I was going to avoid political talk for a little longer, but that seems unrealistic these days, doesn’t it? Actually, it feels irresponsible to avoid it completely if you have any type of platform, no matter how small. I’m not going to address last night’s performance piece of a State of the Union speech, I’m going to focus in a bit more. On health care. Yeah, that old topic. You’d think we’d have exhausted and put it to bed by the year 2020, but far from it.

So. When I was a kiddo in the wilds of south Brooklyn, everyone knew one other kiddo whose dad had died in his thirties or forties–maybe when we were a little older, in his fifties–from a massive heart attack. Shoveling snow, working construction, running to catch the train, maybe eating Sunday dinner. “So young,” it would be whispered. It happened, and really, outside of the immediate family/friend circle, it wasn’t all that shocking, because it happened. Not frequently, but. Actually, it often wasn’t all that shocking within the circle either, because more than half the time you’d hear the same had happened to Grandpa/Uncle/Cousin. Genetics, though then we’d say “it runs in the family,” like freckles or broad hips.

We also all knew at least one someone whose Grandma/Grandpa lived with them, but you didn’t know until you’d been to their house or apartment twelve times, because Gramps was hidden in the basement or a back room. Gran was creepy, with an odd lurch to her step and slurred speech in the brief periods that she was awake and banging for dinner. Sounds like the setup to a gothic novel, doesn’t it? No, an elderly person post-stroke, with a poor or working class family who couldn’t afford home health attendants or a decent nursing home. There was social security and medicare, but it didn’t cover enough for many families who couldn’t supplement.

Now we hear, “So young!” when someone dies at 75. Because health care is better, and more broadly available. Not for everyone, not enough, but certainly better. The 43 year old who has nausea and sharp jaw pain goes to her cardiologist and gets a stress test, the 38 year old with chest pains goes to the ER and has an angio resulting in a drug eluding stent placed to unclog his left anterior descending artery. True, pollution was much worse (in our air and water) and everyone smoked, but it’s now rare to hear of someone under the age of 70 who had rheumatic fever as a child leaving them with cardiac issues, and the number of people living with diabetes has skyrocketed. Oh, you didn’t know diabetes is actually a multi-systemic, devastating disorder?

When the Affordable Care Act was passed, things improved for many. Medicaid was expanded, adult children could stay on parents’ health care plans until age 26 (so important in this age of shrinking unions and gig economy), lifetime caps were eliminated. If you don’t think the elimination of lifetime caps is a big deal, congrats! Your life has been charmed. Annual caps were eliminated (also, a really big issue for anyone dealing with chronic disease). Insurers were no longer allowed to deny coverage to people with preexisting conditions, insurers were no longer allowed to jack up the rates for those with preexisting conditions (making health insurance unattainable), preventative health care had to be covered, garbage plans that basically offered no protections were banned. Was the ACA enough? No. Was it still too expensive for too many? Yes. Are there too many doctors who don’t accept ACA plans? Yup. But it was better than what we had before. Much better for many, and a huge step in the right direction for all.

One of the first things this administration and GOP did was try to roll back the ACA. By the grace of John McCain (there’s a phrase I never expected to type) and the huge push of constituents nationwide, they were defeated.

Well, guess what? They’ve been successfully chipping away at it ever since. The individual mandate has been eliminated. States were allowed to tie work requirements to Medicaid (now in court, but so far tens of thousands have been kicked off Medicaid in Arkansas). Access to garbage (called short term or skinny plans) was expanded. And now, right now, this administration is in court, trying to take away protections for those with preexisting conditions. Of course, this President spews lies about this along with everything else. Why does he lie so much? Because he can. Because he gets away with it. Because of his supporters, many aren’t informed enough to know he’s in court trying to take away their healthy care–and savvy enough to tell SCOTUS not to hurry to hear the case, wait until after the 2020 election. A number of his supporters know and don’t care, they’d rather lose their own protections and health care than know one of those others is getting a bypass in the operating room next door.

My personal favorite (and by favorite I mean drooling/sobbing/ready to throw myself off the terrace) is when I see/hear people who continue to support this administration and President because who knows why, but they know it’s ok, and they’ll be ok, because they aren’t like those greedy libs who want entitlements. Sure they want and need their Social Security and Medicare, but those aren’t entitlements. Oops. But come November, they’ll still vote for him. Why? Because in the meantime he’ll lie, and they’ll swallow those lies because they want to, and really, when you think about it, maybe Uncle Joe’s had a good run after all.