Ian Shapiro, Sterling Professor of Political Science and Global Affairs at Yale, examines why K-12 education and universal health insurance have proven so difficult to reform in the United States. Part of his DeVane Lecture series course Power and Politics in Today's World, taught at Yale in fall 2019, the lecture identifies fiscal federalism and path dependence as the structural obstacles that keep both policy areas locked in place despite widespread dissatisfaction. Shapiro traces how state and local control over school funding perpetuates inequality, and how the historical accident of employer-based health coverage created entrenched interests resistant to change. The lecture fits within his broader argument, developed in the book After the Fall, about the erosion of postcommunist optimism into today's politics of resentment. It is a case study in why some reforms that command majority support still fail to happen.