Ask the Expert: Health Policy Wonk Harold Pollack

Chair of the Center for Health Administration Studies, among other things, Harold Pollack

Health care has a really high barrier to entry. Far too many people feel intimidated at the thought of having an opinion about complicated policy debates over a public option, health care exchanges, comparative effectiveness research, and any number of other sub-topics of health care. Campus Progress sat down with Harold Pollack, a professor at the University of Chicago’s School of Social Service Administration and chair of the Center for Health Administration Studies, to sort out the state of the health care reform movement. Pollack blogs for the New Republic’s health care blog, The Treatment. Pollack got Campus Progress up to speed with some of the basics of what’s going on and what’s ahead.

Is the type of health care reform that’s being discussed these days good health care policy?

I think we’ll get something good. I think it’s very likely that there will be a health care reform that will be a significant achievement, hopefully this year. Whether it has everything in it that activists like me want to have in it, that remains to be seen. It’s a difficult process that we’re talking about. [Health care costs are] one-sixth of the U.S. economy and probably more than one-sixth of the interest groups in the American political economy, so it’s a heavy lift. But I’m feeling pretty optimistic. I think there’ll be some real disappointments too, but that kind of comes with the territory.

What disappointments are you expecting?

Well, I won’t telegraph my disappointment too explicitly because that wouldn’t be polite, but I just think that the realities of moving bills through the United States Senate constrain what you can do. We have a system where you need to effectively get 60 senators [to vote in favor of something], and we dramatically [over represent] the population of some states over others. The senator from Wyoming gets the same vote as the senator from California even though there’s a difference in population size that’s almost a factor of a hundred.

One question I’ve always had about major health care reform is that will it make you healthier?

There are some areas where it will make you healthier. There are many areas where the health care delivery system is not the critical issue for a population’s health. I think one of the areas where this will be very helpful is in race and ethnic disparities in some important cardiovascular areas. We have very large black and white disparities in hyper tension which lead to a whole series of health conditions. One reasons for those disparities is that low-income people who are often minorities go to the doctor less often. It turns out that a lot of what the doctor does for you is not of any value but one thing that the doctor does do for you is take your blood pressure. Getting people into primary care where their hypertension can be detected and can be addressed can be a huge help.

There’s very interesting work that looks at some of the disparities before and after age 65 and we see some real narrowing of some of the disparities once we get almost 100 percent of the population into Medicare at age sixty five. So there will be some health benefits. Health reform won’t change people’s vulnerability to lots of social and environmental threats to health and it will certainly not move us in the world infant mortality rankings from the near the bottom of the wealthy countries to near the top, but it will be helpful.

Daniel Strauss is a staff writer for Campus Progress, an editorial intern for Democracy: A Journal of Ideas, and senior at the University of Michigan.

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