WEBVTT - A Post-ACA World 0:00:11.760 --> 0:00:15.000 Good morning, peeps, and welcome to OOKP Daily with me 0:00:15.200 --> 0:00:20.720 your Girl, Daniel Moody pre recording from the Long Island Bunker. Folks. 0:00:20.760 --> 0:00:26.240 As many of you know, my birthday comes up over 0:00:26.640 --> 0:00:31.280 the weekend and there is just well, let's just say, 0:00:31.440 --> 0:00:35.040 not a whole hell of a lot to celebrate. Nonetheless, 0:00:35.560 --> 0:00:38.280 I'm going to be taking a couple of days for 0:00:38.360 --> 0:00:42.319 some rest and restoration. But I'm leaving you all with 0:00:42.560 --> 0:00:48.280 really fantastic pre recorded interviews that I have done to 0:00:48.360 --> 0:00:52.600 prepare for this time. So coming up is a really 0:00:52.640 --> 0:00:58.360 great conversation that I had with doctor Rob Davidson, who 0:00:58.400 --> 0:01:04.760 is an emergency room doctor in West Michigan. And doctor 0:01:05.360 --> 0:01:09.440 Davidson and I spoke before the election. We actually, I 0:01:09.520 --> 0:01:12.679 think spoke on election day, so we didn't know the results. 0:01:12.760 --> 0:01:19.080 But what he was laying out in this interview is 0:01:19.160 --> 0:01:21.280 what the world looked like, what America looked like, I 0:01:21.319 --> 0:01:26.720 should say, before the ACA, and what it can potentially 0:01:26.880 --> 0:01:30.880 and what it will look like POSTACA, because as we know, 0:01:31.480 --> 0:01:38.440 the Republicans one overwhelmingly every seed of power, and first 0:01:38.480 --> 0:01:43.000 up on their agenda is to deport tens of millions 0:01:43.000 --> 0:01:45.880 of people from this country. And then second up is 0:01:45.920 --> 0:01:50.120 to ensure that tens of millions of people inside of 0:01:50.160 --> 0:01:54.440 this country are sick and desperate. And so in this 0:01:54.520 --> 0:01:59.880 conversation we talk about what a post ACA world will bring. 0:02:00.640 --> 0:02:04.800 And you know, now we're here. Now we're here, so 0:02:04.920 --> 0:02:07.760 there is no like, well, what if and what if? 0:02:07.800 --> 0:02:11.440 It's not even a what if anymore. It is a 0:02:11.480 --> 0:02:16.640 when you know, how long do people have in order 0:02:16.760 --> 0:02:22.400 to get doctor's appointments and take care of themselves and 0:02:22.480 --> 0:02:26.840 their families. So coming up next my conversation with doctor 0:02:27.160 --> 0:02:34.560 Rob Davidson, Folks, I am excited to welcome to WOKF 0:02:34.960 --> 0:02:39.040 Daily doctor Rob Davidson, who is an er doctor in 0:02:39.200 --> 0:02:42.800 West Michigan and is the executive director of the Committee 0:02:42.800 --> 0:02:50.200 to Protect Healthcare, whose Twitter account went viral after creating 0:02:50.240 --> 0:02:57.320 a thread to respond to speaker Mike Johnson's unearthed video 0:02:57.560 --> 0:03:01.000 I guess we can call it of him claiming that 0:03:01.720 --> 0:03:06.360 he is going to do away with the ACA and 0:03:06.440 --> 0:03:12.560 that there will be no Obamacare. Doctor Davidson talk to 0:03:12.639 --> 0:03:19.679 us about why the ACA is so important and how 0:03:20.240 --> 0:03:24.959 it has transformed lives that you see on a regular basis. 0:03:26.160 --> 0:03:29.440 Absolutely, Danielle, and this is this is really important to me. 0:03:29.520 --> 0:03:33.639 I've been in an emergency position for oh gosh, since 0:03:33.720 --> 0:03:36.160 nineteen ninety eight when I graduated medical school, so I've 0:03:36.160 --> 0:03:38.480 been at this a long time. I was probably about 0:03:38.480 --> 0:03:40.920 half of my career before the Affordable Care Act, about 0:03:40.920 --> 0:03:44.200 half of my career thus far after the Affordable Care Act, 0:03:44.240 --> 0:03:48.000 and primarily you know where I am, a pretty poor 0:03:48.080 --> 0:03:51.240 rural area, also worked in some urban areas in West Michigan, 0:03:51.840 --> 0:03:54.800 and the medical expansion piece of the Affordable Charact has 0:03:54.800 --> 0:03:58.600 been so incredible for the patients that I see. You 0:03:58.640 --> 0:04:01.760 know that we have people who, for so much of 0:04:01.800 --> 0:04:04.320 the time that I knew them, you know, working multiple jobs. 0:04:04.400 --> 0:04:07.200 None of the jobs provide a health insurance. You know, 0:04:07.240 --> 0:04:10.440 they didn't. They were were enough to quite qualify for Medicaid, 0:04:10.560 --> 0:04:14.360 but they couldn't afford to buy health insurance, particularly people 0:04:14.400 --> 0:04:18.719 with pre existing conditions, as insurance companies were able to 0:04:18.760 --> 0:04:21.640 deny people coverage or price it so far out of 0:04:22.040 --> 0:04:26.279 affordability that essentially they couldn't get coverage. And so many 0:04:26.320 --> 0:04:28.279 of those people I'd see over and over in the 0:04:28.560 --> 0:04:31.320 er with crazy high blood pressures, with blood sugars that 0:04:31.360 --> 0:04:34.240 were off the charts, who couldn't get a doctor who 0:04:34.240 --> 0:04:36.719 couldn't get insulin, who couldn't get blood pressure meds, and 0:04:36.760 --> 0:04:39.320 we'd sort of patch them up in the er. We'd 0:04:39.320 --> 0:04:41.720 get them maybe a month or two worth of their medication. 0:04:41.920 --> 0:04:45.280 We'd refer them to somebody, but again, because they didn't 0:04:45.279 --> 0:04:49.960 have insurance, they couldn't go see anybody. And it's certainly anecdotal, 0:04:50.000 --> 0:04:53.720 but it is so incredibly profound to see since the 0:04:53.760 --> 0:04:56.279 Affordable Career, how many more people have insured, how many 0:04:56.279 --> 0:04:59.320 more people can go see a doctor, how they are 0:04:59.320 --> 0:05:01.719 not dependent upon the er to get you know, reshills 0:05:01.720 --> 0:05:04.360 of their blood pressure meds or their insulin, or waiting 0:05:04.440 --> 0:05:06.280 until they're in a health crisis to be able to 0:05:06.360 --> 0:05:09.920 manage those chronic conditions that then result in heart attacks 0:05:09.960 --> 0:05:14.000 and strokes and kidney failure. So it's you know, having 0:05:14.360 --> 0:05:18.360 that option, expanded Medicaid and then having the subsidies that 0:05:18.520 --> 0:05:21.480 you know. Unfortunately, when President Trump was present the last time, 0:05:21.520 --> 0:05:25.200 he undermined and he cut and President Biden and Vice 0:05:25.200 --> 0:05:29.000 President Harris have now restored and strengthened and a placial 0:05:29.040 --> 0:05:32.320 Reduction Act the subsidies, so people who don't quite qualify 0:05:32.440 --> 0:05:35.680 for even expanded Medicaid can buy insurance, but do it 0:05:35.680 --> 0:05:39.160 more affordably. I think those pieces have been so important 0:05:39.200 --> 0:05:40.000 to my patients. 0:05:40.680 --> 0:05:43.680 Talk to us about like your reaction when you heard 0:05:43.720 --> 0:05:49.240 that audio by Speaker Johnson just so smugly basically saying 0:05:49.360 --> 0:05:53.240 that he's going to condemn tens of millions of American 0:05:53.400 --> 0:05:58.600 two emergency rooms as their primary care facility. Talk to 0:05:58.720 --> 0:06:04.000 us about what means you know, and saying that following 0:06:04.240 --> 0:06:07.240 a global health pandemic, that if we had had that 0:06:07.320 --> 0:06:11.280 global health pandemic, I would assume hit and we had 0:06:11.320 --> 0:06:14.840 had no ACA. Just walk us through some of the 0:06:14.880 --> 0:06:17.040 things that you would have seen. 0:06:18.160 --> 0:06:20.400 Right if we didn't have the ACA. Certainly, we had 0:06:20.400 --> 0:06:22.360 people who couldn't earn a living the way they were 0:06:22.440 --> 0:06:25.400 used to earning eleven, so their paychecks were down, and 0:06:25.440 --> 0:06:28.039 then they needed health care right they and their families 0:06:28.160 --> 0:06:30.080 needed to be able to go to the doctor or 0:06:30.160 --> 0:06:32.640 having formid occasionally go to the emergency department when they 0:06:32.640 --> 0:06:36.760 couldn't breathe when they had COVID. And that double whammy 0:06:36.920 --> 0:06:39.680 of a health crisis and an economic crisis put so 0:06:39.760 --> 0:06:43.760 many more people into that realm of requiring medicaid who 0:06:44.040 --> 0:06:47.120 frankly still would likely not have followed by for Medicaid, 0:06:47.360 --> 0:06:50.080 and we see in states where they don't have expanded Medicaid, 0:06:50.120 --> 0:06:53.359 those folks had less access to care. And the folks 0:06:53.440 --> 0:06:56.200 in states like Michigan Rye lived and about forty other 0:06:56.240 --> 0:06:59.200 states that do have expanded Medicaid, those folks had access 0:06:59.279 --> 0:07:03.000 to healthcare even though their paychecks were way down. When 0:07:03.040 --> 0:07:05.480 I heard Speaker Johnson say that, you know, to say 0:07:05.480 --> 0:07:07.799 I was surprise would be a lie. It's not surprising 0:07:07.800 --> 0:07:11.280 to hear leaders on the Republican side do this. I 0:07:11.400 --> 0:07:14.360 kind of thought the Republican Congress was kind of past this. 0:07:14.720 --> 0:07:17.840 They had said, you know, when President Trump had suggested 0:07:17.880 --> 0:07:20.320 he wanted to still do away with the APA, and 0:07:20.360 --> 0:07:24.040 he had concepts of a plan, Republicans in Congress came out, 0:07:24.480 --> 0:07:26.000 some of them at least, and said, well, this is 0:07:26.040 --> 0:07:29.200 not on the agenda, and so we were certainly I 0:07:29.320 --> 0:07:33.080 had been concerned about Trump winning and perhaps going after 0:07:33.120 --> 0:07:35.360 the AC again like he did the last time. You 0:07:35.360 --> 0:07:37.920 would then, but I thought, okay, well, maybe they've learned 0:07:37.920 --> 0:07:40.040 their lesson when they couldn't get it through in twenty 0:07:40.080 --> 0:07:43.600 seventeen and they had a backlash in twenty eighteen when 0:07:43.640 --> 0:07:47.760 people you know, voted overwhelmingly for Democrats with the ACA, 0:07:47.880 --> 0:07:50.800 you know, kind of as they're on their banners, as 0:07:50.840 --> 0:07:53.720 they were marching for these folks, and then you hear 0:07:53.920 --> 0:07:56.520 the now speaker and if they keep the ouse, future 0:07:56.560 --> 0:07:59.680 speakers say yes, that's definitely going to happen. That's on 0:07:59.680 --> 0:08:03.280 the it's sort of so crushing as a person who 0:08:03.560 --> 0:08:06.200 provides care as an advocate. I'm the executive director of 0:08:06.200 --> 0:08:08.960 an organization with you, twenty thousand doctors around the country 0:08:09.240 --> 0:08:11.720 fighting for this kind of stuff. We're doing a big 0:08:11.760 --> 0:08:14.760 play in Wisconsin, one of the few states with the 0:08:14.800 --> 0:08:17.600 Democratic governor who still has an expanded medicaid because of 0:08:17.640 --> 0:08:21.280 their jerrymandered Assembly and Senate. And now with new maps, 0:08:21.320 --> 0:08:23.360 we're hoping we're going to get the Assembly or get 0:08:23.360 --> 0:08:26.280 clothes and we think we can get expanded medicaid next 0:08:26.360 --> 0:08:29.280 year in the matter state. And so with all of 0:08:29.320 --> 0:08:32.080 that going on, and now you have a current speaker 0:08:32.120 --> 0:08:34.920 and someone who could be the next president saying, yeah, 0:08:34.920 --> 0:08:37.240 we still want to get rid of this thing. I 0:08:37.280 --> 0:08:39.640 can't think of anything more important than voting against that. 0:08:39.840 --> 0:08:42.079 If there wasn't enough out there to vote against, that's 0:08:42.120 --> 0:08:43.480 certainly critical. 0:08:46.040 --> 0:08:49.400 Paint the picture for us of what would happen if 0:08:49.960 --> 0:08:55.040 Medicaid is stripped away, if ACA is stripped away. Paint 0:08:55.040 --> 0:08:58.720 the picture for us of what it would look like 0:08:59.360 --> 0:09:05.680 inside this country, inside of hospitals, so that folks really understand. 0:09:06.120 --> 0:09:09.280 Well for where I practice, I practice in the emergency department, right, 0:09:09.320 --> 0:09:11.560 That's my entire career, and so that's where people end 0:09:11.640 --> 0:09:14.000 up when there's nowhere else to go. I thank God 0:09:14.080 --> 0:09:17.480 for MTALA, And you know, the state of Idaho was 0:09:17.520 --> 0:09:20.680 threatening m TALA when it came to abortion care, and 0:09:20.760 --> 0:09:23.640 luckily the administration stepped in and they got that at 0:09:23.720 --> 0:09:27.080 least kind of punted down the line. But I'm at 0:09:27.240 --> 0:09:30.079 that intersection where people come where they have nowhere else 0:09:30.120 --> 0:09:33.480 to go, and that undoubtedly will go up. I mean again, 0:09:33.600 --> 0:09:35.640 the days of people coming in with blood pressures of 0:09:35.720 --> 0:09:38.560 you know, too twenty over one twenty and having nowhere 0:09:38.600 --> 0:09:40.240 to go to get follow up and getting a month 0:09:40.320 --> 0:09:42.199 or two is worth of blood pressure met, those will 0:09:42.240 --> 0:09:45.160 be back and forth. They don't just want to get 0:09:45.200 --> 0:09:47.800 rid of the Affortable Care Act. They want to change Medicaid. 0:09:47.880 --> 0:09:50.320 They want to kind of scale people away from Medicaid. 0:09:50.360 --> 0:09:53.640 They want to require work for Medicaid instead of giving 0:09:53.640 --> 0:09:55.800 people health care so that then they are able to 0:09:55.800 --> 0:09:57.760 be healthy in work, which is what we've seen in 0:09:57.800 --> 0:10:00.959 our state. People get medicaid. Guess what, they are healthier, 0:10:01.040 --> 0:10:04.080 they can work, they're more productive, not the other way around. 0:10:04.600 --> 0:10:07.320 And so all of that's on the table. We're going 0:10:07.360 --> 0:10:09.800 to go back to the battle days. Listen, it's not 0:10:09.880 --> 0:10:12.720 perfect now. Health care still costs way too much, and 0:10:12.880 --> 0:10:16.319 our organization and others, and certainly the administration has done 0:10:16.480 --> 0:10:19.000 is a lot to try to put a dent in 0:10:19.040 --> 0:10:21.880 that with prescription drug costs, with subsidies for health insurance, 0:10:22.240 --> 0:10:23.960 and we have a long way to go. But boy, 0:10:24.080 --> 0:10:27.880 this backslide into the days before the ADA and scaling 0:10:27.880 --> 0:10:32.880 back medicaid would it would cost lots and in non 0:10:32.920 --> 0:10:36.480 expansion states. I believe between the time of Medicaid expansion 0:10:36.520 --> 0:10:40.640 and now there's been twenty plus thousand excess deaths that 0:10:40.720 --> 0:10:43.040 could have been averted had they expanded medicaid in these 0:10:43.040 --> 0:10:46.280 other states. I mean, it's real flesh and blood, and 0:10:46.360 --> 0:10:47.640 our patients will pay the price. 0:10:48.360 --> 0:10:50.880 You know. I actually want to go back to something 0:10:50.920 --> 0:10:54.320 that you said with regard to m Tala, which is 0:10:54.800 --> 0:10:59.480 the ability for patients to undergo abortion care in cases 0:10:59.480 --> 0:11:03.120 of emerging, and we have seen that brought back up 0:11:03.120 --> 0:11:05.600 to the Supreme Court, who then kicked it back down 0:11:05.640 --> 0:11:08.880 to the lower courts. And we are watching as women 0:11:08.960 --> 0:11:12.600 in places like Texas and Georgia are in the headlines 0:11:12.640 --> 0:11:17.400 for losing their lives because of untreated miscarriages that led 0:11:17.440 --> 0:11:20.080 to not only the death of the fetus but also 0:11:20.400 --> 0:11:23.360 their deaths. Can you talk to us a bit. I 0:11:23.400 --> 0:11:26.960 know that you're not an abortion doctor, but about what 0:11:27.120 --> 0:11:32.120 it has been like to be a doctor in America 0:11:33.120 --> 0:11:40.280 when the profession itself has been weaponized from covid on. 0:11:40.960 --> 0:11:44.160 I don't think that we have seen such a turn 0:11:44.280 --> 0:11:49.240 away from doctors, from science right and the politicization of that. 0:11:49.480 --> 0:11:51.520 So can you just speak to what it has been 0:11:51.679 --> 0:11:54.680 like to kind of be in the throes of that 0:11:55.040 --> 0:12:01.360 misinformation disinformation tornado that has placed targets on hospitals. I mean, 0:12:01.400 --> 0:12:05.480 hospitals have received bomb threats, right like. I mean, to 0:12:05.600 --> 0:12:09.880 think about that is outrageous. So what has that been 0:12:10.000 --> 0:12:11.839 like for you and for your colleagues? 0:12:12.760 --> 0:12:14.240 You know, I think there's a lot of bad and 0:12:14.240 --> 0:12:16.559 then also some good. There's a sliver of pope there. 0:12:17.280 --> 0:12:20.199 Certainly the bad is that people are being fed disinformation 0:12:20.920 --> 0:12:24.000 started a lot with COVID with them President Trump being 0:12:24.080 --> 0:12:28.040 kind of the chief purveyor of the misinformation and disinformation. 0:12:28.080 --> 0:12:30.400 And people will come in and accuse you of giving 0:12:30.400 --> 0:12:32.200 them COVID when you put a swab in their nose, 0:12:32.240 --> 0:12:34.840 accuse you of giving them the vaccine when you are 0:12:34.880 --> 0:12:37.480 giving them treatment. You know, simple thing like steroids, which 0:12:37.520 --> 0:12:39.480 we give to people for all sorts of things. That 0:12:39.600 --> 0:12:41.760 was one of the treatments for people get to get 0:12:41.760 --> 0:12:44.880 amitted with COVID accusing you of doing that and you 0:12:44.960 --> 0:12:47.960 having to defend that, right, you having to just say, hey, listen, 0:12:48.000 --> 0:12:50.040 I've been in your community at that point in my 0:12:50.120 --> 0:12:53.480 career for over a two decades about and I've been 0:12:53.520 --> 0:12:55.920 treating you and your family members for heart attacks and 0:12:55.960 --> 0:12:59.800 strokes and appendentitis and any number of emergencies, and all 0:12:59.840 --> 0:13:01.839 of a sudden, you think I'm trying to do something 0:13:01.840 --> 0:13:04.040 to you against your will or something that may harm you. 0:13:04.080 --> 0:13:06.640 I mean, it's sort of a gut punch. I think 0:13:06.640 --> 0:13:08.600 there's been quite a bit of burnout in the field, 0:13:08.720 --> 0:13:11.959 both with physicians and with nurses and other allied health professionals. 0:13:12.440 --> 0:13:14.400 So that's been a real challenge. I think when it 0:13:14.440 --> 0:13:17.079 comes to abortion care, I mean m talents. The Emergency 0:13:17.120 --> 0:13:20.000 Medicine Treatment of Active Labor Act came around in nineteen 0:13:20.040 --> 0:13:23.240 eighty six, signed by a Republican president, Ronald Reagan, and 0:13:23.280 --> 0:13:25.520 that basically says, you can go to the er with 0:13:25.559 --> 0:13:28.360 an emergency. We will not ask you your insurance status 0:13:28.400 --> 0:13:30.559 or your ability of pay, and we will treat your emergency. 0:13:31.040 --> 0:13:34.280 And if that emergency includes bleeding to death because you 0:13:34.320 --> 0:13:37.199 are having a miscarriage or an incomplete miscarriage, even if 0:13:37.200 --> 0:13:40.000 it still has a faint heartbeat. In some of these states, 0:13:40.040 --> 0:13:43.240 like you said, Georgia, Texas, others, women have died because 0:13:43.720 --> 0:13:47.360 attorneys general and prosecutors have said we're going to prosecute 0:13:47.360 --> 0:13:52.600 doctors who provide basic emergency care. It's terribly disheartening, and 0:13:52.640 --> 0:13:56.280 it's driving doctors of all stripes, but certainly Obgyan's out 0:13:56.280 --> 0:14:00.199 of these states. These are becoming Obgyan deserts sor of 0:14:00.280 --> 0:14:02.760 hope that I see is that it has inspired many, many, 0:14:02.800 --> 0:14:06.160 many doctors to become active and to become activists and 0:14:06.200 --> 0:14:10.440 advocates on behalf of our patients. Because we are put 0:14:10.440 --> 0:14:12.480 in a privileged place in society. We work hard. You 0:14:12.520 --> 0:14:14.400 go to school. But we all do fairly well in 0:14:14.400 --> 0:14:16.640 our computerit use right, and we're in a position of 0:14:16.679 --> 0:14:20.720 power in a doctor patient relationship, and we can now 0:14:20.880 --> 0:14:24.359 use that to advocate on behalf of our patient who 0:14:24.560 --> 0:14:28.640 frankly are just become victims of a system, victims of dobbs, 0:14:28.760 --> 0:14:32.920 victims of the abortion bands in those cases without anything 0:14:32.960 --> 0:14:35.000 they can do about it, right, I guess they can move. 0:14:35.480 --> 0:14:37.720 That's an economic deficsion for some people. They can go 0:14:37.760 --> 0:14:40.480 to another state to get care. But many folks who 0:14:40.480 --> 0:14:42.440 are the poorest among us, they can't do that. They 0:14:42.440 --> 0:14:44.960 can't take off of work, they can't afford the cost, 0:14:45.280 --> 0:14:48.680 you know. And so we have seen a massive upswing 0:14:48.840 --> 0:14:52.680 and activism trump physicians on behalf of patients, certainly in 0:14:52.680 --> 0:14:55.560 our organization and other organizations. And we've seen those voices 0:14:55.600 --> 0:14:59.640 come out in Unison pushing back against the NCALA crisis 0:14:59.640 --> 0:15:01.880 that we what we had when the Supreme Court finally 0:15:01.960 --> 0:15:04.160 did punt it back. It's still not settled, right, but 0:15:04.240 --> 0:15:07.400 at least MTALA is still intact in Idaho and Texas. 0:15:08.040 --> 0:15:11.120 We've seen that activism come out in COVID where doctors 0:15:11.160 --> 0:15:14.960 giving testimonials on Twitter and Facebook and Instagram. And going 0:15:15.040 --> 0:15:18.360 on TV and telling the stories of what we're seeing 0:15:18.920 --> 0:15:21.480 so that folks can see what's going on out there. 0:15:21.560 --> 0:15:25.000 And again it's on behalf of our patients. It helps 0:15:25.080 --> 0:15:27.280 us for sure, because the practice of medicine's a lot 0:15:27.320 --> 0:15:30.320 better when you know you can actually help people. But 0:15:30.440 --> 0:15:32.600 it really is in service to those folks that come 0:15:32.640 --> 0:15:35.640 to us in the broken system in some ways and 0:15:35.920 --> 0:15:37.400 just are asking us to help them. 0:15:40.480 --> 0:15:43.440 What kills me is that you take an oath to 0:15:43.520 --> 0:15:47.239 do no harm as doctors and nurses and medical professionals, 0:15:47.280 --> 0:15:49.920 and you enter into the field because you want to 0:15:49.960 --> 0:15:54.720 provide care. And the way that politics has intervened in 0:15:54.920 --> 0:15:58.880 such a draconian way for you to now have to 0:15:58.960 --> 0:16:03.720 deny people care because of the legalities that you're facing 0:16:03.840 --> 0:16:07.840 or the criminalization yourself and persecution in that way is 0:16:07.920 --> 0:16:11.560 so unconscionable and terrible. And I wonder you know you 0:16:11.640 --> 0:16:15.760 speak about your colleagues, you know some becoming activists and 0:16:15.880 --> 0:16:19.320 advocating on behalf of patients. Do you ever speak to 0:16:19.440 --> 0:16:22.480 younger doctors doctors that are just entering the field, are 0:16:22.520 --> 0:16:25.520 in school right now, and if so, what are some 0:16:25.600 --> 0:16:29.000 of their concerns as they enter into such a fraud 0:16:29.720 --> 0:16:33.200 environment again with the sole purpose of wanting to help people. 0:16:34.120 --> 0:16:38.800 Yeah, I think it's It gives me hope because so 0:16:38.880 --> 0:16:41.920 many of these people, I mean, medicine has become more 0:16:42.240 --> 0:16:46.600 people of color, more women, trending younger right as people retire, 0:16:46.640 --> 0:16:50.400 people age out, you know, more employees, less quote, business 0:16:50.400 --> 0:16:52.200 owners that are positions, And as you look at the 0:16:52.200 --> 0:16:54.880 positions in Congress, the majority of them are Republican and 0:16:54.960 --> 0:16:57.840 they come from that business minded side of things. So 0:16:57.880 --> 0:17:00.480 it gives me hope because they are the most vocal 0:17:00.520 --> 0:17:03.560 and the most active. Now they have some constraints because 0:17:03.560 --> 0:17:06.320 they also have student loans, and they have employers that 0:17:06.480 --> 0:17:09.040 put sort of guardrails and what they can and fan do, 0:17:09.720 --> 0:17:12.920 but they are among the most vocal folks that I see, 0:17:12.960 --> 0:17:16.640 and it gives me hope for our practice of medicine, 0:17:16.760 --> 0:17:18.879 for our patients, and for this whole system in this 0:17:18.960 --> 0:17:20.679 country that we're going to move in the right direction. 0:17:21.680 --> 0:17:23.840 What do you want to tell people and say to 0:17:23.880 --> 0:17:28.000 people who oftentimes don't necessarily, unfortunately, we don't really think 0:17:28.040 --> 0:17:31.000 about our health care until something goes wrong. We don't 0:17:31.000 --> 0:17:33.720 come from a culture of prevention, We come from a 0:17:33.720 --> 0:17:38.359 culture of mitigation. That is generally driven by pharmaceutical companies 0:17:38.720 --> 0:17:41.960 and their desire to make money. And so I wonder 0:17:42.000 --> 0:17:47.360 what you say to people as again, healthcare will continually, 0:17:47.400 --> 0:17:50.760 I feel, beyond the ballot, whether we're in an on 0:17:50.960 --> 0:17:54.920 season for a presidential or an off season. So what 0:17:54.960 --> 0:17:58.159 advice do you offer to people as they try and 0:17:58.200 --> 0:18:03.080 continue to navigate are very fraught and imperfect system. 0:18:03.880 --> 0:18:06.199 I think, you know, from the political standpoint is that 0:18:06.240 --> 0:18:10.080 healthcare has been politicized, which can be bad. But the 0:18:10.119 --> 0:18:12.840 fact that we recognize it as a political issue, that 0:18:12.880 --> 0:18:17.399 there are very clear differences between the two parties. Even 0:18:17.440 --> 0:18:19.920 before trump Ism and Donald Trump, you know, there are 0:18:20.040 --> 0:18:23.359 very clear differences starting with Reagan in the eighties, allowing 0:18:23.400 --> 0:18:27.679 the privatization or more privatization of healthcare and things like 0:18:27.920 --> 0:18:31.680 high deductible plans where people get insurance that is kind 0:18:31.720 --> 0:18:33.720 of insurance if you have enough money to pay, you know, 0:18:33.800 --> 0:18:36.199 four five thousand dollars when you need something done. But 0:18:36.240 --> 0:18:38.880 for many people it's like having no insurance at all. 0:18:38.880 --> 0:18:41.680 And that's the reality of where we are. I think 0:18:41.760 --> 0:18:45.000 that the sooner we all recognize it, it is a 0:18:45.040 --> 0:18:47.639 political issue. It is on the ballot. Every couple of years, 0:18:47.960 --> 0:18:50.240 it's on the ballot in states. I know, our organization 0:18:50.320 --> 0:18:54.560 has worked in states like Minnesota and Colorado pursuing prescription 0:18:54.640 --> 0:18:57.720 drug affordability boards to lower the costs of prescription drugs 0:18:57.720 --> 0:19:00.160 in these states. And you know, we work with govern 0:19:00.160 --> 0:19:02.600 the Walls in Minnesota and got that pass and have 0:19:02.680 --> 0:19:06.639 a board there to bring down costs. And it's unfortunately 0:19:06.720 --> 0:19:11.440 become an extremely partisan issue. I have never been a partisan. 0:19:11.640 --> 0:19:16.240 Organization is nonpartisan, but it's impossible to not state the 0:19:16.320 --> 0:19:19.760 obvious and that you know, the Democratic Party has done 0:19:20.440 --> 0:19:23.240 far more to bring down those costs of insurance, of healthcare, 0:19:23.280 --> 0:19:25.879 of prescription drugs, and the Republican Party seems to want 0:19:25.920 --> 0:19:28.439 to bring us back to an era where it's everyone 0:19:28.480 --> 0:19:32.080 fighting for themselves. I've once heard my congressman say around 0:19:32.080 --> 0:19:35.040 the time of ACA repeal efforts in twenty seventeen that 0:19:35.080 --> 0:19:36.639 he thinks people should have skin in the game. And 0:19:36.640 --> 0:19:38.280 I actually met up with them at a town all 0:19:38.320 --> 0:19:40.719 and said, well, do you realize were our people. This 0:19:40.800 --> 0:19:43.359 is literal flesh and blood. This is what you're talking about. 0:19:43.720 --> 0:19:47.120 Having skinned the game for them is legit, and they, 0:19:47.400 --> 0:19:51.000 unfortunately haven't ever put themselves in the position of somebody 0:19:51.000 --> 0:19:53.680 who's looking at going to the er having chest pain. 0:19:54.040 --> 0:19:56.320 I had a patient come in five days after starting 0:19:56.320 --> 0:19:58.879 to have chess pain, had completed a heart attack and 0:19:59.040 --> 0:20:00.960 was already in heart failure. We had about fifty percent 0:20:00.960 --> 0:20:03.440 of their art function lab. Had they come in right 0:20:03.480 --> 0:20:05.080 at the beginning, we could have gotten them off from 0:20:05.080 --> 0:20:07.800 gotten a balloon, opened up an artery, and gotten them 0:20:07.800 --> 0:20:09.600 back to normal. But they said, well, you know, not 0:20:09.640 --> 0:20:12.840 having insurance, this is a big cost. Unfortunately, now they've 0:20:12.960 --> 0:20:15.680 you know, someone now will end up on disability. They'll 0:20:15.720 --> 0:20:18.320 get Medicare from that. You know that fifty some drill person. 0:20:18.600 --> 0:20:20.639 This is pre ACA days. This is two thousand and 0:20:20.680 --> 0:20:23.640 eight or nine somewhere in there. That's just the reality 0:20:23.680 --> 0:20:27.160 for way too many people. I've had people tell me, well, 0:20:27.200 --> 0:20:29.399 I sat out in the in the parking lot for 0:20:29.440 --> 0:20:31.439 a while deciding whether or not I should come in, 0:20:31.480 --> 0:20:33.199 but it got bad enough I decided I had to 0:20:33.240 --> 0:20:36.119 come in. You know. So those are the people that 0:20:36.840 --> 0:20:38.879 I'm looking out for. That I think so many of 0:20:38.920 --> 0:20:42.280 my colleagues are looking out for. Definitely, now a majority 0:20:42.320 --> 0:20:45.080 of physicians kind of in that camp of out there 0:20:45.080 --> 0:20:48.800 fighting for voting for expanded healthcare you know, depending on 0:20:48.840 --> 0:20:50.960 the specialty, it goes up and down a bit, but 0:20:51.480 --> 0:20:53.840 it's probably I think I saw a couple of years 0:20:53.840 --> 0:20:56.080 ago for the first time it's more than fifty percent 0:20:56.200 --> 0:20:59.520 are kind of leading, voting and advocating on the side 0:20:59.520 --> 0:21:04.000 of Democrat at policies. That's a shift and that's just 0:21:04.080 --> 0:21:06.480 the reality we see every day that's caused the shift 0:21:06.480 --> 0:21:06.800 that way. 0:21:07.680 --> 0:21:11.280 Well, I can't thank you enough, doctor Davidson for your work, 0:21:11.359 --> 0:21:15.800 for your advocacy, for the use of your platform to 0:21:15.920 --> 0:21:19.640 speak out and encouraging others to do the same. We're 0:21:19.680 --> 0:21:23.040 living in extraordinary times and it is it is good 0:21:23.080 --> 0:21:25.080 every once in a while to talk to good people 0:21:25.440 --> 0:21:27.160 that are trying to move us in the right direction. 0:21:27.400 --> 0:21:28.720 So really appreciate you. 0:21:29.359 --> 0:21:31.360 Well, I appreciate that, and I appreciate having the time 0:21:31.400 --> 0:21:31.919 to talk with you. 0:21:32.760 --> 0:21:38.560 Thank you. That is it for me today. Dear friends 0:21:38.680 --> 0:21:42.359 on Woke af as always, power to the people and 0:21:42.400 --> 0:21:46.440 to all the people. Power, get woke and stay woke 0:21:46.480 --> 0:21:46.960 as fuck.