Sad that this needs to be said. Even sadder that so few Republicans are saying it.

President George W. Bush is rightly remembered as a failed president because of Iraq, Katrina, and more.

I’ve always thought he was a pretty decent man who deserved credit for several things. Foremost was his personal triumph of PEPFAR, which saved millions of lives around the world. There was also his support for mental health parity and his support for religious tolerance after 9/11.

We’ll never know what would have happened had 9/11 not erupted on his watch. I suspect that he would have had a different, more worthy presidency. (h/t Fusion–more here.)

What’s the matter with Kentucky?

My liberal friends are anxiously reading Alec MacGillis’s, “Who Turned My Blue State Red,” in the Sunday New York Times about growing Republican strength in poor communities. Alec brilliantly explores why eastern Kentucky and similar locales support Republican politicians pledged to cut Medicaid, Food Stamps, and disability programs that specifically benefit these very communities.

MacGillis notes two key points. The first is depressingly familiar: low voter turnout among the specific people most harmed by Republican policies.

The people who most rely on the safety-net programs secured by Democrats are, by and large, not voting against their own interests by electing Republicans. Rather, they are not voting, period.

MacGillis presents reams of figures that document the simple fact that nonvoters are much more likely than voters to be uninsured, to be unbanked, to have serious unmet economic needs.

The second point is more interesting and more comprehensible at a human level:

The people in these communities who are voting Republican in larger proportions are those who are a notch or two up the economic ladder… And their growing allegiance to the Republicans is, in part, a reaction against what they perceive, among those below them on the economic ladder.

These Republican voters are not particularly lashing out at supposed others, be they immigrants or black residents of the inner city. Rather, these voters are reacting to their own neighbors and perhaps friends and relatives, who rely on food stamps, Medicaid, or disability payments and who don’t seem fully deserving.

I’m not sure what lesson this provides, from the standpoint of either politics or policy. Supporters of expanded social provision must find better ways to engage poor people, to get out their votes. We can also find more opportunities for fruitful alliances across economic and ideological lines. Over the next several years, I am confident that Medicaid will be expanded across the South, despite widespread opposition. There’s too much money at stake for too many people for the battle to continue much longer after President Obama leaves office. Some tightening of particular programs may help, too. On balance, it’s probably a good thing that federal disability programs have tightened some of their procedures in evaluating mental health and musculoskeletal conditions that have shown the greatest increase in recent years.

Whatever the political or policy lessons, Alec’s essay captures a basic human reality, aptly summarized in the title of Paul Thorn’s great country song: “I don’t like half the folks I love.” 


Viewed from afar, one might think that categories such as “deserving poor” or “disabled” are reasonably clear-cut. Viewed up-close, things seem much more fuzzy. Many people who rely on public aid straddle the boundaries between deserving and undeserving, disabled and able-bodied. Many of us know people who receive various public benefits, and who might not need to rely on these programs if they made better choices, if they learned how to not talk back at work, if they had a better handle on various self-destructive behaviors, if they were more willing to take that crappy job and forego disability benefits, etc.

It’s easy, even viewing our own friends and relatives, to confuse cause and effect regarding more intimate barriers. A sad reality of psychiatric disorders is that the very symptoms which inflict mental pain on the sufferer can make themselves felt to others in ways that undermine empathy and personal relationships.

Across the Thanksgiving dinner table, you see these human frailties and failures more intensely and with greater granularity than the labor economist could possibly see running cold data at the Census Bureau. But operating at high altitude, the labor economist sees structural issues you can’t see from eye level.

There have always been vulnerable people, whose troubles arise from an impossible-to-untangle mixture of bad luck, destructive behaviors, and difficult personal circumstance. That economist can’t see why your imperfect cousin can’t seem to get it together to hold a basic job. She can see that your cousin is being squeezed out by an unforgiving musical-chairs economy. Every year, in the backwaters of America, that economy seems to put out fewer and fewer chairs.

Medicaid beats other insurance for children with special health care needs

A new study by Kreider and colleagues is out in JAMA Pediatrics which compares parents’ experiences with various forms of insurance coverage. On ten of fourteen measures, Medicaid looks better than private insurance coverage and compares favorably with CHIP coverage, too.

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The findings provide valuable corrective to people who unfairly criticize and overlook its many strengths for low-income people and the disabled. Yet it’s more concerning when we think about qualified health plans on the new state marketplaces. I worry that these will fall far short of what Medicaid offers to low-income people and those with special needs. With so many knife fights over ACA, the public conversation hasn’t intensively focused on children with special health care needs. It’s time to pay more attention.

More from me here, at

“As we have no real racial problem, we are not desirous of importing one”

I don’t know whether President Obama is doing everything right in addressing the ISIS/Daesh threat. I depart from some liberal friends on police use of metadata and other security matters. I am, however, reassured by the President’s calm solidity, which presents such a contrast with pandering and posturing politicians looking to score political points in the aftermath of an atrocity.

I don’t know what to say about presidential candidates and governors who would take in only Christian refugees in the wake of the agony in Syria and the Paris attacks. The United States faces a quite-manageable security threat from the refugees we have agreed to admit. Hiding in plain sight, our simplest anti-terrorism policy is our most effective: Embrace people from every religion and community, and ensure their equality and success in American life. It would be a huge mistake, not to mention an equally huge betrayal of our national ideals, to back away from that.

In any event, the openly-expressed anti-Muslim sentiments directed against refugees in recent days bring back memories, and not good ones.

No room at the Inn

No room at the Inn

Rob Wildeboer and I talk Chicago crime on public radio

My friend Rob Wildeboer and I discussed Chicago’s underground gun market and crime challenges on WBUR with Here & Now’s Robin Young. We had a useful conversation and a good experience. I appreciate WBUR’s willingness to speak with us, and the professionalism of the producers and staff.

I am truly baffled by this video.

Here’s a pro-tip. If you are fighting for social justice by interfering with others’ First Amendment rights, you’re doing it wrong. You are violating core principles of American democracy. And the rest of America will encode you as extremists and will simply stop listening to what you have to say.

The individuals in this video associated with #ConcernedStudents1950 owe photographer Tim Tai an unequivocal apology. It isn’t complicated. They were entirely in the wrong.

With the exception of Mr. Tai, the people in this video disgraced themselves in what should have been a moment of triumph. I am just baffled by the whole thing.

Ever wonder whether Medicaid expansion makes a difference?

The New York Times does an amazing job at data journalism within its Upshot section. This interactive map of the uninsured, by Quotrung Bui and Margo Sanger-Katz, is pretty amazing, especially when one considers that Wisconsin, nominally a non-expansion state, already provided significant coverage overlapping with ACA. Why is Medicaid expansion important? Go to the New York Times link and see for yourself. Cross the Kentucky border into any non-expansion state. If anything, this non-population-weighted-map understates the importance of Medicaid expansion, since many of those huge purple counties out west have very few people living in them. Ninety percent of the adults who fall in the Medicaid gap live in formerly-segregated states.

Amazing New York Times infographic.

Amazing New York Times infographic.

PS this amazing GIF showing how patterns have changed since 2013 makes me both proud and sad regarding our country.

The heroism of a school worker, at once unfathomable and the most logical thing in the world

Yesterday in Sweden, a 20-year-old teaching assistant named Lavin Eskandar was stabbed to death while he was protecting children from a deranged sword-wielding assailant who was attacking the school where Eskandar worked. One other person was killed before police intervened.

A conspicuous number of teachers, professors, and school workers have put their lives on the line to protect students when such horrors have occurred. At one level, I am left speechless by such courage and sacrifice. Yet after all these years in the classroom, I kindof get it, too. We pour so much of our lives into our students. I find it quite sane and comprehensible that someone would make that split-second decision: If you’re coming for my students, you have to go through me first.

Lavin Eskandar, RIP

Lavin Eskandar, RIP

Below the fold is a piece I posted in 2012, remembering two other people who made similar sacrifices: Liviu Librescu and Victoria Soto. I wouldn’t change much in that piece. There is no greater love.

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