1
00:00:02,560 --> 00:00:05,920
Speaker 1: Fifty years ago, the average woman gave birth to five

2
00:00:06,160 --> 00:00:09,840
Speaker 1: children during her lifetime. Today that's down to about two

3
00:00:09,840 --> 00:00:13,119
Speaker 1: and a half kids. At the same time, in many countries,

4
00:00:13,200 --> 00:00:16,560
Speaker 1: people are dying at a faster rate than they're being born.

5
00:00:17,120 --> 00:00:21,120
Speaker 1: This presents nations with an ultimately grim result. Without an

6
00:00:21,160 --> 00:00:25,680
Speaker 1: influx of immigrants, their populations will decline. On the first

7
00:00:25,720 --> 00:00:29,000
Speaker 1: of a special two part episode of Benchmark, we explore

8
00:00:29,040 --> 00:00:32,360
Speaker 1: why fertility rates are down around the world, what this

9
00:00:32,440 --> 00:00:35,640
Speaker 1: means for the global economy, and what countries like the

10
00:00:35,720 --> 00:00:49,200
Speaker 1: United States can do to reverse this trend. Welcome to Benchmark.

11
00:00:49,320 --> 00:00:53,080
Speaker 1: I'm Scott Landman, an economics editor with Bloomberg News in Washington.

12
00:00:53,440 --> 00:00:56,640
Speaker 1: We're talking about fertility because it is an underlying driver

13
00:00:56,800 --> 00:00:59,600
Speaker 1: of a nation's economy. You need babies to keep a

14
00:00:59,640 --> 00:01:02,920
Speaker 1: popular relation growing over time, which in turn supports a

15
00:01:03,000 --> 00:01:06,240
Speaker 1: growing workforce. It also means houses and schools need to

16
00:01:06,280 --> 00:01:08,720
Speaker 1: be built, Goods need to be made and sold for

17
00:01:08,840 --> 00:01:12,039
Speaker 1: kids and babies, and so on. One reason why economic

18
00:01:12,040 --> 00:01:15,039
Speaker 1: growth is generally slower today than it was decades ago

19
00:01:15,440 --> 00:01:18,199
Speaker 1: is because there's no baby boom like there was after

20
00:01:18,280 --> 00:01:21,240
Speaker 1: World War Two. In this two part episode of Benchmark,

21
00:01:21,319 --> 00:01:23,880
Speaker 1: we're looking at this drop in fertility rates from two

22
00:01:23,920 --> 00:01:27,200
Speaker 1: different perspectives. Next week, we'll hear from an expert on

23
00:01:27,400 --> 00:01:31,760
Speaker 1: China's demographics who explores whether the nation's one child policy

24
00:01:31,800 --> 00:01:35,160
Speaker 1: is responsible for a very low fertility rate. But our

25
00:01:35,200 --> 00:01:39,400
Speaker 1: guest today isn't our typical expert on economics and demographics.

26
00:01:39,440 --> 00:01:42,080
Speaker 1: She has a much more personal connection to this issue

27
00:01:42,280 --> 00:01:45,520
Speaker 1: that led her to explore and research fertility. Her name

28
00:01:45,600 --> 00:01:49,400
Speaker 1: is Elizabeth Katkin. She's an attorney in Denver, Colorado, and

29
00:01:49,440 --> 00:01:53,320
Speaker 1: the author of the book Conceivability What I Learned Exploring

30
00:01:53,360 --> 00:01:56,800
Speaker 1: the Frontiers of Fertility. It was just published in June

31
00:01:56,840 --> 00:02:00,280
Speaker 1: by Simon and Schuster. Liz, congratulations on the book and

32
00:02:00,320 --> 00:02:03,200
Speaker 1: welcome to Benchmark. Thank you very much for having me.

33
00:02:03,240 --> 00:02:06,160
Speaker 1: It's a pleasure to be here. Liz, tell us a

34
00:02:06,200 --> 00:02:09,359
Speaker 1: bit first about yourself and your personal story that led

35
00:02:09,400 --> 00:02:12,800
Speaker 1: you to write this book. Sure you know as you

36
00:02:12,919 --> 00:02:14,920
Speaker 1: as you mentioned in your introduction, I have not a

37
00:02:14,919 --> 00:02:18,880
Speaker 1: fertility or demographic expert. By background, um far more mundane

38
00:02:18,919 --> 00:02:21,280
Speaker 1: than that. I was a corporate lawyer, and I was

39
00:02:21,400 --> 00:02:24,920
Speaker 1: living in Washington, d C. And got married at the

40
00:02:24,960 --> 00:02:29,240
Speaker 1: age of thirty, and shortly after that started trying to

41
00:02:29,280 --> 00:02:31,920
Speaker 1: have children. There was nothing really in my background or

42
00:02:31,919 --> 00:02:36,560
Speaker 1: my family's background that led me to believe or expect

43
00:02:36,600 --> 00:02:38,440
Speaker 1: that I would have any trouble. We just kind of

44
00:02:38,480 --> 00:02:41,079
Speaker 1: got married and I was working and my husband was working,

45
00:02:41,080 --> 00:02:42,400
Speaker 1: and we thought, well, you know, and that was a

46
00:02:42,400 --> 00:02:45,520
Speaker 1: good time to start a family. And it wasn't until

47
00:02:45,520 --> 00:02:49,240
Speaker 1: we started trying to have to have a baby that

48
00:02:49,240 --> 00:02:52,320
Speaker 1: that we realized, well, we we slowly tipped it into

49
00:02:52,400 --> 00:02:54,000
Speaker 1: long to the long journey ahead of us, But it

50
00:02:54,000 --> 00:02:57,320
Speaker 1: wasn't until we started that that we encountered some troubles

51
00:02:57,480 --> 00:03:02,280
Speaker 1: and what ultimately started out as a as a first

52
00:03:02,280 --> 00:03:04,040
Speaker 1: trip to a doctor to see what might be wrong,

53
00:03:04,120 --> 00:03:06,800
Speaker 1: turned into a nine year journey to have two children.

54
00:03:07,040 --> 00:03:10,679
Speaker 1: So um, over the course of nine years, I had

55
00:03:10,800 --> 00:03:16,480
Speaker 1: seven miscarriages, ten IVF cycles, and saw doctors in six countries,

56
00:03:16,560 --> 00:03:18,960
Speaker 1: and eventually I had a healthy boy and a girl.

57
00:03:20,080 --> 00:03:23,040
Speaker 1: It really is an incredible story that you write about

58
00:03:23,160 --> 00:03:26,320
Speaker 1: in your book, and just to take a step back

59
00:03:26,600 --> 00:03:29,320
Speaker 1: for a moment, I know you don't really go in

60
00:03:29,520 --> 00:03:33,520
Speaker 1: depth into why fertility rates are lower today or why

61
00:03:33,560 --> 00:03:37,280
Speaker 1: there's such a burgeoning industry and fertility treatments. I think

62
00:03:37,320 --> 00:03:41,240
Speaker 1: you do mention some factors. But I'm wondering, are are

63
00:03:41,440 --> 00:03:44,880
Speaker 1: the struggles of people to bear children? Are those kinds

64
00:03:44,880 --> 00:03:47,880
Speaker 1: of struggles more common today than they were forty or

65
00:03:47,880 --> 00:03:50,160
Speaker 1: fifty years ago, or has it just become less of

66
00:03:50,200 --> 00:03:53,480
Speaker 1: a taboo to talk about this kind of thing, you know,

67
00:03:53,560 --> 00:03:55,880
Speaker 1: I think it's actually both. I think it certainly is

68
00:03:55,960 --> 00:03:58,400
Speaker 1: less of a taboo to talk about it. But to

69
00:03:58,480 --> 00:04:01,000
Speaker 1: the extent I did delve into some of the statistics,

70
00:04:01,040 --> 00:04:03,920
Speaker 1: I mean, fertilities at at an all time low in

71
00:04:03,960 --> 00:04:09,880
Speaker 1: the US, and approximately one in six couples are confronting

72
00:04:09,880 --> 00:04:13,640
Speaker 1: and fertility now, which is really an amazingly high number

73
00:04:13,800 --> 00:04:16,279
Speaker 1: if you think about that one in six couples, so

74
00:04:16,360 --> 00:04:19,680
Speaker 1: that seven million women a year are seeking help for fertility.

75
00:04:20,120 --> 00:04:22,240
Speaker 1: And so I think it's it's certainly the case that

76
00:04:22,240 --> 00:04:24,520
Speaker 1: people are talking about it more, but there are a

77
00:04:24,520 --> 00:04:27,200
Speaker 1: lot more people having trouble. And as you mentioned, you know,

78
00:04:27,240 --> 00:04:29,840
Speaker 1: our birth rate is as much lower than it was

79
00:04:30,920 --> 00:04:32,800
Speaker 1: fifty years ago, and I think that is, you know,

80
00:04:32,960 --> 00:04:35,800
Speaker 1: partly by choice, women focusing more on their careers. But

81
00:04:35,920 --> 00:04:38,200
Speaker 1: I think a lot of it is also, you know,

82
00:04:38,279 --> 00:04:41,479
Speaker 1: not by choice, and I think it's probably you know,

83
00:04:41,520 --> 00:04:44,159
Speaker 1: I don't have the exact data on this, but more

84
00:04:44,200 --> 00:04:47,560
Speaker 1: economically skewed now as well. I mean, the reality in

85
00:04:47,560 --> 00:04:51,320
Speaker 1: this country is that if you're confronting infertility, your odds

86
00:04:51,320 --> 00:04:54,159
Speaker 1: of having a baby you're significantly higher if you have

87
00:04:54,279 --> 00:04:57,400
Speaker 1: the funds to make it through a few rounds of treatment,

88
00:04:57,520 --> 00:05:00,520
Speaker 1: and the prices are so astronomical that a lot of

89
00:05:00,560 --> 00:05:04,320
Speaker 1: the population can afford that. And you did end up

90
00:05:04,400 --> 00:05:07,680
Speaker 1: going outside the US for a good portion of your

91
00:05:08,040 --> 00:05:11,800
Speaker 1: treatment of your journey, So you have a pretty broad

92
00:05:11,839 --> 00:05:16,159
Speaker 1: perspective on this issue. How do you think the healthcare

93
00:05:16,279 --> 00:05:20,760
Speaker 1: and fertility industry in the United States helps or may

94
00:05:20,800 --> 00:05:26,320
Speaker 1: even harm people who are having these kinds of fertility problems. Yeah,

95
00:05:26,320 --> 00:05:29,080
Speaker 1: I mean that that's a that's a fantastic question. That

96
00:05:29,240 --> 00:05:31,159
Speaker 1: is the crux of the problem. I mean, I think

97
00:05:31,200 --> 00:05:35,200
Speaker 1: the fertility care, like like a lot of healthcare in

98
00:05:35,240 --> 00:05:37,840
Speaker 1: the United States, it's really a double edged sword. I mean,

99
00:05:37,880 --> 00:05:40,839
Speaker 1: I think it really helps some people, um, and it

100
00:05:40,960 --> 00:05:45,039
Speaker 1: really doesn't serve many other people. That's for a couple

101
00:05:45,040 --> 00:05:46,880
Speaker 1: of reasons that I that I conclude that, I mean

102
00:05:46,920 --> 00:05:50,400
Speaker 1: one one as purely as I mentioned the economics of it, So,

103
00:05:50,560 --> 00:05:54,799
Speaker 1: you know, compared to other countries, women and couples facing

104
00:05:54,800 --> 00:05:59,040
Speaker 1: in fertility start out at a pretty steep disadvantage in

105
00:05:59,040 --> 00:06:03,080
Speaker 1: the US. In most of the developed world, there are

106
00:06:03,920 --> 00:06:07,719
Speaker 1: medical systems in place, whether it's national national health services

107
00:06:07,800 --> 00:06:12,200
Speaker 1: or mandatory insurance that cover fertility services. So fertility is

108
00:06:12,200 --> 00:06:17,479
Speaker 1: really clearly treated as a medical problem in most of

109
00:06:17,480 --> 00:06:20,480
Speaker 1: the developed world, and people are able to get help

110
00:06:20,520 --> 00:06:23,599
Speaker 1: for that. You know, in the United States, of course,

111
00:06:23,640 --> 00:06:25,680
Speaker 1: we have no national health service, and as far as

112
00:06:25,800 --> 00:06:30,760
Speaker 1: insurance coverage goes, only fifteen states require any form of insurance.

113
00:06:31,080 --> 00:06:33,760
Speaker 1: You know, four of those states only require insurance for

114
00:06:33,839 --> 00:06:36,719
Speaker 1: married couples, and there's only about a half a dozen

115
00:06:36,760 --> 00:06:40,640
Speaker 1: states that have enough insurance to really help a woman

116
00:06:40,760 --> 00:06:44,240
Speaker 1: or a couple have a baby. And so in most

117
00:06:44,279 --> 00:06:47,800
Speaker 1: of America, patients confronting and fertility are really on their

118
00:06:47,800 --> 00:06:51,600
Speaker 1: own financially. That makes it a very difficult climate. Do

119
00:06:51,880 --> 00:06:54,520
Speaker 1: you think that if the insurance coverage were much more

120
00:06:54,600 --> 00:06:58,000
Speaker 1: extensive for fertility treatments in the United States that that

121
00:06:58,040 --> 00:07:01,039
Speaker 1: would increase birth rates? I mean, has been shown to

122
00:07:01,160 --> 00:07:04,320
Speaker 1: have some sort of link in the countries that that

123
00:07:04,360 --> 00:07:07,040
Speaker 1: you know that do provide that kind of coverage. It's

124
00:07:07,040 --> 00:07:10,000
Speaker 1: a great question. I don't know that I have the

125
00:07:10,120 --> 00:07:13,440
Speaker 1: data to give you to give you a firm answer

126
00:07:13,480 --> 00:07:15,720
Speaker 1: on that, because I haven't looked at the data so

127
00:07:15,880 --> 00:07:17,920
Speaker 1: much on the on the national insurance and how it

128
00:07:17,960 --> 00:07:21,800
Speaker 1: affects birth rates. But I do know you know from

129
00:07:21,800 --> 00:07:24,920
Speaker 1: my research here that there are a great number of

130
00:07:24,960 --> 00:07:28,680
Speaker 1: people that just don't pursue IVF simply because they can't

131
00:07:28,720 --> 00:07:33,240
Speaker 1: afford it, or that the insurance coverage, you know, is

132
00:07:33,320 --> 00:07:36,680
Speaker 1: limited to certain treatments and not others, So the insurance

133
00:07:36,720 --> 00:07:40,600
Speaker 1: is actually shaping the treatments in ways that are probably

134
00:07:40,640 --> 00:07:43,360
Speaker 1: not beneficial to having a baby. So you know, I'm

135
00:07:43,360 --> 00:07:45,040
Speaker 1: sorry I can't give you a give you the hard

136
00:07:45,080 --> 00:07:47,880
Speaker 1: numbers on that, but I think it's something well worth

137
00:07:48,560 --> 00:07:53,320
Speaker 1: worth looking into. But I think it does really disservice

138
00:07:53,320 --> 00:07:55,440
Speaker 1: a lot of people that they can't they can't afford

139
00:07:55,440 --> 00:07:58,160
Speaker 1: the care, or that the insurance is really you know,

140
00:07:58,280 --> 00:08:02,280
Speaker 1: dictating their care. That's that's another problem I encountered in

141
00:08:02,360 --> 00:08:04,360
Speaker 1: a number of the people I interviewed for the book,

142
00:08:04,480 --> 00:08:08,960
Speaker 1: or people feeling like they didn't have choices or didn't

143
00:08:09,360 --> 00:08:13,720
Speaker 1: make the healthiest choices because of the limitations of their insurance.

144
00:08:15,600 --> 00:08:19,640
Speaker 1: Now it's not just insurance coverage for fertility treatments that

145
00:08:20,080 --> 00:08:23,400
Speaker 1: helps people have children. But you also spend a lot

146
00:08:23,400 --> 00:08:26,800
Speaker 1: of your book covering the issue of of using a

147
00:08:27,000 --> 00:08:31,320
Speaker 1: surrogate carrier to to have a child. And it's really

148
00:08:31,360 --> 00:08:35,200
Speaker 1: interesting to read about how there's just such vastly different

149
00:08:35,280 --> 00:08:39,360
Speaker 1: laws and regulations, not just from country to country, but

150
00:08:39,520 --> 00:08:41,920
Speaker 1: in the US, you know, practically every state has some

151
00:08:42,080 --> 00:08:45,720
Speaker 1: different law on this issue. How do you think, you know,

152
00:08:45,800 --> 00:08:51,760
Speaker 1: having more uniform regulations or laws on surrogate mothers would

153
00:08:51,920 --> 00:08:56,400
Speaker 1: potentially affect people's ability to have more children. Well, I

154
00:08:56,440 --> 00:08:59,880
Speaker 1: think having having uniform laws, you know, across the US

155
00:09:00,000 --> 00:09:04,240
Speaker 1: would certainly make things easier for a lot of people,

156
00:09:04,320 --> 00:09:07,240
Speaker 1: because right now what you have is sort of among

157
00:09:07,320 --> 00:09:09,439
Speaker 1: people that have already gotten to the stage that they've

158
00:09:09,600 --> 00:09:12,440
Speaker 1: figured out they need a surrogate. And there, you know,

159
00:09:12,440 --> 00:09:14,880
Speaker 1: you've got to be pretty far in the process and

160
00:09:14,920 --> 00:09:17,360
Speaker 1: have reasonably deep pockets to get to the point of

161
00:09:17,360 --> 00:09:19,880
Speaker 1: doing I v F with surrogacy. You then have to

162
00:09:19,920 --> 00:09:21,800
Speaker 1: plunge into a new realm of do we need to

163
00:09:21,840 --> 00:09:24,400
Speaker 1: travel and go somewhere else or do we have to

164
00:09:24,440 --> 00:09:26,800
Speaker 1: pick a surrogate that lives somewhere else. And it's it's

165
00:09:26,880 --> 00:09:30,600
Speaker 1: kind of like complex pieces of a puzzle to find

166
00:09:30,600 --> 00:09:33,240
Speaker 1: a state with the right clinic that you want and

167
00:09:33,240 --> 00:09:36,320
Speaker 1: the right doctor that you want, and the surrogacy surrogacy

168
00:09:36,360 --> 00:09:40,040
Speaker 1: favorable laws that you want. And I think, you know,

169
00:09:40,200 --> 00:09:42,480
Speaker 1: having more clarity of that would make it a lot

170
00:09:42,480 --> 00:09:44,320
Speaker 1: easier for patients and would make it a lot a

171
00:09:44,320 --> 00:09:48,040
Speaker 1: lot more equitable for people throughout the country. Is there

172
00:09:48,080 --> 00:09:52,079
Speaker 1: any sort of main database that tells people our websites.

173
00:09:52,120 --> 00:09:54,439
Speaker 1: I'm sure that there's got to be some some sources

174
00:09:54,480 --> 00:09:57,560
Speaker 1: of information, but it does even with that, it probably

175
00:09:57,600 --> 00:10:01,480
Speaker 1: is pretty bewildering to most people. Yeah, and most people

176
00:10:01,559 --> 00:10:04,600
Speaker 1: end up hiring an agency and or a lawyer to

177
00:10:04,640 --> 00:10:07,480
Speaker 1: handle it for them, which adds again substantially to the cost.

178
00:10:07,960 --> 00:10:10,600
Speaker 1: We never went that route. We didn't use a US surrogate,

179
00:10:10,720 --> 00:10:13,439
Speaker 1: but we also didn't use a US you know, agency

180
00:10:13,520 --> 00:10:16,040
Speaker 1: or a lawyer. Partly I had the advantage of being

181
00:10:16,080 --> 00:10:18,880
Speaker 1: a lawyer, but I was able to research it on

182
00:10:19,000 --> 00:10:21,960
Speaker 1: available resources. But it is it is like a massive

183
00:10:22,040 --> 00:10:25,240
Speaker 1: my friend called it a secret second job. It's a

184
00:10:25,280 --> 00:10:30,040
Speaker 1: massive research project and it's a lot of information to

185
00:10:30,120 --> 00:10:33,280
Speaker 1: handle on your on and I think you know, hand

186
00:10:33,320 --> 00:10:36,480
Speaker 1: in hand, it's it's a little a little different from

187
00:10:36,520 --> 00:10:38,280
Speaker 1: your question, but hand in hand with the regulation of

188
00:10:38,360 --> 00:10:41,640
Speaker 1: surrogacy is the regulation of the egg and sperm donors.

189
00:10:41,840 --> 00:10:44,800
Speaker 1: And I think that, you know, that's really a minefield

190
00:10:44,840 --> 00:10:48,880
Speaker 1: in this country, where it's not only different state by state,

191
00:10:49,160 --> 00:10:54,480
Speaker 1: but has much longer term implications for the children who

192
00:10:54,480 --> 00:10:57,199
Speaker 1: are actually born born of a donor egg or donor

193
00:10:57,240 --> 00:11:00,480
Speaker 1: sperm or the parents. And there's there's not only any

194
00:11:00,559 --> 00:11:04,000
Speaker 1: regulation of it, there's also no tracking of it, which

195
00:11:04,000 --> 00:11:06,240
Speaker 1: makes us an outlier, you know, an outlier in the

196
00:11:06,280 --> 00:11:10,520
Speaker 1: developed world where other countries are paying careful attention. I mean,

197
00:11:10,559 --> 00:11:15,079
Speaker 1: between all these barriers to infertility treatments, of financial barriers,

198
00:11:15,280 --> 00:11:19,080
Speaker 1: figuring out the surrogacy laws and regulations, I mean, how

199
00:11:19,160 --> 00:11:22,800
Speaker 1: much does this discourage people who don't have kind of

200
00:11:22,840 --> 00:11:26,920
Speaker 1: the you know, the fierce will, plus the financial resources

201
00:11:27,080 --> 00:11:32,120
Speaker 1: to figure out how to solve their own fertility issues. Yeah,

202
00:11:32,160 --> 00:11:34,920
Speaker 1: I think it discourages people a lot. I mean, I

203
00:11:34,960 --> 00:11:37,679
Speaker 1: think there are a lot of people who feel like

204
00:11:37,679 --> 00:11:39,960
Speaker 1: they hit a brick wall because they know they want

205
00:11:40,000 --> 00:11:42,000
Speaker 1: to have a child and they're not quite sure how

206
00:11:42,040 --> 00:11:44,200
Speaker 1: to get there. Then I think there are those that

207
00:11:44,240 --> 00:11:46,280
Speaker 1: figure out how to get there, but realize they need

208
00:11:46,280 --> 00:11:48,120
Speaker 1: a hundred thousand dollars to get there, and they don't

209
00:11:48,160 --> 00:11:50,960
Speaker 1: have it, and then they're the intrepid few, you know

210
00:11:51,000 --> 00:11:54,400
Speaker 1: that go overseas. I I myself went overseas, and I

211
00:11:54,480 --> 00:11:57,080
Speaker 1: interviewed quite a few others, but I spoke with a

212
00:11:57,120 --> 00:11:59,400
Speaker 1: woman I profiled her and her husband in the book,

213
00:11:59,440 --> 00:12:02,679
Speaker 1: who had done all the research on their own and

214
00:12:02,760 --> 00:12:05,960
Speaker 1: really just couldn't. They had gone through a few cycles

215
00:12:05,960 --> 00:12:09,280
Speaker 1: in the US without an egg donor, had spent pretty

216
00:12:09,360 --> 00:12:12,760
Speaker 1: much all the money they had allotted for IVF, then

217
00:12:12,800 --> 00:12:15,840
Speaker 1: found out they needed an egg donor, and we're looking

218
00:12:15,840 --> 00:12:19,160
Speaker 1: at cost estimates of about fifty dollars for that cycle,

219
00:12:19,720 --> 00:12:23,400
Speaker 1: and they went to Spain and for all in cost

220
00:12:23,440 --> 00:12:27,160
Speaker 1: of ten thousand euros, including the full I VF, the

221
00:12:27,200 --> 00:12:30,520
Speaker 1: medication for the mother, the medication for the donor, the

222
00:12:30,640 --> 00:12:34,920
Speaker 1: travel um, their whole total cost was ten thousand euros. So,

223
00:12:35,400 --> 00:12:38,080
Speaker 1: you know, some people are able to get around that

224
00:12:38,520 --> 00:12:42,600
Speaker 1: by leaving the country. Not everybody really has the knowledge

225
00:12:42,600 --> 00:12:45,160
Speaker 1: and resource base to figure to figure that out yet,

226
00:12:45,200 --> 00:12:49,720
Speaker 1: but it's starting to grow quite significantly. But ten thou euros,

227
00:12:49,960 --> 00:12:52,680
Speaker 1: you know, it's it's kind of low for uh, these

228
00:12:52,760 --> 00:12:56,760
Speaker 1: kinds of treatments or journeys. And yet it's still a

229
00:12:56,760 --> 00:12:59,560
Speaker 1: lot for you know, the average American who may not

230
00:12:59,679 --> 00:13:02,400
Speaker 1: make much money. And you know, we write a lot

231
00:13:02,440 --> 00:13:05,200
Speaker 1: about people can't come up with four hundred dollars for

232
00:13:05,200 --> 00:13:08,160
Speaker 1: an emergency expense. You know, something like this would probably

233
00:13:08,160 --> 00:13:11,319
Speaker 1: bankrupt most people. It's true. I mean, there are that

234
00:13:11,440 --> 00:13:15,600
Speaker 1: sad reality is that about fertility costs in the US

235
00:13:15,640 --> 00:13:19,520
Speaker 1: are paid out of pocket. And that's that's pretty much

236
00:13:19,520 --> 00:13:22,360
Speaker 1: the inverse of what you'd see and in many other

237
00:13:22,400 --> 00:13:26,680
Speaker 1: developed countries. Now, one interesting thing you write about at

238
00:13:26,679 --> 00:13:29,120
Speaker 1: the end of your book, when you're talking about possible

239
00:13:29,200 --> 00:13:33,040
Speaker 1: solutions and advice to people facing these issues. One part

240
00:13:33,080 --> 00:13:36,680
Speaker 1: that I found interesting as an economics editor is, you know,

241
00:13:36,720 --> 00:13:39,200
Speaker 1: we spend a lot of time covering the US labor market.

242
00:13:39,720 --> 00:13:42,320
Speaker 1: We've done a variety of stories on low unemployment, how

243
00:13:42,360 --> 00:13:46,280
Speaker 1: it affects people's ability to quit their job, and you

244
00:13:46,320 --> 00:13:49,840
Speaker 1: write that some people are actually switching jobs to move

245
00:13:49,920 --> 00:13:55,600
Speaker 1: to companies that actually provide better benefits for fertility treatment.

246
00:13:55,960 --> 00:13:59,080
Speaker 1: I want to ask you one question past that, which

247
00:13:59,120 --> 00:14:02,439
Speaker 1: is has anybody you've been able to use fertility treatment

248
00:14:02,440 --> 00:14:06,160
Speaker 1: as bargaining power with their employer say, you know, can

249
00:14:06,200 --> 00:14:08,880
Speaker 1: you provide me this treatment and I'll stay with you?

250
00:14:09,120 --> 00:14:12,280
Speaker 1: Or you know, as as bargaining for a new job,

251
00:14:12,360 --> 00:14:15,680
Speaker 1: say you know, that's a great question. You may have

252
00:14:15,720 --> 00:14:18,559
Speaker 1: just planted an idea for quite a few people, I'd say,

253
00:14:18,640 --> 00:14:23,080
Speaker 1: especially in the technology sector. I have not encountered anyone

254
00:14:23,120 --> 00:14:25,760
Speaker 1: that actually used it as a bargaining chip. But I

255
00:14:25,800 --> 00:14:30,200
Speaker 1: did encounter one woman who realized afterwards that she could have.

256
00:14:30,960 --> 00:14:34,080
Speaker 1: She left her company to go to Apple because of

257
00:14:34,120 --> 00:14:37,480
Speaker 1: their coverage, and when she resigned and told them why,

258
00:14:37,640 --> 00:14:41,280
Speaker 1: her direct manager was shocked, and he was a man,

259
00:14:41,400 --> 00:14:43,600
Speaker 1: and he asked her why she didn't tell him or

260
00:14:43,600 --> 00:14:45,600
Speaker 1: talk to him instead of that that was that important

261
00:14:45,600 --> 00:14:48,120
Speaker 1: to you, we probably could have gotten that for you.

262
00:14:48,360 --> 00:14:51,560
Speaker 1: So I think you're you're on the right track there,

263
00:14:51,840 --> 00:14:55,000
Speaker 1: and there may be women starting to do that, or

264
00:14:55,040 --> 00:14:57,080
Speaker 1: may listen to your show today and get the idea

265
00:14:57,560 --> 00:15:01,160
Speaker 1: to do that. But to date, so far, what I've encountered,

266
00:15:01,560 --> 00:15:03,880
Speaker 1: both through my own personal interviews and from reading quite

267
00:15:03,920 --> 00:15:07,640
Speaker 1: a few interesting blogs about it, is people figuring out

268
00:15:07,640 --> 00:15:10,920
Speaker 1: where would have the best coverage and targeting jobs at

269
00:15:10,920 --> 00:15:14,600
Speaker 1: those companies. It's it's interesting to think about in a

270
00:15:14,640 --> 00:15:18,400
Speaker 1: world where we have something like Uber and lyft that's

271
00:15:18,560 --> 00:15:23,480
Speaker 1: filled the demand for say taxi cabs in major cities,

272
00:15:23,800 --> 00:15:26,840
Speaker 1: you know, or even not in major cities like suburbs

273
00:15:26,840 --> 00:15:28,960
Speaker 1: where it's really hard to get a cab. You know

274
00:15:29,040 --> 00:15:33,240
Speaker 1: that you have such demand for these kinds of services,

275
00:15:33,320 --> 00:15:36,360
Speaker 1: and maybe there's just a company willing to come along

276
00:15:36,520 --> 00:15:40,720
Speaker 1: or or some sort of medical recommendation or innovation that

277
00:15:40,840 --> 00:15:45,040
Speaker 1: could you know, really cut through and uh, you know,

278
00:15:45,120 --> 00:15:48,640
Speaker 1: solve fertility issues for the many, many people who are

279
00:15:48,680 --> 00:15:52,200
Speaker 1: facing this. I'm just wondering, as one last question, when

280
00:15:52,200 --> 00:15:55,520
Speaker 1: you think about ten years from now, twenty years from now,

281
00:15:56,120 --> 00:16:00,640
Speaker 1: what the future of fertility looks like, you know, where

282
00:16:00,680 --> 00:16:02,760
Speaker 1: do you see it going from here? Are you are

283
00:16:02,760 --> 00:16:05,680
Speaker 1: you optimistic or do you think there's still a long

284
00:16:05,720 --> 00:16:09,480
Speaker 1: ways to go before people to have ready access to

285
00:16:09,560 --> 00:16:13,960
Speaker 1: the kinds of treatments that will help them overcome infertility. Yeah,

286
00:16:14,000 --> 00:16:16,880
Speaker 1: I mean that's both. That's a cop out of an answer.

287
00:16:16,880 --> 00:16:20,840
Speaker 1: But I'm optimistic on the scientific side because the scientific

288
00:16:20,880 --> 00:16:25,560
Speaker 1: progress has been really incredible. What scientists in the labs

289
00:16:25,560 --> 00:16:29,680
Speaker 1: are learning about egg quality and embryo evolution. And I

290
00:16:29,760 --> 00:16:32,240
Speaker 1: delve into this in a book, But how quality can

291
00:16:32,440 --> 00:16:36,520
Speaker 1: potentially be improved and what some current researchers are looking

292
00:16:36,560 --> 00:16:39,160
Speaker 1: at or how to actually improve eg quality in the

293
00:16:39,240 --> 00:16:42,160
Speaker 1: human body before you try to get pregnant. Um. So,

294
00:16:42,200 --> 00:16:47,120
Speaker 1: I think on the scientific side, progress in fertility, like

295
00:16:47,360 --> 00:16:50,320
Speaker 1: you know many other illnesses, it's it's making leaps and bounds,

296
00:16:50,400 --> 00:16:54,040
Speaker 1: and our research capabilities are only improving, you know. And

297
00:16:54,120 --> 00:16:57,520
Speaker 1: the financial side, you know, it is a little bleaker

298
00:16:57,520 --> 00:16:59,240
Speaker 1: when you put it in the context of what's going

299
00:16:59,280 --> 00:17:02,440
Speaker 1: on with healthcare and generally in this country. And I

300
00:17:02,480 --> 00:17:05,320
Speaker 1: think there has to at some point be a reckoning

301
00:17:05,359 --> 00:17:07,679
Speaker 1: with the fact that infertility actually is a medical problem,

302
00:17:07,840 --> 00:17:10,480
Speaker 1: you know. In my view, now it's it's treated a

303
00:17:10,480 --> 00:17:13,240
Speaker 1: bit more akin to having a nose job. It's really elective,

304
00:17:13,280 --> 00:17:14,600
Speaker 1: like if you want to have a baby, you have

305
00:17:14,640 --> 00:17:16,960
Speaker 1: to go spend all this money to have one. But

306
00:17:16,960 --> 00:17:19,080
Speaker 1: but as you you mentioned in your opening, it's the

307
00:17:19,240 --> 00:17:23,000
Speaker 1: real demographic implications, and you know, we have a loop

308
00:17:23,080 --> 00:17:26,359
Speaker 1: low birth rate and we need a growing workforce. And

309
00:17:26,400 --> 00:17:30,480
Speaker 1: then the only real ways to increase the population are

310
00:17:30,480 --> 00:17:34,320
Speaker 1: our fertility and immigration, and there those are both facing

311
00:17:34,359 --> 00:17:37,480
Speaker 1: some obstacles in this country right now. So I think

312
00:17:37,480 --> 00:17:40,159
Speaker 1: the the political solution is a little harder to be

313
00:17:40,160 --> 00:17:44,200
Speaker 1: optimistic about, but the scientific solution, I'm fairly optimistic for

314
00:17:44,240 --> 00:17:46,960
Speaker 1: our future, so I think we've just got to get

315
00:17:46,960 --> 00:17:49,800
Speaker 1: the balance right, all right, Well, glad to hear there's

316
00:17:49,840 --> 00:17:53,000
Speaker 1: some glimmer of hope on that front. Really is an

317
00:17:53,040 --> 00:17:57,800
Speaker 1: issue that affects so many people personally and has implications

318
00:17:57,920 --> 00:18:02,440
Speaker 1: for for the national fonomy and the global economy. So

319
00:18:02,920 --> 00:18:05,680
Speaker 1: it's something that we all have to follow very closely.

320
00:18:06,280 --> 00:18:10,639
Speaker 1: Liz Catkin, author of Conceivability, really fantastic book, Thank you

321
00:18:10,680 --> 00:18:13,480
Speaker 1: so much for joining us on Benchmark. Thank you, Scott,

322
00:18:13,520 --> 00:18:19,120
Speaker 1: I've really enjoyed it. Thanks. Benchmark will be back next

323
00:18:19,160 --> 00:18:22,520
Speaker 1: week with part two of our episode on fertility. Until then,

324
00:18:22,560 --> 00:18:25,800
Speaker 1: you can find us on the Bloomberg terminal, Bloomberg dot com,

325
00:18:25,800 --> 00:18:30,560
Speaker 1: our Bloomberg app, and podcast destinations such as Apple Podcasts, Spotify,

326
00:18:30,840 --> 00:18:33,480
Speaker 1: or wherever you listen. We'd love it if you took

327
00:18:33,480 --> 00:18:36,000
Speaker 1: the time to rate and review the show so more

328
00:18:36,040 --> 00:18:38,680
Speaker 1: listeners can find us. You can also check us out

329
00:18:38,680 --> 00:18:42,520
Speaker 1: on Twitter, follow me at Scott Landman. Our guest, Liz

330
00:18:42,600 --> 00:18:47,440
Speaker 1: Catkin is at Liz cat Can Underscore Books. Benchmark is

331
00:18:47,480 --> 00:18:50,560
Speaker 1: produced by tofor Foreheads, the head of Bloomberg podcast is

332
00:18:50,600 --> 00:19:02,160
Speaker 1: Francesco Levie. Thanks for listening, See you next time, Scott

333
00:19:02,640 --> 00:19:05,200
Speaker 1: then nger Bour