A gutted healthcare system will result in a sicker, more expensive America.

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Dimitrios Kambouris / Getty Images

A sweet friend empathetic to my disabled-during-a-pandemic restrictions had just dropped off an eggplant Parmesan grinder, one of my favorite comfort foods, when my phone notifications revealed to me I was about to read either Very Bad or Very Good news.

It was the former.

I sat on our back steps, barefoot, eating my sandwich and scrolling through Twitter. Justice Ruth Bader Ginsburg, or RBG, had died.

And with that, there was now a vacancy on the Supreme Court that the Trump administration had long been waiting for.

As soon as the news broke, with vigils immediately organized to mourn her loss and honor how much worse things could get, we learned of RBG’s dying wish to not be replaced until there is a new president. Just as quickly, we learned of the intentions of Republicans in the Senate to fast-track a conservative judge to replace her as soon as possible.

If the Senate Republicans successfully push through a Supreme Court nominee before the election, the Affordable Care Act (ACA) will likely be dismantled.

Republicans are already committed to this work, with a case currently pending as the Trump administration and 18 Republican state attorneys ask the Supreme Court to strike down the entire ACA as unconstitutional.

If this happens, more than 20 million Americans stand to lose their health insurance during a pandemic that’s killed more than 210,000 Americans and has caused more than 30 million to lose their jobs (millions also lost their employee-sponsored health insurance).

This may cause rates to skyrocket for people like me who are living with a preexisting condition.

Those who have had and recovered from COVID-19, or have tested positive for antibodies — especially those with “long-haul” COVID-19 — are and will be considered to have a preexisting condition.

The Republican agenda fails to recognize — or worse, refuses to acknowledge — that the single top issue for voters in the 2018 midterm elections was healthcare access and affordability.

With “repeal the ACA and replace it with nothing” on the docket during the COVID-19 crisis, healthcare is once again a defining issue of the upcoming election.

If the Supreme Court is stacked with enough anti-healthcare justices willing to do what Congress would not, our worst fears could become our reality.

A 6-3 Supreme Court would fundamentally change the country. It would fundamentally change a country that already fails the chronically ill and disabled community.

The disease I have, systemic lupus erythematosus (SLE), is both expensive and life-limiting. This year to date, the medications I require for my survival have cost me and my insurer $314,908.22.

I typically meet my high deductible for the entire year just days into January, and my prescription plan is only made possible through a very expensive medical insurance plan. Not to mention the high cost I’m required to pay for the medications my insurance plan doesn’t cover.

This is what “excellent” healthcare looks like in the United States.

Simply put: Surviving in this country is often too expensive.

I say that as someone with immense privilege as a white, cisgender, heterosexual woman. I say that as someone with socioeconomic privilege who can navigate the medical system and rely on the support of family. I say that as someone who has the privilege of a firm diagnosis.

I wouldn’t be alive without these medications. But how could I, despite the aforementioned privileges, ever pay for them without insurance?

It isn’t just poor moral policy to strip Americans of healthcare and other basic rights. It is poor fiscal policy.

It’s more expensive to have a sicker population requiring more expensive emergency intervention than it is to have compassionate capitalism that uplifts those in this country who are worse off with preventive measures.

It’s more expensive to have a large portion of society too sick to work than it is to uplift our sickest. The repeals are in the name of cost savings, which contradicts the evidence and the science: It is more expensive to restrict access to quality healthcare.

The outcomes for those with preexisting conditions depends on quality healthcare, and a gutted healthcare system will result in a sicker, more expensive America.

My feelings about RGB’s death are complex and contain a nuance I know is mirrored in those who are also a part of underrepresented groups. I was not, and am not, devastated in the way many who idolized her are.

Their grief is real, but I try to not idolize anyone. It’s unfair to dehumanize a person that way.

Canonization undermines the good we do in our lives and erases the harm we have caused. RBG held tight to the thread of good that existed in our government that protected some of the least represented, though fell short of protecting all of us.

It shouldn’t be up to one sick person, let alone an 87-year-old with terminal cancer, to hold up our failing justice system.

But RBG did protect the healthcare we have, however flawed it may be, as well as the Americans with Disabilities Act, reproductive rights, and gender equity.

During the late justice’s memorial ceremony, Rabbi Lauren Holtzblatt spoke of RBG’s relationship to “tzedek, tzedek tirdof,” which means “justice, justice you shall pursue” in Hebrew.

With RBG’s death, there is more clarity on the failing system. We listen to those whose experiences are still difficult regardless of her rulings and see how far we have to go.

We listen to patient advocates and medical experts and see how much more dangerous our situation could become, and we combine that information with the motivation to do better to see the path forward.

We do not need to go back to where we were, but we can also prevent things from getting worse. In that work, may her memory be a blessing.

Alyssa MacKenzie is a writer, editor, educator, and advocate based just outside Manhattan with a personal and journalistic interest in every aspect of the human experience that intersects with disability and chronic illness (hint: that’s everything). She really just wants everyone to feel as good as possible. You can find her on her website, Instagram, Facebook, or Twitter.