Seven questions on health reform (with bonus Capitol sunrise pics)

Tim Jost and I wrote an op-ed for the New York Times today: “Seven questions about health reform.”

Capitol Hill Sunrise, January 9, 2017

We offer many questions about what Republicans plan to do in their “repeal and replace” or “repeal and delay” approach to the ACA. The single most important point in our essay is simple: Congress should not repeal ACA until they have submitted their specific replacement proposal for analysis by nonpartisan authorities such as the Congressional Budget Office and the Tax Policy Center to determine how the repeal will affect health insurance coverage, state and federal finances, and individual tax burdens. That practice was followed in the long debate leading to the ACA. It should be followed now.

Bonus Washington sunrise pictures below

Author: Harold Pollack

Harold Pollack is Helen Ross Professor of Social Service Administration at the University of Chicago. He has served on three expert committees of the National Academies of Science. His recent research appears in such journals as Addiction, Journal of the American Medical Association, and American Journal of Public Health. He writes regularly on HIV prevention, crime and drug policy, health reform, and disability policy for American Prospect,, and other news outlets. His essay, "Lessons from an Emergency Room Nightmare" was selected for the collection The Best American Medical Writing, 2009. He recently participated, with zero critical acclaim, in the University of Chicago's annual Latke-Hamentaschen debate.

8 thoughts on “Seven questions on health reform (with bonus Capitol sunrise pics)”

  1. How on earth, in the current political environment, did Harold manage to get the bipartisan moment with the flags, waving harmoniously both left and right?

    Am I alone in disliking the Washington Monument? A big blank phallic object that just advertises Greatness without content or values.

    1. They were going for an Egyptian look to the thing, representing, according to the National Park Service, timelessness. Or something along those lines. It's not entirely blank, at least not on the inside. Back when it was possible to walk up it you could see and read the commemorative stones, representing various organizations and states, set into the walls. Which was useful in giving you places to pause, because it is a long climb.

      For a while there it really was visible from a great deal of the city, so it was effective in helping you figure out where you were in case you got lost. And it looks nice as a visual anchor for a fireworks display.

      You're very far from alone in disliking it, but I believe it was once the case–and may still be–that schoolchildren in the D. C. area tended to learn the word "phallic" rather earlier than their peers in most other American cities. (Not joking.)

      1. The original obelisks put up by pharaohs, of which two were looted and stand today in Paris and London, are covered by inscriptions. They tell us who put them up and why.

  2. "That sounds like a lot — unless you are a 42-year-old man with leukemia." Even worse, as in the case of our son, an 18-year-old (who is now 35) with leukemia.

    1. Yes. But that's one of many ways health insurance is different than other kinds. With property insurance there is a natural limit on how much coverage you need, and with life insurance you can make a sensible decision based on family considerations.

      Even with liability insurance, where there is no theoretical limit to how much you could be on the hook for, you can determine an amount and, if total catastrophe strikes you may be bankrupted, but you won't die. And the payments don't go on for years and years.

  3. "..analysis by nonpartisan authorities such as the Congressional Budget Office and the Tax Policy Center to determine how the repeal will affect health insurance coverage, state and federal finances, and individual tax burdens.." I remember utterly duplicitous manipulation of the ACA proposal by its backers to minimize the predicted costs by gaming the ten-year time frame of CBO predictions. Sort of analogous to the way VW set up its engines to burn in the least polluting (but not as fun-to-drive) manner when being tested by the EPA. So I'm not convinced that's the right model for looking at repeal proposals.

    1. Systematic lying to customers and regulators through deeply concealed algorithms embedded in proprietary engine control software and causing thousands of deaths worldwide = designing a lifesaving law so as to come under a self-imposed and arbitrary financial limit, in ways informed observers could and did easily discover and report on.

Comments are closed.