Harold Pollack

Harold Pollack is the Helen Ross Professor of Social Service Administration and Public Health Sciences at the University of Chicago and a nonresident Fellow of the Century Foundation.

Recent Articles

Put to the Test

Genetic screening is more accessible than ever, and health-care providers are scrambling to catch up.

Scientist John Sulston announcing the completion of the mapping of the human genome in 2001. (AP Photo/Adam Butler)
When my children were born in the mid-1990s, new parents could already see that prenatal genetic testing was altering the terrain of pregnancy and childbirth. Growing numbers of educated women were having children at older ages, with resulting difficulties and risks. More and more parents faced challenging, deeply personal decisions about whether to engage in genetic testing and what to do if they received unfavorable results. I remember my own anxieties when my wife, Veronica, took a blood test that searched for elevated alpha-fetoproteins, which are associated with diverse ailments ranging from spina bifida to anencephaly. The mere prospect of these rare conditions -- and even the choice to undergo the tests -- was surprisingly painful. At least genetic counselors and other professionals were available to help guide us. By that point, amniocentesis had been in wide use for more than two decades. As researchers identified the genetic markers associated with a growing list of...

The Cost of Delayed Reform

The temporary federal high-risk pools won't reach most of the medically uninsured.

(iStock)
Several million Americans without insurance face the challenges of cancer, heart failure, or other serious illnesses. As of 2014, they'll receive coverage through a new and inclusive system of health-insurance exchanges, affordability credits, and other measures, but what happens to them in the interim? The Affordable Care Act includes a number of measures that go into effect in the short term -- some of them this year, such as a regulation prohibiting insurers from denying coverage of children's pre-existing conditions. That provision, along with the expansion of the Children's Health Insurance Program, should help many families with sick or disabled children who would otherwise be uninsured. The picture continues to be grim, though, for uninsured adults with serious medical problems. The legislation does provide funds for temporary high-risk pools, but this program, the Pre-Existing Condition Insurance Plan, suffers from major drawbacks. The most serious of those drawbacks is that...

Neglecting the Swine Flu Frontlines

Stimulus spending couldn't have hit the ground fast enough to avert the current swine flu crisis. But moderate senators -- including new Democrat Arlen Specter -- still have a lot to answer for in terms of their lack of support for local public-health funding.

Tuesday morning, I walked into our university hospital for a meeting. I was stopped at the door by a police officer. He didn't check my ID, he pointed to a bottle of hand sanitizer. As I scrubbed, he gave me a card telling me what to do if I had a fever or other symptoms. That's good. Chicago has had some likely cases of H1N1 flu. We aren't panicking, but we are paying attention. Such experiences remind us that local institutions are at the real front lines in addressing public-health emergencies. The capacity of state and local governments to coordinate and mobilize these efforts is a crucial, and readily overlooked, variable in the current flu challenge. Unfortunately, these components of our nation's public-health infrastructure are less prepared and less capable than they would otherwise be, thanks to that small but critical group of Senate moderates who controlled Senate votes on this year's stimulus bill. Perhaps these votes would have gone differently had H1N1 arrived three...

BYE-BYE ADVICE: HOLDING EVERYONE ACCOUNTABLE TO THE SCIENCE, ESPECIALLY OURSELVES

By Harold Pollack Thanks for the hospitality, Ezra. Thanks, especially, to the commenters for great observations and corrections. The combination of anonymity, spontaneity, and immaturity render many comment threads a depressing and toxic brew. Not here. I’m grateful that readers here care about public health, not merely healthcare delivery. One final Polonius-like note: For the past eight years, our presidential administration ignored or rejected scientific consensus in critical matters: climate change, syringe exchange, condoms, abstinence-only education, the health impact of environmental pollutants, and much more. Many people in the reality-based scientific, medical, environmental, and public health communities are breathing a sigh of relief that the Obama administration appears committed to evidence-informed policy. By all means, let’s collectively exhale. Then let's be sure to hold progressives to the same high scientific standards many of us wanted to apply to...

THE NEW GUY AT CDC

Richard Besser has the conventional good looks of a TV anchorman. That’s a useful qualification for public office. Fortunately, that is not what got him appointed Acting Director of the Centers for Disease Control and Prevention. I’m pretty happy about this pick, which hasn’t gotten the attention or visibility it deserves. As I have written before , our nation’s flagship public health agency is troubled. Besser takes the reins of an agency that has endured severe administrative and morale difficulties. CDC was traumatized by the ideological battles of the Bush years, by management reorganizations and budget difficulties, and by new challenges posed by 9/11, anthrax, and (later) Katrina…...

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