September 19, 2020

The Notorious RBG is gone. It’s not often that elderly women become pop culture icons, but once in a while, one breaks through and is embraced by all ages as a symbol of the strength and wisdom of the elder. Or maybe it’s a testament to the very human need to believe in endurance, no matter what life throws at each of us and those few work and live their full best lives into their eighties and beyond, come to embody that hope for continued relevance as time continues to march on and on and on. It’s been marching across my face recently. I looked in the mirror this morning when I got up and was not happy with the cross of Christopher Walken’s Headless Horseman and Christopher Lloyd’s Doc Brown that looked back at me.

One of the curses of being a well trained geriatrician is hearing news about the health of aging public figures and being able to draw far more conclusions about life span than most. I’ve got a good deal more data to work with than the average American. I wasn’t in the least surprised by RBG’s death. I had hoped she would hang on a while longer but frankly, I was surprised she made it as long as she did given what I was able to glean from news reports about her overall health. As much as I admired her and her jurisprudence over many years, I was never able to cast her in my mind as this tiny, but towering figure holding dark forces at bay and I doubt she ever conceived of herself that way either. She used her keen mind and her wit and her knowledge to make the law serve as many people as possible, rather than serve the few and bludgeon the many, and she was well aware that some of her opinions were going to be in the minority. She never fussed, she never went to the media trying to rally the court of public opinion. She simply dissented with vigor and well honed argument knowing full well that her dissents and their legal reasoning might help form the basis of a win sometime in the future.

The biggest problem with the American political system at the moment is the American preoccupation with instant gratification. We want results and we want them now. The system wasn’t built that way and by, trying to force it into that mold, it’s been made into a constant two party slugfest with one side constantly trying to score a TKO and proclaim victory. There’s lots of things that have gone into this devolution. The rise of 24 hour news and news cycles, consolidation of media outlets, politicians playing to the camera rather than to the public, the expense of campaigning requiring constant fundraising etc. etc. RBG knew this all to well and avoided it. Her best friend on and off the court for years was Justice Scalia. Despite their diametrically opposed judicial philosophies, they bonded over their love of the arts, especially opera. The two of them may have lived in different idealogical worlds but they inhabited the same cultural sphere as Americans and it strikes me that we need to start doing more of that as a people, get out of our confirmatory bias echo chambers and spend more time together in common space. Of course that’s been made a tad more difficult due to our old friend Covid-19.

And here’s where I cleverly segue to tonight’s accidental plague diary. which is about an event scheduled for November 10th. On that day, the Trump administration will argue California v Texas in front of the Supreme Court. For those of you who have forgotten, this is a case brought by a number of conservative states claiming that the Affordable Care Act is fundamentally flawed from a constitutional point of view and that the entire law must be declared unconstitutional and therefore, null and void. It is highly unlikely that RBG’s seat will be filled in seven weeks no matter what happens, so only eight justices will hear the arguments with a decision likely rendered in the late spring before the court retires for the summer.

What happens if the ACA is found unconstitutional? The most important thing in regards to Covid-19 is the provision about pre-existing conditions. Since the ACA was passed in 2010, it has been illegal for health insurance to discriminate against you based on your past health history. If this goes away again, then pretty much anyone who was infected with Covid-19 will become uninsureable. No insurance underwriter in their right mind is going to allow someone to purchase their product who has been infected by a disease that causes significant changes to nearly every organ system and for which the possible long term sequelae are essentially unknown. That’s roughly 7 million people so far and growing rapidly. And given that the attempts to limit its spread on any sort of a national level are sorely lacking, we may get to that mythical herd immunity at some point, but only after the numbers of those infected are in the tens of millions.

How do we change things for the better? We do this by using the system the way it was designed to work. It’s a slow, laborious process which requires a lot of labor, patience, and willingness to accept defeat, learn from it and move on. We have to let go of the idea that a single election or a single figure is going to either save or condemn us. We have to be willing to understand and play the long game. As Tip O’Neill famously said, all politics is local. If you want to see change, join the local chapter of your preferred political party. Volunteer to be a precinct chair. Be willing to do a lot of thankless work in terms of door knocking, get out the vote campaigns, learning to compromise while crafting platform positions. When you lose an election, take a day off to mourn, then start working on the next one. That’s how it works. The national parties bubble up from the grassroots. The work that has come to fruition in conservative circles over the last decade is the result of this kind of work starting in the early 1970s. It took them nearly fifty years to get where they wanted. If you want something different in the future, go to work now. Of course, you can always tear the entire system down in some sort of revolutionary action but movements like that are often either hijacked or take on a life of their own and you end up somewhere very different from where you intended so I can’t say I recommend that course of action.

Quiet weekend here at the condo. Me and the kitties reading, writing, and watching bad television. I feel a need to burst out of here next weekend. Maybe I will. If I do, you’ll hear about it.

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