August 28, 2026
Dear Interested Readers,
Are Advocates For Better Healthcare Part of an Effective Majority?
There are about nine weeks until the crucial 2026 midterm elections on November 3rd. If you want to know the exact number of weeks, days, and hours until we have the chance to begin the process of turning around the slide of American healthcare under the forces of the president, RFK, Jr., and his MAGA minority, click here.
I am at that stage in life where I need a pill box to manage the double-digit number of pharmaceuticals I consume each day. I probably far exceed my peers in the average number of hours of exercise I do each day. According to Social Security actuarial tables, a man aged 81 has an average life expectancy of about 8 years. So I might have a shot at 89. It has occurred to me that there are just three reasons I try to do everything I can to lengthen my life. First, I want to be part of the lives of family members and friends for as long as possible. Second, I want to see the beginning of the recovery journey toward health equity and the damage done to our scientific and healthcare delivery systems. Thirdly, I am not sure about what comes next after this life. Like my father, I am fond of the old adage, “Heaven may be my home, but I am not homesick yet.” I would add that, like Dad, I am not eager to read the “afterword” on my life. Dad made it to six weeks shy of his 98th birthday, but he thought and lived as if every day might be his last after he got prostate cancer in his mid-seventies. Said differently, my second motivation is to see how the nightmare of the Trump/MAGA detour our nation has taken finally ends.
Over the last six months or so, since I canceled my subscription to the Washington Post, I have found that my daily search of the print copy of my local paper, and the online and podcast output of the New York Times, the Boston Globe, and The New Yorker, and The Atlantic have become less satisfying, even tedious at times. Perhaps I am frustrated when there is no specific account of a new crack in the Trump facade. Don’t get me wrong, I still find gems in these publications and quote their pundits to you frequently, but after Paul Krugman left The Times and Jennifer Rubin left The Post, I followed them to Substack because I missed their bolder writing. Both had noted that they had begun to feel more “edited” before leaving their previous outlets. While reading Rubin and Krugman on Substack, I began to read Heather Cox Richardson’s daily “Letters From an American” much more regularly. She has long been a favorite of my wife. The shift in focus has been enlightening for me.
I should qualify that there are still pundits at the New York Times who give me insight into our times. Jamelle Bouie, Michelle Cottle, David French, Tom Friedman, E.J. Dione, Ezra Klein, Carlos Lozada, Maureen Dowd, and Nicholas Kristof are all sources of new insights, with some like French offering a thoughtful conservative perspective, as did David Brooks before departing for the Atlantic and Yale, but they don’t write every day, as the Substack writers do. I should also add that you should read any book or New Yorker article by Jill Lepore you can find. She is great at the big picture, showing how what happened in our past connects to this moment. I offer this perspective to you because I think keeping hope alive in our times is as important as treating your hypertension and cholesterol with pills or getting enough physical activity, and paying effective attention to what you eat to keep your A1C below 6 and your BMI under 25.
A couple of Heather Cox Richardson’s posts this last week are worth your attention. Her post from August 20 was stimulated by a New York Times editorial from August 15 entitled “Republicans Are Trying to Hide These Health Care Cuts.” The editorial focuses on the deception arising from how Republicans structured “The One Big Beautiful Bill. Most of the cuts to Medicaid don’t take effect until 2027, after the midterm elections. Republicans knew there would be millions more angry voters if the cuts were implemented before the election. Even passionate MAGA voters will probably be angry when they realize that their fealty to Trump has cost them access to healthcare. Even those who will still be theoretically eligible for care may be justifiably angry because it is estimated that over two-thirds of those who will lose their care will do so because they can’t navigate the complicated bureaucratic processes. Simultaneously, due to the subsequent loss of Medicaid revenue, many hospitals, particularly those in inner-city neighborhoods and rural America, will be vulnerable to closure. When hospitals close, not only is care compromised, but many jobs are lost.
In her post, Professor Richardson reached into the comments submitted following the editorial for insight into Republican hypocrisy. She writes:
As the New York Times editorial board noted, Republicans deliberately put off the implementation of most of the Medicaid cuts until after the 2026 midterms.
New York Times reader KAM from Marin County, California, noted in a comment on the story that Treasury Secretary Scott Bessent defines onerous paperwork differently than Republicans in Congress. Bessent recently announced the Treasury will no longer require shell companies to disclose even the name, address, and identification of people who own an interest of more than 25% or who exercise “significant control” over the company, as Congress required in the 2021 Corporate Transparency Act. Congress designed the law to combat money laundering, but Bessent says the paperwork puts an undue burden on businesses.
It seems morally questionable to justify reducing “undue paperwork” for potentially fraudulent business practices while burdening an already stressed population with entirely unnecessary hurdles to eligibility for a public benefit to which they are entitled. This week Ezra Klein interviewed his wife, Annie Lowry, the author of a well received book on the benefits of Uniiversal Basic Income and writer for The Atlantic, about her new book, The Time Tax, which reveals just how pervasive the strategy of building barriers between the poor and their potential benefits has become, and how frustrating it is compared to the ease of getting a benefit like a home mortgage deduction, if you are not poor. The interview will enlighten even those of us who think we know the reality of how pervasive benefit denials are as a Republican strategy.
Democrats have also participated in this strategy, as Lowry points out by reminding us of President Clinton’s attack on “welfare as we have known it” in 1996. The sin of it all is that some people who were born with significant social disadvantages suffer and die unnecessarily while many who have more than they need get even more at the expense of all of us. The injustices embedded in these policies make me wish I did believe in an ultimate Judgment Day, but, theoretically, we do have elections for accountability, which brings me to Professor Richardson’s post last Saturday (written version). The audio version is entitled “You Are Not Alone.”
In her post, Richardson covers a lot of ground. She begins with comments about Darlene Graham’s debate gaffe in the South Carolina Senate race, and then informs us of a school committee race won by progressives in deep-red West Coast Florida. She then comments on the Republican platforms of 2020 and 2024 before commenting on the Grand Prix auto race last week around the Mall in Washington, which was the final jewel in Trump’s self-aggrandizing celebration of our nation’s 250th birthday before briefly commenting on the latest Trump tariff dustup with Canada, the war in Iran, ICE killings, and the $2.2 billion personal corruption bonus gleaned by Trump. In short, Richarson gives us a review of the president’s crimes and incompetence that could serve as a prosecutor’s presentation to a grand jury, or a bill of impeachment, but it is, in fact, a lead-up to a report on a recent YouTube video by Pete Buttigieg titled “Don’t Let Them Fool You: You are Not Alone.” You should invest the six minutes it takes to watch the clip. I could not find a transcript, so I will couple my remarks with what Professor Cox wrote about Buttigieg’s remarks. She presents Buttigieg’s words:
On August 17, former transportation secretary Pete Buttigieg recorded a video to assure those Americans who oppose the Trump administration that they are in the large majority. He noted that the strategy Republicans are pursuing shows how unpopular they are.
“Think about it,” he said. “They’re not out there showing that the economy is somehow better than it looks…. They’re not defending their cuts to healthcare, they’re not defending the tax cuts for the wealthy. They’re not defending the corruption that’s going on in Washington.”
“It’s too late for that,” he said, because “we’ve all seen that those policies have failed. They made us all pay tariffs and said the reason we got to do this is to bring back manufacturing jobs…. Well, we paid the tariffs, and then America lost manufacturing jobs. They cut taxes for the rich. They said we’ve got to do that in order to speed up economic growth. And what happened? Economic growth slowed down…. They said they were going to cut costs and prices. Inflation is actually higher now than the day Donald Trump took office. They said they were gonna drain the swamp. And then they expect us to be okay with the first family making a billion dollars or more in crypto deals while the president’s in office….
“A lot of people believed this president and Republicans when they said no new wars. Then, what do we get? A war with Iran in the Middle East right now, which means all of us here at home are paying higher gas prices.”
The Republican strategy is not to change their policies, Buttigieg said. “It’s changing the maps. Changing the rules. Because that’s the only way they could win. They know they’re on the wrong side of the American people….
Pete is doing his own survey of Trump’s miserable performance, which has been uninterrupted by a subservient Republican controlled Congress that deserves to be sent packing with Liz Cheney’s prediction of their lifelong shame ringing in their ears. During the hearings on the January 6 riots at the Capitol, Cheney said:
“Tonight, I say this to my Republican colleagues who are defending the indefensible: There will come a day when Donald Trump is gone, but your dishonor will remain.”
Buttigieg continues with a positive and reassuring message; the bolding is mine:
“You’re already in the majority if you think that we need healthcare for all, not Medicaid cuts and cutting Obamacare…. Right now, if you think that the wealthiest people in the country need to be paying their fair share in taxes, which is more than they’re doing today, where they currently pay less than a lot of teachers and nurses and firefighters. You are definitely in the majority if you believe that the wealthiest nation in the world ought to do the best job of funding public education and making sure it works. Not this Republican approach, which is to literally eliminate the Department of Education. You’re not alone if you think that in any decent economy, one job ought to be enough. And you’re certainly not alone if you believe that a woman’s healthcare decisions ought to be up to her and no one else, that in a free country, you should get to be who you are, and love who you love, and live a life of your choosing. When you believe these things, you’re not just not alone. You’re part of a powerful majority. Really a supermajority of the American people.
Next, Pete extends a hand to those who have been previously conned by all of the “fake promises” of the president and gave him a chance to improve their lives rather than create the mess he has produced. It is a call for unity of the abused with those who were never fooled. We have a lot in common, and together we could form a supermajority of voters.
“So, whether you’re a Democrat, an independent, or someone who has generally voted Republican in the past, most voters want the same things right now: to be led and represented by normal people who are good at getting things done. People want leaders who respect those who disagree or vote differently instead of calling them the enemy. People who know that God does not belong to a political party in the United States of America. Most voters want to elect leaders who are not simply trying to rebuild the past, but trying to create something new and better.”
The clock is ticking toward November 3rd. There is no guarantee that the supermajority Buttigieg envisions will emerge. Will it be a “silent majority?” Will the president add to his crimes and succeed with Republican complicity in undermining the election? Will the attempts at gerrymandering to protect Republican dominance of the House succeed in intent? What you can know for sure is that even if the House and/or the Senate come under Democratic control, the damage of the One Big Beautiful Bill will continue until Democrats control Congress and the Presidency. History tells us that authoritarians don’t need a majority to take control. Just as an American president can be elected without a majority, Hitler took control of Germany after his party won only a third of the seats in the German parliament. Democracies can be fragile, and when they fail, the health of many of their citizens suffers. I hope that Pete Buttigieg’s assertion that we are not alone and that we can begin to end this growing nightmare becomes a proven truth rather than an unrealized opportunity.
This and That in My World
I have a little bit of the end-of-summer blues. The Danube is dry, and although my wife and I have not yet officially canceled the trip that was to highlight her 80th birthday, the prospects don’t look good. A recent high point was seeing the blue heron again, which occasionally stops by our lake. Several years ago, I got a great early-morning photo of a blue heron on my swim platform. I wondered if the stately bird I saw this week was the same bird. Even better than seeing the heron was that my neighbor, Peter Bloch, who is a fantastic photographer, also saw the blue heron while it was visiting our lake and made a great video titled “Yoga With Heron,” which you can see by clicking here. I lifted a screenshot from Peter’s video for today’s header.
I continue to enjoy discovering new wildflowers on my walks. This week has been particularly productive. I don’t know if the new discoveries just popped up because they flower in late summer, or if they had been there all along and I just had not noticed them. This week’s new sightings were Swap Aster (Symphyotrichum puniceum), Devil’s Beggarticks (Bidens frondosa), Low Smartweed (Persicaria longiseta), Tall Rattlesnake Root (Nabalus altissimus), Silverrod (Solidago bicolor), and Tansy (Tanacetum vulgare).
If you follow the links, you will discover that most of them are native plants, but some were brought here from Europe or Asia. I have no idea how they got off the beaten path to my little world, but here they are. Some have known medicinal uses. Read the link about Tansy as a good example of a “wildflower” from across that sea that was used for everything from treating “rheumatism” to being a deodorant for dead bodies. Tansy is also a pretty good insect repellent.
When we bought our home on the lake, we discovered that the previous owner liked tall plantings like foxglove, which, as you may remember, is the origin of all the digitalis preparations. In 1785, William Withering published evidence of the benefit of a tea made from foxglove leaves for the treatment of “dropsy,” the old term for CHF. Apparently, wise folk healers had known the benefit of a carefully prepared concoction. As with many naturally occurring products, “a little dab will do you,” but “a little more will do you in.” The digitalis glycosides have a very narrow “therapeutic window,” the safe dosage that treats a condition without causing serious toxic side effects. A little bit of the tea brewed by the wise old women of English villages was good for AF, shortness of breath, and swollen ankles, but a little bit more was fatal. In my practice, I prescribed digoxin frequently, but with great care. With the flood of new medications for cardiology, the use of digoxin has declined substantially.
Finally, I want to steal an idea from Paul Krugman, who usually adds an appropriate “Musical Coda” to his posts. Lately, I have been listening to some of the hundreds of my old CDs while I drive around on my errands in my 2005 Toyota Tacoma pickup truck after getting its radio repaired. This week I was listening mostly to Elvis’ 1967 gospel album titled “How Great Thou Art.” I had the idea that one song in particular might be appropriate as we consider moving on from MAGA and its Christian Nationalist supporters. Elvis called the old spiritual “Run On”; it is also known as “God’s Gonna Cut You Down.” Johnny Cash and many others have also covered the song. Click here to hear the Elvis version I have enjoyed this week.
The song reminds me, and perhaps will encourage you, to believe that even though MAGA and Trump have been “running on for a long time,” they are vulnerable to being “cut down,” not necessarily by God, but at the midterm elections by those of us who have endured enough and want something better. Pete Buttigieg tells us we are a majority. Let’s act like one.
Be well,
Gene
