HealthyGamerGG - The Medical Impacts of Overturning Roe v. Wade

Episode Date: June 25, 2022

Today Dr. K talks about what the medical effects of overturning of Roe v. Wade are including anencephaly, access to safe abortions, and overarching problems with the current health care system. Support this podcast at — https://redcircle.com/healthygamergg/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy Learn more about your ad choices. Visit megaphone.fm/adchoices

For those of you that don't know, there was a landmark Supreme Court case in the United States. So this is going to be basically U.S. focused for all our international audience. And, you know, thankfully doesn't really apply to you. Hopefully it doesn't apply to you. But where the Supreme Court of the United States basically upheld the right to get an abortion. And so based on this case, it was like basically a federally protected ability to get an abortion. So today, the U.S. Supreme Court in a 6-3 decision overturned that case and basically said the states get to decide. So there's not a federal protection against abortion.

It's a state-specific issue where states get to decide whether you can have an abortion or not. As a consequence of this, there are many states that based on their political leanings will basically outlaw abortion. So I'm not a political expert by any means. I don't, I have some political opinions, but it's not like my political opinions are more valid or than anyone else's. But I just want to share with y'all like a couple of stories and what I understand about abortion is a medical provider. So when I was on my obstetrics and gynecology rotation in medical school, I had a patient who had a fetus that had something called anencephaly. So anencephaly is an exceedingly rare condition. It happens to about one to three pregnancies out of about 10,000, right?

So we're talking like, you know, somewhere around one out of 10,000, two out of 10,000, one out of 3,000. Depends a little bit on ethnicity and there are other kinds of different variables. But anencephaly is a fetus that does not have basically a brain. So it's possible in the development of a fetus for you. something goes wrong and they're born without the cranium, or not born, they're developing without a cranium and without a brain. So naturally what happened in this case is that, generally speaking, it's a reasonable thing for someone to have an abortion and terminate

the pregnancy when you have a fetus that is completely unviable. So the fetus has a heartbeat. It just has no brain. And its capacity to live is like basically non-existent. So a lot of times, these, you know, the fetuses can be alive at the time of birth, but many times they're not. And then they all, inevitably, I can't think of, I've never heard maybe there is a single, I can't think of a single case, this will turn into a viable human being. So the first thing that I want to say is a medical doctor, like there are absolutely reasons to get abortions from medical reasons. It's like there's no way, like, despite the fact that it has a heartbeat, there's no way

that this will ever be like a human being. it just is missing a brain right so like you can have and essentially what happens is they go into cardiac arrest because the part of your brain that governs your heartbeat there's a part of your brain that governs and keeps you breathing and governs your heartbeat which is non-functional because it's missing or it's like severely underdeveloped in people within encephaly and so like in my mind there's no doubt that abortions are medically necessary at some points okay That's the first thing. The second thing is that generally speaking, there's also a lot of public health and epidemiologic data.

That restricting access to abortion does not, it may reduce abortions to some amount, but what it really does is reduces access to safe abortions. And that women who aren't able to care for a child or aren't able to stay pregnant will seek abortions in other ways. So there are all kinds of kind of like homebrew kind of abortion. techniques and things like that. You know, people use the phrase coat hanger. But there's good evidence that shows that when you restrict access to safe abortions, what happens is people are going to like get abortions in unsafe ways. There's also all kinds of evidence that shows that restrictions on safe abortions disproportionately affect poor people. So what this means is that

if you're rich and you live in a place where abortions aren't legal, what you'll probably do is just fly to a place where they are illegal, get a procedure in secret, and fly back. What happens, though, is if you're, if you lack means, like this is, this is a law that disproportionately affects poor people who don't have the means to handle the abortion. And there's a lot of evidence, not, I mean, that's an overstatement. I've heard stories about, you know, cases of this where people who are very anti-abortion, who have gotten abortions themselves. And in their case, it was okay, right?

But like all the other abortions, all the abortions except for mine are morally reprehensible. I think we just sort of know, and there's all kinds of other negative impacts. So we see negative economic impacts. We see crime rates increase about a decade or 15 years after abortion becomes unavailable. So we'll also see similarly crime rates decrease 15 years after you make abortion sort of accessible. So I think from a medical standpoint, you know, there are tons of reasons like ectopic pregnancies and stuff like that

where abortions are like medically, I wouldn't quite say necessary, but medically, I mean, there are cases where they're medically necessary, but I'm not an obstetrician. They're definitely medically like reasonable cases for abortion. And so I think these kinds of blanket protections are important to preserve those kinds of. kinds of things because I don't I don't know that lawmaker so first of all like a lot of the people who are

passing laws don't really consider medical evidence when they pass laws right so they'll sort of say like viable heartbeat for example is something that I hear a lot is sort of a dividing line but like what about the case of anencephaly and so this is the kind of thing where like I think it's a real unfortunate thing that the Supreme Court has done I think it's like going to disproportionately affect people who are poor I think it's not going to be good for our society, I think it's not going to be good for potentially fetuses or prospective mothers. And it's really unfortunate. Like, I mean, if you all want to talk more about it, I suppose we can.

But I don't really have much more. I mean, in a sense, I have a lot to say. But in a sense, like, it's pretty open and shut, at least in the medical community, about the importance of abortions. Like, I don't think that there's a whole lot of debate amongst actual doctors about the importance of this. So like, you know, but like doctors are not necessarily lawmakers and like that's, I think, okay in a sense.

I just wish that lawmakers would really consider medical science a little bit more when they instituted policies like this. So here's like basically what I kind of think about it. It's like, okay, if you want to outlaw abortion at the minute, like, this is my basic problem in terms of like policy is that people don't. play the tape through to the end. So it's like, what happens to that child when it's born? So if you've got like a 16-year-old who's like, has a kid, like, what happens to the child?

What happens to the mother? Like, do you have maternity leave? Do you have childcare services? Like, what happens? And I think we sort of learned this in medicine where, so we decided at some point as medical doctors, which is a good decision, that we're not going to let someone die. So when you come into the emergency room with a heart attack or whatever, we don't care what you did prior to coming into our doors. We're going to do our best to save your life.

So this is like really important. It became also pretty important during COVID when people, you know, were like anti-vacc and didn't get vaccinated. And like, is a doctor like, do you let that person die because it's their decision? No, you don't. So we have a simple rule in medicine, which is that we're going to try to help people no matter what. I think it's a great rule. The problem is that we'll create some interesting issues. So the first is that if we're going to provide emergency services, and when someone comes in, we don't ask you, like, can you afford, you know, cardiac ICU time?

We're going to save the person's life. The problem is that when we do that, it's very expensive. So as it's very expensive, like someone has to eat that cost, it's generally speaking eaten by the taxpayer. This is also something that people in the U.S. don't really understand. is that without socialized medicine, we have socialized medicine already. The difference is we just have a very, very, very expensive form of it. So let me walk y'all through like what happens. And I guess this is a tangent that we're going on.

So if a homeless person comes in with severe heart disease and a heart attack, we put that person in the cardiac ICU. We provide care for them, right? Because we're not going to let people die. That's not, that's the line that we've drawn in the sand. We're going to provide people with care. Then let's say that the ICU costs $100,000 in terms of, of the stay. So the patient can't pay because they're homeless and they have no money. So then

who eats the cost? The hospital eats the cost. If the hospital keeps on eating costs, if they keep on providing $100,000 worth of care and never get reimbursed in it, what happens? The hospital goes under, right? Because you can't keep on giving free care without getting like paying, you know, for your ventilators and nurses and doctors and all cleaning people and all this kind of stuff. So then what the hospital does is goes to the government and says, hey, by the way, we're going to go out of business because there's a bunch of uninsured people that are getting life-saving medical care. The government says, okay, what do you need from us to not go out of business because we as the government need you to exist, right? Because otherwise our populace can't get medical care. And the hospital

says, we need this amount of money to stay afloat because of the care we're providing the and the government says, okay, fine, and then they pay that money. And where does that money come from? It comes from taxpayers, right? That's where the government gets its money. So we're already subsidizing this care. Now, the problem, the real problem, is that if we had started that person on medication for $40 a month, like if we had started this person on a statin, we'd started them on blood pressure medication,

if we had provided this person with $1,000 of medical care over the last five years, it would have saved us $99,000 in ICU care. But we don't pay for that because this person can't afford it. So this is one of the reasons why the United States has one of the best healthcare systems in the world in terms of like the quality of particular procedures and outcomes that we can deliver. and it is so bloated and expensive. So the value of the United States health care system is low, like so that what you get for what you spend is actually inefficient.

But what you get is excellent in terms of like the quality of care that we provide, if that makes sense. And so this is my basic issue with a lot of like healthcare policy is that I think you've got to like, if you're thinking about, you know, socialized health care and stuff, It's not about, like, we're already doing it. We just, people, I don't, people don't seem to understand this. Like, people don't get it. That it would just be cheaper to, like, and astronomically cheaper to provide this person

with medical care longitudinally for free. Like, we would save money. We would save, like, 99 grand in this scenario, right? And so it's like, it's just such an inefficient system. And so this is the thing about medical policy is that, like, I think you got to play the tape through to the end. So like even if you want to make an argument for being pro-life and like not letting people get abortions, like what happens next? Right. That's what I, that's what I think is really unfortunate about like all these policies.

Like, you know, you got to play the tape through to the end and account for all of the consequences for your law. And that doesn't happen. And so then what we sort of end up with is situations that are just like objectively worse. Like we could do objectively better. we could save a life, provide a greater quality of life, reduce morbidity and reduce mortality, and save money doing it. So Wondrichimp is asking the preventive care price isn't wrong, but don't hospitals only accruped 70% of the cost of Medicare Medicaid stay? The rest is covered by inflating costs to private insurance. Yeah. In essence, yes.

So a lot of times hospitals will lose money on certain payers and make money on other pairs. But there are other advantages of Medicare and Medicaid. So, for example, like, Medicare will pay. They'll pay on time. Private insurance will, like, fight you for, like, three or six months, and then they'll pay you more. So there's all kinds of, I mean, it gets super complicated, which is part of the reason that the health care system is so messed up.

Basic problem with the health care system in the United States, in my opinion, is that the person who spends the dollar has no recourse if their dollar is misspent. Right? So like when I purchase a candy bar, if I don't like the candy bar, I have the option to not purchase it again. So what this does is guarantees some amount of feedback between me and the candy bar producer, where if they make their candy bar too small or they make it taste too crappy, I'm going to stop buying it. Basic issue is that this feedback mechanism is not in place. Right?

So when I have employer-based health insurance, like if I'm unhappy with my health, health insurance, I can't quit, right? Like, I can't do that. So when you, when you have a fundamental, like, when there's a, when I pay a dollar to you and you pay a dollar to someone else, and that person provides me with health care, that triangle sort of situation is, like, not conducive to, because they're altered incentives. So it's, that's a basic issue.