November 6, 2020 

Dear Interested Readers,

 

Observations During A Nail Biter That Will Determine The Future Of The Country And Healthcare

 

I have been watching CNN or listening to NPR for most of the time since the polls closed on Tuesday evening. I’ve been up late, and I have awakened wide eyed at dawn ready to resume the vigil. It is no exaggeration to say that this election will determine the future of healthcare for decades to come. The big surprise in this election was not that Joe Biden will be the likely eventual winner and may end up carrying the popular vote by more than 5 million votes. The surprise was the continuing popularity of the president in most “red states” despite the COVID-19 pandemic. As I have been watching the dramas in Michigan, Wisconsin, Pennsylvania, Georgia, Arizona, and Nevada, I have been impressed that the job that faces Joe Biden, if on January 20 he becomes the 46th president, will be much more difficult than I had previously understood or wanted to admit. 

 

Like most Democrats, I had hoped for a “blue wave” that would signal that the country was tired of the politics of division that we have endured for the past four years. At this moment, the only thing that is certain is that there will be continuing uncertainty in the near future. Donald Trump is not going to passively return to private life even if he does eventually accept defeat and leaves the White House. He is likely to be a force in politics for years to come, and his power will continue to affect the attitudes of other Republican politicians and office holders. He may become a “leader in exile.” What I did not fully appreciate until my wife and I drove across the country was just how deeply divided we are, and how popular the president is in the “red states.” 

 

The important observation that emerges as I stare at the red and blue presentation of the vote on the state maps of CNN that show the counties is that in many of the states that Biden will carry, his majority comes mostly from the urban areas, and rural America will continue to be Trumpland. If you subtract Chicago from Illinois, Detroit from Michigan, Milwaukee from Wisconsin, Atlanta from Georgia, Las Vegas from Nevada, or Tucson and Phoenix from Arizona you produce a red state where people love the president, support his policies, and forgive his behavior despite his many flaws. The savvy politicians of the “red states” know that if they abandon Trump, whether he wins or loses, they will be as powerless in the future as Jeff Flake of Arizona and Bob Corker of Tennessee became when they expressed concerns about the president’s divisiveness and fitness for office. 

 

My eyes have been opened to the reality of the riven state of our nation. Even now as the election math demonstrates the will of the majority of Americans, the president and his committed supporters are claiming that the election is a fraud. I would not be as concerned as I am for what might happen in the two months between now and Inauguration Day if I had not just come back from a tour of “red state” America. 

 

Over the 41 days before the election, my wife and I covered over 8,000 miles, almost all of which were in rural America. Our initial objective was simply to see our grandsons. To do that we wandered west to the coastal redwoods of California with our trip through Vermont, New York, Pennsylvania, Ohio, Indiana, Illinois, Missouri, Iowa, Nebraska, Wyoming, Idaho, Utah, and Nevada.  Because of our fear of exposure to the coronavirus, we avoided or skirted large cities like Albany, Pittsburg, Cleveland, Chicago, St. Louis, Kansas City, Omaha, Salt Lake City, and San Francisco. On our return trip, we visited Arizona, New Mexico, Texas, Oklahoma, Missouri, Illinois, Kentucky, West Virginia, Virginia, Maryland, Pennsylvania, New York, and Vermont. On the return trip we “skirted” Albuquerque, Amarillo, Oklahoma City, Lexington, Kentucky, and Albany. In total we visited twenty two states, while staying in a predominantly rural environment.

 

Twelve of the states were “red states,” but our travels took us through the rural parts of each of the states we visited, so in retrospect we were touring the red counties of America. Early on in our trip, we began to play a game of counting yard signs for Trump versus Biden. It was not a very good game because it was no contest. You lose count and interest when it becomes 30 to 3, Trump over Biden, a few minutes into the process. We were soon just interested in who might have the courage to plant a Biden sign in their yard when most of their neighbors seemed so enthusiastic about the president. It did not take us long to discover that rural, poor, white, America was Trump country even if we were in a “blue state” like New York, or Illinois.  The exceptions were places like California, New Mexico and Arizona where a large part of the very poor rural population was not white, and those in poverty gave evidence of the hope they still had in the benefits of a progressive agenda.

 

At times, I got the feeling that the poorer a home in a rural hamlet or farm looked, the more likely it was to be sporting Trump signs and flags. The poverty of the red state world is visually represented by the reality that many rural Americans live in rusty mobile homes and RVs. There are abandoned businesses and motels along the roadsides, and boarded up storefronts on many “Main Streets.” Along the Interstate highways one can see the occasional hospital that looks like a converted Hampton Inn, but the clinics that I saw in the deteriorating hamlets were in tired looking small buildings. The parsonage where I lived in 1949 as a child in Miami, Oklahoma (population 13,000 in 2018) is now the office of a primary care physician. The side yard, which you can not see in the picture, where I played with my friends and brother, is now paved over, and is an empty parking lot. The local hospital where my sister was born is around the corner, and is now part of a larger system of care. 

 

 

What I am trying to describe is that there are at least two Americas. I think that there are many more than two Americas, and the agendas of the various Americas are often in conflict. Worse yet, there are misunderstandings and fears about the “others” that are deeply rooted, and have the power to prevent communication across the huge divide that President Trump used to get elected. There is no question in my mind that a farmer in Nebraska is no more certain about what goes on in my head than I am able to fully understand his view of the world, and his fears and concerns for the future. 

 

I do not mean to imply that all of rural America is poor. I saw spectacular rural properties in many places. It is also obvious that agriculture in many places is now the domain of large corporations, which means that the poor that work those properties are minimum wage employees on the land that they or their families once owned. Huge stretches of rural America present the striking vision of a beautiful land that is populated by sad but proud people who have lost a lot and see little prospect for a better future. Many of the victims of the diseases of despair live in rural America where the natural beauty of the land exists in stark contrast to their lack of economic opportunity.

 

Seen from the perspective of those who live in these difficult circumstances, it is easy to understand how they would be loyal to a leader who sought to gain power by blaming all of their woes on the wealthier, better educated intellectuals on both coasts who had joined forces with lazy minorities who wanted to exist in a welfare state. Add religious fundamentalism and a love for firearms to the picture and it becomes plausible that the results of the election may be hard for them to accept.   

 

Yesterday, we were given a glimpse of what may happen as we move from the counting of votes to the unusual but possible situation of a large segment of the population being unwilling to accept the results of an election. I can understand the emotional distress of the president’s supporters. I felt exactly the same way in 2000, and especially in 2016. As distressed as I was, and as distressed as a majority of Americans were who had voted for Al Gore and Hilary Clinton, none of us contemplated declaring that the election was a fraud, nor did either Gore or Clinton put their own interests over the interests of the nation. 

 

Joe Biden seems to understand that he must do more than announce that he has won the election. Each day since Election Day, he has made a brief appearance on television to reassure the country that if he is finally determined to have won the election, as he expects, he will be the president for all Americans. In the wee hours of Wednesday morning the president made a very bizarre statement that vote counting should stop. All through Wednesday and Thursday there were lawsuits and threats of more lawsuits that Republicans launched to try to avoid the inevitable reality of a vote count that could reveal the size of Joe Biden’s victory.

 

The confusion was compounded by the successes of the Republican party in the “down ballot” races. In my state Republicans won the governorship and regained majorities in both houses of the legislature and the Governor’s Council. Nancy Pelosi and Democrats lost some of their majority in the House, and without a second Georgia miracle on January 5, 2021, Mitch McConnell will remain the Senate Majority Leader. The pundits are saying that ironically the president’s ability to bring out his loyal supporters everywhere blocked the “blue wave,” and saved several vulnerable red state office holders from defeat. 

 

Late yesterday afternoon, after the president had been silent except for his Twitter barrages, we were told that the president had decided to speak during the 6:30 time slot of the evening broadcast of the national news. All attention of the media was immediately turned toward the White house, and we waited. When he did speak, I was stunned by the string of lies that constituted the president’s comments. The difference between Biden’s reassuring comments and the president’s eruption which occurred less than an hour apart were described in an article about the events of the day written in the New York Times by Jonathan Martin and Katie Glueck. It had been a very long day, and the article had a long title: Biden Makes Gains in Key States as Anxious Nation Awaits Winner: Joe Biden picked up votes in Pennsylvania, Nevada and Georgia and urged patience with the slow-moving vote count. President Trump appeared in the evening to break his silence, lying about “illegal” votes.”

 

First they reported on Joe Biden’s brief speech from Delaware:

 

In a brief appearance before reporters in Wilmington, Del., Mr. Biden said he remained confident that he would ultimately prevail but did not lay claim to the White House.

“Democracy’s sometimes messy,” said Mr. Biden, who remained ahead in Arizona Thursday night but lost some ground there. “It sometimes requires a little patience as well. But that patience has been rewarded now for more than 240 years with a system of governance that’s been the envy of the world.”

He urged calm and emphasized that “each ballot must be counted.”

 

It was a very brief speech, but the former vice president was positive and reiterated that if elected he would be the president of all Americans. Perhaps, Joe Biden’s words pushed Mr. Trump over some edge of propriety and sanity. We soon learned that the president couldn’t contain himself any longer. He had been tweeting lies all day, but tweeting may not give him the same relief that he gets from his bombastic rallies and press conferences. The media was summoned. The news programs all turned their attention to the impending presidential presentation, and the pundits began to offer opinions about what he might say and do.

 

None of the “experts” were optimistic about the possibility of the president recognizing his defeat. There was conjecture about what he might say. The commentators that I heard expressed the hope that the president would not say things that might incite his base to rash actions, although they expected that his comments would be inflammatory. I watched former Republican Senator Rick Santorum, who is now a talking head on CNN, squirm under the comments of the other CNN panel members working with Anderson Cooper. David Axelrod, Gloria Berger, and Van Jones all expressed the expectation that the president would say rash things that might excite unfortunate events. I felt sorry for Santorum. He looked like he was in pain. After the president spoke Santorum was visibly upset. He contended that eventually we would hear more responsible voices in the Republican Party. There was nothing he could say that could provide any coverage for the lies, craziness, and the potential destructiveness of the president’s comments. 

 

Martin and Glueck commented on the president’s performance:

 

…in a stunning news conference, Mr. Trump lied about the vote-counting underway in several states, conjuring up a conspiracy of “legal” and “illegal” ballots being tabulated and claiming without evidence that states were trying to deny him re-election.

“They’re trying to steal an election, they’re trying to rig an election,” the president said from the White House briefing room. He also baselessly suggested nefarious behavior in Philadelphia and Detroit, cities that he called “two of the most corrupt political places.

Mr. Trump’s remarks, mostly read off notes, were at times more valedictory than defiant. Far from insisting that he would stay in power, he used much of his appearance to complain about pre-election polls, demonize the news media and try to put the best face on Tuesday’s results, trumpeting his party’s congressional gains. He did not take questions from reporters.

 

That was a very charitable rendering of what I heard. The president used the “dog whistle” of race to imply that Philadelphia and Detroit were corrupt cities. The deniable implication was that they were cities that were controlled by African Americans. He implied that Georgia was controlled by Democrats when both the Secretary of State and Governor of Georgia are among his staunch Republican supporters. He explained his dilemma as the result of “fraud and cheating.” 

 

I had the distinct impression that I was watching the agonizing contortions of a man who was desperately trying to find a way to avoid an inevitable reality. What was disgusting was that the president was willing to try to undermine our democratic processes in a desperate effort to save himself from defeat. The contrast between Trump and John McCain, a noble American and true patriot whom the president denigrated, was obvious. In acknowledging his loss in 2008 to Barack Obama, McCain showed that he cared more about the country than himself. McCain’s concession speech was a remarkable demonstration of grace and patriotism, the president’s demonstration of his self serving claims was the polar opposite.

 

The president’s inconsistencies were obvious. In Arizona where he is gaining ground as mail-in ballots are counted, he has no problem with counting mail-in ballots. He had even voted for himself in Florida with a mail-in ballot. As one might expect, he threatened to take the election to the Supreme Court which he has shaped as a tool of conservative power. For me, the most disgusting component of his presentation was the implication that all of the poll workers and ballot counters were part of a large conspiracy to deny him a second term. I was watching the presentation on CBS. Suddenly the cameras were turned off and the commentators came back. I switched back to CNN which had stayed with the president. Today, the New York Times reports that many broadcasters left the president because he was lying. In the article written by Peter Baker and Maggie Haberman we read:

 

The New York Post, which published salacious articles on Hunter Biden planted by Mr. Trump’s associates before the election, headlined an article: “Downcast Trump Makes Baseless Election Fraud Claims in White House Address.” Even Fox News noted it had seen no “hard evidence” of widespread wrongdoing.

 

Martin and Glueck report that some Republicans shared Rick Santorum’s embarrassment:

 

Representative Adam Kinzinger, Republican of Illinois and a frequent critic of Mr. Trump, offered the sharpest rebuke, saying “this is getting insane” and demanding that the president stop “spreading debunked misinformation.”

Larry Hogan, the Republican governor of Maryland, wrote, “There is no defense for the President’s comments tonight undermining our Democratic process.”

 

Baker and Haberman quoted former New Jersey governor and Trump adviser Chris Christie. 

 

Former Gov. Chris Christie, Republican of New Jersey and a longtime ally of Mr. Trump’s, likewise disputed the president. “I talk tonight now not as a former governor but as a former U.S. attorney — there’s just no basis to make that argument tonight,” he said on ABC News. “There just isn’t.”

 

Unfortunately, not all Republicans acted responsibly. Axios reported that two of the most notable supporters of the president’s false claims were Lindsey Graham and Ted Cruz. As time has passed, more and more Republicans have failed to speak realistically about the lack of evidence that there is any evidence of truth in the president’s comments. 

 

These are strange times. It is now likely that Joe Biden has won the presidency with perhaps as many 306 electoral college votes and a plurality of over 5 million votes, but we are uncertain about what will happen next, and there is an outside possibility that violence may occur before the issues are resolved. What we have learned is that our divisions are so deep that we can no longer be assured of a peaceful transfer of power to a fairly elected president. Several elected Republican leaders are failing to speak decisively in defense of the Constitution, and they seem reluctant to exercise their responsibility to rise above self interest in defense of the agreements and norms that have made this country remarkable and successful for more than 200 years. 

 

What we face now may be weeks of lawsuits and recounts. Will any of the concerns eventually get to the Supreme Court? If the claims do get to the Supreme Court, will the court members appointed by the president hear the case in search of what is best for the country or will they try to find a way to satisfy the presidents demands? Will cooler heads in the Republican Party try to convince the president to leave office peacefully? Will there be violence over the outcome of the election?

 

What is certain is that when, or if, Joe Biden is sworn in as our next president, he will face a greater challenge than any recent president. It is clear that his first job must be to begin a process of healing. Part of that process will by necessity be an attempt to close the natural divides that President Trump has exploited for his own benefit, and has made worse by his behavior in the aftermath of the election. Returning to the reform of healthcare and the objective of giving every American access to adequate healthcare in the spirit of the Triple Aim, or developing a legislative agenda that will improve the social determinants of health for all Americans, will need to follow a healing process. In the interim, depending on what the Supreme Court does with the ACA, there are many things that a President Biden can do administratively to give Americans some relief, but those things would be easily reversible in the courts, or could be reversed following the next election of the next Trumpian Republican, if the gaps between the various Americas are not closed first. In the interim, until there is some certainty about how the transition of power will occur we will continue to suffer from the self serving nature of this strange man and his loyal supporters who want to equate what is good for him with what should be good for us all. I remain hopeful that reason and allegiance to the Constitution and political norms will eventually prevail, and a healing can soon begin that will pave the way toward equality and quality in healthcare.  

 

Happy To Be Home

 

If you follow these notes on a regular basis, you already knew that for the last six weeks my wife and I had been on the road. As I implied in the first section of this letter, I thought that I knew my country, but as I have tried to indicate there was more for me to learn than I realized. Our trip was not conceptualized as an opportunity to get an instructive look at rural America. The idea was simply to visit our grandsons in California without exposing ourselves to a significant risk of acquiring a COVID infection or taking COVID to them. 

 

By avoiding airplanes, hotels, restaurants, and indoor gatherings, we were essentially quarantining ourselves for the thirteen days on the road going out and two weeks coming back. We did buy diesel fuel a couple of times a day, but I was never near anyone at the pumps, and my wife never got out of the RV. We had a couple of trips to the grocery store to replenish our food supply, but our interactions with other people were much less frequent than they would have been had we been at home. We always kept our distance, and we were always masked. The two times when we were most challenged to keep our distance were while we viewed Old Faithful at Yellowstone, and when we visited the South Rim of the Grand Canyon. Even at these two places, I was impressed by how most people wore masks and endeavored to stay at least six weeks apart. On our way out we visited friends in Indiana but stayed distanced on their deck. On the return trip, we did get together with friends in New Mexico, but they have also practiced good COVID habits. 

 

The trip home was more eventful than the trip west. We were trapped in a three day snow and ice storm in New Mexico, the panhandle of Texas, and in Oklahoma. The temp was below 20 for the two days while we hunkered down outside of Amarillo. The howling wind made it feel much colder. The weather changes fast on the plains. In Texas the equivalent of the New England phrase “Montreal Express” is a “blue norther.” When I was a kid in Texas, I was told that when you were out on the plains you could see the dark sky associated with a cold front coming at you when it was thirty miles away. The weather warmed quickly and by the time we bypassed Tulsa, Oklahoma,  and Joplin, Missouri, the warmth was back. The drive across Kentucky, West Virginia, and Virginia was warm, but windy while it was snowing back in New Hampshire. 

 

After the ice and snow in the Southwest, I thought we were “home free.” We spent last Sunday night at Douthat State Park, a lovely place in the mountains of Virginia. It was one of our nicest campsites, but it was extremely windy. During the trip, since we drove during the day, I took many of my daily walks after dark with a head lamp while listening to an audio book, so I did not hear the thunder-like explosion that my wife heard, but I suddenly realized that there was a roaring fire in the woods about fifty yards from where our RV was parked. Somehow the wind had caused an electrical transformer to explode, and the stiff winds were rapidly fanning the flames of a rapidly expanding fire. A crowd of campers gathered quickly, and it was not long before we were joined by park rangers and firefighters. You can see the scene in today’s header. Fortunately, on a Sunday night in early November there were many, many open campsites. While the firefighters contained the fire,  we moved to a new site several hundred yards away from the fire. After that excitement, we had only one more night in the Lehigh Valley of Pennsylvania before seeing the snow at home. It was great to turn into our road at home at sunset (4:30 PM) on Tuesday with plenty of time to settle in front of the fireplace to watch the election returns. Who knew it would be a multiday drama?

 

I was delighted when I learned that the “retrograde Mercury” would end at 12:48 PM on Tuesday, what I did not know was the reputation of the “post retrograde.” It turns out that the misery persists during a “wind down period” called “the post retrograde.” I guess that explains the continuing issues related to the election. That we are experiencing the impact of cosmic forces as the explanation of the bizarre process of this election makes as much sense as the president’s concept that his election miseries are the result of a widespread conspiracy led by the Democrats and the “fake news.” 

 

It was a great trip. I learned a lot. It was fun to adjust to the challenges that came our way. At home, I was united with my lost wallet, and have a whole new suite of credit cards in a brand new wallet. It is good to be at home and comfortable in front of my fireplace. I am ready for the winter, but I am already beginning to think about a new adventure during “mud season.” I am sure that we will still be concerned about COVID in the first half of 2021. I am hoping that my wife’s need to see her grandsons will translate into an agreement to do it again. 

 

Be well! I am praying that we all survive the election and its uncertain aftermath. While you are absorbed with the election, don’t forget that the pandemic is raging. When you are out and about, wear your mask and practice social distancing as best you can. Look for opportunities to be a good neighbor. Let me hear from you. I would love to know how you are managing the uncertainties of our times,

Gene