I had some face time with Rahm Emmanuel two weeks ago at my friend Owen's. (Owen's brother-in-law is the former chair of the Democratic National Committee.) Rahm said nothing surprising but made his points. He had just finished David Kennedy's 1999 book Freedom from Fear, about WW II, the Depression and, germane to this conversation, the tremendous compromises involved in forging the New Deal.

Politically, he asserted, if you want to make big changes, you have to choose your battles and win the big ones. If health reform goes down, then energy, global warming, financial reform and labor's legislative agenda are all at risk. He stayed right on message.

I posed this to him: "Many Democratic politicians, including our Blue Dog Rep. Baron Hill, tell us in private conversations that they believe we have to get to single payer eventually. What advice would you give on how to get there?" Without a blink, he replied it's "going to be a long haul," and if we don't pass this bill it's going to be even longer. He asserted that this bill begins building the required infrastructure for any future progress.

BROOKLYN, N.Y. - Five years after the publication of his book on autism and mercury in vaccines, David Kirby finds much of the ongoing debate on both subjects rather tiresome. Before dismissing the notion that the connection between the two has been debunked, he pauses. He only wishes the public discourse were focused there.

"It's crazy that in this debate, we're still debating whether autism numbers are actually going up or not, which is insanity to me," he said. "It's people desperately clinging to this belief that autism is genetic, that it's always been with us at this rate, that we're just better at counting it, better at diagnosing it."

The two most recent government-backed studies put the rates in children at 1 in 110 and 1 in 91. And since males are four times more likely to be diagnosed with autism than females, that means roughly one in every 60 males of all ages has an Autism Spectrum Disorder (ASD).

"So where are the 1 in 60 men with autism in this country, in this world?" asked the author of Evidence of Harm: Mercury in Vaccines and the Autism Epidemic: A Medical Controversy. "They don't appear to exist. I've never seen them. I've met a few adults with autism in my life, but very, very few."

BROOKLYN, N.Y. - Two days before the Centers for Disease Control and Prevention (CDC) released its newest data on U.S. autism rates, author David Kirby consented to a two-hour, videotaped interview in his street-level brownstone apartment in the Park Slope section of Brooklyn. The government, the former New York Times reporter said, always drops its worst news late on Fridays, assuming the attention-addled mainstream media will forget it by Monday, when people actually pay some attention.

While the release of new autism data on the Friday before Christmas would normally trigger nervous anticipation in the whirlwind of Washington spin, this year's holiday news dump was anticlimactic. The CDC had revealed the gist of its autism findings in October, after a study in the journal Pediatrics said its incidence had reached 1 in every 91 children.

To inoculate the public against the 65 percent increase the Pediatrics study represented over the CDC's last estimate of 1 autistic child in every 150 born in 1994, Health and Human Services Secretary Kathleen Sebelius herself intervened the day it came out. In a hastily arranged conference call with the autism community, Sebelius announced that preliminary numbers in the third in a series of CDC studies show the ratio was 1 in 100 for kids born in 1996.

Editor's note: This story is the third in a series on autism and the Southwest Indiana environment.

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MOUNT VERNON, IND. - When she discusses her autistic clients, Marcella Piper-Terry almost always speaks in reverential and laudatory tones. "They're just absolutely gorgeous children," she says of kids with Asperger's Disorder, such as her 15-year-old daughter Rachel. "Great big eyes, long eyelashes -- amazing, beautiful children. And very smart, very creative and extremely sensitive. Extremely sensitive."

Only when a two-hour interview in her Posey County, Ind., home turns to the notion that children with Autism Spectrum Disorders (ASDs) cannot be treated does Terry's demeanor assume an edge.

"That is not true," she says. "It's unacceptable to write these kids off because standard medical practice says there is no medical treatment for autism."

Editor's note: This story is the second in a series on autism and the Southwest Indiana environment.

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MOUNT VERNON, IND. - Listening to Marcella Piper-Terry detail her journey from artist to autism researcher is like any conversation with someone whose life has been touched by the pervasive developmental disorder. It sometimes takes the breath away.

Her family life has been impacted by loved ones diagnosed with multiple disorders and conditions: autism spectrum, bipolar, attention-deficit hyperactive, obsessive compulsive, pediatric autoimmune neuropsychiatric associated with Streptococcus and depression. And through it all, she has become more self-aware.

"The apple doesn't fall far from the tree," she says in her spacious, hardwood-floor dining room a half mile or so north of the Mount Vernon Middle School. "I can definitely see a lot of Asperger's tendencies in myself." Her voice slows. "I don't do clubs. I don't do social events. I would rather be reading and researching than having a dinner party or being part of that kind of stuff."

On a cold and rainy Dec. 2, while the Senate in Washington was slogging along debating health reform, a remnant troupe of public-option-supporting Organizing for America stalwarts stood outside the corporate headquarters of WellPoint, Inc. in the center of downtown Indianapolis. Minutes before their demonstration started, three single payer activists slipped in and out of the WellPoint office dropping off a shareholder resolution for next May's annual meeting.

WellPoint, also known as Anthem or Blue Cross, is the perverted spawn of what was once a charitable venture known as Blue Cross/Blue Shield of Indiana. From the '40s up into the '90s Blue Cross of Indiana was like all the other Blues around the country, non-profit with a charitable mission. Its board of directors included physicians, hospital administrators and labor and community leaders, and it existed to serve the needs of patients.

A group of public-option-supporting Organizing for America activists delivered the following Shareholder Resolution to the offices of WellPoint health insurance in Indianapolis. They want the resolution to be considered at the next WellPoint annual meeting next May.

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Whereas, the United States allows too many people to suffer and die due to lack of adequate health insurance and this is threatening the economic stability of the country; and

Whereas, no country has achieved universal healthcare through for-profit health insurance; and

One of my professors years ago was a round, little man who liked to warn us, with a twinkle in his eye, "Making predictions is very difficult, especially predictions about the future." Will a bill pass, in what form, and then what will the long-term implications be? It's hard to predict.

Dr. John Geyman, former president of Physicians for a National Health Plan, makes the case in a Tikkun magazine article, "The Affordable Health Care for America Act (HR 3962): Enough Reform to Succeed?" He argues that whatever bill this Congress is able to pass will probably set the cause of single payer health care back because it "would leave in place an inefficient, exploitive insurance industry that is dying by its own hand, even as [the bill] props [the industry] up with enormous future profits through subsidized mandates."

His argument backs up Dr. Marcia Angell, who asks in the Huffington Post, "Is the House Health Care Bill Better than Nothing?"

With the U.S. House vote Nov. 7 approving historic health care reform, America's working families are another step closer to winning quality, affordable health care for all.

The citizens of Indiana owe thanks to U.S. Rep. Baron Hill, D-Ninth, who voted for the bill. Rep. Hill and other representatives who supported the bill faced down a daylong barrage of blatant falsehoods from opponents. Let's get the facts straight.

The Affordable Health Care for America Act, which now must be merged with a bill the Senate is expected to pass in coming weeks, covers 96 percent of Americans, is fully paid for and reduces the federal deficit, according to the nonpartisan Congressional Budget Office. The White House Council of Economic Advisers confirms it will aid job creation in both the short term and the long term.

Indiana citizens with autism are 20 percent more likely to be medicated than their counterparts are nationwide, according to an ongoing survey by the Interactive Autism Network (IAN).

One of every two Hoosiers with autism receives medication, whereas the national average is 41 percent. The disparities hold across the three main diagnoses of Autism Spectrum Disorders (ASDs):

Autistic Disorder - 22 percent;

Asperger's Disorder - 20 percent; and

Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) - 22 percent.

The IAN data also show that Hoosiers spend less out of pocket caring for those on the ASD spectrum than the national average, $3,952 in Indiana versus $6,082 nationwide.