This time three weeks ago many Americans were wearing masks while standing in lines with six feet of distance on either side from others in line while waiting patiently to cast their vote. Some stood for hours in lines designed to discourage them from exercising their franchise to vote. The biggest story three weeks ago was not the time and patience required to vote on election day. The biggest story was that before election day over 100 million people had already voted either by mail or by taking advantage of the convenient “early voting opportunities” that had been offered in their state. The biggest story to follow the election has been that many of the president’s supporters seem to believe him and support attempts to get many of those votes thrown out so that he can be declared the winner of an election that he claims was stolen from him. 

 

President Trump is prescient. For weeks before the election he had advanced the idea that the election would be flawed, and warned us that he would not accept the outcome if he did not win. Prior to election day many of us were concerned about how the president would react to defeat. Would he unleash a fifth column of Internet bots and white supremacists to aid him in an effort to hold on to the presidency against the will of the majority? It was no joke. Across the country, businesses covered their windows with plywood just in case there were post election riots. What was not expected was the dancing in the streets that occurred spontaneously when the news services finally called the election for Biden on Saturday morning four days after the election. 

 

The president has made it very clear over the last four years that facts don’t have much impact on his opinion or actions. For me the most remarkable development post election has been the way in which the vast majority of Republicans holding office, who should have a higher allegiance to the peaceful transfer of power, have feared his rath and have silently tolerated his attack on democracy or have been trying to cover their lack of allegiance to our constitutional norms and processes with limp statements that say that “every legal vote should be counted.” 

 

There are a few conservative Republicans like Mitt Romney, Maryland’s Governor Larry Hogan, and former Governor of New Jersey and Trump adviser Chris Christie who have had the courage to speak out, and we should hope that there are many more who agree but just don’t have the courage to speak up now. Rich Lowry, an editor for the National Review, a conservative publication, published an opinion piece last week in Politico, which I consider to be a slightly right of center publication, where he stated:

 

Trump’s central failing as president has been his inability to distinguish between his personal interest and the public interest. No president in memory has made less of an effort to allow the institution of the presidency to shape him and to conform to the constraints it imposes. Instead, he’s acted as if he’s the host of “Celebrity Apprentice,” merely relocated to 1600 Pennsylvania Avenue and with more Twitter followers…

 

Later in the article he said:

 

It [his declaration that the election was a fraud] takes away some of the sting of defeat, and the millions of his supporters who think it was rigged will fortify him in all future endeavors. They will watch his TV interviews, subscribe if there is a Trump digital media property, give him continuing clout in the GOP, and perhaps support him if he runs again in 2024 to avenge the wrong done to him in 2020.

 

That is consistent with the fear that even if out of office Trump will not be out of mind and will be stirring the pot of dissent much like he did before he was elected by propagating the myth that Barack Obama was born in Kenya and therefore was not a legitimate president even though his mother was an American citizen. 

 

It is an interesting article because it is written by a person who understands the minds of conservative politicians and voters and is sympathetic to their pain, but Lowry also recognizes the norms and the mutual understandings that support our tenuous hold on a functioning democracy, and the responsibility of the president to put our collective interests above his own personal feelings and need for power. Many in the grand old party seem to have put their fealty to him and their fear of his rath above their responsibilities to our tradition of the orderly transfer of power.

 

Trump has such a strong hold on the GOP base that Republicans feel the need to play along with his deep-seated inability to admit defeat. The slogan of counting every “legal vote” is a safe harbor that all Republicans can hew to, but it should go without saying that it must mean counting — and certifying— valid votes for Joe Biden.

 

So, the last three weeks have been frustrating. The greatest disappointment for those hoping that the election would create an opportunity for a great leap forward toward legislation that would move us closer to universal access to healthcare, a more equitable society, and significant efforts to protect the environment is the fact that Biden will not start his term with commanding majorities in both houses of Congress. The hope for a “blue wave” that rolled on toward sweeping change through legislation was defeated. There is hope that a double win in the Georgia runoff elections on January 5th will give the Democrats the smallest possible majority that enables procedural control of the Senate, but even if they win the Georgia elections their control will be so tenuous that meaningful legislation prior to the midterm elections of 2022 is unlikely. There is disappointment on both sides. It is likely that even if Donald Trump were convicted of some fraud in New York, where a presidential pardon can’t protect him, he will continue to be a force that impacts the opinions of almost 50% of voting Americans. If there was ever a moment that called for a bipartisan approach to policy, that moment is now. 

 

Yesterday, we got a step closer to the inauguration of Joe Biden when the election results in Michigan were certified. Perhaps connected, but the connection was not admitted, was the president’s suggestion that Emily Murphy, the GSA official with the legal responsibility to name “the likely winner” of the electoral college vote, could now allow the orderly transition of government to begin even as he continued to fight for recognition of his victory. Even this pronouncement which is usually an unnoticed milestone in the process of installing a new administration was not free of controversy. In a report prepared for NPR by Brian Naylor and Alana Wise we read:

 

While Trump said he had recommended the moves, Emily Murphy, the Trump appointee who heads the GSA, wrote in her “letter of ascertainment” to Biden that she had reached the decision independently.

“Please know that I came to my decision independently, based on the law and available facts,” Murphy wrote in the letter, dated Monday. “I was never directly or indirectly pressured by any Executive Branch official — including those who work at the White House or GSA — with regard to the substance or timing of my decision. To be clear, I did not receive any direction to delay my determination.”

 

“Whatever,” you say. At least the orderly transfer may finally begin. “May” is the operative word. Perhaps “might” would be a more accurate description because the one thing that is certain these days is that nothing is ever certain. I am assuming that in the end President Elect Biden will be inaugurated. I believe that he will do his best to end the pandemic. That means that I expect that he will follow the advice of his scientific advisors to hasten our recovery from the COVID-19 pandemic. I also hope that I will be protected from the worries of COVID by vaccination sometime around the fourth of July. I have not had a haircut, eaten in a restaurant, or flown on an airplane since March 11 and will do none of those things until I get my vaccination because the small risk of becoming a COVID victim is just not worth a haircut, an evening at a restaurant, or a plane ride. We have endured a lot to get this far. I do not see the benefit of discarding the behaviors that are most likely to insure our continued health when the possible end of this pandemic is only a half year away. 

 

Eventual control of the pandemic is not the only thing I expect. I also expect that Biden’s success in modifying the ACA by legislation will be limited by Republicans even if the Democrats regain control of the Senate by winning both of the races in Georgia. Substantial modifications of the ACA or expansions of Medicare to include people before they are sixty five would require sixty votes. Getting sixty votes for a public option seems unlikely. To get around the sixty vote threshold would require that the filibuster be eliminated which is possible with a simple majority vote at the start of the legislative term, but that is highly unlikely because even one Democrat voting against the end of the filibuster would kill the possibility. Since meaningful reconstruction of the ACA is unlikely, we will need to be satisfied by reversing some of the things that Trump has done by executive order and by administrative processes within HHS and CMS. Even though it will not be possible to offer a “public option,” it could be true that many more people could get access to care through adjustments to current regulations, better support of the exchanges, and by the gradual acceptance of the Medicaid expansion by resistant “red states.” 

 

A major uncertainty that circumstances will clarify in late January is how much resistance Biden appointees will encounter as they come up for Senate confirmation. If that seems unlikely to you let me remind you that as excellent a candidate as Don Berwick was for the administrator of CMS, he could not win confirmation, and had to settle for a year and a half tenure as a “recess appointment.” If Mitch McConnell still controls the Senate, and if his objective is to defend the status quo for four years by any means, you can expect that the confirmation process will be a rocky road. 

 

If what I expect does happen, what should those of us who want change to occur do? First, at this season of Thanksgiving, be thankful that in the end we will have the ability to begin to build back better. Secondly, we should pray that the Supreme Court does sustain the bulk of the ACA when it makes its ruling in late spring or early summer. Thirdly, we need to “shoot low” while realizing that beyond what can be done with executive orders and changes in administrative actions, progress toward better cae will require seeking small bipartisan improvements in areas where there is some consensus that a problem exists. Some have pointed to the possibility of bipartisan support for efforts to lower the cost of drugs and to eliminate “surprise” medical expenses for unavoidable out of network care. Finally, in states where progressive ideas can be turned into law we should make the effort to “pilot” some of the ideas that might eventually become law at the national level.

 

It is good to remember that “Romneycare” in Massachusetts preceded “Obamacare.” New York had made abortion of unwanted pregnancies legal before Roe v. Wade. Marriage and civil unions for same sex couples became a reality through a slow process beginning in the states.  Even slavery was abandoned at the state level in a majority of states before the passage of the 13th, 14th, and 15th amendments after the Civil War. By nature we favor gradual change.  The arc of our history does bend very gradually toward justice, and that is something for which we should be thankful as we ponder the clarity about the strategic possibilities for change that become obvious as the dust settles following this election. 

 

Because of making appropriate personal choices in the midst of the pandemic my wife and I will be alone at this Thanksgiving, but we will be giving thanks for the fact that the possibility for change has been renewed by the election. It seems that our Democracy has survived even if all of our dreams of economic and social equity, the Triple Aim, an improving climate, and racial harmony have not yet come true. The hope that they might someday happen is off of life support and beginning a rehab program that may lead to long term improvement. I hope that you will also enjoy this “not normal” thanksgiving with those who live under your roof. I hope that you will be able to see new opportunities and special meaning in the challenges that we will face and this year. We still have a chance for our dreams of an America that lives up to its long stated ideals, and for that we should be thankful.