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	<title type="text">Harold Pollack | Vox</title>
	<subtitle type="text">Our world has too much noise and too little context. Vox helps you understand what matters.</subtitle>

	<updated>2019-03-06T04:10:04+00:00</updated>

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		<entry>
			
			<author>
				<name>Harold Pollack</name>
			</author>
			
			<title type="html"><![CDATA[We have a political problem no one wants to talk about: very old politicians]]></title>
			<link rel="alternate" type="text/html" href="https://www.vox.com/the-big-idea/2017/8/7/16105120/politicians-elderly-death-disability-mccain-supreme-court" />
			<id>https://www.vox.com/the-big-idea/2017/8/7/16105120/politicians-elderly-death-disability-mccain-supreme-court</id>
			<updated>2017-08-07T08:40:05-04:00</updated>
			<published>2017-08-07T08:40:02-04:00</published>
			<category scheme="https://www.vox.com" term="Politics" /><category scheme="https://www.vox.com" term="The Big Idea" />
							<summary type="html"><![CDATA[In one of the most dramatic moments in the Senate in years, 80-year-old John McCain rallied from surgery and a diagnosis of brain cancer to cast a 1 am vote that torpedoed Republican efforts to repeal Obamacare &#8212; for now. The vote had been put on hold once already, to give him time to recuperate. [&#8230;]]]></summary>
			
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<img alt="" data-caption="The Senate Judiciary Committee is among the power centers in Washington dominated by people in their 70s and 80s. | Susan Walsh/AP" data-portal-copyright="Susan Walsh/AP" data-has-syndication-rights="1" src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/9003219/AP_17080558532411.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" />
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	The Senate Judiciary Committee is among the power centers in Washington dominated by people in their 70s and 80s. | Susan Walsh/AP	</figcaption>
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<p>In one of the most dramatic moments in the Senate in years, 80-year-old John McCain rallied from surgery and a diagnosis of brain cancer to cast a 1 am vote that torpedoed Republican efforts to repeal Obamacare &mdash; for now. The vote had been put on hold once already, to give him time to recuperate.</p>

<p>For all the drama, we shouldn&rsquo;t be surprised that a medical emergency interfered with Senate business. The highest levels of American politics bear an uncomfortable resemblance to a gerontocracy.&nbsp;From the Senate to the presidency to &mdash; perhaps most strikingly &mdash; the Supreme Court, top positions are held more and more by people in their 70s or above.</p>

<p>Disruptive medical tragedies are an unavoidable statistical consequence of this trend, as is the risk that key political actors will develop cognitive impairment. There&#8217;s no easy solution to the problem, but it demands a frank conversation.</p>

<p>Reforms such as term appointments for justices could help with the problem, but it&rsquo;s just as important to try to shift societal norms to take more seriously some elemental realities of human aging.</p>

<p>Tact and, perhaps, anxiety surrounding our own mortality too often short-circuit these conversations.<strong>&nbsp; </strong></p>

<p>McCain&#8217;s diagnosis was hardly the first time senatorial health played a key role in the partisan battles over health reform. The Affordable Care Act passed in the first place because 92-year-old Sen. Robert Byrd <a href="http://www.nytimes.com/2009/12/24/us/politics/24byrd.html">was wheeled out onto the Senate floor for three vital votes</a> in 2009.<strong> </strong>And Byrd&rsquo;s votes were especially critical as a result of Sen. Edward Kennedy&rsquo;s poignant struggle with the brain cancer that killed him, at 77, in August 2009.</p>

<p>Kennedy was replaced by Republican Scott Brown, depriving Democrats of a filibuster-proof majority and therefore almost destroying the centerpiece achievement of the Obama presidency.</p>

<p>Blanket judgments about older politicians are of course indefensible. Many of our older leaders have more skill and intellectual firepower than most of us will ever have. Feel free to debate Mitch McConnell on legislative tactics or Hillary Clinton on health policy if you doubt me. Countless examples, down to <a href="https://twitter.com/JohnDingell?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor">@JohnDingell</a>&rsquo;s hilarious Twitter feed, remind us that gifted people contribute to our common life well after the conventional retirement age.</p>

<p>Still, people who do not watch Congress regularly can be taken aback by just how advanced in age &mdash; and sometimes evidently slowed &mdash; people at the pinnacle of power can be. Viewing the confirmation hearings of Christopher Wray, the new FBI director, the magazine writer Jason Fagone tweeted:</p>
<div class="twitter-embed"><a href="https://twitter.com/jfagone/status/885150170408734721" target="_blank" rel="noopener noreferrer">View Link</a></div>
<p>In the body as a whole, 23&nbsp;senators <a href="http://www.wow.com/wiki/List_of_current_United_States_senators_by_age">are at least 70</a>. Seven are 80 or older.</p>

<p>The geriatric Supreme Court has long inspired hand-wringing but no action. Rumors abound that Supreme Court Justice Anthony Kennedy, now 81, <a href="https://www.washingtonpost.com/opinions/the-terrifying-and-terrible-prospect-of-justice-kennedy-retiring/2017/06/23/bc73ff9a-5830-11e7-a204-ad706461fa4f_story.html?utm_term=.2aa5b7dce9c8">may retire</a>. Five of the nine justices are older than 67, three are 78 or older, and several have serious age-related health problems. Out of fear of letting President Trump choose their successor, Justices Stephen Breyer and Ruth Bader Ginsberg surely feel obliged to hang on until at least 2020, if they can.</p>

<p>Worries about decline on the bench aren&rsquo;t theoretical: After William O. Douglas suffered a stroke in 1974, it took 11 months for his colleagues to <a href="https://www.economist.com/blogs/democracyinamerica/2016/02/age-and-wisdom">convince him to retire</a>. Chief Justice William Rehnquist fended off suggestions that he might be too weak to work as he underwent chemotherapy and an emergency hospitalization, before his death in 2004.</p>

<p>Obviously, the more elderly our judges and politicians become, the higher the probability of illness or death within their ranks.&nbsp;By my count, 29 <a href="https://www.senate.gov/history/SenatorsDiedinOffice.htm">senators</a> and <a href="https://en.wikipedia.org/wiki/Lists_of_United_States_Congress_members_who_died_in_office">House members</a> have died in office since 1999. More than half were 72 or older when they died.&nbsp;</p>

<p>Twenty-nine deaths may seem like a lot, but it&rsquo;s actually less than what one would predict, given the statistics for the entire US population. Below, I used the most recent government age-specific mortality data to calculate the probability of dying within six years for a randomly selected American man or woman of a given age.</p>
<img src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/9003347/aging.mortality.PNG?quality=90&#038;strip=all&#038;crop=0,0,100,100" alt="" title="" data-has-syndication-rights="1" data-caption="" data-portal-copyright="" />
<p>A randomly selected 70-year-old American woman would have an 18 percent mortality risk. By age 80, this mortality risk doubles to 36 percent.&nbsp;</p>

<p>Sen. Dianne Feinstein (D-CA), who is 84, has not ruled out running for reelection. At her age, the randomly selected man or woman would have a less than 50 percent statistical chance of serving a full term.</p>

<p>Senators like Feinstein, of course, are hardly a random draw from the US population. People that successful tend to be vigorous and healthy, and to have access to excellent medical care and other supports. But the statistics remain daunting, especially when one adds rising <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3334445/pdf/nihms339730.pdf">age-related incidence of mild cognitive impairment</a> to the mix. Over age 70, almost one-fifth of American adults experience <a href="https://www.ncbi.nlm.nih.gov/pubmed/20820000/">some mild cognitive impairment</a>.</p>

<p>I find much to admire in Sen. Feinstein&rsquo;s pioneering career. She is smart and tough. She works well with Republicans. But I do not believe she should run again. She&rsquo;s been in office since 1992, and she would almost certainly be replaced by another Democrat who shares her overall values. It&rsquo;s time to give someone else a chance in this major position of influence and power.</p>

<p>That doesn&rsquo;t mean that Feinstein should withdraw from public life. Consider President Jimmy Carter&rsquo;s glorious post-presidential career. At 92, he continues to work to improve public health around the world &mdash; and to wield a hammer for Habitat for Humanity.</p>

<p>Rumors regularly hit Washington about the cognitive function of various senators. Strom Thurmond served to age 100, and was visibly infirm and unable to perform his senatorial duties toward the end of his service. McCain&rsquo;s <a href="https://www.washingtonpost.com/news/the-fix/wp/2017/06/08/sen-john-mccains-bizarre-questioning-of-comey/?utm_term=.d7031a97053a">confused questioning</a> of former FBI Director James Comey led to much commentary, before his diagnosis, as did <a href="http://www.slate.com/blogs/the_slatest/2017/06/09/sen_mccaskill_rips_into_sen_hatch_over_gop_scheme_to_revamp_trumpcare_in.html">Sen. Orrin Hatch&rsquo;s parroting of a young aide&rsquo;s talking points</a> in a colloquy with Sen. Claire McCaskill.</p>
<h2 class="wp-block-heading">80-year-old senators tend to be healthier than the average octogenarian. They also might be too driven to step aside.</h2>
<p>The potential presence of mild impairments should not disqualify people from public office. At 75, Edward Kennedy remained one of the most effective senators in American history &mdash; whatever his capacity for rapid memory recall. Still, health and mental acuity is a relevant concern when we expect senators to spot likely problems in eleventh-hour amendments to health legislation.</p>

<p>The prevalence of real dementia is far lower than the risks of mild cognitive impairment, but annual risks among the healthy <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3334445/">roughly double</a> every five years after age 70. By age 85, <a href="https://www.ncbi.nlm.nih.gov/pubmed/8417380">almost one-third</a> of adults experience some form of dementia.</p>

<p>On the one hand, competitive and successful senior politicians are surely less likely to suffer these difficulties. On the other, driven people are less likely to be self-reflective about when it&rsquo;s time to move on.</p>

<p>Then there&rsquo;s the presidency. Ronald Reagan&rsquo;s age at inauguration, 69, caused some concern &mdash; at the time he was the oldest to take the job &mdash; but Donald Trump is 70.&nbsp; Vox&rsquo;s Matt Yglesias has argued that <a href="https://www.vox.com/policy-and-politics/2017/7/5/15802616/bernie-sanders-2020">Sen. Bernie Sanders is now the Democratic frontrunner</a> for 2020. The three leading Democratic contenders &mdash; Elizabeth Warren, Joe Biden, and Sanders &mdash; would be 71, 78, and 79, respectively, on Inauguration Day 2021.</p>

<p>Some medical experts have expressed concern that President Trump may be experiencing mild cognitive impairment: They say it&rsquo;s reflected in <a href="https://www.statnews.com/2017/05/23/donald-trump-speaking-style-interviews/">declining verbal complexity in his responses to media interviews</a>. Yes, there is more than a whiff of politicking in some of this discussion. But this remains a legitimate issue, especially in light of similar assessments made <a href="https://www.theguardian.com/society/2017/feb/21/long-winded-speech-could-be-early-sign-of-alzheimers-says-study">regarding President Reagan</a>, who later succumbed to Alzheimer&rsquo;s.</p>
<h2 class="wp-block-heading">There are reforms that could help, but we need to change norms too   </h2>
<p>One useful reform would be to subject all candidates for major office to a proper medical review from nonpartisan authorities. Presidential candidates might be examined by the staff of&nbsp;Bethesda Naval Hospital. They should be entitled to privacy regarding matters that don&rsquo;t affect their capacities to hold public office, but qualified and nonpartisan medical authorities should have an opportunity to examine them and to review their records.</p>

<p>In this, as in so many other areas, President Trump made a mockery of the process by submitting a gonzo health report from his Manhattan physician. (&#8220;If elected, Mr. Trump &hellip; will be the healthiest individual ever elected to the presidency.&#8221;) That seemed funny when the smart money assumed a Clinton presidency. It&rsquo;s less funny now, as we depend upon Trump&rsquo;s health and mental acuity as he negotiates with North Korea.</p>
<figure class="wp-block-embed is-type-rich is-provider-twitter wp-block-embed-twitter alignnone"><div class="wp-block-embed__wrapper">
<blockquote class="twitter-tweet" data-dnt="true"><p lang="en" dir="ltr">EXCLUSIVE: Trump doctor says he wrote health letter in just 5 minutes as limo waited <a href="https://t.co/NCYgaU6KfM">https://t.co/NCYgaU6KfM</a> <a href="https://t.co/16o9dwEYcu">pic.twitter.com/16o9dwEYcu</a></p>&mdash; NBC News (@NBCNews) <a href="https://twitter.com/NBCNews/status/769293280945246208?ref_src=twsrc%5Etfw">August 26, 2016</a></blockquote>
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<p>We should also scrap lifetime appointments to the Supreme Court in favor of<a href="http://www.politico.com/magazine/story/2016/02/scalia-how-to-fix-supreme-court-vacancy-reform-213637"> fixed 18-year terms</a>. Under such a system, each presidential administration could appoint one Supreme Court justice every two years on a predictable schedule. (It&rsquo;s noteworthy that these changes would increase the prospects for older jurists to be appointed in the first place. Today, a president would be foolish to nominate a 65-year-old to the high court, but the calculus changes if terms are limited.)</p>

<p>Aware of the challenges facing elderly judges, the Ninth Circuit Court of Appeals has several sensible programs. It &ldquo;offers a battery of mental health assessments, hosts discussions with neurological experts and has created a hotline where staff may report signs of cognitive decline in their colleagues,&rdquo; <a href="http://www.latimes.com/opinion/op-ed/la-oe-0202-garrow-aging-judiciary-20160202-story.html">notes</a> the law professor and biographer David J. Garrow, who has long expressed concern about cognitive decline on the bench. The Supreme Court could take a cue.&nbsp;</p>

<p>Justices should take personal responsibility too. Justices should not serve 30 or 40 years, particularly when they can be replaced by someone from their own party. In 2011, Randall Kennedy <a href="https://newrepublic.com/article/87543/ginsburg-breyer-resign-supereme-court">called upon Justices Ginsburg and Breyer to immediately retire</a>. They should have done so.</p>
<h2 class="wp-block-heading">Is Sanders “too old” to run in 2020?</h2>
<p>Let&rsquo;s also work to establish sensible norms for people running for high office. Senators over the age of 75 should not ordinarily run for reelection, in my view. Candidates well over 70 should not ordinarily run for president either. Yes, I would say that to Joe Biden and Bernie Sanders, although I would proudly support either man against Mike Pence or Trump.</p>

<p>I&rsquo;m confident that Biden and Sanders could run effective and compelling presidential campaigns. I&rsquo;m much more worried about their capacity to continue to perform at a high level over the full course of their presidencies. For that reason, I also want presidential candidates of every age to openly discuss how they plan to manage their health issues as they assume the weightiest job in the world. It&rsquo;s not dirty pool for reporters and political opponents to press them on such questions.</p>

<p>We should address these matters without rancor or cruelty, but also without euphemism or undue reticence. &nbsp;</p>

<p>These matters are hard to talk about in American politics because they are hard to talk about in our own lives. I see my mortality etched on my father&rsquo;s face, as my daughters see it in mine. Mortality and bodily fragility are two great constants of human life.&nbsp; How we handle those constraints provides a small but important test of American democracy.</p>

<p><em>Harold Pollack is the Helen Ross professor of social service administration at the University of Chicago.</em></p>
<hr class="wp-block-separator" />
<p><a href="http://vox.com/the-big-idea">The Big Idea</a> is Vox&rsquo;s home for smart discussion of the most important issues and ideas in politics, science, and culture &mdash; typically by outside contributors. If you have an idea for a piece, pitch us at <a href="mailto:thebigidea@vox.com">thebigidea@vox.com</a>.</p>
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			<entry>
			
			<author>
				<name>Harold Pollack</name>
			</author>
			
			<title type="html"><![CDATA[13 smart ways to improve your finances in 2017]]></title>
			<link rel="alternate" type="text/html" href="https://www.vox.com/2016/1/1/10644348/financial-new-years-resolutions" />
			<id>https://www.vox.com/2016/1/1/10644348/financial-new-years-resolutions</id>
			<updated>2019-03-05T16:25:31-05:00</updated>
			<published>2017-01-06T12:30:00-05:00</published>
			<category scheme="https://www.vox.com" term="Culture" /><category scheme="https://www.vox.com" term="Money" /><category scheme="https://www.vox.com" term="Personal Finance" />
							<summary type="html"><![CDATA[A new year is a useful time to consider large and small ways we can improve our lives. We can be more generous to the people around us and improve our physical and mental health. We can also take small steps to put our financial houses in order. Of course, your overall finances depend on [&#8230;]]]></summary>
			
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<p>A new year is a useful time to consider large and small ways we can improve our lives. We can be more generous to the people around us and improve our physical and mental health. We can also take small steps to put our financial houses in order.</p>

<p>Of course, your overall finances depend on your income and prior wealth, and on big-ticket items such as your housing, student loans, and car. Still, a succession of smart decisions helps you stay on a methodical path. <a href="http://www.vox.com/2014/10/30/7083499/you-should-be-saving-more">Most of us can save a little more, and a little smarter, than we currently do</a>.</p>

<p>This stuff really isn&rsquo;t rocket science. Yet financial planning is easy to screw up or avoid &mdash; either because it&rsquo;s boring or because it&rsquo;s intimidating. Few hard deadlines force you to pay attention, so it&rsquo;s easy to put things off.</p>

<p>As you contemplate the financial hangover from the holiday season, this is a great time to align your everyday personal decisions with your long-term financial goals. Below are a few suggestions that may help in the coming year.</p>
<h2 class="wp-block-heading">1) Pay off (or chip away at) your credit card debt</h2><img src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/5848987/shutterstock_123256873.0.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" alt="" title="" data-has-syndication-rights="1" data-caption="" data-portal-copyright="" /><p class="caption">(dean bertoncelj/Shutterstock)</p>
<p>High-interest credit card debt is the worst financial burden facing many Americans. Over the past 50 years, the average return on stocks was <a href="http://pages.stern.nyu.edu/~adamodar/New_Home_Page/datafile/histretSP.html">about 9.8 percent</a>. The Federal Reserve reports that the average annual rate imposed on Americans who are paying credit card interest is <a href="http://www.federalreserve.gov/releases/g19/current/default.htm">13.93 percent</a>. That&rsquo;s the rate of return you get &mdash; tax- and risk-free &mdash; on every dollar you devote to paying down your credit card debt. Doing so will get you to your financial goals faster &mdash; dollar for dollar &mdash; than almost anything else you can do with your money.</p>
<h2 class="wp-block-heading">2) Buy an hour’s time with a financial adviser or accountant</h2><img src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/4317401/shutterstock_275207513.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" alt="Fiduciary rule in action!" title="Fiduciary rule in action!" data-has-syndication-rights="1" data-caption="" data-portal-copyright="&lt;a href=&quot;http://www.shutterstock.com/&quot;&gt;Shutterstock&lt;/a&gt;" />
<p>When it comes to retirement savings, a financial adviser can be either part of the problem or part of the solution. Much depends on which advisers you listen to, and for what purposes.</p>

<p>A lot of advisers <a href="http://www.vox.com/2015/12/21/10634980/obama-fiduciary-rule-explained">provide biased, self-serving advice</a>. In <a href="http://www.samefacts.com/2012/03/everything-else/think-twice-about-that-financial-advisor/">a famous empirical study</a> by Sendhil Mullainathan and colleagues, the majority of audited advisers steered investors away from the excellent and economical investments that would be chosen by independent experts into wasteful, actively managed funds that, oddly enough, tend to pay larger commissions to the advisers. Against fierce industry opposition, the Department of Labor is <a href="http://www.politico.com/agenda/story/2015/08/the-new-obama-rule-thats-making-stockbrokers-swear-000192">now seeking to curb such behavior</a>.</p>

<p>This is a real problem, but it shouldn&rsquo;t sour you on the importance of seeking financial advice. A good financial professional, facing the proper incentives, can offer genuinely valuable advice. A good accountant can play a similar role. You can ask about whether to prioritize your retirement savings over saving for your kids&rsquo; college, how you might set aside more for your retirement, the pluses and minuses of a Roth IRA, disability insurance, and whether you are financially ready to buy your dream home. A financial adviser provides critical distance and another pair of eyes for some important life decisions.</p>

<p>The key to finding an adviser who will actually work for you is simple: Pay the adviser out of your own pocket. So-called fee-only investment advisers typically bill by the hour and eschew commissions and other third-party payments. If you&rsquo;re not sure if an adviser gets paid on commission, ask cordially but directly at the beginning of the meeting about how this adviser is paid &mdash; in all of her dealings with you.</p>

<p>You might feel some initial sticker shock when asked to pay (say) $250 for an hour of someone&rsquo;s time. But remember the old adage: If it&rsquo;s free, you are the product.</p>

<p>The reality is that you&rsquo;ll pay a lot more in the long run if you go with a nominally free financial professional whose business model is to make extra money by steering customers to particular retirement and investment products.</p>

<p>It&rsquo;s almost embarrassing to run the numbers. Suppose you make an appointment with a financial professional to discuss your $100,000 retirement account. She doesn&rsquo;t charge you anything for the visit, and she gives you basically sensible advice. But she convinces you to buy her firm&rsquo;s preferred investment, which costs you a smidgen more every year &mdash; say, 0.2 percent &mdash; than an otherwise identical competing product. Let&rsquo;s assume for simplicity that both investments return 6 percent every year, not counting fees. After 10 years, you will have overpaid about $2,900, compared with what you would have gotten had you paid $250 for independent advice. After 20 years, the gap is $11,000. After 30 years, it exceeds $30,000.</p>
<h2 class="wp-block-heading">3) Pay cash up front</h2><img src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/5848719/shutterstock_146762978.0.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" alt="" title="" data-has-syndication-rights="1" data-caption="" data-portal-copyright="Melpomene / Shutterstock" /><p class="caption">(Melpomene/Shutterstock)</p>
<p>One smart way to save money is to lay off your credit or debit card and to simply pay cash. <a href="https://www.apa.org/pubs/journals/releases/xap143213.pdf">Experiments</a> confirm <a href="http://download.springer.com/static/pdf/823/art%3A10.1023%2FA%3A1008196717017.pdf?originUrl=http%3A%2F%2Flink.springer.com%2Farticle%2F10.1023%2FA%3A1008196717017&amp;token2=exp=1450307072~acl=%2Fstatic%2Fpdf%2F823%2Fart%3A10.1023%2FA%3A1008196717017.pdf%3ForiginUrl%3Dhttp%3A%2F%2Flink.springer.com%2Farticle%2F10.1023%2FA%3A1008196717017*~hmac=a565ee77ff3c59def5ad660bf113f8e0ebbd79e02475996e89f800da0892e3d5">commonsense reality</a>: Many of us spend more when we can deploy a brightly colored piece of plastic rather than actual cash dollars.</p>

<p>Ignore that nice credit card rewards program, too. Economists Sumit Agarwal, Sujit Chakravorti, and Anna Lunn <a href="http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1719054">examined what happened when credit cardholders received a $25 cash-back reward</a>. Average monthly spending increased by $79, and average monthly debt increased by $191. It&rsquo;s better to pay cash, spend less, and give yourself your own reward program.</p>

<p>One final tip: When sellers offer easy payment plans that help you manage your cash flow, they&rsquo;re lending you money. The implicit interest rate is often surprisingly high. Suppose, for example, that you are buying an annual gym membership. You can pay $550 up front or make 12 monthly payments of $50. The payment plan is pretty good by the standards of such things. There is only one extra payment. You might feel really good if this payment plan allows you to avoid charging $550 on your credit card. There&rsquo;s only one problem: The effective interest rate on these 12 payments is nearly 20 percent. That&rsquo;s worse than your credit card.</p>

<p>There&rsquo;s a simple lesson in all this. If you need to borrow, get money from a bank. Otherwise, pay cash.</p>
<h2 class="wp-block-heading">4) Don’t time the market based on political events</h2>
<p>Donald Trump&rsquo;s election victory underscores the role of political risk in one&rsquo;s investment portfolio, and the potential opportunities from timing the market based on surprising political events. Journalist Kurt Eichenwald <a href="https://twitter.com/kurteichenwald/status/796211475270471680">sold his stock portfolio and went all-cash, &#8220;just in case&#8221; of a Trump victory</a>.</p>
<blockquote class="twitter-tweet"> <p dir="ltr" lang="en">I hate to say this but, against my investment advisor&#8217;s recommendation, I sold all stocks and went all cash months ago, just in case.</p>&mdash; Kurt Eichenwald (@kurteichenwald) <a href="https://twitter.com/kurteichenwald/status/796211475270471680">November 9, 2016</a> </blockquote><p></p>
<p>Mr. Eichenwald was not alone in this assessment. Stocks rose sharply after Hillary Clinton won the first presidential debate and when damaging material emerged about Donald Trump. Stocks correspondingly fell when public statements by FBI director James Comey damaged Hillary Clinton. A <a href="http://www.nytimes.com/2016/11/19/upshot/markets-sent-a-strong-signal-on-trump-then-changed-their-minds.html?_r=0">widely-cited analysis of stock market futures pricing</a> suggested that the markets would regard a Trump victory as a harmful event roughly similar to 9/11.</p>

<p>I received many concerned emails from family and friends asking how they should adjust their investments given this risk. I responded that they should sit tight. So far, anyway, that has turned out to be good advice. The S&amp;P 500 is up about 5 percent since election day.</p>

<p>But I didn&rsquo;t suggest sitting tight because I thought the market would rise after a Trump victory. Quite the opposite. I told a friend on election night that I expected the stock markets to drop 1,000 points the next day.</p>

<p>What I did know &mdash; why I advised people to sit tight &mdash; is that it&rsquo;s a fool&rsquo;s errand to time markets based on transient events, whether these are major political upsets or surprising economic news. An impressive research literature suggests that <a href="http://faculty.haas.berkeley.edu/odean/papers%20current%20versions/individual_investor_performance_final.pdf">almost all of us are terrible at figuring out the best times to buy and sell</a>, and that people who try to time the market usually wind up with lower, not higher, returns.</p>

<p>To the extent that a Trump victory increases your personal and financial risks, you might want gradually reduce the mix of stocks in your portfolio. And it never hurts to increase your personal savings. But lurching to an extreme position &mdash; like dumping all your stocks &mdash; in response to the day&rsquo;s headlines is almost certainly a mistake.</p>
<h2 class="wp-block-heading">5) Perfectly safe long-term bonds are still risky</h2>
<p>In one sense, the safest investment on the planet is a 30-year Treasury bill, because it is backed by the full faith and credit of the United States. There is essentially no chance that the US government will default on these obligations. And if a Treasury default ever were to occur, it would be the result of an unprecedented catastrophe. I somehow doubt that your Google stock or alternative investment would be worth all that much in that world, either.</p>

<p>In another sense, though, long-term government bonds carry significant risk. Although the specific payout from that bond is incredibly secure, its economic value if I need to sell is surprisingly volatile. This is because the value of a bond moves in the opposite direction of interest rates: when interest rates rise, as they&rsquo;ve done over the last two months, the market price of existing bonds goes down. When interest rates are low, even a small change &mdash; say 0.25 percent &mdash; can cause a big swing in bond prices.</p>

<p>I own some shares in Vanguard&rsquo;s Long-Term Treasury Fund Investor fund, which specializes in US Treasury securities with maturities exceeding ten years. On November 7, each share was worth $13.11. Since then, the yield on a 30-year T-bill has ticked up from 2.6 percent to about 3.1 percent. As a result, the value of my Long-Term Treasury Fund Investor shares have correspondingly declined by almost eleven percent since then to about $11.67.</p>

<p>I&rsquo;m happy to have these in my portfolio. Over the past decade, <a href="https://personal.vanguard.com/us/funds/snapshot?FundId=0083&amp;FundIntExt=INT">long-term T-bills have done well</a>. When things happen, the price of long-term Treasuries <a href="http://www.vanguard.com/pdf/s130.pdf">generally moves in the opposite direction from the S&amp;P500</a>, which helps diversify your risks. But long-term bonds carry risks like anything else. Don&rsquo;t load too much on these if your goal is to protect yourself against broad economic risks. If you are trying to play things safe, your bond investments should be weighted towards shorter-term securities that are much less volatile &mdash; and, of course, command correspondingly lower returns.</p>
<h2 class="wp-block-heading">6) Keep a financial diary</h2><img src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/5848727/shutterstock_247105780.0.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" alt="" title="" data-has-syndication-rights="1" data-caption="" data-portal-copyright="" /><p class="caption">(Vitaly Korovin/Shutterstock)</p>
<p>It&rsquo;s hard to make a sensible financial plan when you don&rsquo;t know what you&rsquo;re spending. So keep a financial diary for a few months, in which you record everything that you spend. You can do that in a notebook or a spreadsheet. <a href="http://guides.wsj.com/personal-finance/managing-your-money/how-to-choose-and-use-financial-software/">Many apps and websites can help with this, too</a>. You might be surprised at what you learn. Make sure that you include everything on your credit card bill, too &mdash; like that old identity protection service or electronic subscription you forgot you even had.</p>
<h2 class="wp-block-heading">7) Look for savings on your cellphone and cable bills</h2><img src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/5848765/shutterstock_116321677.0.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" alt="" title="" data-has-syndication-rights="1" data-caption="" data-portal-copyright="" /><p class="caption">(William Perugini/Shutterstock)</p>
<p>Your cellphone bill is a target-rich environment for saving money. Do you need so many minutes on your calling plan? (Probably not.) Are you willing to sacrifice some real or perceived network quality for cheaper service? And if you haven&rsquo;t shopped around for cellphone service in the past two years, you are <a href="http://www.vox.com/2015/10/12/9489267/buying-a-cellphone-explained">probably overpaying</a>.</p>

<p>Your cable bill also rewards a closer look. Many of my University of Chicago students have <a href="http://money.usnews.com/money/the-frugal-shopper/2015/09/09/5-easy-ways-to-kill-your-cable-bill">cut the cord entirely</a> and get their entertainment from affordable services such as Netflix or Amazon.com. My wife and I are too sports-addicted to go this far, but it&rsquo;s worth a thought.</p>

<p>For reasons that now embarrass and baffle me, we rented our cable box &mdash; until we read that <a href="http://www.vox.com/2015/1/2/7481639/comcast-modem-rental-ripoff">there&rsquo;s no good reason to do this</a>.</p>
<h2 class="wp-block-heading">8) Build up three months&#039; worth of expenses in a strategic reserve</h2><img src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/5848787/shutterstock_224377375.0.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" alt="" title="" data-has-syndication-rights="1" data-caption="" data-portal-copyright="" /><p class="caption">(Rrraum/Shutterstock)</p>
<p>You can&#8217;t follow a sensible plan if you are always frantically managing your daily cash flow. I know this one from experience. When our daughters were young, my wife and I were always juggling our money to finish out the month without bouncing a check or failing to pay our big day care bill. We were so frantic that we made avoidable mistakes. We accumulated punishing credit card bills because our plastic got us through various immediate crises.</p>

<p>We weren&rsquo;t alone in this struggle. Eldar Shafir and &mdash; again &mdash; Sendhil Mullainathan document how <a href="https://www.washingtonpost.com/news/wonk/wp/2013/09/13/being-poor-changes-your-thinking-about-everything/">the continual need to address short-term crises erodes the cognitive bandwidth people require for effective budgeting and long-term planning</a>.</p>

<p>One way out of this trap is to build up a strategic reserve, which you keep separate from your normal bank account, so you won&rsquo;t be tempted to spend it. Ideally this reserve should cover a few months&rsquo; living expenses in case you get sick or lose your job.</p>

<p>Accumulating this reserve is definitely hard. You won&rsquo;t do it overnight, either. But it&rsquo;s worth it. You&rsquo;ll be ready for a real emergency such as your car getting totaled, a burst water main, or losing your job. A strategic reserve brings enormous peace of mind, too. You don&rsquo;t have to frantically check your bank balance or waste time juggling expenses to navigate short-term financial challenges. Now you&rsquo;re ready to really save and invest for the long term.</p>
<h2 class="wp-block-heading">9) When you’re ready, start an investment account dedicated to your children’s college</h2><img src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/5848939/shutterstock_221215363.0.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" alt="" title="" data-has-syndication-rights="1" data-caption="" data-portal-copyright="" /><p class="caption">(Prasit Rodphan/Shutterstock)</p>
<p>If you have young children, this might be a good year to open a dedicated college account, to which you make modest contributions straight from your paycheck.</p>

<p>Coverdell accounts are simple and economical. These <a href="https://www.irs.gov/publications/p970/ch07.html#en_US_2014_publink1000178417">allow you to put aside $2,000 for a given child every year</a>. And 529 accounts allow you to <a href="https://www.irs.gov/uac/529-Plans:-Questions-and-Answers">set aside much more</a>. These also provide nice opportunities, if you are lucky enough to have generous relatives, for others to kick in a little something on birthdays and holidays. As with retirement accounts, it&#8217;s important to choose an account with low fees.</p>

<p>Some smart people recommend against these accounts. They argue that it&rsquo;s easier to borrow to cover college expenses than it is to make up a retirement shortfall. They also argue that setting aside funds in a college account will reduce your child&rsquo;s financial aid.</p>

<p>These points are well taken. Don&rsquo;t feed your 529 or Coverdell if you lack a proper strategic reserve, or if you struggle with credit cards. The bulk of your savings should be in your retirement. If your employer offers matching 401(k) contributions, take full advantage of that first. Your retirement accounts are treated favorably by most colleges&#8217; financial aid process, too.</p>

<p>Here at Vox, <a href="http://www.vox.com/personal-finance/2015/8/28/9217075/save-for-college">Libby Nelson</a> noted another smart option: You might open a Roth IRA account on the understanding that it will be used for your child&rsquo;s college. Depending on your income, you can contribute up to $5,500 ($6,500 if you are older than 50) in after-tax income every year.</p>

<p>Roth IRAs have three nice features. First, you will never be taxed on your investment returns, which helps your retirement. Second, you can withdraw your contributions (though not your investment returns) anytime without penalty, so you can use the principal to help pay for your child&rsquo;s college, saving the rest for your retirement. Third, Roths aren&rsquo;t counted in basic financial aid formulas. Whatever way works best for you, you should open some modest college savings account. Tax savings on all three options are good, and the compound interest adds up. If you contribute $100 per month into a reasonable stock fund starting the day your child is born, you can reasonably expect to accumulate more than $30,000 before her freshman year. Average in-state tuition and fees for four-year public colleges is <a href="http://trends.collegeboard.org/college-pricing/figures-tables/2015-16-state-tuition-and-fees-public-four-year-institutions-state-and-five-year-percentage">about $9,400</a>. This modest, methodical strategy goes a long way.</p>

<p>You might also worry that you&rsquo;ll be penalized for your 529 or Coverdell through reductions in financial aid. The financial aid hit is actually mild. For every $100 you accumulate there, your annual expected financial contribution will grow by at most $5.64, with less of a hit if you have modest assets or many children &mdash; or if you don&rsquo;t receive financial aid at all. The tax bite also declines over four years as you deplete these accounts.</p>

<p>Intangibles matter, too. The best savings plan, like the best diet, is the one you actually follow. Your kids provide powerful psychic rewards for saving. In <a href="http://journals.ama.org/doi/abs/10.1509/jmkr.48.SPL.S14?journalCode=jmkr">one study</a>, low-income parents <a href="http://nudges.org/2010/05/27/all-bank-accounts-have-numbers-what-if-they-had-names-too/#sthash.wIh7Cqo5.dpuf">nearly doubled their savings</a> when the money went into an envelope with their child&rsquo;s picture on it.</p>
<h2 class="wp-block-heading">10) Check the fees on your investments</h2><img src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/5848957/shutterstock_158232629.0.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" alt="" title="" data-has-syndication-rights="1" data-caption="" data-portal-copyright="" /><p class="caption">(Kinga/Shutterstock)</p>
<p>Mutual funds list an &#8220;expense ratio,&#8221; which tells you how much you&rsquo;ll lose each year due to overhead. Barring unusual circumstances, you shouldn&rsquo;t invest in funds with an expense ratio higher than 0.3 percent &mdash; and you might be able to do even better. Almost all of my retirement savings are in total stock and bond market index funds with annual expenses of about 0.1 percent.</p>

<p>Don&rsquo;t be fooled by mutual funds that charge higher fees and claim they&rsquo;ll be able to deliver above-average returns. They probably won&rsquo;t, and meanwhile the higher fees will eat into your savings. Instead, <a href="http://www.vox.com/2015/2/6/7983147/mutual-fund-rip-off">look for index funds</a>, funds whose goal is to provide customers with a broad portfolio of assets at the lowest cost. Large providers such as TIAA-CREF, Schwab, Vanguard, and Fidelity offer them, and studies suggest they will maximize your returns in the long run.</p>
<h2 class="wp-block-heading">11) Seek cheap thrills</h2><img src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/5848961/shutterstock_92917855.0.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" alt="" title="" data-has-syndication-rights="1" data-caption="" data-portal-copyright="" /><p class="caption">(Aspen Photo/Shutterstock)</p>
<p>Cultivate some new cheap sources of pleasure that protect your budget without making you feel that you&#8217;re missing out. Taking a friend to a high school basketball game, finding that inexpensive Middle Eastern restaurant, or hitting the state park or a public beach are all pretty fun. They don&rsquo;t cost much, either.</p>

<p>Not coincidentally, cheap thrills are often shared experiences with people we like or love. A long line of psychology research initiated by Thomas Gilovich documents that <a href="http://www.news.cornell.edu/stories/2010/03/study-shows-experiences-are-better-possessions">memorable experiences give us more lasting happiness than do enjoyable new things</a>.</p>
<h2 class="wp-block-heading">12) Quit smoking (and cut down your restaurant drinking, too)</h2><img src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/5848969/shutterstock_214726639.0.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" alt="" title="" data-has-syndication-rights="1" data-caption="" data-portal-copyright="" /><p class="caption">(StepanPopov/Shutterstock)</p>
<p>I&rsquo;m a zealot about smoking, not least because both of my in-laws died horribly and young from lung cancer. Smoking is expensive, too. The <a href="https://www.tobaccofreekids.org/research/factsheets/pdf/0202.pdf">national average price of cigarettes</a> is about $6.25 per pack. A pack of cigarettes costs more than $10 in many localities. So pack-a-day smokers are spending thousands of dollars on cigarettes every year. You can save a lot of money by quitting or cutting down. If you do this, make sure to do something you enjoy with some of the money you save. That will help your finances. It may also lengthen your life by bolstering your mojo to keep it up.</p>

<p>Watch your drinking, too, particularly when you are dining out. Vox readers already know that <a href="http://www.vox.com/2015/2/25/8104917/drug-dangers-marijuana-alcohol">alcohol is a serious public health problem</a>. More to the point of this column, alcohol is the most <a href="https://www.quora.com/Why-are-wines-so-overpriced-in-restaurants">notoriously high markup on restaurant menus</a>. Economists debate <a href="http://freakonomics.com/2007/06/15/question-of-the-day-whats-up-with-restaurant-wine-prices/">why the markup is so high</a>. One theory holds that consumers like to buy expensive wine to signal their affluence and sophistication. Another theory holds that restaurants dramatically overcharge for things like coffee and wine because these complement the ambience, which is nominally free. Whatever the explanation, you can save a lot of money by not buying into it.</p>
<h2 class="wp-block-heading">13) Raise the deductibles on your auto and homeowners insurance</h2><img src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/5848975/shutterstock_345372506.0.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" alt="" title="" data-has-syndication-rights="1" data-caption="" data-portal-copyright="" /><p class="caption">(Tidarat Tiemjai/Shutterstock)</p>
<p>Your auto and homeowners insurance may be ripe for savings. Insurance policies come with a deductible &mdash; the amount you have to pay out of pocket before the insurance company will start picking up the tab. The higher your deductible, the lower your insurance premium will be. So get the largest deductible you can handle on your auto and homeowners insurance.</p>

<p>Of course, this runs the risk that you&rsquo;ll have larger out-of-pocket costs. That&rsquo;s okay, because you&rsquo;ve got your strategic reserve (see above) if you require costly repairs.</p>

<p>High-deductible policies carry lower monthly premiums for two different reasons. Most obviously, these insurance policies are less generous. Insurers don&rsquo;t bear the costs of covering smaller claims. There&rsquo;s another factor, too: Consumers who buy high-deductible policies are generally a safer group. By purchasing these policies, you are lumping yourself in with a better risk pool, and thus pay lower premiums.</p>

<p><em>Harold Pollack teaches social service administration at the University of Chicago. He is co-author with Helaine Olen of the new book </em><a href="http://www.amazon.com/gp/product/1591847680?keywords=pollack%20index%20card&amp;qid=1450402906&amp;ref_=sr_1_1_twi_har_1&amp;sr=8-1"><em>The Index Card: Why Personal Finance Doesn&rsquo;t Have to Be Complicated</em></a></p>
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									</content>
			
					</entry>
			<entry>
			
			<author>
				<name>Harold Pollack</name>
			</author>
			
			<title type="html"><![CDATA[People are tougher on poor, pregnant opioid addicts than well-off ones]]></title>
			<link rel="alternate" type="text/html" href="https://www.vox.com/the-big-idea/2016/11/2/13492298/pregnant-opioid-abusers-treatment-interventions" />
			<id>https://www.vox.com/the-big-idea/2016/11/2/13492298/pregnant-opioid-abusers-treatment-interventions</id>
			<updated>2016-11-01T17:56:41-04:00</updated>
			<published>2016-11-02T09:30:03-04:00</published>
			<category scheme="https://www.vox.com" term="Criminal Justice" /><category scheme="https://www.vox.com" term="Health" /><category scheme="https://www.vox.com" term="Policy" /><category scheme="https://www.vox.com" term="Politics" /><category scheme="https://www.vox.com" term="Public Health" /><category scheme="https://www.vox.com" term="The Big Idea" />
							<summary type="html"><![CDATA[With surprising speed, prescription opioids have become our greatest challenge in drug policy &#8212; not to mention an issue in the presidential election. An estimated 10 million Americans take prescription opioid medications for nonmedical reasons. Deaths from prescription opioid medications have quadrupled since 1999. Both Hillary Clinton and Donald Trump have felt compelled to make [&#8230;]]]></summary>
			
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											<![CDATA[

						
<figure>

<img alt="" data-caption="Family members of heroin and opioid addicts talk, as part of a support group, in Groton, Connecticut. | John Moore / Getty" data-portal-copyright="John Moore / Getty" data-has-syndication-rights="1" src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/7389569/opioid.support.group.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" />
	<figcaption>
	Family members of heroin and opioid addicts talk, as part of a support group, in Groton, Connecticut. | John Moore / Getty	</figcaption>
</figure>
<p>With surprising speed, prescription opioids have become our greatest challenge in drug policy &mdash; not to mention an issue in the presidential election. An estimated 10 million Americans take prescription opioid medications for nonmedical reasons. Deaths from prescription opioid medications <a href="https://www.cdc.gov/drugoverdose/epidemic/">have quadrupled since 1999</a>. Both Hillary Clinton and Donald Trump have felt compelled to make the issue part of their campaigns.</p>
<div class="chorus-snippet s-related" data-analytics-action="link:related" data-analytics-category="article"> <span class="s-related__title">Related</span><a href="http://www.vox.com/2016/9/21/12973740/trump-clinton-opioid-heroin-epidemic">Clinton wants a public health response to the opioid crisis. Trump wants more of the old drug war</a> </div><!-- ######## END SNIPPET ######## --><p><span>Prescription opioid misuse among pregnant women poses especially difficult issues given the complex medical challenges of addiction treatment and pain management during pregnancy, the possibility of harm to the developing fetus, and the unique legal and ethical sensitivities arising in any potentially coercive intervention involving pregnant women. The prevalence of such disorders among pregnant women appears to have </span><a href="https://www.drugabuse.gov/related-topics/trends-statistics/infographics/dramatic-increases-in-maternal-opioid-use-neonatal-abstinence-syndrome">also increased</a><span> by roughly a factor of four since 1999.</span></p><p>The plight of pregnant women struggling with addiction elicits widespread compassion and, sometimes, support for policies such as expanded access to addiction treatment. Yet the sight of pregnant women misusing intoxicating substances and media reports of newborns experiencing symptoms of acute opioid withdrawal elicit harsher reactions, too. And <span>those</span><span> reactions may increase support for policies such as criminal charges or child abuse referrals. Health experts </span><a href="http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Ethics/Alcohol-Abuse-and-Other-Substance-Use-Disorders-Ethical-Issues-in-Obstetric-and-Gynecologic-Practice">worry</a><span> that such policies drive may drive pregnant women away from health care providers or lead them to conceal their drug use from their doctors.</span></p><h2 class="wp-block-heading">The search for interventions that reduce stigma</h2>
<p>Public health practitioners have long sought ways to reduce the stigma directed at pregnant women experiencing opioid disorders. One approach has been to publicize brain scans and other scientific information in order to frame addiction as a chronic condition &mdash; a legitimate disease, not a moral failing. Another is to present stories that highlight poverty and other poignant life struggles faced by these women.</p>

<p>Neither approach seems to have moved public opinion appreciably in the direction of evidence-informed interventions. One might assume that depicting pregnant women as caught in the grip of a brain-altering chronic disease or stuck in broader pathologies of their life circumstances might make voters less angry at these women. But these same depictions may also intensify the psychological distance many Americans feel toward such people.</p>

<p>That perceived distance might even make voters more receptive to coercive interventions. Suppose we learn that a pregnant woman&rsquo;s debilitating Oxycodone habit reflects the altered brain chemistry of addiction or reflects other pathologies rooted in her difficult life circumstances. This knowledge might lead us to pity her. It&rsquo;s not obvious that it would make us any less willing to infringe on her autonomy during pregnancy, or to trust her any more with the responsibility of raising a new baby.</p>

<p>A <a href="http://jhppl.dukejournals.org/content/41/5/873.full">recent study</a>, however, both highlights the challenges facing advocates for addicted women and identifies an intervention that actually changes people&rsquo;s minds: It makes them less punitive.</p>

<p>Put another way, it leads people to transfer some of the natural empathy they have for well-off pregnant opioid addicts to poorer addicts.</p>

<p>In a randomized web experiment, Alene Kennedy-Hendricks, Emma McGinty, and Colleen Barry of the Johns Hopkins Bloomberg School of Public Health recruited 1,620 statistically representative US adults online.</p>

<p>The researchers then <a href="http://jhppl.dukejournals.org/content/41/5/873.full">divided</a> these participants into six groups. Researchers asked a control group about their attitudes toward various policy issues &mdash; whether they would support prosecuting pregnant drug users, for example. In contrast, the diverse treatment groups were presented with different vignettes about addicted pregnant women in varied economic circumstances who faced barriers to getting help.</p>

<p>Some were described as successfully completing treatment; in other vignettes, treatment outcomes were not specifically discussed. After reading the vignettes, participants in each treatment arm got the same questions as the control group. (The work appears in the current <em>Journal of Health Politics, Policy, and Law</em>, which I help edit.)</p>
<h2 class="wp-block-heading">People are more likely to object to employers refusing to hire a well-off person with a pain pill problem</h2>
<p>The researchers&rsquo; most chastening findings reflect the obvious class overhang in any discussion of the opioid epidemic. When respondents were presented with accounts of a woman of high socioeconomic status (SES) running into trouble with pain pills, they were notably less likely than the control group to support punitive criminal justice and health care policies toward pregnant opioid users. The high-SES woman was described as a regional manager of a restaurant chain who holds an MBA, a new homeowner, and as experiencing a first pregnancy in her early 30s.</p>

<p>When the stories depicted this woman, respondents were less likely to say they wouldn&rsquo;t work closely with a colleague addicted to opioid pain medication. They were also less likely to say that companies and landlords are justified in denying employment or housing on the basis of these disorders.</p>

<p>Researchers found the opposite reaction when they presented a vignette involving a pregnant woman who ran into precisely the same addiction problems but who was in her early 20s, a high school dropout, by implication unmarried, and living in a government-subsidized apartment. In virtually every category, respondents who learned about <em>that</em> woman endorsed more punitive policies and expressed greater anger and disgust toward pregnant addicted women than was observed in the control group.</p>
<img src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/7389551/Pollack.chart.one.png?quality=90&#038;strip=all&#038;crop=0,0,100,100" alt="" title="" data-has-syndication-rights="1" data-caption="" data-portal-copyright="Harold Pollack" />
<p>These biases are especially concerning when we consider the strong class overtones attached to opioids, sometimes called &#8220;hillbilly heroin.&#8221;</p>
<h2 class="wp-block-heading">When you explain the barriers opioid addicts face in seeking treatment, empathy rises</h2>
<p>Such findings are depressing, if not entirely surprising. But there was also a bright side to the paper. In another part of the study, respondents provided more compassionate responses when presented with the barriers facing low-income pregnant women who seek addiction treatment. One group was told that &#8220;Michelle&rsquo;s&#8221; doctor told her that Oxycontin could cause trouble for her pregnancy, and therefore she should begin methadone treatment. But there was a waiting list at the closest clinic, so she was forced to try one two hours away.</p>
<p><q aria-hidden="true" class="center"><span>The researchers&rsquo; most chastening findings reflect the obvious class overhang in any discussion of the opioid epidemic</span></q></p>
<p>She didn&rsquo;t have a car, felt bad about imposing on friends, and taxis were too expensive. &#8220;Traveling four hours round-trip on the days she was able to find a ride became exhausting and began to create problems for Michelle at work,&#8221; continued the narrative. &#8220;Her manager became angry when she was repeatedly late for shifts and threatened to let her go. Michelle missed days of treatments and began using OxyContin again. She felt guilty and ashamed.&#8221;</p>

<p>Respondents presented with this tale were notably less willing to support punitive policies such as requirements for health providers to report pregnant opioid users to child welfare authorities. When barriers to treatment were concretely described, respondents were also more willing to require Medicaid to cover such treatment.</p>
<img src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/7389559/Pollack.chart_.2.png?quality=90&#038;strip=all&#038;crop=0,0,100,100" alt="" title="" data-has-syndication-rights="1" data-caption="" data-portal-copyright="Harold Pollack" />
<p>Similar but weaker effects were observed when respondents were presented with &#8220;treatment success&#8221; vignettes indicating that &#8220;Michelle&#8221; had successfully completed treatment and hadn&rsquo;t used narcotic prescription pain medication in the past two years. (These vignettes did not include all the details about the challenges.)</p>

<p>Americans hold complex and ambivalent views regarding pregnant women with addiction disorders. That human mixture of compassion and anger leads us to support apparently contradictory policies, depending how the issue is framed.</p>

<p>This data suggests that voters are most likely to reject punitive attitudes and interventions when they recognize pregnant women struggling with addiction as functional and appealing in other aspects of their lives, and when voters see some basis for realistic, evidence-based optimism that treatment actually works.</p>
<h2 class="wp-block-heading">Attitudes are still too dependent on seeing opioid addicts as &quot;people like us&quot;</h2>
<p>That&rsquo;s good news. Yet I confess that reading this paper was a bittersweet experience. I began working in public health 25 years ago, when the intertwined HIV and crack epidemics were peaking. Most Americans emphatically did not regard low-income, LGBTQ, and minority citizens at the epicenters of these crises as recognizably similar to themselves. Reflecting that sense of distance, our nation failed to protect people who injected drugs and faced the most immediate HIV risk. We imposed heavily coercive policies on the predominantly-minority population of pregnant women who used crack.</p>

<p>Compared with these earlier epidemics, today&rsquo;s prescription opioid crisis is less respectful of the usual economic and racial-ethnic boundaries. Not coincidentally, our current response is decidedly more inclusive, bipartisan, and humane.</p>

<p>Kennedy-Hendricks, McGinty, and Barry&rsquo;s important experiment suggests ways to expand that zone of inclusiveness a little bit further. Given the checkered history of drug-abuse policy, that&rsquo;s no small thing.</p>

<p><em>Harold Pollack is the Helen Ross Professor of Social Service Administration at the University of Chicago.</em></p>
<hr class="wp-block-separator" />
<p>The Big Idea is Vox&rsquo;s home for smart, often scholarly excursions into the most important issues and ideas in politics, science, and culture &mdash; typically written by outside contributors. If you have an idea for a piece, pitch us at <a href="mailto:thebigidea@vox.com"><strong>thebigidea@vox.com</strong></a>.</p>
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			<entry>
			
			<author>
				<name>Harold Pollack</name>
			</author>
			
			<title type="html"><![CDATA[This election isn&#8217;t about right vs. left. It&#8217;s about &#8220;we&#8221; vs. &#8220;I.&#8221;]]></title>
			<link rel="alternate" type="text/html" href="https://www.vox.com/2016/8/5/12387674/hillary-clinton-political-philosophy-bowling-alone" />
			<id>https://www.vox.com/2016/8/5/12387674/hillary-clinton-political-philosophy-bowling-alone</id>
			<updated>2016-08-05T11:51:56-04:00</updated>
			<published>2016-08-08T08:01:00-04:00</published>
			<category scheme="https://www.vox.com" term="2016 Presidential Election" /><category scheme="https://www.vox.com" term="Politics" />
							<summary type="html"><![CDATA[In a recent interview on Vox, Ezra Klein asked Hillary Clinton to name three books everyone should read that have influenced how she thinks about policy. She mentioned Christopher Lasch&#8217;s work, without naming a title (his best known book is probably The Culture of Narcissism), and Habits of the Heart, a collection of sociological pieces [&#8230;]]]></summary>
			
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<img alt="" data-caption="Political scientist Robert Putnam accepts a National Humanities Medal from President Obama, in 2012. | Pete Marovich/Getty Images" data-portal-copyright="Pete Marovich/Getty Images" data-has-syndication-rights="1" src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/6895549/173232773.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" />
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	Political scientist Robert Putnam accepts a National Humanities Medal from President Obama, in 2012. | Pete Marovich/Getty Images	</figcaption>
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<p>In a recent <a href="http://www.vox.com/a/hillary-clinton-interview">interview on Vox</a>, Ezra Klein asked Hillary Clinton to name three books everyone should read that have influenced how she thinks about policy. She mentioned Christopher Lasch&rsquo;s work, without naming a title (his best known book is probably <a href="http://books.wwnorton.com/books/The-Culture-of-Narcissism/"><em>The Culture of Narcissism</em></a>), and <a href="https://www.amazon.com/Habits-Heart-Individualism-Commitment-American/dp/0520254198"><em>Habits of the Heart</em></a>, a collection of sociological pieces on the nature of American community written by a team led by Robert Bellah. But her fullest comments were reserved for the most recent book by Harvard government professor Robert Putnam:</p>
<blockquote class="wp-block-quote has-text-align-none is-layout-flow wp-block-quote-is-layout-flow">
<p>I think there&rsquo;s a lot of wisdom in Bob Putnam&rsquo;s latest book, <em>Our Kids</em>. I think there&rsquo;s a really great story that he tells about going back to the town he grew up in outside of Cleveland, where kids of all different backgrounds, economic family standing, and they&rsquo;re all together and everyone was in it together. And there was so little distinction, and there was so much economic integration in that small town. Now he goes back to it, and it&rsquo;s so divided. It&rsquo;s divided on income; it&rsquo;s divided on race; it&rsquo;s just a very different environment. And winners and losers are preordained at a very early age. So I think that&rsquo;s a book that people should read right now.</p>
</blockquote>
<p>Putnam, past president of the American Political Science Association, is best known as the author of <a href="http://bowlingalone.com/"><em>Bowling Alone</em></a><em>, </em>which explored the decline in &#8220;social capital&#8221; in the United States: the shift from communal engagement to more solitary activity.<em> </em>(Disclosure: I helped conduct research for that book many years ago, and I consider Putnam a mentor and friend.) He has advised presidents in both political parties about what might be done to strengthen social ties in America.</p>

<p>After I heard the interview, I emailed Putnam to congratulate him for the name check, and to continue a conversation we had started last year when <em>Our Kids</em> first appeared.</p>

<p>The book begins with a poignant account of Putnam&rsquo;s boyhood home of Port Clinton, in Ottawa County, Ohio, just east of Toledo. The social and economic challenges in this former manufacturing stronghold reflect some of the deepest problems facing America today. Not coincidentally, Ottawa is a battleground county within a battleground state that may determine the 2016 election.</p>

<p><em>Our Kids</em> then provides a statistical dive into the hugely different opportunities available today &mdash; both nationwide and in Port Clinton &mdash; to middle-class and affluent children and to kids whose families occupy roughly the bottom third of the income distribution.</p>

<p>Putnam is alarmed about the decline of social ties over the decades, and equally alarmed about the corrosive impact of inequality on the life chances of millions of children across America. Yet he combines that alarm with a Progressive Era optimism that Americans can be mobilized to address these inequalities through both moral appeal and appeal to our enlightened self-interest.</p>

<p>Putnam and I caught up recently to discuss how Secretary Clinton&rsquo;s interview captured her liberal-communitarian worldview. After our conversation, Clinton has made &#8220;stronger together&#8221; a central slogan of her campaign, a deliberate contrast to Donald&rsquo;s Trump&rsquo;s rhetoric pitting different American subgroups against one another, and a stark challenge to Trump&rsquo;s claim that he &#8220;alone&#8221; can fix our problems. Below is an edited and condensed transcript of our conversation.</p>

<p><strong> Harold Pollack:</strong> <strong>When you and I corresponded about Hillary Clinton&rsquo;s praise for your book, you mentioned that Clinton is a &#8220;liberal communitarian<em>.&#8221;</em> First of all, what do you mean by that, and how do you think that would actually matter in terms of what she might do as president?</strong></p>

<p>Robert Putnam: It&#8217;s easier to answer the first of those questions than the second. I basically agree with the way that E.J. Dionne divided up the political world in his book of a few years ago, <em>Our Divided Political Heart</em>. He said that over the course of American history, American political debate has moved back and forth along two, not one, big dimensions. There is a left-right dimension, which is basically a dimension of how much you care about equality. It&#8217;s about class differences and so on. Then there&#8217;s another that he says is basically orthogonal to that, which is the dimension between individualism and communitarianism.</p>

<p>Those two dimensions create a two-by-two table, if you&#8217;re simplistic about it. That is, you can be a conservative and an individualist. In our current political discussion, that refers to libertarians, basically. They&#8217;re generally conservative. They&#8217;re not all that concerned about equality, but they are certainly hostile to any collective action, especially any collective action by the state.</p>

<p>Then there is another kind of conservatism that is actually much more communitarian. In contemporary jargon, those are people you might call compassionate conservatives. It has historically meant a certain kind of noblesse oblige Tory-ness. In the Bush family, there are a number of representatives of this kind of outlook, people who are conservative but believe that we&#8217;re all in this together.</p>

<p><strong>HP: Sticking to the liberal column, there&#8217;s the communitarian box and the more individualistic box. Can you unpack a bit the tension between those two groups?</strong></p>

<p>RP: I want to be careful, because these liberal individualists are many of my best friends. They&#8217;re inclined to emphasize individual rights &mdash; what Michael Sandel calls the &#8220;unencumbered self,&#8221; the individual without context.</p>

<p>Communitarian liberals are more inclined to be conscious of social ties, and so are more likely to think about social-network-based solutions: still wanting equality and therefore being liberal in that sense, but being more attentive to social networks. I&#8217;m usually described by other people as a liberal or left-wing communitarian.</p>

<p><strong>HP: Are you comfortable with that description?</strong></p>

<p>RP: Yeah. You&#8217;ve got to be careful when you accept labels, because they don&#8217;t necessarily mean the same thing to everybody else. Yes, if you interpret liberal communitarian or left-wing communitarian in the sense that I just described, I think Hillary Clinton is, too.</p>

<p>I think, actually, it&#8217;s not an accident that the other people whose books she mentioned are all also from that same quadrant, [although] I&#8217;m not sure that they would like to be put there. I don&#8217;t mean she was trying to convey a message. I think it&#8217;s really true that that&#8217;s her intellectual matrix.</p>
<h2 class="wp-block-heading">The travails of Port Clinton, Ohio</h2>
<p><strong>HP: Your book starts with an account of Port Clinton, Ohio. The trajectories of places like Port Clinton seem to be a fundamental backdrop of the 2016 election. You note the economic decline of this solid working-class community. </strong></p>

<p><strong>We can deconstruct the book in lots of ways, but the basic idea is that this area of Port Clinton was a successful working-class place that once nurtured you and that now seems to have both decayed and to have fallen prey to profound inequality. One can easily imagine a Sanders or a Trump speech entirely based on Port Clinton. I don&#8217;t know if you read it the same way.</strong></p>
<aside id="aATMDj"><q class="is-align-right"><span>&#8220;By many measures, I think the 1950s and 1960s were a high point in &#8216;we&#8217;-ness in America. I think now, after 60 years of moving in an &#8216;I&#8217; direction, we&#8217;re now at a level of &#8216;I&#8217;-ness that is probably more extreme than any period in our history. Donald Trump is the apotheosis of I-ness.&#8221;</span></q></aside>
<p>RP:<strong> </strong>Yeah, I do. I think [Sanders and Trump] are both very, very different people with very different politics, but both are popular in Port Clinton today.</p>

<p>A lot of my own political outlook and social outlook comes from the fact that I grew up in that other Port Clinton, which was high in social capital and also high in class equality, though as I emphasize in <em>Our Kids</em>, there was also race and gender inequality in Port Clinton in those years. That sort of egalitarian, communitarian ethos<strong> </strong>feels correct to me and also normal to me. If I were writing a critical intellectual biography of this guy, <em>Putnam</em>, I would theorize that a lot of what he writes about is a somewhat idealized version of his hometown.</p>

<p>I do think there is a direct connection between this year&#8217;s election and this communitarian versus<strong> </strong>individualistic dimension &mdash; what we might term the &#8220;we/I&#8221; distinction. By many measures, I think the 1950s and 1960s were a high point in we-ness in America. I think now, after 60 years of moving in an &#8220;I&#8221; direction, we&#8217;re now at a level of I-ness that is probably more extreme than any period in our history.</p>

<p>Donald Trump is the apotheosis of I-ness. It&#8217;s kind of like I-ness taken to the most ridiculous extreme. It&#8217;s all about him personally. I don&#8217;t want to say that Hillary Clinton is devoid of self-interest. Of course not. But I do think her outlook, her philosophic outlook, is very much a &#8220;we&#8221; outlook. I think this year&#8217;s election will be more defined by the &#8220;I/we&#8221; or individualistic-communitarian dimension than it will be by the left-right dimension, honestly.</p>

<p>[In fact,] if you flatten this year&#8217;s campaign into a single left-right dimension, there are issues in which Trump looks like he&#8217;s to Clinton&rsquo;s left.</p>

<p><strong>HP: Trade, for example?</strong></p>

<p>RP:<strong> </strong>That would be one, but not only that. If you flattened politics to a single left-right dimension, that&#8217;s one reason he sits uncomfortably with many members of the Republican Party. If instead<strong> </strong>you see their differences through the lens of &#8220;I/we,&#8221; I think they are poles apart.</p>
<h2 class="wp-block-heading">Port Clinton: a bellwether city where Trump has significant support</h2>
<p><strong>HP:</strong> <strong>If I can get back to Port Clinton, Ohio may be the most critical state for Donald Trump. You can imagine the voters of Port Clinton will pick the next president of the United States.</strong></p>

<p>RP: Port Clinton is the county seat of Ottawa County, and Ottawa County is the bellwether county in the bellwether state of the United States. Historically, that&#8217;s true.</p>

<p><strong>HP: Are you hearing anything on the campaign trail that suggests anyone across the political spectrum is really offering public policies that might help the people in places like Port Clinton, who are suffering in the way you laid out in your book? Are you hearing things that are making you optimistic, that, hey, there&#8217;s some things we might do for these places?</strong></p>

<p>RP: Yeah, I think that, actually, there are a lot of things we could do. &hellip; I don&#8217;t think this is a question of policy wonkery. It&rsquo;s not that we don&#8217;t know what to do to help poor kids. We know a lot of things would work &mdash; and many of them happen to be in the 2016 Democratic platform. A lot of things have been shown to work. I think the problem is fundamentally political.</p>

<p>I could go through some of the policies that I think are honestly no-brainers, but the question is the politics of this. We&#8217;ve become so polarized politically that as a reformist trying to change America,<strong> </strong>I&#8217;ve moved my attention to the state and local level, because I think we&#8217;re a little less frozen in our political corners at the local level than we are at the national level.</p>

<p>I&#8217;ve said before, I think the problem of poor kids is a political problem, meaning there are some things that I think people on the left, like me, think would be really good to do, like raising the minimum wage or making early childhood education universal. Not just pre-K, but I mean going back really early. [Or] like helping restructure the economy in ways that would provide the working class with a decent chance going forward.</p>

<p>In some of those areas, I&#8217;m enough of an expert to say exactly how to do it. Some, like the economic side, I&#8217;m not able to say exactly what could be done.</p>

<p>I do think that, for example, Port Clinton was badly hurt by trade. No doubt about it. Many of the dads of my classmates had well-paying UAW jobs in local factories in Port Clinton, and there are no UAW workers in factories in Port Clinton anymore.</p>

<p>There are things that we can do to help people like that today, [including] substantially upgraded assistance to workers who were displaced by trade. That, I think, is more or less the evolving consensus in the Democratic Party, and I share those views.</p>

<p>Plus, you have to know there&#8217;s a good chance that Donald Trump will win Port Clinton. He&#8217;s doing very well in many of the struggling white counties in Ohio.</p>

<p><strong>HP: How many of his supporters around Port Clinton are actually going to vote?</strong></p>

<p>RP:<strong> </strong>That&#8217;s the right question. I don&#8217;t know the answer to that. Probably many won&rsquo;t, but that doesn&#8217;t make me happy.</p>
<h2 class="wp-block-heading">The top one-third of earners no longer interact with the bottom third</h2>
<p><strong>HP: Do you think that liberal cosmopolitans like myself need to find a different way to relate to people like those you spoke with for your book &mdash; to reach out in a different way to them?</strong></p>

<p>RP:<strong> </strong>The answer is yes. I think the category of people that you&#8217;re calling liberal cosmopolitans, really the upper and upper middle class of America, are increasingly disconnected from working-class America. I mean that in a very specific sense. Our residences are increasingly segregated by class. Our schools are increasingly segregated by class. Our extended families are increasingly separated by class.</p>

<p>Therefore, where two generations ago it would be not at all uncommon for people from opposite sides of the tracks to be on the same bowling team, it&#8217;s now extremely rare. Not just because bowling teams are rare, but it&#8217;s extremely rare because of big structural change &mdash; economic and other changes that have moved us toward two separate places.</p>
<div class="align-right"><img src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/6896251/OurKids.cover.0.jpg" alt="OurKids.cover.0.jpg" data-chorus-asset-id="6896251"></div>
<p>I draw hope from earlier periods of American history when we have solved problems like this. The most important example that I use is the transition from the Gilded Age to the Progressive Era.</p>

<p>I think it&#8217;s not at all an accident that one of the first things that began to shift America from the Gilded Age toward the Progressive Era is the publication of <em>How the Other Half Lives</em>, which was simply a verbal and photojournalistic<strong> </strong>description of life on the Lower East Side of New York, meant to be read by affluent folks in the Silk Stocking districts of the Upper East Side of New York.</p>

<p>Basically, Jacob Riis, the author of that book, along with a talented and aggressive young politician who read it &mdash; namely Teddy Roosevelt &mdash; did actually trigger change in American politics.</p>

<p>I do not mean for a second that <em>Our Kids</em> will have anything like the same historic effect that <em>How the Other Half Lives</em> demonstrably had, but that&#8217;s the genre in which I wrote it. I wrote it because I thought that people like me &mdash; unless you&#8217;re a specialist in working on the subject of working-class Americans &mdash; are much more ignorant of the actual worsening conditions of life lower in the hierarchy than we were, or people like us were, 30 or 40 years ago.</p>

<p><strong>HP: Obviously, the rising income and wealth share of the super wealthy is very important, but I wonder if the focus on the top 1 percent allows many of us in the top 20 percent to avoid confronting the fact that we are living different lives than those available to the bottom 80 percent.</strong></p>

<p>RP: That&#8217;s exactly, Harold, why the argument in <em>Our Kids</em> is framed not as Bill Gates&#8217;s kids versus some homeless kids. That&#8217;s why virtually all of the graphs and charts in that book, and virtually all of the analysis in that book, is phrased in terms of comparing in round numbers the upper third of American society &mdash; those who have a college degree &mdash; and the lower third, those Americans who didn&#8217;t get past high school.</p>

<p>Of course the income distribution is important. I&#8217;m not for a second saying it&#8217;s not important. The focus purely on what&#8217;s changed recently with respect to the distribution of income encourages this focus because recently the big change has been this pulling away of the upper one-tenth of 1 percent from everybody else.</p>

<p>That has somewhat distracted us, and maybe even allowed us to escape worrying about what I think is the more deeper change, that pulling apart physically and psychologically and sociologically and politically, the upper third and the lower third.</p>

<p><strong>HP:</strong> <strong>Two things really concern me when I consider whether we will engage in these problems. You note one in your book: the scary feedback loop between the fraying of the country and unequal political participation. One of the big differences between the upper third and the lower third is the upper third votes. What can we do to equalize the playing field when it comes to just the basics of political participation?</strong></p>

<p>RP: The easy answer, of course, is to halt and reverse the voting obstruction policies, [including voter ID laws]. There&#8217;s been a wide discussion about how to increase voting turnout by institutional changes.</p>

<p>Actually, I think much more important is social organizing, political organizing. If you look back at the earlier period of the Progressive Era, which is where I draw most of my inspiration, it was not just that some sympathetic voters on the Upper East Side of New York began to worry about folks on the Lower East Side. There was a lot of organizing going on, to pull isolated individuals, who were down at the bottom, together into a stronger coalition. That&#8217;s true especially in terms of unions, but also in terms of political organizing in that period</p>

<p>Sometimes people [believe] that I ignore the importance of political organizing, especially political organizing of the have-nots themselves. That&#8217;s not at all my view. Let me cite one of my first encounters with Hillary Clinton, actually. In January 1995,<strong> </strong>I was invited with some other people to Camp David to talk with the president about what was going to be the State of the Union message that year.</p>

<p>I &mdash; as I have done perhaps too often &mdash; began talking about the Progressive Era and the inspirations it holds for our times. Hillary Clinton, at that point, who was in the room, interrupted me and said, &#8220;Yes, Bob, I agree with that, but let&#8217;s go back. Let&#8217;s imagine that Bill is one of the Progressive Era presidents trying to make things happen: to have a Federal Reserve system, to have a federal income tax, to have child labor laws, or to have various kinds of social insurance programs. Those were the kinds of things that were needed then, were done then. And they were led by Progressive Era presidents, but they could also call upon the unions and have the unions, as a base, strengthen their hand.&#8221;</p>

<p>Clinton said: &#8220;Now, if Bill calls up the same allies today, this won&#8217;t happen.&#8221; Not because he&#8217;s moderate or conservative, but because many of these allies no longer exist. All of those working-class and progressive organizations don&#8217;t exist now or are much weaker now than they were then.</p>

<p>The point she was making is absolutely right. It wasn&#8217;t just top-down, <a href="https://www.hks.harvard.edu/saguaro/glossary">&#8220;bridging&#8221;</a> social capital that was important in that earlier period. It was also bottom-up, <a href="https://www.hks.harvard.edu/saguaro/glossary">&#8220;bonding&#8221;</a> social capital, coming out of the working class.</p>

<p>Remember, what was the subject of her thesis at Wellesley? It was Alinsky. I don&#8217;t mean to make her sound like a student radical. She certainly isn&#8217;t that now, if she ever was. But it&#8217;s true that being aware of the importance of synergy between top down and bottom up is not just some tactic that some political consultant told her about. I think she really does, in a deep sense, understand that.</p>

<p><em>Harold Pollack is the Helen Ross professor at the School of Social Service Administration at the University of Chicago.</em></p>
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			<entry>
			
			<author>
				<name>Harold Pollack</name>
			</author>
			
			<title type="html"><![CDATA[Single-payer health care is more popular than ever. Here are 10 questions for its future.]]></title>
			<link rel="alternate" type="text/html" href="https://www.vox.com/2016/5/23/11703190/single-payer-questions" />
			<id>https://www.vox.com/2016/5/23/11703190/single-payer-questions</id>
			<updated>2016-05-20T11:35:03-04:00</updated>
			<published>2016-05-23T08:20:02-04:00</published>
			<category scheme="https://www.vox.com" term="Politics" />
							<summary type="html"><![CDATA[Sen. Bernie Sanders has started a political revolution: not enough of one to win the Democratic presidential nomination, but enough to put the dream of single-payer health care back on the national political agenda in a way few would have expected five years ago. Sanders&#8217;s campaign website states: &#8220;The only long-term solution to America&#8217;s health [&#8230;]]]></summary>
			
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<img alt="" data-caption="Bernie Sanders awakened a single-payer health care revolution. | Justin Sullivan/Getty Images" data-portal-copyright="Justin Sullivan/Getty Images" data-has-syndication-rights="1" src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/15816825/GettyImages-532642540.0.1463760827.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" />
	<figcaption>
	Bernie Sanders awakened a single-payer health care revolution. | Justin Sullivan/Getty Images	</figcaption>
</figure>
<p>Sen. Bernie Sanders has started a political revolution: not enough of one to win the Democratic presidential nomination, but enough to put the dream of single-payer health care back on the national political agenda in a way few would have expected five years ago.</p>

<p>Sanders&rsquo;s campaign website states: &#8220;The only long-term solution to America&#8217;s health care crisis is a single-payer national health care program.&#8221; Many Americans &mdash; by no means all of them Sanders voters &mdash; seem to agree. Just this week, Gallup <a href="http://www.gallup.com/poll/191504/majority-support-idea-fed-funded-healthcare-system.aspx?g_source=Politics&amp;g_medium=newsfeed&amp;g_campaign=tiles">released a poll</a> indicating that &#8220;58% of U.S. adults favor the idea of replacing [the Affordable Care Act] with a federally funded healthcare system that provides insurance for all Americans.&#8221; Politico Magazine <a href="http://www.politico.com/story/2016/05/poll-health-care-bernie-sanders-223206">reports</a> that Sanders&rsquo;s health plan &#8220;is the most popular of the three remaining candidates.&#8221;</p>

<p><a href="http://prospect.org/article/false-lure-sanders-single-payer-plan">Critics</a> have <a href="http://krugman.blogs.nytimes.com/2016/01/28/single-payer-trouble/">noted</a> many <a href="http://www.vox.com/2016/1/17/10784528/bernie-sanders-single-payer-health-care">shortcomings</a> and <a href="http://www.vox.com/2016/1/28/10858644/bernie-sanders-kenneth-thorpe-single-payer">gaps</a> in <a href="http://www.urban.org/research/publication/sanders-single-payer-health-care-plan-effect-national-health-expenditures-and-federal-and-private-spending">Sanders&rsquo;s specific plan</a>. Still, the public&rsquo;s appetite for single-payer suggests that policymakers should take the idea seriously. Though Sanders has thought through some specifics of how to implement his plan, the newly awakened single-payer constituency will have to answer some hard questions about how America might implement a sound single-payer plan.</p>

<p>Here are 10:</p>
<div data-chorus-asset-id="6519491"><img src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/6519491/Single%20payer%20index%20card.JPG"></div><h2 class="wp-block-heading">1) What taxes should be enacted or raised to pay for it?</h2>
<p>Single-payer would greatly increase federal spending, putting hundreds of billions of additional dollars onto the federal budget every year. <a href="http://jhppl.dukejournals.org/content/early/2015/06/09/03616878-3150160.full.pdf+html">Proponents estimate that the required increment to federal revenues</a> would be roughly equivalent to a <a href="http://www.vox.com/2016/1/16/10779270/pollack-single-payer-in-america">doubling of the federal income tax</a>. Much of this increase would be offset by other reductions in public and private expenditures.</p>

<p>Even if single-payer reduced overall medical expenditures, it would still require big federal tax increases. These would bring correspondingly big efficiency and distributional implications across the American economy. It&rsquo;s probably unwise to finance single-payer through the income tax. <a href="http://www.urban.org/research/publication/blueprint-tax-reform-and-health-reform-0">Some experts have proposed a value-added tax</a>, which causes fewer economic distortions and losses per dollar raised. A carbon tax &mdash; which should be enacted anyway for environmental reasons &mdash; could be another valuable revenue source.</p>
<h2 class="wp-block-heading">2) Would patients pay copayments or deductibles?</h2>
<p>Sanders&rsquo;s plan is labeled &#8220;Medicare for all.&#8221; Yet as <a href="http://www.vox.com/2016/1/17/10784528/bernie-sanders-single-payer-health-care">Ezra Klein observed here at Vox</a>, Sanders&rsquo;s proposed coverage is much more generous and comprehensive than the current iteration of Medicare. It apparently includes no patient copayments or deductibles. This generous structure would protect millions of chronically ill Americans who now sometimes face punishing medical bills.</p>

<p>Yet <a href="http://www.urban.org/research/publication/sanders-single-payer-health-care-plan-effect-national-health-expenditures-and-federal-and-private-spending">recent analysis by an Urban Institute team indicates that such generous coverage would sharply increase costs</a>. Some patient copayments and deductibles, guided by evidence-based approaches such as <a href="http://vbidcenter.org">value-based insurance design</a>, might improve the quality and cost-effectiveness of a single-payer plan.</p>
<h2 class="wp-block-heading">3) Who decides what is covered, for whom, and at what price?</h2>
<p>A sensible single-payer program should say no to questionable or overly costly interventions more often than our current system is able to do. Private insurers lack the public legitimacy to reject dicey therapies. Medicare is susceptible to pressure from industry, provider, and patient groups.</p>

<p>It&rsquo;s especially hard for private insurers to refuse coverage for a particular drug, device, or surgical procedure once Medicare agrees to pay. (I haven&rsquo;t even mentioned bitter social policy disputes over immigration, abortion coverage and birth control. I&rsquo;ll get into these later.)</p>

<p>A single-payer system requires tougher mechanisms. The Affordable Care Act established the controversial Independent Payment Advisory Board (IPAB). Yet IPAB and most other cost-containment efforts encounter <a href="http://www.nejm.org/doi/full/10.1056/NEJMp1105144?viewType=Print">fierce bipartisan congressional resistance</a>. The ACA <a href="http://www.nejm.org/doi/full/10.1056/NEJMp1007168?viewType=Print">unwisely limits </a>the use of economic tools such as cost-utility analysis in coverage decisions. An effective single-payer system requires real economic analysis to determine who is covered for what service, and at what reimbursement rates.</p>
<h2 class="wp-block-heading">4) Is the &quot;public option&quot; the right path to single-payer?</h2>
<p>One might think that Congress could pass a short law that simply announced all Americans are now eligible for Medicare. For a million practical reasons, that can&rsquo;t happen. There are too many delicate and interconnected moving parts to the American health care financing system. Patients, providers, and pretty much every other interested stakeholder would rebel against abrupt radical changes.</p>

<p>No one knows what a careful transition to single-payer would actually look like, and how this transition might be accomplished without causing undue damage to existing systems. A Medicare-based public option such as <a href="http://www.nytimes.com/2016/05/11/us/politics/hillary-clinton-health-care-public-option.html">the one Hillary Clinton endorses</a> offers one strategy to develop infrastructure that might someday evolve into single-payer. This is one reason the public option attracts both fervent support and bitter opposition.</p>
<h2 class="wp-block-heading">5) What happens to Medicaid and other state programs?</h2>
<p>Healthy low-income Medicaid recipients could be subsumed in a single-payer plan. Single-payer could integrate supports for nursing home care now financed through Medicaid. The intricate and costly patchwork of disability, school-based, and medical services would be much more difficult to incorporate or to replace, as would the complicated world of Medicaid-financed social services to vulnerable populations.</p>

<p>State Medicaid programs greatly vary in structure, generosity, and expense. Medicaid subsidizes many state and local social services, too. Plenty of questions remain about how 51 state Medicaid programs might be combined into one national framework, whether states could or should offer complementary programs on top of a single-payer effort, whether the federal government might provide some cost-sharing for such state efforts.</p>

<p>National policy might emulate generous Medicaid programs in Massachusetts and New York. Or it might resemble less generous Medicaid programs in Arkansas or Illinois.</p>
<h2 class="wp-block-heading">6) What about the potential losers?</h2>
<p>Single-payer is potentially cheaper than our current health care financing system because government could use its market power to impose lower prices. There are many advantages to such a system.</p>

<p>Yet if government squeezes too hard or too indiscriminately, it could cause serious harm. It might also provoke <a href="http://www.nytimes.com/2011/11/20/books/review/remedy-and-reaction-the-peculiar-american-struggle-over-health-care-reform-by-paul-starr-book-review.html?_r=0">a punishing political backlash from virtually the entire supply side of the medical economy</a>. Rural hospitals on thin margins would be one obvious vulnerable constituency. Veterans, current Medicare recipients, and unionized workers with generous tax-subsidized health plans are three others. Single-payer cannot pass until the interests of such constituencies are addressed.</p>
<h2 class="wp-block-heading">7) How would our kludgy political process produce a decent system while deterring political meddling?</h2>
<p>Fragmentation of American governance poses another serious obstacle. Efforts by <a href="http://www.nytimes.com/2015/01/30/opinion/no-case-for-killing-the-medical-device-tax.html">solid ACA supporters</a> to weaken the ACA&rsquo;s medical device tax exemplify this challenge. Establishing coherent and disciplined national policies requires a major power shift from Congress to the executive branch health care bureaucracy.</p>

<p>Many Democrats and Republicans oppose a more centralized policy process that might work better for the nation as a whole but would also <a href="http://prospect.org/article/real-problem-independent-payment-advisory-board">reduce their individual leverage to help constituents</a> and political supporters. A robust single-payer system must retain proper congressional oversight while <a href="http://www.nejm.org/doi/full/10.1056/NEJMp1105144?viewType=Print">constraining toxic micromanagement and special interest pleading</a>.</p>
<h2 class="wp-block-heading">8) What about abortion, immigration, and other related policy disputes?</h2>
<p>Single-payer further nationalizes fights that are now addressed through private coverage or through diverse policies across the different states. Obvious questions remain about low-income women&rsquo;s access to abortions and reproductive health services in a single-payer system.</p>

<p>One must also address the myriad coverage challenges related to the presence of undocumented children and adults <a href="http://healthpolicy.ucla.edu/publications/Documents/PDF/undocumentedreport-aug2013.pdf">in millions of households</a>. Democrats prefer not to ponder the prospect of a future President Ted Cruz issuing executive orders on sensitive social policy matters. At some point, conservative Republicans will be at the helm, exercising considerable power over national health policy.</p>
<h2 class="wp-block-heading">9) Could the affluent buy additional or alternative coverage?</h2>
<p>Many among the top 20 percent will perceive themselves to be losers within a single-payer plan. As with ACA, they would pay higher taxes to support universal benefits, even as a single-payer plan will likely offer less attractive coverage than they currently have, typically supported by generous tax subsidies.</p>

<p>Many democracies strike an implicit bargain by allowing wealthy people to skip waiting lines or purchase generous wrap-around coverage. Such policies provide a safety valve that reduces some political opposition. Allowing some complementary private coverage also reduces pressure for overgenerous basic coverage. Allowing too many private add-ons runs the risk of unraveling the universal nature of single-payer coverage. An American system would have to manage these trade-offs.</p>
<h2 class="wp-block-heading">10) How do we get from here to there without replicating the defects of our current system?</h2>
<p>Sanders and his supporters rightly note that a well-implemented single-payer system would likely be cheaper, more disciplined, and more humane than our current health system. Yet two huge questions must be answered before the potential of such a single-payer plan can be realized.</p>

<p>First, we need a realistic road map that does not merely describe a sound single-payer system but that also describes how we might get there from here. It&rsquo;s telling that no detailed single-payer legislative proposal has been advanced that provides a realistic transition plan. Many of the presumed or hoped-for financial savings one might expect from a single-payer system won&rsquo;t be achieved. The political and administrative obstacles are simply too high.</p>

<p>Second, we require a strategy to ensure that a politically achievable single-payer system won&rsquo;t replicate prominent defects of our current system. Almost by definition, single-payer cannot cure the pathologies that underlay our current health care system, because <a href="http://www.vox.com/2016/1/16/10779270/pollack-single-payer-in-america">single-payer would necessarily be enacted through the same legislative structures, implemented within the same path-dependent $3 trillion medical care political economy, that created and sustained our current pathologies</a>.</p>

<p>These are huge challenges, but at least we have some time to think about them. Single-payer can&rsquo;t be enacted until progressives win comprehensive presidential and congressional victories on a scale we haven&rsquo;t seen since the New Deal. If and when that moment comes, progressives will be hard-pressed to provide more solid answers than anyone has provided thus far.</p>
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					</entry>
			<entry>
			
			<author>
				<name>Harold Pollack</name>
			</author>
			
			<title type="html"><![CDATA[How the housing market and retirement system are tilted against black and Hispanic workers]]></title>
			<link rel="alternate" type="text/html" href="https://www.vox.com/personal-finance/2016/2/29/11121590/black-hispanic-wealth-gap" />
			<id>https://www.vox.com/personal-finance/2016/2/29/11121590/black-hispanic-wealth-gap</id>
			<updated>2019-03-05T23:10:04-05:00</updated>
			<published>2016-02-29T08:10:02-05:00</published>
			<category scheme="https://www.vox.com" term="Money" /><category scheme="https://www.vox.com" term="Personal Finance" />
							<summary type="html"><![CDATA[The mortgage meltdown that preceded the Great Recession decimated minority wealth in my neighborhood, a majority&#8211;African-American suburban community in South Chicago. Housing prices fell, and remain more than 30 percent below what they were in 2006. Our area is still dotted with dozens of fading for sale signs, sometimes in front of foreclosed or empty [&#8230;]]]></summary>
			
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<p>The mortgage meltdown that preceded the Great Recession decimated minority wealth in my neighborhood, a majority&ndash;African-American suburban community in South Chicago. Housing prices fell, <a href="http://www.chicagomag.com/Chicago-Magazine/April-2015/chicago-real-estate/home-condo-prices?show=burbs&amp;sortby=name&amp;attached=false">and remain more than 30 percent below what they were in 2006</a>. Our area is still dotted with dozens of fading for sale signs, sometimes in front of foreclosed or empty homes. Things never fully recovered.</p>

<p>Race and segregation play a big role in this story. Five <a href="http://www.chicagonow.com/chicago-muckrakers/2010/10/chicago-ahead-of-la-and-nyc-in-foreclosures/">of the 10 Chicago zip codes with the highest foreclosure rates</a> are <a href="http://zipatlas.com/us/il/chicago/zip-code-comparison/percentage-black-population.htm">at least 94 percent African American</a>.</p>

<p>And this is a national problem. As one <a href="http://www.responsiblelending.org/mortgage-lending/research-analysis/Lost-Ground-2011.pdf">shocking 2011 report concluded</a>: &#8220;Approximately one-quarter of all Latino and African-American borrowers have lost their home to foreclosure or are seriously delinquent, compared to just under 12 percent for white borrowers.&#8221;</p>

<p>In the runup to the foreclosure crisis, <a href="http://www.motherjones.com/politics/2013/08/black-america-foreclosure-crisis">nearly 50 percent of loans to African Americans were subprime</a>. Nonwhite homeowners <a href="http://www.epi.org/publication/latino-black-borrowers-high-rate-subprime-mortgages/">were much more likely than white homeowners to receive subprime loans</a> &mdash; even when the nonwhite applicants qualified for better mortgages.</p>

<p><a href="http://www.motherjones.com/mojo/2015/07/race-gender-interest-rates-mortgages">Black borrowers are charged roughly 0.3 percentage points more in interest than white borrowers</a>, even accounting for individual debts and credit histories. (That translates to an extra $40 per month on a $250,000 mortgage.) And that common phrase &#8220;accounting for&#8221; itself freezes in amber many other factors, which are themselves the product of long-term disparities.</p>

<p>Minorities&rsquo; struggles with homeownership are one facet of a larger story. When all types of investments are taken into account, there&rsquo;s a startling wealth gap between white people and African Americans &mdash; and between white people and Hispanics. According to the Federal Reserve&rsquo;s Survey of Consumer Finance, the median net wealth of non-Hispanic whites in 2013 was about $142,000. The comparable figure among nonwhite and Hispanic Americans was $18,100, down from $21,900 only three years before.</p>

<p>What explains the gap? It&rsquo;s obviously hard to generalize about the decisions and circumstances of millions of white, black, and Hispanic households. The tangled causal pathways are often hard to pin down. But a big part of the story is that young white people tend to come from more economically secure backgrounds, making it easier for them to make educational and financial investments early in life that pay off in the long run.</p>
<h2 class="wp-block-heading">With less wealth to start, it’s harder for minorities to invest for the long term</h2>
<p>As a percentage of annual income, non-Hispanic white workers <a href="http://www.epi.org/publication/retirement-inequality-chartbook/">have three times as much in retirement accounts as their Hispanic or African-American counterparts</a>. And when researchers examine what&rsquo;s actually in different retirement accounts, African-American and Hispanic workers are notably less likely to invest in high-yielding stocks instead of safer investments such as bonds or money market funds. Only 30 percent of black people have stock investments, compared with 57 percent of white people.</p>

<p>Underexposure to equities softened the blow of the stock market swoon of 2007 and 2008, but it also deprived minority households of corresponding gains when markets recovered.</p>
<figure class="wp-block-pullquote alignleft"><blockquote><p>Minority workers were much more likely to withdraw money or to borrow against their 401(k) accounts</p></blockquote></figure>
<p>Some of these disparities reflect differences in investment sophistication that might be reduced through information and behavioral-economic nudges. Programs that automatically enroll workers into sensible low-fee target-date funds &mdash; and then let them opt out if they want to &mdash; would be helpful. But the larger problems go beyond information and reflect the reality of people&rsquo;s economic and family lives.</p>

<p><a href="http://www.nber.org/papers/w20937">Kai Yuan Kuan and colleagues</a> tracked workers&rsquo; 401(k) contributions, investment practices, and withdrawals at a single firm between 2003 and 2010. It&rsquo;s good practice for workers to save 20 percent of their gross income, but <a href="https://www.washingtonpost.com/news/wonk/wp/2015/02/20/middle-age-blacks-have-less-in-their-401ks-than-young-whites/">few workers in any racial or ethnic group</a> managed to do that.</p>

<p>Still, white people managed to accumulate much more money than their minority counterparts. And, surprisingly, the gap didn&rsquo;t arise because white people contributed that much more. Median 2010 contribution amounts were similar across racial and ethnic groups. The difference was that nonwhite workers were more likely to withdraw money or to borrow against their 401(k) accounts.</p>

<p>Minority workers effectively used their retirement accounts as <a href="http://www.samefacts.com/2015/02/everything-else/how-401k-accounts-widen-raceethnic-wealth-disparities/">a short-term savings vehicle and emergency fund</a> rather than as a long-term tool for retirement. Not surprisingly, then, they invested their 401(k) in money market funds and other really safe assets. Although these choices provide low long-run returns, they make a certain amount of sense for families who have little other wealth and who might need to address an unexpected contingency or help a loved one facing sudden need.</p>

<p>In short, our 401(k) system was designed by and for upper-middle-class people. It imposes penalties on early withdrawals, based on the assumption that workers will have other ways to address short-term life challenges. It doesn&rsquo;t work well for workers who are less likely to have a broader financial safety net. It was entirely predictable that intergenerational wealth disparities would reproduce themselves as less-advantaged workers use the existing system differently.</p>
<h2 class="wp-block-heading">Buying a house too early can be a trap</h2><div data-chorus-asset-id="4006986"> <img src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/4006986/shutterstock_111393506__1_.0.jpg"><div class="caption">(bikeriderlondon/Shutterstock)</div> </div>
<p>For better and for worse, housing is a standard aspirational path to wealth accumulation in minority communities. And it&rsquo;s not hard to see why.</p>

<p>There is something unique about crossing the threshold at your own front door. Housing is one form of wealth that you can see, touch, and smell. Investing in a house seems less risky or ethereal than buying a stock index fund whose value can plummet at any time. Buying a home offers the prospect of gaining access to a safe and pleasant community with good, integrated schools while building family wealth at the same time.</p>

<p>But buying a home can be risky too. In <a href="http://www.vox.com/2016/2/23/11095958/stock-real-estate-bubbles">a recent article</a>, I emphasized that homeownership is the most leveraged and undiversified investment most of us will ever make. And every disadvantage and risk of homeownership is an even greater disadvantage and risk to families who are just starting out. If you stretch to buy a home, you can get into real trouble if something happens to your marriage or your job.</p>

<p>Families who lack financial reserves are unlikely to get the best mortgages, especially within an opaque and often discriminatory credit market. A lack of personal savings or access to family assistance gives many families a dangerously weak safety net if something were to go wrong.</p>

<p>So young families should be wary of over-investing in homeownership. Employment or family instability could necessitate costly moves. It&rsquo;s wise not to leap into buying a home until one has gotten a handle on high-interest credit card and student loan debt and accumulated a nice down payment plus a few months&#8217; living expenses as an emergency reserve.</p>

<p>If you get on a firm financial footing first, homeownership can be a blessing. If you buy a home before you&rsquo;re financially ready, it can lead to lost wealth, foreclosures, and a lot of stress.</p>

<p>That means many families should wait years before buying their first home. That&rsquo;s a tough pill to swallow &mdash; and society should be doing more to help close racial wealth gaps. I wish the Obama administration <a href="http://prospect.org/article/staggering-loss-black-wealth-due-subprime-scandal-continues-unabated">had been much more aggressive</a> in its efforts to help families refinance bad mortgages. And programs like Pell Grants and child care subsidies can provide financial help to people trying to move up the economic ladder whether they own a home or not.</p>

<p>It takes patience, hard work, and discipline to accumulate the financial rewards that make comfortable homeownership possible. The economic playing field can be pretty tilted, too. There&rsquo;s no easy path to leap over racial disparities in opportunities and family resources.</p>
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									</content>
			
					</entry>
			<entry>
			
			<author>
				<name>Harold Pollack</name>
			</author>
			
			<title type="html"><![CDATA[Here&#8217;s how to survive bubbles in the stock market and real estate]]></title>
			<link rel="alternate" type="text/html" href="https://www.vox.com/2016/2/23/11095958/stock-real-estate-bubbles" />
			<id>https://www.vox.com/2016/2/23/11095958/stock-real-estate-bubbles</id>
			<updated>2019-03-05T22:54:36-05:00</updated>
			<published>2016-02-23T10:00:03-05:00</published>
			<category scheme="https://www.vox.com" term="Business &amp; Finance" /><category scheme="https://www.vox.com" term="Money" /><category scheme="https://www.vox.com" term="Personal Finance" />
							<summary type="html"><![CDATA[After six years of strong returns, the market suddenly lost about 10 percent of its value in mid-August 2015. In September, after the market had regained some of August&#8217;s losses, Yale economist Robert Shiller, a Nobel laureate, told CNBC that the stock market might be in a bubble. &#8220;I think the market might do what [&#8230;]]]></summary>
			
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<p>After six years of strong returns, the market suddenly <a href="http://www.vox.com/2015/8/25/9205663/stock-market-crash-explained">lost about 10 percent of its value</a> in mid-August 2015. In September, after the market had regained some of August&rsquo;s losses, Yale economist Robert Shiller, a Nobel laureate, <a href="http://www.cnbc.com/2015/09/15/robert-shiller-this-is-the-sign-were-in-a-bubble.html">told CNBC</a> that the stock market might be in a bubble. &#8220;I think the market might do what it did in 2000,&#8221; he said.</p>

<p>Six months later, the market is roughly where it was the day Shiller made his comments. With plunging oil prices, China&rsquo;s serious economic troubles, and the ever-present possibility of a security crisis, one can hardly rule out the possibility of a big further drop.</p>

<p>If you remember the past two stock market meltdowns, in 2000 and 2008, you might be tempted to dump your stock investments so you can avoid big losses when the current bubble &mdash; if it is in fact a bubble &mdash; ultimately pops.</p>

<p>I asked several experts what they thought about this question. They told me that trying to predict market bubbles is generally a fool&rsquo;s errand. However, there are some steps ordinary investors can take to protect themselves that work whether there&rsquo;s a bubble or not.</p>

<p>The lessons are a bit different regarding a housing market bubble. Because these are more immediately dangerous to regular people, you should be more restrained in your decisions about housing, especially if local real estate prices race ahead of local rents, or if your life situation would makes it hard to ride things out if housing prices really dropped.</p>
<h2 class="wp-block-heading">No one knows if there’s a stock market bubble or not</h2><div data-chorus-asset-id="6088865"> <img src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/6088865/GettyImages-52487062%20(1).jpg"><div class="caption">Pets.com seems ridiculous in hindsight, but many other technology companies founded around the same time proved to be hugely valuable.</div> </div>
<p>The first thing to remember is that we don&rsquo;t know if we&rsquo;re in a bubble right now. Shiller suggested we&rsquo;re in a bubble, and he&rsquo;s pretty smart. But there are plenty of smart people who think current prices are sustainable.</p>

<p>&#8220;Bubbles are only &lsquo;predictable&rsquo; after the fact,&#8221; writes Princeton&rsquo;s Burton Malkiel, author of a famous investment book called <a href="http://www.amazon.com/Random-Walk-Down-Wall-Street/dp/0393340740"><em>A Random Walk Down Wall Street</em></a>, in an email.</p>

<p>We all know about the 2000 dot-com bubble and the 2008 real estate bubble. We like to think that if we&rsquo;d been there we would have seen them coming. But bubbles are more deceptive than that. Genuinely smart investors lose serious money when bubbles burst. After all, that&rsquo;s how they become bubbles in the first place: If they were truly obvious, so many people wouldn&rsquo;t have gotten fooled.</p>

<p>During a bubble, there&rsquo;s always a plausible argument that higher prices are justified by more favorable market fundamentals. After the dot-com bubble burst, for example, it seemed obviously stupid to bet the farm on Pets.com. But during the 1990s boom, it sure looked like Amazon, Microsoft, and other innovative companies were changing the nature of American business.</p>

<p>The same point applies today. Maybe the possibility of Indian and Chinese growth has spawned unrealistic expectations about the companies that sell goods and services there. Maybe those hopes will actually be realized. Either way, it will seem more obvious afterward than it does right now.</p>

<p>And it&rsquo;s important to remember that the stock market has experienced solid periods of strong growth that were not bubbles at all. For example, after the stock market boom of the mid-1980s, a lot of people thought the market was due for a fall. Pessimists predicted that the 22 percent, single-day stock market crash on October 19, 1987, would be the start of a big recession and a bear market. Instead, the market shrugged it off, delivering spectacular stock market returns for another 12 years. People who panic-sold in October 1987 expecting further declines missed out on big gains instead.</p>

<p>Even if some financial experts might be able to recognize stock market bubbles, you and your financial adviser probably aren&rsquo;t in this group. If you&rsquo;re saving for retirement, what you care most about is stock market returns over the long run. Neither excessive alarmism nor undue optimism is helpful.</p>
<h2 class="wp-block-heading">Lifelong saving is the best defense against stock market bubbles</h2>
<p>The key to investment success is to save 10 to 20 percent of your gross income over the course of your career &mdash; regardless of what the stock market is doing. You&rsquo;ll ride some serious upswings, and you&rsquo;ll experience some stomach-churning declines. But in the long run, you&rsquo;re likely to do fine, or at least as well as you would do following any other available strategy that doesn&rsquo;t involve a time machine.</p>

<p>Don&rsquo;t panic-sell when the market plummets. Don&rsquo;t get overconfident when the market soars, either.</p>

<p>Avoiding the cacophony of financial media can help you stay on course. As <a href="http://www.chicagobooth.edu/faculty/directory/t/richard-h-thaler">my University of Chicago colleague Richard Thaler told me</a>: &#8220;Never watch a financial news network. ESPN is much better for your financial health.&#8221;</p>
<figure class="wp-block-pullquote alignleft"><blockquote><p>Don’t panic-sell when the market plummets</p></blockquote></figure>
<p>If you live below your means during your working years, you&rsquo;ll build up a nice cushion against a major stock market downturn. If you get lucky, you might enter your golden years with greater wealth than you expected. As worst-case scenarios go, that one isn&#8217;t so bad.</p>

<p>As you age, you can also reduce your risk by somewhat reducing your exposure to stocks &mdash; which offer higher returns but are more volatile. A &#8220;target date&#8221; fund set to your date of likely retirement can do this automatically for you. There are more details on how to do this in my new book (with Helaine Olen), <a href="http://www.amazon.com/The-Index-Card-Personal-Complicated/dp/1591847680"><em>The Index Card</em></a>.</p>
<h2 class="wp-block-heading">Your stock market returns are likely to be lower than in the past</h2>
<p>Today&rsquo;s high stock prices don&rsquo;t necessarily mean that stocks are about to crash. But they do mean you should expect stock market returns to be a bit lower in the future than they have been in the past.</p>
<figure class="wp-block-pullquote alignleft"><blockquote><p>Current stock values imply that the inflation-adjusted rate of return is likely to be below 5 percent</p></blockquote></figure>
<p>&#8220;If someone gives you a rule of thumb that you can expect 7 percent real returns in the stock market over a long-term, this is wrong,&#8221; writes <a href="http://www.epi.org/people/dean-baker/">Dean Baker</a>, an economist at the Center for Economic and Policy Research. That&rsquo;s the average rate of return over the past century, but these generous returns occurred at a time when stock prices were often less than 15 times corporate earnings.</p>

<p>Today, by contrast, stocks are worth more than 20 times earnings. And that means we should expect the rate of return on stocks to be correspondingly lower. Baker says current stock values imply that the inflation-adjusted rate of return is likely to be below 5 percent over the long run.</p>

<p>That doesn&rsquo;t mean you should run away from stocks. Other options, like bonds and money market funds, are also offering lower returns than they used to. But it is a reason to save a little more and spend a little less in the expectation that the stock market won&rsquo;t be going like gangbusters as it did in the late 1980s, the late 1990s, or between 2009 and 2015.</p>
<h2 class="wp-block-heading">Be cautious about buying a house when prices are high</h2><div data-chorus-asset-id="3510258"> <img src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/3510258/shutterstock_112335221.0.jpg"><div class="caption">Don&#8217;t spend too much on a house &mdash; especially if home prices have been rising relative to rents.</div> </div>
<p>I don&#8217;t believe ordinary investors should spend much time wondering if the stock market is overvalued. I&rsquo;m more cautious when it comes to housing, because a fall in your local housing market can do you greater and more immediate harm.</p>

<p>The money you put down on your house is different from the money you put down on an index fund for your retirement. Your house is the most leveraged, illiquid, and undiversified investment you will ever make. So a 10 to 20 percent swing in your local housing market can have an outsize impact on your wealth.</p>

<p>Housing runups and bubbles are distinctive risks for a second reason, too. Most people don&rsquo;t need to draw on much of their stock portfolio until they&rsquo;re at or near retirement. Even then, people draw down their wealth gradually in their 70s, 80s, and hopefully beyond.</p>

<p>In contrast, buying a house is an all-or-nothing proposition. And depending on what happens in your life, you might need to sell unexpectedly. You or your partner might lose a job. You might have a child or get a divorce. You might have to move to a new city to find work. If the local housing market drops just as you need to sell your house, that can be financially devastating.</p>

<p>How vulnerable you are depends a lot on your own life situation. If you&rsquo;re confident you&rsquo;ll be able to stay in the same house for a decade or more, you can ride out a bursting housing bubble in the same way you can ride out a bursting stock bubble. You&rsquo;re less vulnerable if you are a tenured professor than if you work in a more volatile profession. Employment is not the only variable in play, either. If your marriage is troubled, that&rsquo;s harder to talk about, but it also increases the risk that a separation will force you to sell earlier than you expected.</p>

<p>The best defense against these dangers is to be patient &mdash; especially if there has recently been a runup in the local housing market. The more you feel yourself stretching to buy a house, the more it makes sense to rent longer or to buy a more modest home. A vanilla fixed-rate mortgage with a 20 percent down payment is your best bet. These monthly payments, plus your property taxes, plus a few percent annually for repairs and maintenance, shouldn&rsquo;t exceed 30 percent of your income.</p>

<p>Pay attention to <a href="http://money.cnn.com/real_estate/storysupplement/price_to_rent/">the ratio of home prices to annual rents for similar properties</a>. Dean Baker suggests that when this ratio exceeds 15 to 20, &#8220;caution is in order.&#8221; Readily available data isn&#8217;t perfect. Typical data compares median home prices to average annual rent. In areas that include a preponderance of hugely expensive homes, this can be misleading. But if this ratio creeps well above an area&rsquo;s historic average, think twice before buying.</p>

<p>One final risk arises when your house rapidly appreciates. That risk is you. It&rsquo;s tempting to spend too much by drawing on your home equity. During the Great Recession, millions of Americans learned that home equity can fall as quickly as it rises. I&rsquo;m leery of home equity loans for a luxurious kitchen upgrade, a vacation, or a costlier car than you would otherwise drive. In this, as in so many things, living below your means is the best way to achieve financial security.</p>

<p><strong>Correction:</strong> This article originally misidentified Dean Baker&#8217;s affiliation.</p>
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			<entry>
			
			<author>
				<name>Harold Pollack</name>
			</author>
			
			<title type="html"><![CDATA[When it&#8217;s worth paying for a financial adviser — and when it&#8217;s not]]></title>
			<link rel="alternate" type="text/html" href="https://www.vox.com/2016/2/11/10964022/financial-adviser-pay" />
			<id>https://www.vox.com/2016/2/11/10964022/financial-adviser-pay</id>
			<updated>2019-03-05T21:20:47-05:00</updated>
			<published>2016-02-11T09:50:02-05:00</published>
			<category scheme="https://www.vox.com" term="Money" /><category scheme="https://www.vox.com" term="Personal Finance" />
							<summary type="html"><![CDATA[Last month I did a Reddit &#8220;Ask me Anything&#8221; on personal finances to promote my new book on the subject. I got hundreds of questions and comments about a wide variety of financial questions. This being Reddit, many questioners were young adults who wanted advice about how to manage their credit cards and tens of [&#8230;]]]></summary>
			
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<p>Last month I did a <a href="https://www.reddit.com/r/IAmA/comments/426116/im_harold_pollack_a_uchicago_professor_who/">Reddit &#8220;Ask me Anything&#8221;</a> on personal finances to promote my <a href="http://www.amazon.com/The-Index-Card-Personal-Complicated/dp/1591847680">new book</a> on the subject. I got hundreds of questions and comments about a wide variety of financial questions.</p>

<p>This being Reddit, many questioners were young adults who wanted advice about how to manage their credit cards and tens of thousands of dollars in student loan debt. Many were early in their work years and trying to figure out how best to save for retirement or (eventually) their children&rsquo;s college. Some older questioners were nearing retirement and wanted a better plan for how to draw down their savings safely and effectively.</p>

<p>I hope I helped these readers make better financial decisions. But if you&rsquo;re facing a tricky financial situation, or just struggling to make ends meet, online resources aren&rsquo;t always enough. So you might help yourself by doing something counterintuitive: paying a financial professional to advise you about how to manage your money.</p>

<p>I come to this view somewhat reluctantly. Financial services don&#8217;t come cheap. If you&rsquo;re already struggling to make ends meet, it&rsquo;s hard to justify paying someone to help you. Helaine Olen and I note at length <a href="http://www.amazon.com/Index-Card-Personal-Finance-Complicated/dp/1591847680/ref=tmm_hrd_title_0?_encoding=UTF8&amp;qid=&amp;sr=">in our book</a> that many specific products and services offered by financial professionals are overpriced or actually harmful. You don&rsquo;t need someone to sell you complicated variable annuities, actively managed mutual funds, or &#8220;heard on the street&#8221; stock tips. You&rsquo;re better off sticking to vanilla index funds.</p>

<p>Still, the right advice, offered under the right consumer protections, can save you a lot of money in the long run. A financial professional can help you get a handle on your spending, sensibly structure and manage your financial portfolio, help you understand the trade-offs as you consider whether and how to buy your first home, and a lot more.</p>
<h2 class="wp-block-heading">Free resources will only get you so far</h2>
<p>Of course, you shouldn&rsquo;t spend money for financial advice if you get the information you need for free. For example, your employer&rsquo;s benefits office might be able to connect you with an adviser from a reputable provider such as Vanguard, Fidelity, or TIAA-CREF who can provide sensible information &mdash; sometimes more substantial guidance &mdash; about your retirement accounts. There are also automated online services called &#8220;robo-advisers&#8221; that help people choose the best mutual funds for their retirement savings.</p>

<p>But of course people face financial challenges that have nothing to do with investing for retirement. Am I ready to buy a home? What kind of insurance should I purchase? How can I reduce my expenses to save for my children&rsquo;s education?</p>
<figure class="wp-block-pullquote alignleft"><blockquote><p>Some financial &quot;advisers&quot; are really salespeople who make money by steering clients toward expensive financial products</p></blockquote></figure>
<p>For complex financial questions, there&rsquo;s no substitute for having a face-to-face conversation with a human being. And this advice can be extremely valuable &mdash; saving thousands of dollars in lower fees, a lower tax bill, or saved expenses.</p>

<p>If your income is low, you might be able to find a financial coach who will give you advice for free (more on that below). But if you make too much to qualify for these services, then you should consider paying for a financial adviser.</p>
<h2 class="wp-block-heading">Paying the full bill ensures you’re getting impartial advice</h2>
<p>Some financial &#8220;advisers&#8221; are really salespeople who make money by steering clients toward expensive financial products and then pocketing commissions. If an adviser isn&rsquo;t charging you (or perhaps your employer) money, then he or she may be making money on the side in ways that creates <a href="http://www.vox.com/2015/12/21/10634980/obama-fiduciary-rule-explained">huge conflicts of interests</a>.</p>

<p>So the first time you meet with a financial adviser, you should have a direct and cordial conversation about how your financial professional expects to get paid. Some advisers make money by charging clients directly. Others work for nonprofit organizations that provide financial advice for people who couldn&rsquo;t otherwise afford it. But if an adviser makes the conversation awkward or gives vague answers, that might be a sign that the adviser has a conflict of interest; you probably should go elsewhere.</p>
<figure class="wp-block-pullquote alignleft"><blockquote><p>People face financial challenges that have nothing to do with investing for retirement</p></blockquote></figure>
<p>More specifically, your financial adviser should commit in writing to act as <a href="http://fiduciarystandard.info">a fee-only fiduciary adviser in all of her dealings with you</a>. This <a href="http://www.napfa.org/UserFiles/File/ConsumerServices/2015%20Pursuit%20of%20a%20Financial%20Advisor%20Field%20Guide%20-%20v2015.pdf">guide</a> from the National Association of Personal Financial Advisers (NAPFA) provides useful advice, including ways to check on complaints from past clients. NAPFA&rsquo;s website can help you find a fee-only fiduciary adviser in your area.</p>
<h2 class="wp-block-heading">The case for paying an adviser by the hour</h2>
<p>There are two different ways to hire a financial adviser. One option is to hire someone to manage your assets for an annual fee, perhaps 1 percent for average investors. That&rsquo;s valuable for some people who need ongoing investment management or have recurring life issues that require ongoing advice.</p>

<p>But it&rsquo;s also pretty expensive. Barring special circumstances, most people don&rsquo;t need that level of continued hand-holding. Leaving aside your home, your wealth should be concentrated in low-cost index funds that don&rsquo;t require active monitoring. You can use cheaper services and online tools to understand whether you are saving and spending at a sensible pace. And the fees do pile up.</p>

<p>Therefore, <a href="http://www.kiplinger.com/article/retirement/T023-C000-S002-financial-planning-for-the-middle-class.html">an hourly adviser</a> is often more sensible. The <a href="http://www.garrettplanningnetwork.com/">Garrett planning network</a> and others allow you to find a fee-only fiduciary adviser in your area who charges on an hourly basis.</p>
<figure class="wp-block-pullquote alignleft"><blockquote><p>You can expect an hourly fee around $250</p></blockquote></figure>
<p>This person won&rsquo;t sell you securities or continually manage your investments, but she can answer a wide variety of important questions. Advisers may also be aware of tax breaks, insurance products, or other financial opportunities you&rsquo;re not. Millions of people could benefit by bringing their shoebox full of papers to an hourly adviser and buying an hour or two of focused advice. She will provide useful answers and send you on your way.</p>

<p>You can expect an hourly fee around $250 for this sort of service. This isn&rsquo;t cheap, but it often pays for itself. If this person helps you make a more sensible budget, or if she finds a 401(k) investment that charges just 0.1 percent less than what you currently pay, the visit will more than pay for itself in the long run. You&rsquo;re not wasting your time on sales pitches for overpriced investment products. And you&rsquo;re not hitching your wagon to someone for a large recurring expense.</p>
<h2 class="wp-block-heading">You might qualify for financial coaching</h2>
<p>Suppose you have a modest income and you need more basic help. Maybe you&rsquo;re trying to get a handle on credit card debt, establish and follow a sensible budget, improve your credit rating, or save up an emergency fund for car repairs or sudden medical bills. For these basic issues, you might consider attending sessions with a financial coach.</p>

<p>Such coaches can help you get on sound financial footing, and provide feedback and accountability to help you stay on course. The <a href="http://workingfamiliessuccess.com/network-sites/">Working Families Success Network</a> is one way to find such services, which are now available in many cities across the US. Your local United Way may also offer <a href="https://www.bostonglobe.com/business/2014/11/28/one-stop-financial-centers-becoming-model-for-helping-low-income-residents/VWWDpXtm15ENkzdjV235QM/story.html">valuable services</a> through <a href="https://www.unitedway.org/our-impact/focus/income">Financial Stability One Stop Centers</a>.</p>

<p>Unlike the commercial services I discussed earlier, financial coaches are typically free. They are usually connected with nonprofit social service agencies and can often help you with other needs you might have such as job assistance, legal aid, or tax preparation. They can connect you with other kinds of resources if you&rsquo;re in more serious financial trouble and have debts you can&rsquo;t realistically pay.</p>

<p>The Urban Institute recently conducted <a href="http://www.urban.org/research/publication/evaluation-impacts-and-implementation-approaches-financial-coaching-programs">a nice randomized trial of financial coaches</a> provided by two providers in New York and Miami. The mixed findings are instructive regarding both the benefits and the inherent limitations of such efforts.</p>

<p>Clients who worked with financial coaches reported being less stressed than their counterparts in the control group, which didn&rsquo;t meet with a financial coach. Clients were also more likely to do basic things well: paying bills on time to reduce late fees, reducing balances in long-term delinquency, making regular deposits into a savings account, chipping away at high-interest debt, building up a modest emergency fund.</p>

<p>Financial coaching didn&#8217;t much help with bigger challenges such as avoiding foreclosure or bankruptcy, where the fundamental problem is that people didn&#8217;t have enough money to meet their obligations. It&rsquo;s unclear that such services help people markedly reduce their spending, which isn&rsquo;t easy. Financial coaches also would not be appropriate for more complex investment questions that typically arise for clients of higher incomes.</p>

<p>Coaching helps people do the relatively easy things better, which is no small thing.</p>
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					</entry>
			<entry>
			
			<author>
				<name>Harold Pollack</name>
			</author>
			
			<title type="html"><![CDATA[The NFL&#8217;s Donté Stallworth on what it&#8217;s like to manage millions as an athlete]]></title>
			<link rel="alternate" type="text/html" href="https://www.vox.com/2016/1/18/10779790/donte-stallworth-personal-finance" />
			<id>https://www.vox.com/2016/1/18/10779790/donte-stallworth-personal-finance</id>
			<updated>2019-03-05T18:50:25-05:00</updated>
			<published>2016-01-18T09:30:02-05:00</published>
			<category scheme="https://www.vox.com" term="Money" /><category scheme="https://www.vox.com" term="Personal Finance" />
							<summary type="html"><![CDATA[Many people make poor financial decisions in their 20s. I was one of them. When I landed my first job at 22, evaluating missile guidance systems, I stuffed the boring 401(k) paperwork into my desk drawer, never to be read. The Dow Jones Industrial Average was then about 1,500. It is now more than 10 [&#8230;]]]></summary>
			
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<img alt="" data-caption="Donté Stallworth. | The Washington Post / Getty" data-portal-copyright="The Washington Post / Getty" data-has-syndication-rights="1" src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/15657988/GettyImages-460796786.0.1499986276.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" />
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	Donté Stallworth. | The Washington Post / Getty	</figcaption>
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<p>Many people make poor financial decisions in their 20s. I was one of them. When I landed my first job at 22, evaluating missile guidance systems, I stuffed the boring 401(k) paperwork into my desk drawer, never to be read. The Dow Jones Industrial Average was then about 1,500. It is now more than 10 times higher.</p>

<p>Professional athletes face the same problem in a much more dramatic way. The lucky ones earn millions in their early 20s, in on-field careers that typically end before age 30. They face the sudden burden of managing large amounts of money &mdash; money that they hope will last a lifetime.</p>

<p>Their wealth is also public. They have people in their lives who want or need financial help. They are targets for unscrupulous financial professionals as well as well-meaning friends and relatives who steer them into wildly inappropriate investments.</p>

<p>As a result, around <a href="http://www.si.com/vault/2009/03/23/105789480/how-and-why-athletes-go-broke">78 percent of retired NFL players experience serious financial problems within a few years of retirement</a>. <a href="http://www.slate.com/blogs/moneybox/2015/04/13/nfl_players_and_bankruptcy_fewer_football_players_go_bust_than_you_might.html">About 16 percent go bankrupt within 12 years</a>. It&rsquo;s easy to assume the resulting disasters are the product of stupidity or irresponsibility. It&rsquo;s easy to point to athletes who blew their money on women or bling. Sometimes racial and class stereotypes come into play, too, now with the added twist of <a href="https://en.wikipedia.org/wiki/Chronic_traumatic_encephalopathy">head trauma</a>.</p>

<p>But these stereotypes are unfair. It&rsquo;s rare for elite athletes to succeed based on their physical gifts alone. Most people who excel at that level are intelligent and focused. But they are so focused on using their talent and discipline on the playing field that they don&rsquo;t learn to methodically manage their money. Most are also like most other young adults, too: typically naive and impatient in basic financial matters.</p>

<p>I discussed these issues with Dont&eacute; Stallworth. Stallworth attended the University of Tennessee, where he studied psychology on a football scholarship. He was drafted by the New Orleans Saints in 2002, and played wide receiver in the NFL for 10 years. He now works as a journalist and a football commentator. His Twitter feed <a href="https://twitter.com/DonteStallworth?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor">@DonteStallworth</a> conveys the complexity and the craft of professional football, as seen by an expert practitioner of the game.</p>

<p>The interview has been edited for length and clarity.</p>

<p><strong>Harold Pollack: How did you feel when you first started making serious money as an NFL player?</strong></p>

<p>Dont&eacute; Stallworth: The first check that I got from the NFL was $1 million. I thought: &#8220;What is this?&#8221; Obviously, I had already signed my contract and knew what to expect, but when I was working in the summer in college, the biggest check I ever had received was for maybe $300. The check just looked fake. I really didn&#8217;t know what to do with it.</p>

<p><strong>HP: Isn&#8217;t it a little insane to get a $1 million check? Things would be so much better if you had gotten a check for maybe $500,000 and the remainder had been put in an annuity that would give you a monthly check for the rest of your life. Why don&#8217;t they pay it that way?</strong></p>

<p>DS: Being able to reflect on things now, that seems like a great idea. I don&#8217;t think the NFL or the NFL Players Association would change how things work now. But from a financial adviser&#8217;s standpoint, and even from a player&#8217;s standpoint, that is something that the player should probably take ownership of.</p>
<figure class="wp-block-pullquote alignleft"><blockquote><p>&quot;A lot of guys live like they&#039;re going to be making $5 million for the next 20 years&quot;</p></blockquote></figure>
<p>Throughout the season, if the guy is making, let&#8217;s say, $4 million, $5 million, you get all of that money in eight checks, every two games. I&rsquo;ve started to believe that it would be better if players at least got that money spread out over the course of the entire year, not just the football season.</p>

<p>You get these checks and they&#8217;re $60,000 or $80,000. That messes with you, mentally. You really don&#8217;t understand that once you&#8217;re done playing, these checks will stop. When you get back into the &#8220;real world,&#8221; your boss may not even be making $150,000 or $200,000 per year. That&#8217;s not even the NFL league minimum nowadays.</p>
<h2 class="wp-block-heading">What NFL players do with their millions</h2><div data-chorus-asset-id="5910387"> <img src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/5910387/53208322.jpg"><div class="caption">Stallworth in 2005.</div> </div>
<p><strong>HP: So you get that $1 million. What do players actually do with it?</strong></p>

<p>DS: Many guys, especially the higher-drafted guys who are getting a lot of money, will buy their parents a home, buy themselves a home. Then they&rsquo;ll buy a car and get their parents a car. After that, it&#8217;s kind of up in the air.</p>

<p>I did everything in my power to make sure I was up to the best of my football ability: my speed, my strength, my route running. My main focus was on football, trying to put myself in position to be drafted first wide receiver. Looking back, I wish I had taken that same approach to my finances before I was drafted. I didn&#8217;t. A lot of guys didn&rsquo;t.</p>
<figure class="wp-block-pullquote alignleft"><blockquote><p>&quot;If you&#039;re lucky in the NFL, you get to play past the average of three years&quot;</p></blockquote></figure>
<p>I wish I would have taken the same approach to learning about finances and learning how to budget, taking the same approach that you do when you&#8217;re watching game film, when you&#8217;re lifting weights and running for three hours, conditioning. I don&#8217;t think we put in that same time to learn about our finances as we do on the football field.</p>

<p>Some guys are totally on it. Right away they put themselves on a budget. There are many smart guys who do know the ins and outs of investing. These are the smarter ones; <a href="http://www.usatoday.com/story/tech/columnist/baig/2013/07/25/vilma-tackles-bar-scene-with-bareye/2585471/">Jonathan Vilma</a>, for one. That guy is on top of everything.</p>

<p><strong>HP: How do you know what to do when you suddenly have that much money? It&#8217;s hard to get into your head, &#8220;I can do this, but I can&#8217;t do that.&#8221;</strong></p>

<p>DS: That&#8217;s key. When you initially get this money, you have to take ownership to understand: &#8220;I have all this money now, but it&#8217;s not going to last forever.&#8221; If you&#8217;re lucky in the NFL, you get to play past the average of three years. I was blessed to play 10. You have to understand that you could be making three, four, five million dollars a year. Then the next year it&#8217;s all over. You&#8217;ll never make that type of money again.</p>

<p>A lot of guys live like they&#8217;re going to be making $5 million for the next 20 years. The smarter guys would say that you want to put yourself in a position where you don&#8217;t have to work when you&#8217;re done. Live like a prince now if you have to, so you can live like a king later.</p>

<p><strong>HP: How do athletes decide where to put their money?</strong></p>

<p>DS: Ninety-nine percent of the guys know nothing about the investment world. You&#8217;ll hear from so-and-so that, &#8220;Tom Brady is doing this,&#8221; or, &#8220;We&#8217;ve worked with Brett Favre.&#8221;</p>

<p>They throw names out there. When you&#8217;re a rookie or a young guy, you&#8217;re thinking: &#8220;If Tom Brady&#8217;s doing this, of course I should be doing it too.&#8221;</p>
<figure class="wp-block-pullquote alignleft"><blockquote><p>&quot;I don&#039;t think we put in that same time to learn about our finances as we do on the football field&quot;</p></blockquote></figure>
<p>That is how a lot of guys get taken advantage of. It&#8217;s the people that you trust, the people that you meet. You&#8217;re automatically a target. There are people whose lives are solely based around clinging to athletes. They try to find ways that they can get money out of people. I&#8217;ve seen it, I&#8217;ve lived it. It&#8217;s just horrible.</p>

<p>A lot of my friends were caught up in <a href="http://nypost.com/2015/09/12/nfl-players-reach-53m-settlement-in-bank-scam/">this casino scam</a>. This guy scammed guys out of millions. This was years ago, and they&#8217;re still trying to work out the logistics of getting their money back.</p>
<h2 class="wp-block-heading">Learning to say no</h2>
<p><strong>HP: You were also a public rich person, a celebrity. What is it like to not only have money but to have everybody around you knowing that you have money, to have your money be a topic of public conversation?</strong></p>

<p>DS: It&#8217;s tough, Harold. Not only are your family members and cousins, even distant relatives, expecting you to be the money guy, it&#8217;s also friends and other people. When you are put in that situation at such a young age, it&#8217;s hard to say no to some of your family, or to some of your best friends. A lot of times, guys don&#8217;t say no.</p>

<p>I had one relative who I hadn&#8217;t spoken to &mdash; not one time &mdash; the entire time I was in college. Then once I got drafted, she asked me if she could have $50,000. This was before I even got any checks or anything. I remember thinking to myself, &#8220;A &lsquo;congratulations&rsquo; first might be a better way to go about this.&#8221;</p>

<p>As a young athlete, before you made it to the NFL, you would always hear those stories. But you never would believe it was true. So when it happens, it&#8217;s like, &#8220;Wow, $50,000. They&#8217;re asking me like it&#8217;s $5 or like it&#8217;s $5.&#8221; You get that often. It&#8217;s very difficult to learn how and when to say no and not feel bad about it.</p>

<p><strong>HP: How do you manage that? How do guys manage it?</strong></p>

<p>DS: Some guys don&#8217;t ever manage it. These are the ones who go broke the fastest. It took me a while to learn, until I had people I was able to talk to, people who were in the same position.</p>

<p>Let&#8217;s face it, every professional athlete that I had come in contact with &mdash; especially guys who are making millions of dollars a year or close to that &mdash; has been in that position. You want to be in a position where you can take care of your immediate family, the people that you feel responsible for.</p>
<figure class="wp-block-pullquote alignleft"><blockquote><p>&quot;Even distant relatives are expecting you to be the money guy&quot;</p></blockquote></figure>
<p>In my case it was my mother, and I was the one to take care of my immediate family. I also had close friends I would like to be in position to help if they needed it.</p>

<p>I won&#8217;t say that I felt obligated to do it. But I have literally millions of dollars in the bank, and somebody is asking me for $1,000. It doesn&#8217;t seem that bad. Then $1,000 will turn into $5,000, or it will turn into more frequent requests.</p>

<p>You automatically become that safety net. Instead of someone taking responsibility for their own finances, it&#8217;s like, &#8220;Uh, I can spend this and if there is an issue I can just ask Dont&eacute; for $500 and it won&#8217;t be an issue.&#8221;</p>

<p><strong>HP: It seems to me that financially successful African Americans face a particular challenge. You&rsquo;re more likely than I am to be connected to many people in serious need. There is also a culture of loyalty and mutual support that makes it easier for people to put the hand on your shoulder, or that makes you feel obligated when people need help. I don&#8217;t know if that&#8217;s real to you.</strong></p>

<p>DS: That&#8217;s very real. When you do come into this type of money, there are so many people to whom you become that safety net.</p>

<p>Then you have to worry about if you don&#8217;t &#8220;loan&#8221; someone $1,500 or $2,000 &mdash; and it&#8217;s usually a &#8220;loan&#8221; &mdash; people will decide that you&#8217;ve changed or you think you&#8217;re too good. We could spend another hour talking about those situations. They happen often.</p>
<h2 class="wp-block-heading">Helping pro athletes learn to manage their money</h2>
<p><strong>HP: Did you take any courses in college on budgeting or the stock market or anything like that?</strong></p>

<p>DS: I didn&#8217;t. I really wish I had. There are not many jobs where you&#8217;re 19, 20, 21 years old that make you a millionaire, or at least wealthy, literally overnight. That just doesn&#8217;t happen often in this world.</p>

<p>I would definitely advise the young guys to take some type of business course to help them understand their finances better once they make it to the professional level, or even if they don&#8217;t make it to that.</p>

<p><strong>HP: Do the players union or the teams help you transition into that? </strong></p>

<p>DS: Yeah, the NFL does a pretty good job. They have preseason symposiums where they&#8217;ll bring in all the drafted rookies. They give you advice on the wide range of things that you need to be aware of as a young adult coming to the world of the NFL: on-the-field issues, off-the-field issues, financial issues, legal stuff. Each team also has a player development director whose sole job is to make sure that everyone is on board, especially the rookies. The NFL Players Association also does a great job and has a great benefits package for players post-career.</p>

<p><strong>HP: Do agents help you with these financial things?</strong></p>

<p>DS: Some agents will recommend people that they know or have worked with. Others will totally stay away from it. They don&#8217;t want anything to do with your finances.</p>

<p><strong>HP: I can imagine how the agents might not want to get involved. They might wonder what might happen to your relationship if they hook you up with an adviser and things don&rsquo;t work out. </strong></p>

<p>DS: That&#8217;s exactly what it is&hellip;</p>

<p>The NFL has a great program, too, if you&#8217;re looking to get into some type of investment or want to start working with a certain financial group. The NFL works with the FBI to make sure people aren&#8217;t scamming. They run background checks. I think the NFL is doing pretty much everything it can, outside of actually making these programs mandatory.</p>

<p><strong>HP: Should college football programs be doing more to help their players financially?</strong></p>

<p>DS: We can go into talking about how college kids should be able to have some type of compensation. That&#8217;s a whole other conversation. I do believe it should start in college somehow. The NCAA should take more responsibility. They make hundreds of millions of dollars from college kids every year. There should be some better way to prepare these guys to be financially successful.</p>
<h2 class="wp-block-heading">When the end is in sight</h2>
<p><strong>HP: As an athlete, you always know that your time is limited. At what point do players start thinking about what their subsequent career will look like when they can no longer be on the football field?</strong></p>

<p>DS: That varies. The average NFL career is three or three and a half years. For someone like me, drafted in the first round, I knew (or at least assumed) that I would be around for a while. My own turning point was probably when I turned 30.</p>

<p>For my first seven or eight years, it just never dawned on me that I couldn&#8217;t play forever. Obviously I knew that in the back of my mind, but it just never hit me. I was living in the moment, playing the game. You live from meeting to meeting, practice to practice, game to game, week to week, season to season.</p>

<p>When I got close to 30, I started to realize that I wasn&#8217;t in my prime anymore. I could feel my skills very slowly starting to diminish. I wasn&#8217;t as fast as I used to be. Then you start to understand, &#8220;Okay, this is the point where I maybe need to start thinking about what I&#8217;m going to do for the next 50, 60 years.&#8221;</p>

<p><strong>HP: What kinds of jobs do people take when they leave the NFL?</strong></p>

<p>DS: Many guys like to stay close to the game because it&#8217;s what you know. It&#8217;s what you&#8217;ve done your whole life. A lot of guys get into coaching, whether it&#8217;s on the college, pro, or even high school level. A lot of guys get into the television side and try to stay close to it somehow.</p>

<p>When you leave the NFL, it&#8217;s almost like you&#8217;re in the draft again, but you&#8217;re kind of drafting yourself now. You have to understand everything that you&#8217;ve learned throughout your NFL career, how that can help you moving forward. A lot of guys get into the business and financial sectors. That&rsquo;s good. Not only are they in a position to understand their own personal finances, but they&#8217;re able to work on other portfolios and see how money is supposed to be handled. They can pass that information along to other professional athletes, and to others.</p>

<p><em>Harold Pollack teaches social service administration at the University of Chicago. He is co-author, with Helaine Olen, of the new book </em><a href="http://www.amazon.com/Index-Card-Personal-Finance-Complicated/dp/1591847680/ref=sr_1_1?ie=UTF8&amp;qid=1450799161&amp;sr=8-1&amp;keywords=pollack+index+card">The Index Card: Why Personal Finance Doesn&rsquo;t Have to Be Complicated</a>.</p>
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				<name>Harold Pollack</name>
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			<title type="html"><![CDATA[Here&#8217;s why creating single-payer health care in America is so hard]]></title>
			<link rel="alternate" type="text/html" href="https://www.vox.com/2016/1/16/10779270/pollack-single-payer-in-america" />
			<id>https://www.vox.com/2016/1/16/10779270/pollack-single-payer-in-america</id>
			<updated>2019-03-05T18:45:42-05:00</updated>
			<published>2016-01-16T11:20:02-05:00</published>
			<category scheme="https://www.vox.com" term="archives" />
							<summary type="html"><![CDATA[The Hillary Clinton campaign is taking some hard knocks from liberals over its maladroit attacks on Bernie Sanders&#8217; single-payer proposal. In one sense, the knocks are well-deserved. Even if single-payer markedly lowers medical expenditures, proponents such as Larry Seidman estimate that a tax increase of at least 8 percent of GDP would likely be required [&#8230;]]]></summary>
			
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<img alt="" data-caption="Bernie wants to believe in single-payer. But how would we get there? | Joshua Lott/Getty Images" data-portal-copyright="Joshua Lott/Getty Images" data-has-syndication-rights="1" src="https://platform.vox.com/wp-content/uploads/sites/2/chorus/uploads/chorus_asset/file/15656999/GettyImages-502373238.0.1453225762.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" />
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	Bernie wants to believe in single-payer. But how would we get there? | Joshua Lott/Getty Images	</figcaption>
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<p>The Hillary Clinton campaign is taking <a href="http://www.huffingtonpost.com/entry/chelsea-clinton-bernie-sanders-single-payer_56956c06e4b05b3245dad15a">some hard knocks from liberals</a> over its maladroit attacks on <a href="http://www.sanders.senate.gov/newsroom/must-read/a-single-payer-system-makes-economic-sense">Bernie Sanders&rsquo; single-payer proposal</a>. In one sense, the knocks are well-deserved. Even if single-payer markedly lowers medical expenditures, proponents such as Larry Seidman estimate that a tax increase of at least <a href="http://pnhp.org/blog/2015/07/09/seidman-and-pollack-aca-versus-medicare-for-all/">8 percent of GDP would likely be required</a> to finance it. That&rsquo;s a heavy political lift. It&rsquo;s about as much as <a href="https://www.whitehouse.gov/sites/default/files/omb/budget/fy2014/assets/tables.pdf">the entire federal income tax on individuals</a>.</p>
<p>Yet as proponents rightly observe, these taxes would replace many visible and invisible ways we now provide to support a health sector that consume more than 17 percent of our economy. The experience of peer industrial democracies suggests that a well-designed single-payer system would be more humane and markedly less expensive than what we have right now.</p>

<p>Such a system would certainly be less convoluted and bureaucratically hidebound. Aggressively deploying government power to rein in prices, a well-designed single-payer system would be more fiscally disciplined, and would probably be more effective in targeting resources to best promote public health. Sanders deserves credit for noting the real virtues of a well-executed single-payer system.</p>

<p>In another way, though, Clinton&#8217;s critique raises uncomfortable questions that deserve greater attention. It&rsquo;s commonplace (though true) to note that single-payer is beyond the current boundaries of American politics. But what if, by some miracle, liberal Democrats won comprehensive victories that created a window of opportunity in which single-payer becomes realistically possible?</p>
<h2 class="wp-block-heading">Designing a single-payer system in America</h2>
<p>Imagine what would happen were President Bernie Sanders to sweep into office backed by a Democratic congressional majority similar to what President Obama enjoyed in 2008. Imagine further that President Sanders were sufficiently fortunate and skilled after that victory to enact a single-payer system. I wonder how different our policy dilemmas would really be from what we now face in implementing the Affordable Care Act.</p>

<p>As I have <a href="http://jhppl.dukejournals.org/content/early/2015/06/09/03616878-3150172.full.pdf"> written at length in the <em>Journal of Health Politics, Policy, and Law</em> </a> (and draw upon here), an American single-payer system would be more complex and kludgy than many proponents have considered or admitted. The source of these problems resides in American politics rather than the technocratic or ideological premises of our health care system. A different system operating through the same political mechanisms would produce <a href="http://www.nationalaffairs.com/publications/detail/kludgeocracy-in-america">similar complexity and kludge</a>.</p>

<p>The pitch for single-payer is admirably simple: We cover every (legal) resident. We mail a Medicare card to everyone. Everyone is covered. That&rsquo;s a lot easier to explain and market than it is to explain the convoluted structures of Medicaid and state marketplace plans.</p>

<p>This is also a caricature of how such a single-payer plan would be passed and how it would touch the lives of millions of Americans. Single-payer would immediately raise myriad intricate and divisive transition issues. It would potentially uproot thousands of critical arrangements President Obama, Speaker Pelosi, and Sen. Reid struggled to leave intact.</p>

<p>After all, ACA&rsquo;s sales pitch to the healthy and insured was, &#8220;If you like your insurance, you can keep it.&#8221; This pledge proved politically damaging when it could not be fully kept for <a href="http://www.politifact.com/truth-o-meter/article/2013/dec/12/lie-year-if-you-like-your-health-care-plan-keep-it/">several million people</a>. Single-payer would be far more disruptive to even more people.</p>
<h2 class="wp-block-heading">Winners and losers in the single-payer system</h2>
<p>It&rsquo;s telling that no fully articulated single-payer bill was ever drafted as an alternative to the ACA. Such a bill would have been no less complicated, and would probably have been more encyclopedic than the ACA was. A huge reform that creates millions of winners creates millions of losers, too.</p>

<p>As with ACA, the biggest winners would be relatively disorganized low-income people in greatest need of help. The potential losers would include some of the most powerful and organized constituencies in America: workers who now receive generous tax expenditures for good private coverage, and affluent people who would face large tax increases to finance a single-payer system. At least some of these constituencies would need to be accommodated in messy political bargaining to get single-payer enacted. And states would have a role to play, too, potentially replicating the messy patchwork we got with ACA reforms.</p>

<p>Single-payer would require a serious rewrite of state and federal relations in Medicaid and in many other matters. It would radically revise the Employee Retirement Income Security Act (ERISA), which strongly influences the benefit practices of large employers. Single-payer would require intricate negotiation to navigate the transition from employer-based coverage. The House and Senate would be in charge of this tension, and at risk of the negotiations among key legislators and committees who hold sway.</p>
<h2 class="wp-block-heading">How even the public option died</h2>
<p>Single-payer would be openly or quietly opposed by virtually the entire supply side of the medical economy. We saw this dynamic during the political knife fight over ACA&rsquo;s &#8220;public option.&#8221; Early versions of the public option would have allowed consumers shopping in the state marketplaces to buy into some public insurance modeled on Medicare.</p>

<p>Many stakeholders who supported other aspects of ACA <a href="http://www.washingtonmonthly.com/magazine/november_december_2011/on_political_books/sisyphus_gets_to_the_top033000.php?page=all"> noisily or quietly wanted to see the public option dead</a>. Community hospitals, medical groups, pharmaceutical and medical device companies feared precisely the outcome liberals hoped to see: a viable public insurance product that gained broad acceptance and market share, and that used Medicare&rsquo;s tremendous market power to discipline providers.</p>

<p>These constituencies understood and dreaded the heavy hand of government across from them at the bargaining table. These constituencies helped to kill the public option. They would be a force to be reckoned with in any political process that seeks to implement a single-payer system.</p>
<h2 class="wp-block-heading">What the Supreme Court might do in a single-payer world</h2>
<p>Given our polarized judiciary, there would be legal and constitutional challenges, too. Whatever fine print of the ACA found its way to the Supreme Court, the real fight concerned the propriety of an expansive federal government that seeks to regulate and humanize a national health care market. Constitutional conservatives reject this vision of American government. A single-payer system would engage even more contentious issues of federalism and the reach of national government.</p>

<p>Some progressives hope that single-payer could provide an attractive replacement for the grubby, path-dependent logrolling that now dominates our $3 trillion health care political economy. No viable single-payer program will replace these grubby politics. That&rsquo;s logically impossible, because such a program must be produced through that very same process. Barring a historically comprehensive defeat of Republicans at every level of American government, advocates for expanded health coverage will face this discomfiting reality.</p>

<p>Passing a single-payer plan requires precisely the same interest group bargaining and logrolling required to pass the ACA. The resulting policies will thus replicate some of the very same scars, defects, and kludge that bedevil the ACA.</p>

<p>Progressives should still push for basic reforms that improve our current system. I supported the public option in 2009. I still do. <a href="http://www.tcf.org/bookstore/detail/key-proposals-to-strengthen-the-affordable-care-act"> I hope it resurfaces in some form, particularly for older participants in the state marketplaces</a>. It may open a pathway to a true single-payer. If it doesn&rsquo;t &mdash; which I suspect it will not &mdash; it might still provide a valuable alternative and source of pricing discipline within our pathological health care market.</p>

<p>Whatever policy one supports, we must actually consider how this imperfect and messy process will actually play out. There&rsquo;s no immaculate conception in American politics.</p>
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