Harold Pollack

It has been a rough two months for the Affordable Care Act and its defenders. Having spent years fighting ridiculous allegations about socialized medicine and "death panels," supporters of near-universal coverage now face something different. The performance failures in the rollout of healthcare.gov have triggered cries of "I told you so!" from some liberals. This wouldn’t have happened, they say, if only Obama had supported some form of single-payer plan, such as Medicare for all.

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What a relief—but much damage was still done. Maybe it’s inevitable and right that the fate of such a large social reform was ultimately ratified or undone at the Supreme Court. I tend to think the opposite: It’s pretty disgraceful that the case got this far. We have a national, $2.8 trillion healthcare system that includes huge and obvious inefficiencies. That same system includes huge and obvious cruelties towards the sick or injured.

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[Guest post by Harold Pollack and Vivek Murthy] Forbes has published another slam against health reform. This one is written by Sally Pipes, president, CEO, and Taube Fellow in Health Care Studies at the Pacific Research Institute. She is the author of a forthcoming book, The Pipes Plan: The Top Ten Ways to Dismantle and Replace Obamacare, put out by the conservative publishing juggernaut, Regnery. This follows Pipes’ previous volume, The Truth About Obamacare.

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Not So Super

[Guest post by Harold Pollack. Cross-posted from The Incidental Economist] It’s disappointing but unsurprising to read that Super-committee Democrats may cut the Affordable Care Act’s ten-year $15 billion Prevention and Public Health Fund. The Obama administration had already signaled a willingness to scale back the initiative, having previously proposed of a 25 percent cut as part of one of its deficit reduction deals. Super-committee Democrats have now called for cuts roughly twice as big, or $8 billion. The Fund is less than two percent of new spending initiated under health reform.

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Gretchen Morgenson and Joshua Rosner just published a major book, Reckless Endangerment: How Outsized Ambition, Greed, and Corruption Led to Economic Armageddon. The book is excellent in explaining the misconduct of executives who ran Fannie Mae and Freddie Mack. Yet it goes off the rails by overstating the role of these firms (and understating the role of others) in creating the housing meltdown and the closely-linked foreclosure crisis.

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“There are so many ways a brain can let you down. Like an expensive car, it’s intricate, but mass-produced.” So wrote Ian McEwan in his short work, Saturday. The British novelist wasn’t pondering autism’s heartbreaking and mysterious symptoms when he wrote those words. But he might have been. Autism’s social, communication, and behavioral challenges reflect some biological package of human brain disorders.

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It’s never a happy thing to see someone convicted of serious crimes. With rare exceptions, I don’t believe people should serve really long prison sentences. So I don’t want Rod Blagojevich to serve decades in prison. Still, these were just and necessary verdicts. The Chicago Tribune’s Annie Sweeney reports that our corrupt former governor is expected to serve ten years. This seems about right. It’s hard for outsiders to understand just how toxic Blagojevich’s presence was. He took office on the heels of a disgraced, scandal-plagued Republican administration.

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President Obama faces a knife fight for reelection next year. Of course, the catastrophic economy poses his greatest political challenge. He also faces implacable Republican opposition, two difficult wars, and a host of other toxic foreign and domestic legacies of the Bush administration. Have I mentioned that he is still African-American and has a funny name? The president has created some problems for himself, too. He has struggled to combine the inside and the outside political game.

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My kids and I just read Jose Antonio Vargas’s brave and gripping account, “My life as an undocumented immigrant.” His essay underscores what many people across the political spectrum already know: “Unauthorized residents” are here. They do more than pick our fruit and mind our kids. Their kids go to school with our kids. They sometimes work down the hall or in the next cubicle. Vargas describes his ambivalent encounters with many people, from whom he needed to keep secret his undocumented status. He notes many people along the way whom he told or who figured things out.

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Pardon my excursion into graphs and scatterplots today. There is a broader purpose. Last Tuesday I hit the “send” button on a big grant concerned with intellectual and developmental disability (I/DD) policy issues. Last Wednesday, the bible of the field, State of the States in Developmental Disabilities, appeared in my mailbox. Such is life. State of the States is a periodic compendium of state policies, service patterns, and spending across the country.

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