photo by Joe Skipper/Reuters
Preventing Suicide After a Mass Shooting
The trauma of gun violence can be far-reaching. Last month, two survivors of the massacre at Marjory Stoneman Douglas High died by suicide. Shortly thereafter, the father of a victim of the 2012 Sandy Hook Elementary shooting also took his own life. RAND experts say there's a great need for mental health support and suicide-prevention programs focused on survivors of mass shootings. These efforts could help people heal—and prevent future tragedy.

Used Narcan containers and syringes, after paramedics revived a man who overdosed on opioids in Salem, Massachusetts, August 9, 2017
Photo by Brian Snyder/Reuters
What 'Grey's Anatomy' Gets Right About the Opioid Crisis
More than 130 Americans die every day after overdosing on opioids. This has led to questions about whether opioids should be prescribed—and if so, how? The popular ABC medical drama Grey's Anatomy has been exploring this real-life issue. RAND experts say the show delivers a powerful message. It highlights both the pain-killing power of opioids and the importance of putting clear prescribing guidelines into practice.
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