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March 2011

March 31, 2011

Afghanistan War, Forgotten Again?

Jeffrey Laurenti

While your local newspaper or radio station filled its international news hole the past few days with breathless reporting on Libya’s roller-coaster rebellion and Godzilla reactors run amok in Japan, you may not have heard much about Afghanistan. 

It had been the “forgotten war” for most of the Bush administration, and although over 130,000 American and allied troops are now battling there daily to secure the country against the tenacious Taliban, the tsunami of dramatic news from Libya and Japan has again washed it out of public consciousness.

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March 29, 2011

Obama's Tale of Two Cities

Jeffrey Laurenti

Once there was Baghdad.  Now there is Tripoli.

In the shadows behind President Obama last night as he defended his air war over Libya--and the strict limits he has put on it--was George W. Bush's disastrous invasion and occupation of Iraq.  Obama defines the latest military operation in the Muslim world by how it differs from his predecessor's. 

Indeed, in explaining why he rebuffs the counsels of advocates for simply lancing the boil of Moammar Qaddafi, he sounds very much like his predecessor's father explaining, in his memoirs with Brent Scowcroft, why he did not order American forces to sweep to Baghdad in 1991.  "If we tried to overthrow Qaddafi by force, our coalition would splinter," Obama said Monday night.  "The dangers faced by our men and women in uniform would be far greater.  So would the costs and our share of responsibility for what comes next."

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Cutting Tax Breaks for Wealthy Seniors is Entitlement Reform, Too

Harold Pollack

Austin Frakt, Don Taylor, and Ezra Klein have good pieces today on Social Security and Medicare reform. All three make the point that whatever changes should be made in these programs should be made soon. From both the perspective of the federal budget and the perspective of individual retirees, pushing this off is unwise. (One caveat: given the current extreme nature of the Republican House majority and this majority's allergy to sensible tax increases, the prospect for a truly bipartisan agreement to improve these programs seems dim right now.)

Another piece of the puzzle bears mention. Any reasonable solution should include a closer look at the tax breaks we give to affluent seniors.

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March 27, 2011

We Asked for Workers, but They Sent Us Men (and Women, Too)

Harold Pollack

Denying Medicaid-funded prenatal care to undocumented immigrants. Cross-posted at the Reality Based Community.

I happen to be an immigration moderate. It seems a bit crazy to me that we handle birthright citizenship the way that we do, and that we don’t have a credible national ID card system to enforce immigration law. If there is a humane,  intellectually coherent, administratively  effective, politically feasible pathway to decent immigration policies, I haven’t seen it. One tragedy of the last decade has been the failure of such disparate figures as George W Bush, John McCain, Ted Kennedy, and Barack Obama to forge a sensible compromise.  

The enemies of such a sensible policy continue to be an odd combination of hypocrisy across the political spectrum, xenophobia within the Republican base, and employers’ powerful desire to legally or illegally employ compliant and productive low-wage workers. There is also the unstated--but possibly correct--belief held by many people that the human and economic costs of our current muddle would be worsened if our dysfunctional political system now attempted to meet the challenge of comprehensive immigration reform.  

Maybe we’re better off tackling this issue a decade from now, when the Latino vote is more powerful than it is today, and (if we are lucky) the American body politic is less polarized and more accepting of race/ethnic diversity than it is right now. There’s only one problem with this suggestion.

Postscript: For further administrative details (including the program's impact on low-income women legally authorized to be in the country), see Table 7 of this Voices for Children issue brief.

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March 24, 2011

Elizabeth Taylor, HIV/AIDS activist, 1932-2011

Harold Pollack

(This piece is cross-posted at the Reality Based Community)

I’ve only seen one or two Elizabeth Taylor movies. I can only identify a few of her eight husbands, and that’s double-counting Richard Burton. I do know that Elizabeth Taylor did a lot for gay rights and for honoring the humanity of people living with HIV and AIDS. She is missed.

Taylor caught some criticism and resentment from segments of the gay and HIV/AIDS activist communities who deserved more of the limelight that she immediately received because of who she was. There was no way she was going to match the intensity or the boldness of (say) many ACT-UP participants and supporters. Desperate, abandoned, often fatally ill, these men (and some women, too) lacked the time for some usual niceties of coalition politics. I can’t blame them for that. They also lacked the recognition and the social acceptance they deserved. In different ways, both ACT-UP and people like Liz Taylor did much good.

Taylor also provides a chastening reminder of something else. She could have followed the path of most other self-indulgent celebrities: being quietly decent to affected friends, otherwise keeping her head down about the epidemic. She did a lot more than that.

I myself was in my early 20s when Elizabeth Taylor really stepped forward on this issue to lead amfAR. Like most people at some remove from this epidemic, I watched passively, saddened by the scale of the catastrophe, but having a million reasons for doing…not much to help out. Elizabeth Taylor’s contributions stand as a rebuke to those of us who could have done more when it most mattered, especially in those early days when HIV advocacy was a politically marginal cause.

Phoebe Connelly has a nice piece in the Awl with more. This Frontline piece is pretty great, too (h/t Andrew Golis).

March 22, 2011

“Getting To Chicago’s Boys Before Gangs Do…”

Harold Pollack

This column is cross-posted on the Reality-Based Community)

My kids may wonder what I do at work in the morning. Seeing the forbidding tattoos and facial hair configuration of my colleague Tony DiVittorio, they might be a bit scared to find out.

Today’s Morning Edition had a nice story by Cheryl Corley about BAM Sports Edition, a school-based prevention intervention fielded by two local nonprofit organizations, Youth Guidance and World Sport Chicago. Tony originated the intervention. I and my colleagues at the University of Chicago Crime Lab spent much of the past two years helping to field and evaluate this intervention. My craggy voice can be heard for a few seconds, too. NPR did a nice job explaining what BAM is trying to do. Unfortunately, NPR didn’t give World Sport’s component the same attention. I hope Ms. Corley comes back for more.

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March 17, 2011

The 1970s were bad. So said James Tobin, anyway

Harold Pollack

Ezra Klein recently reviewed Jacob Hacker and Pail Pierson’s new book, Winner-Take-All Politics.  James Suriowecki chimed in to remind Klein of how much trauma the U.S. economy endured in the 1970s. This little exchange reminds me of one of the last conversations I had with James Tobin, the great economist.

Tobin was part of that generation of Keynesian economists who witnessed the human tragedy of the great depression. Some among this number, such as Paul Samuelson, have passed on. Others, such as Robert Solow and Kenneth Arrow, are still with us, contributing.

This group believed that policymakers could, by effectively intervening in the economy, prevent such a catastrophe from happening again. They didn’t get everything right, but they got a lot right. They had a hugely beneficial impact on the world and on their profession. Their successors leading the profession built on their work, but rarely retained the largeness of spirit of that pioneering group.

Fifteen years ago, I lived in New Haven. Tobin lived around the corner, and we became friendly. I was star-struck by his intellectual accomplishments and his deep commitment to liberal principles. I still am. He did so many things. I’d hardly be the one to summarize his massive accomplishments. Economists would note Tobin’s q, the Tobin tax, portfolio choice and asset pricing. You might think that William Julius Wilson or maybe Bayard Rustin were first to discuss African-Americans’ incredible stake in maintaining a tight labor market. They learned much from Tobin, whose long-ago observations on this topic provide chilling reading during our current economic crisis. He was even the model for a character in the Caine Mutiny.

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A case of quiet rationing in Medicaid

Harold Pollack

(This is cross-posted at the Reality Based Community)

Mona Mangat has a nice post over at Doctors for America (a group I advise). Her column conveys some of the street realities of providing safety-net care and the value-subtraction entailed by our fragmented health insurance system:

I currently participate in 5 private Medicaid plans. Four of them require paper claims for reimbursement as well as onerous authorization procedures. I currently care for a 4 year old child with recurrent seasonal wheezing that has concomitant growth delays. I have attempted to treat her with a leukotriene modifier drug. Her private Medicaid provider denied my request, insisting that I use a generic nebulized steroid preparation. I engaged in a peer-to-peer review to try and get approval (that lasted 15 minutes over the phone), after exhausting 3 levels of paper prior authorizations. The friendly doctor I spoke with apologized that the drug could not be approved and when pressed for a reason, his answer was clear- COST. My patient will have to be placed on a medication that could further stunt her growth when a safer option is available, because her privately administered Medicaid insurance plan needs to make more profit.

Such stories indicate why everyone involved–insurers, patients, policymakers–desperately needs a transparent evidence-informed process based on clinical judgment and comparative effectiveness research.

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March 14, 2011

Why Not Put Some Thought into the Potential Root Causes of Extremism?

Patrick MacLeod

Peter King’s Muslim extremism hearings were just another example of how certain members of the GOP are disconnected from the realities on the ground in this country and abroad. There is really no evidence to suggest – and so far King himself has not offered any – that a Muslim brand of extremism, i.e. violence in the name of Islam, is any more dangerous than any other type of radical ideology, or that it constitutes a type of crime with root causes inherently different from any other. While the United States does indeed suffer from the risk of increasing attacks, whether individual or group, organized or disorganized, people like King may be loathe to admit that much of it has little to do with the religion of Islam in general, and more to do with the underlying issues associated with declining quality of life, poor job prospects, high levels of inequality, and a general worsening of economic conditions throughout increasingly disaffected youth populations both here and abroad. 

This is not to say that Muslim extremism in particular is not a threat to Western countries, but the threat is much more nuanced than someone like King would have us believe. Take for example the recent shooting of four American airmen at the Frankfurt Airport in Germany by Arid Uka, who has since been labeled a Muslim extremist from Kosovo – a notion which has stoked the incendiary debate about the nature of radical Islam coming out of Southeastern Europe.

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March 11, 2011

Donald Berwick's Predicament: Do We Want Excellence in American Government?

Harold Pollack

Maggie Mahar has a terrific piece on Donald Berwick.

My Kaiser Health News piece with Chris Lillis provides a useful complement. Aside from the partisan implications, the spectacle of excellent people being treated like this is going to chase many excellent people from government. Both Democrats and Republicans have good reason to worry about this.