Speaker 1: Madera Community Hospital is reopening after a two plus year hiatus,
Speaker 1: and I want to talk about what it means why
Speaker 1: I closed in the first place, why I'm not necessarily
Speaker 1: still hopeful for its long term stability, because some of
Speaker 1: the same problems that led to its closure are still around.
Speaker 1: And this is the California healthcare landscape that is kind
Speaker 1: of a creation of Gavin Newsom, where we have these
Speaker 1: sort of insoluble problems on the front end, we sort
Speaker 1: of do our best to kind of fix things on
Speaker 1: the back end with more government spending, but eventually I'm
Speaker 1: not sure how that's all going to work. So let
Speaker 1: me explain what I mean, okay, Madera Community Hospital. Madera
Speaker 1: Community Hospital suffered from a couple of different problems that
Speaker 1: led to its closure in December of twenty twenty two.
Speaker 1: One of the big problems was a lack of qualified nurses,
Speaker 1: so this resulted in Madair Community having to rely on
Speaker 1: travel nurses to cover up the gaps that they had.
Speaker 1: So basically, travel nurses are nurses from out of the area.
Speaker 1: They travel to different hospitals who need coverage, and you
Speaker 1: have to pay a lot of money for them. It's
Speaker 1: more expensive than just having your own nurses, so they
Speaker 1: had to spend a lot of money on travel nurses.
Speaker 1: But the main financial problem, the sort of fundamental problem.
Speaker 1: Maybe at some point we could address the nursing thing
Speaker 1: if we could produce more nurses out of you know,
Speaker 1: and this is one of the arguments FIR measure that
Speaker 1: local hospitals in the San Laque Valley don't have enough
Speaker 1: nurses and that maybe Measure E could help expand Prisno
Speaker 1: State's capacity to produce more nurses. Now, problem with Measure
Speaker 1: E was that it wasn't just funding nursing. It was funding,
Speaker 1: you know, expanding the football stadium and just a bunch
Speaker 1: of other basically doing construction on everything at Frisno State.
Speaker 1: And I don't know that enough people were really in
Speaker 1: favor of an increased sales tax to pay for all
Speaker 1: those things. I think if Measurrey had actually just been
Speaker 1: focused on some of the aspects of Fresno State's life
Speaker 1: that produce more engineers, more nurses, et cetera, then maybe
Speaker 1: people would have been more open to it. But that's
Speaker 1: that was one of the difficulties with Measure E was
Speaker 1: it was in general just funding for building improvements at
Speaker 1: Fresno State in general, not just for the nurses and
Speaker 1: engineers that the proponents of Measury were putting forward. Anyway,
Speaker 1: even if you address the problem with not having enough
Speaker 1: nurses in the San Joaquin Valley, there's this problem which
Speaker 1: is medical, medical and the fundamental unsustainability of medical that
Speaker 1: Gavin Newsom has only made more unsustainable. Why well, California
Speaker 1: is the most overtext state in the Union. Medical is
Speaker 1: a payer, So within the circle of life within healthcare,
Speaker 1: you have the three p's payers, providers, patients. The payers
Speaker 1: are the insurance companies, including government payers like medical Medicare, Medical,
Speaker 1: though is the most significant of these. Medical is government
Speaker 1: funded health insurance health care coverage for anyone who is
Speaker 1: under a certain income threshold, a certain household income threshold,
Speaker 1: so they are a payer. Then you have the provider,
Speaker 1: which is the doctor or the nurse practitioner who is
Speaker 1: the one providing the service to the patient. Now, the
Speaker 1: patient may pay a health insurance premium for his or
Speaker 1: her health care, or the patient's work might pay that
Speaker 1: health insurance premium for the patient goes to the pay or.
Speaker 1: But in the case of medical patients, they're not paying
Speaker 1: that much that they're not paying that the government's paying that. Okay,
Speaker 1: So that's the circle of life. You have the payers,
Speaker 1: the health insurance company medical, you have the providers, you
Speaker 1: have the patients. The providers give the service to the patient.
Speaker 1: The patient pays their premium to the payer or not
Speaker 1: in the case of the medical, patient or taxpayers pay
Speaker 1: for effectively the healthcare to medical, and then the payers
Speaker 1: pay the providers for their services. Now, medical is funded
Speaker 1: partially by California state taxpayer dollars, partially by federal taxpayer dollars,
Speaker 1: and there is a limited pool of that money. California
Speaker 1: is already the most overtaxed state in the Union. There's
Speaker 1: just not any more water we can twist out of
Speaker 1: this rock. Okay. We also have lost taxpayer revenue in
Speaker 1: California since COVID. A lot of wealthy people who were
Speaker 1: paying a lot of money either in income tax or
Speaker 1: in capital gains tax, said enough of this, I'm out
Speaker 1: of here. I'm going to Nevada, there's no state income tax.
Speaker 1: I'm going to Arizona. I'm going to Florida. I'm going
Speaker 1: to Texas, I'm going to Idaho, I'm going to Utah.
Speaker 1: People just left California and they took their tax revenue
Speaker 1: with them. So the pool of money for medical patients
Speaker 1: is not getting any bigger, and yet the pool of
Speaker 1: people eligible for health insurance under medical has grown. This
Speaker 1: is the fruit of decisions Gavin Newsom made. Gavin Newsom
Speaker 1: ran for governor. What did he run for governor on?
Speaker 1: He ran for governor on the promise that he would
Speaker 1: do a single payer health care system. So in California,
Speaker 1: get rid of all the payers except for one. Have
Speaker 1: a state government run health insurance system cal care or
Speaker 1: whatever you want to call it, where you get rid
Speaker 1: of all the private insurance payers, get rid of all
Speaker 1: that no one gets has private health insurance. Everyone is
Speaker 1: covered under one payer, a single payer. Now, as a result,
Speaker 1: if everyone is covered under a single payer, what does
Speaker 1: that mean, Well, it means that everyone's money, whatever money
Speaker 1: is being paid right now by your job to cover
Speaker 1: your health insurance premium, instead, that would go to the
Speaker 1: government to fund this massive pool of money for providing
Speaker 1: health insurance for everyone in the state, every single one
Speaker 1: of you whose job pays for your health insurance. Instead,
Speaker 1: imagine all of that money, all of your taxes, and
Speaker 1: all of that money all going into one pool for
Speaker 1: covering everyone in the state, so everyone gets calcare. Now,
Speaker 1: I'm not here to say single payer health care is
Speaker 1: a great idea. There are plenty of examples of it
Speaker 1: not being a great idea in many respects. However, it
Speaker 1: does have a certain financial sensibility to it. It does
Speaker 1: kind of the math works out fairly well. It doesn't
Speaker 1: work out so that everyone gets a Cadillac as far
Speaker 1: as the quality of their health insurance, but everyone can
Speaker 1: maybe get a Honda Civic as far as the quality
Speaker 1: of their health insurance. And it relies on basically the
Speaker 1: wealthy taxpayer paying for the non wealthy. There's a certain
Speaker 1: financial solubility to it, all right. Gavin Newsom was elected
Speaker 1: saying that that's what he wanted to do. In fact,
Speaker 1: he had these brash proclamations in twenty eighteen about all
Speaker 1: these liberal politicians who say they're going to support single payer,
Speaker 1: and then when the going gets tough, when they actually
Speaker 1: come time to do it, they say that it's too
Speaker 1: expensive or it's not the right time, and I'm not
Speaker 1: going to do that. And then that's precisely what he did.
Speaker 1: He didn't do it because it was too expensive, and
Speaker 1: the going got tough, and the health insurance companies got
Speaker 1: to him and convinced him not to do it. So
Speaker 1: what did he do instead? Newsom focused on the idea, well,
Speaker 1: I'm not gonna do single payer. The benefit of single
Speaker 1: payers that everyone's covered. But what I'll do is I'll
Speaker 1: attain universal coverage. I'll make sure everyone eligible for health insurance.
Speaker 1: And he did that by progressively expanding Medicaid eligibility medical eligibility.
Speaker 1: And why didn't he go for single pair? He didn't
Speaker 1: go for single payer because he realized it would require
Speaker 1: a massive tax increase to do it. It would be
Speaker 1: enormously expensive. Now, the argument might be, well, if you
Speaker 1: just take all the money that people pay in health
Speaker 1: insurance premiums and combine it with all the money they're
Speaker 1: spending in their taxes right now, it's really not actually
Speaker 1: that significant of a tax increase. Okay, you try selling
Speaker 1: that to the people, and you try being a politician
Speaker 1: who's up for reelection, and you try selling that anyway.
Speaker 1: Instead of a massive tax increase and a massive reshaping
Speaker 1: of California health care, Newsome instead off opted for what
Speaker 1: was really a half measure increase. The pool of medical
Speaker 1: eligible people. And this is sort of the trajectory that
Speaker 1: Democrats have been on since Obamacare, since Obama basically abandoned
Speaker 1: his single payer idea for the government option idea of
Speaker 1: you know, lots of heavily government subsidized plans for lower
Speaker 1: income people, and an expansion of Medicaid eligibility. So that's
Speaker 1: what Newsom did. He expands Medicaid eligibility, but he doesn't
Speaker 1: really expand revenue into the state, either by increasing taxes
Speaker 1: or doing whatever is necessary to spur economic growth to
Speaker 1: prompt more income into the state's coffers. So medical eligibility expands,
Speaker 1: we have more and more and more people becoming medical eligible,
Speaker 1: receiving healthcare through medical but we're not increasing the resources
Speaker 1: available to have the payer of medical pay providers for
Speaker 1: their services. More people getting healthcare, but not a proportionally
Speaker 1: increasing pool of money to pay for their health care
Speaker 1: as a result, and maybe the Coup de Gras, I
Speaker 1: don't know that we've really understood the full impact of it.
Speaker 1: The Coup de Gras was expanding medical eligibility to people
Speaker 1: regardless of their immigration status, which was like the last thing. Basically,
Speaker 1: people who aren't in the country. Legally, illegal aliens are
Speaker 1: eligible for medical, so further expanding the pool. So medical
Speaker 1: hasn't gotten more money to pay for the healthcare for
Speaker 1: more and more and more people. This results in providers
Speaker 1: getting very little money as far as reimbursement for the
Speaker 1: care that they give. And this was the fundamental problem
Speaker 1: with Madera Community Hospital. Maderic Community was serving mostly lower
Speaker 1: income patients who were on medical. It's really hard to
Speaker 1: make any money serving those patients. And depending on you know,
Speaker 1: some of it depends on what kind of reimbursement rates
Speaker 1: medical sets for you or for your region, what you
Speaker 1: can negotiate with medical. Some of it depends on what
Speaker 1: area of medicine you're talking about. For example, I mean,
Speaker 1: I know this within Obgyancare because of starting Ourobia Clinic
Speaker 1: that if you do a normal you know, a normal pregnancy,
Speaker 1: a normal, healthy pregnancy that results in a vaginal delivery,
Speaker 1: a medical reimbursement for sort of the global bill for
Speaker 1: services throughout the course of that pregnancy, including the delivery
Speaker 1: is about fifteen hundred dollars. A private insurance reimbursement is
Speaker 1: like three times that amount. If you have like Anthem,
Speaker 1: Blue Cross or something, or you know you're gonna your
Speaker 1: reimbursement's gonna be three times greater than that. That's how
Speaker 1: much we're talking. Is the difference between a private insurance payer,
Speaker 1: a private insurance company that's providing coverage for a patient
Speaker 1: and medical and Maderia Community Hospital couldn't sustain that. And
Speaker 1: this is a problem that you see with every single
Speaker 1: hospital in California. Like this is why I laugh when
Speaker 1: I hear these stories. You know, some folks we are
Speaker 1: using Valley Children's, Oh they is val You know, there's
Speaker 1: this story about Todd Centripack, the CEO of Valley Children's,
Speaker 1: and the compensation he was being given, and people thought, oh,
Speaker 1: he's receiving way too much money in compensation, that this
Speaker 1: is a disproportionately high amount of money that they're giving
Speaker 1: to their executives. And then someone raises the question, oh, well,
Speaker 1: is this because of medical fraud? Is Valley Children's misappropriating
Speaker 1: it's medical funding. No, Valley Children's gets money from medical
Speaker 1: as reimbursement for services they provide patient. What they get
Speaker 1: from medical is barely even covering their costs. Valley children
Speaker 1: is not making money off of medical patients. The reason
Speaker 1: why Valley Children's is doing well is because of one,
Speaker 1: donations and grants. Two because of their investment portfolio, which
Speaker 1: they've done a really good job of handling. That guy's
Speaker 1: like Todd Centrapack, have done a really good job of handling.
Speaker 1: And I guess I don't know what would you rather
Speaker 1: have a hospital that has a highly paid executive that's
Speaker 1: functioning really really well and doing financially really really well
Speaker 1: and therefore able to provide really great care for patients,
Speaker 1: Or would you rather have Madera Community Hospital going out
Speaker 1: of business for you know, two almost two and a
Speaker 1: half years. So that's the fundamental problem that led to
Speaker 1: Madera Community's closure. And yes, they got some loans, they
Speaker 1: got some state assistance, more state spending to help them reopen.
Speaker 1: But I guess I don't know if these fundamental economic
Speaker 1: and insurance market problems are really gonna be resolved When
Speaker 1: don't we return more of the problems that the sort
Speaker 1: of unsustainability of medical results in. That's next on the
Speaker 1: on the John Girardi Show. Madera Community Hospital is reopening.
Speaker 1: This is a result of basically zero interest loans from
Speaker 1: the State of California. The distressed Hospital Loan program, which
Speaker 1: Annacabairo and Esmuel Dasoria helped pass through the state legislature
Speaker 1: in twenty twenty three. This program awarded Madera Community Hospital
Speaker 1: a fifty seven million dollars zero interest loan to help
Speaker 1: it reopen. Now, my wife laughed when she read this.
Speaker 1: She's the management company that's running this, that's reopening the
Speaker 1: hospital is called American Advanced Management, which is a Modesto
Speaker 1: based hospital management firm, which said it is an updated
Speaker 1: workflow that will quote reduce wait times and overall patient outcomes.
Speaker 1: It will reduce wait times and it will reduce patient outcomes.
Speaker 1: I mean they've been reducing patient outcomes by having zero
Speaker 1: patients for the last you know, almost two and a
Speaker 1: half years. I mean, they've done a great job, clearly,
Speaker 1: the folks that have I really hope the folks at
Speaker 1: American Advanced Management are better at patient management than they
Speaker 1: are at copy editing. Because they're going to reduce weight
Speaker 1: times and reduce overall patient outcomes. What are they going
Speaker 1: to just pull the plug on any patient who's, you know,
Speaker 1: causing them any difficulties. What are we doing? We're reducing
Speaker 1: outcomes anyway, This problem that we've discussed with medical impact
Speaker 1: certain kinds of areas of medicine more acutely. And so
Speaker 1: the basic problem is we have too many medical patients,
Speaker 1: and our pool of taxpayer dollars to pay for health
Speaker 1: coverage for people on medical has not grown own proportionally
Speaker 1: to the pool of medical people. The pool of medical
Speaker 1: eligible people has grown since Obamacare was passed. It grew
Speaker 1: more under Gavenusom, and finally Gavenuwsom expanded it to include
Speaker 1: people who are here in the country illegally, so illegal aliens.
Speaker 1: So the pool of people eligible for medical covered by
Speaker 1: medical has grown and grown and grown and grown. But
Speaker 1: the tax revenue to pay for that insurance coverage that
Speaker 1: has not grown, that's stayed, you know, it hasn't grown proportionally.
Speaker 1: So as a result, the reimbursement that medical can give
Speaker 1: to a provider, a doctor, a nurse, pectition or whatever
Speaker 1: for providing a service to a patient who has medical
Speaker 1: coverage is less and less and less. And as a result,
Speaker 1: those doctors, those nurse practitioners, those hospitals, they can't make
Speaker 1: money off of medical patients, certain kinds of medical patients.
Speaker 1: By the way, here's one area where that's true. It's
Speaker 1: provision of obgyn care. You know, I've gotten to know
Speaker 1: about this by opening our Obria Clinic, which, by the way,
Speaker 1: for anyone who wants to go, Friday, March twenty first.
Speaker 1: This Friday, We're gonna have a great fundraiser for our
Speaker 1: Obria Clinic at the Toka Maderra Winery out in Madera.
Speaker 1: You can go to Obria three six five dot org
Speaker 1: Obria three six five dot org. It says for twenty
Speaker 1: twenty four. We miss stated on the website, but it's
Speaker 1: for twenty twenty five. You can click there. You can
Speaker 1: buy tickets, you can purchase a sponsorship. This Friday, March
Speaker 1: twenty first at the Toka Madera Winery. A really cool
Speaker 1: fundraiser for our Obria Clinic. I'd love to have as
Speaker 1: many of my John Gerardy Show listeners as possible go.
Speaker 1: But one of the things I've learned, basically is that
Speaker 1: medical reimbursement for pregnant women, who women having their babies
Speaker 1: is really poor. It's so poor that it results in
Speaker 1: more and more doctors just don't want to take medical
Speaker 1: patients for care, so you have more and more women
Speaker 1: on medical who need care. And fewer and fewer doctors
Speaker 1: who want to take them because they lose money off
Speaker 1: medical patients. Again, the reimbursement is like a third of
Speaker 1: what you would get for taking care of a woman
Speaker 1: who has private health insurance. AAM, the company that's running
Speaker 1: Maderia Community Hospital for its new opening, has announced that
Speaker 1: the hospital will be reopening without a maternity ward. So
Speaker 1: Minderic Community is not going to have a maternity ward.
Speaker 1: The hospital's reopening partner has said its main focus will
Speaker 1: be financial sustainability before it decides whether it can add
Speaker 1: maternity services. So this is the problem. This is the
Speaker 1: problem with medical right here, boiled right here. Certain kinds
Speaker 1: of areas of medicine are so unsustainable with medical that
Speaker 1: here where we're going to open a general hospital without
Speaker 1: maternity care, no maternity care services at Madeira Community when
Speaker 1: it reopens. Why because they've got to demonstrate some basic
Speaker 1: level of financial sustainability before they add in ob services,
Speaker 1: because that's even less financially sustainable. If you're taking a
Speaker 1: bunch of medical patients to deliver their babies, you're gonna
Speaker 1: lose money and no one. I feel like this is
Speaker 1: a huge problem that this unsustainability of medical being able
Speaker 1: to take care of pregnant women that nobody is addressing.
Speaker 1: When we return, I want to talk. I want to
Speaker 1: talk a little bit more about this, about this fundamental
Speaker 1: problem with caring for pregnant women and how it ties
Speaker 1: in a little bit with the abortion debate that's next
Speaker 1: on the John Gerardy Show. A couple of weeks ago,
Speaker 1: I had the privilege of I've been able to get
Speaker 1: a couple of articles published by National Review, and I'm
Speaker 1: kind of in their sort of orbit as someone I
Speaker 1: contribute articles to them occasionally. I've had three articles published
Speaker 1: by them as of now, and I had this longer
Speaker 1: piece I wrote about messaging the pro life movement and
Speaker 1: being directorate Right to Life. This is obviously something I've
Speaker 1: thought about a lot, and I think one of the
Speaker 1: difficulties pro lifers are facing is basically the way most
Speaker 1: people think about abortion in America, insofar as they think
Speaker 1: about it at all. That's my other thesis is that
Speaker 1: people just don't like thinking about the abortion issue in general,
Speaker 1: and so to the extent that they do think about it,
Speaker 1: they think about it in brief snatches in ways that
Speaker 1: aren't super fundamentally like logically consistent. People think of abortion
Speaker 1: like this. They see a pregnant woman facing a bunch
Speaker 1: of burdens or challenges or difficulties, and they think, gosh,
Speaker 1: that would be really hard for her to continue to
Speaker 1: be pregnant and to have this baby and to care
Speaker 1: for that baby, and they therefore think abortion would be
Speaker 1: a compassionate thing to alleviate those burdens. This ignores the fact, however,
Speaker 1: that seventy percent of women don't want to have the
Speaker 1: abortion they have. They would rather keep the baby, but
Speaker 1: they feel compelled to have an abortion by financial constraints,
Speaker 1: pressure from their partner, whatever, in some cases outright coercion.
Speaker 1: And I think one of the coercive forces that women
Speaker 1: face is a lack of health care access. Let me
Speaker 1: look at and I'm prompted to think about this, but
Speaker 1: the news. So we have this news that Maderk Community
Speaker 1: Hospital is going to reopen after over two years being closed.
Speaker 1: It's finally reopening. It's reopening without a maternity ward. And
Speaker 1: this plays into what I think is a really underdiscussed
Speaker 1: crisis in California, in particular that in this state that
Speaker 1: the state does so much to pat itself on the
Speaker 1: back for saying that they are champions of reproductive rights.
Speaker 1: Gavin Newsom did this again on his Stupid podcast when
Speaker 1: he was talking with Charlie Kirk. He said, oh yeah,
Speaker 1: as everyone. No, no one's a bigger champion of reproductive
Speaker 1: rights than me. They're not champions of quote reproductive rights.
Speaker 1: What they're champions of is abortion, which last I checked,
Speaker 1: is a non reproductive service. The point of it is
Speaker 1: so that you don't reproduce to actually help someone who
Speaker 1: would like to reproduce, who would like to have a child.
Speaker 1: I think California is doing a disastrous job, and a
Speaker 1: lot of it has to do with medical. Let's again
Speaker 1: the basic economics of what's wrong with medical right now?
Speaker 1: What's wrong? Why did Madeira Community Hospital go out of business?
Speaker 1: You have a growing pool of people covered by medical
Speaker 1: and the pool of money state taxpayer revenue that is
Speaker 1: used to fund medical reimbursement to doctors. That pool of
Speaker 1: money isn't growing proportionally to the number of people covered
Speaker 1: by medical So, as a result, the reimbursements that a
Speaker 1: doctor or a hospital gets for providing service, providing healthcare
Speaker 1: to a medical covered person, that amount of money is
Speaker 1: smaller and smaller and very often it's barely even covering
Speaker 1: the cost of providing the care to the patient. One
Speaker 1: of the fields of medicine where this is most acutely felt,
Speaker 1: where you're getting very little in reimbursement for the services
Speaker 1: you're providing is obstetrics care for pregnant patients. It's really
Speaker 1: expensive to provide that care, and the reimbursement you get
Speaker 1: from medical is not You're losing money. Very often, you
Speaker 1: are losing money unless you can find a way to
Speaker 1: structure your practice in a very precise way where you're
Speaker 1: basically just a factory line, just boom boom, boom boom,
Speaker 1: seing patient patient, patient, patient, patient, unless you can circle
Speaker 1: them through like cattle, and that's going to result in
Speaker 1: lower quality care. It's almost impossible to make money providing
Speaker 1: ob care to lower income women who are on medical
Speaker 1: and we see this with Maderic Community. Maderic Community Hospital
Speaker 1: is quote reopening, but they're not gonna have their maternity
Speaker 1: ward open. They're not going to open up their maternity
Speaker 1: ward for a little while until they can figure out Apparently,
Speaker 1: according to their statement from AAM, American Advanced Management, which
Speaker 1: is the modesto based hospital management company that's reopening the hospital.
Speaker 1: They said. This is from the Fresno b story. AAM
Speaker 1: has announced that the hospital will be reopening without a
Speaker 1: maternity ward. The hospital's reopening partner has said its main
Speaker 1: focus will be financial sustainability before it decides whether it
Speaker 1: can add maternity services. This is a major issue. If
Speaker 1: you're a pregnant, lower income woman in Madera and you're
Speaker 1: on medical, what the hell exactly are you supposed to do?
Speaker 1: Do you go to Merceed to get healthcare? Do you
Speaker 1: have to drive to Fresno to get healthcare? To find
Speaker 1: somebody who will take your baby? Guys, this is why
Speaker 1: I at Right to Life. I started our Obria clinic.
Speaker 1: There are fewer and fewer doctors willing to take medical
Speaker 1: patients for obgyncare again because it loses money. Let me,
Speaker 1: I mentioned this in the first segment, but I'll say
Speaker 1: it again. A lot of the health insurance billing for
Speaker 1: a pregnant patient for her obstetric care is done globally.
Speaker 1: It's sort of all of her patient visits plus the
Speaker 1: delivery for a normal vaginal delivery, a patient who has
Speaker 1: all of her exams, all of her inpatient you know,
Speaker 1: in clinic exams plus her delivery. Your medical reimbursement is
Speaker 1: somewhere around fifteen hundred bucks. Your private insurance reimbursement is
Speaker 1: three times that amount. Doctors are losing money on these
Speaker 1: medical patients and as a result, they're not taking them,
Speaker 1: and these women have fewer and fewer places to go.
Speaker 1: If you're in Madeira again, if you're in Madera, I
Speaker 1: don't know what you do. Maybe you have to drive
Speaker 1: down to Fresno. Maybe you can get someone from Saint
Speaker 1: Agnes to take you. Maybe you can get our Obria
Speaker 1: clinic to take you. We have patients from Madera. Maybe
Speaker 1: you can go up to Merced and find some clinic
Speaker 1: that'll take you. But here's the thing. You can open
Speaker 1: as many United Health Centers as you want. You can
Speaker 1: open as many of these Federally qualified health clinics as
Speaker 1: you want. They're not a substitute for an obgyn clinic.
Speaker 1: They're not a substitute for a hospital that has groups
Speaker 1: of obgyns who can take patients for the whole duration
Speaker 1: of their pregnancy. These FQHCs they offer certain limited services
Speaker 1: to help care for someone, but they're not a substitute
Speaker 1: for obgyn care, and that's all these rural areas have.
Speaker 1: They have these FQHCs that pop up all over the place.
Speaker 1: They get tons of federal reimbursement, so they make money,
Speaker 1: but they're not really providing good obgyn care. They're not
Speaker 1: really an adequate replacement for an obgyn. But there's been
Speaker 1: a ton of investment in these in these FQHCs because
Speaker 1: people who invest in them know we can make a
Speaker 1: crap ton of money on the back end because the
Speaker 1: ensure durance, the reimbursements that an FQAHC gets. Yeah, they're
Speaker 1: taking care of medical patients, so they don't get much
Speaker 1: reimbursement from medical but they get subsidized by the federal
Speaker 1: government too, and the amount of money they get is
Speaker 1: like comically high from the Feds. There's no provision of
Speaker 1: care like that for pregnant women. None. And then I'm
Speaker 1: supposed to, as a pro lifer, tell a woman in
Speaker 1: that situation, you need to keep your baby. How can
Speaker 1: I do that if I'm not also providing her with
Speaker 1: the health care she needs to care for her baby
Speaker 1: during pregnancy. I mean, that's why we started Obria. How
Speaker 1: could we with a straight face tell lower income women,
Speaker 1: keep your baby, but you're on your own as far
Speaker 1: as finding a doc. So we started a clinic to
Speaker 1: do that. We started a clinic so to say, keep
Speaker 1: your baby and come to us. We will take care
Speaker 1: of your baby. We will take care of you over
Speaker 1: the course of your pregnancy. And that's sort of the
Speaker 1: other problem. Why is Madeira Community not opening its maternity ward.
Speaker 1: Often medical pay patients their lower income. They have much
Speaker 1: higher rates of obesity, They often have more difficult medical histories,
Speaker 1: much higher percentage of those patients are high risk patients.
Speaker 1: So if anything Madeira Community, if they were to open
Speaker 1: up their maternity ward, they would have to spend more
Speaker 1: per patient for patients who are providing them with less
Speaker 1: revenue in reimbursement, don't have to pay more of their
Speaker 1: insurance coverage, et cetera. And this is just this is
Speaker 1: not just a central Valley problem. I really think this
Speaker 1: is a problem throughout California, in lower income parts of
Speaker 1: the state. We don't have great numbers about abortion rates
Speaker 1: in California because California refuses to report its abortion numbers
Speaker 1: to the CDC, but we know it's staggering. I mean,
Speaker 1: we know the amount of abortions California has I mean
Speaker 1: California has done. California has done so much to facilitate
Speaker 1: abortion and comparatively nothing to address this financial unsustainability of
Speaker 1: medical and the gaps in care for lower income women
Speaker 1: who need prenatal care that results from it. Of course,
Speaker 1: this contributes to abortion numbers. If you're a lower income
Speaker 1: woman and you're pregnant and you're not sure if you
Speaker 1: can take care of this baby, and you call some
Speaker 1: clinic to see if you can get an appointment to
Speaker 1: be a patient, and they tell you, well, our first
Speaker 1: available slot is four months from now. Or you can
Speaker 1: go get the abortion pill in a week and have
Speaker 1: it be mailed to your house, or just pick it
Speaker 1: up at the CBS around the corner. I don't know
Speaker 1: if CVS actually distributes the abortion pill. Certain certain major
Speaker 1: pharmacies do. I don't think all of them do. Anyway,
Speaker 1: I mean, how are you You're obviously propelled towards that solution.
Speaker 1: You are financially pushed in that era. California's public policy,
Speaker 1: the way it's public policy has been structured, These structures
Speaker 1: of sin that we've set up push people towards abortion.
Speaker 1: And you can see it. You can see it right here.
Speaker 1: With this reopening of Mederic Community. We're all, you know,
Speaker 1: we're all applauding it, we're all celebrating it. But this
Speaker 1: fundamental unsustainability of medical I don't know if this goes away.
Speaker 1: Azrael Dasria can pat herself on the back, Anakabairo can
Speaker 1: pat herself on the back for getting these zero interest
Speaker 1: loans from the state to help Medera Community open up.
Speaker 1: It's not changing the fundamental financial problems with medical and
Speaker 1: instead of a a normal, fully functioning hospital, you have
Speaker 1: a hospital without a maternity ward. That's what you've got
Speaker 1: because ob care is so financially unsustainable under medical that
Speaker 1: they're not even going to try to open Maderia Community
Speaker 1: with it at the start. They have to wait and
Speaker 1: see if they can make any money first before they
Speaker 1: can build that up. When we return, why, I hope
Speaker 1: there can be a more intelligent pro life movement to
Speaker 1: actually focus on these kinds of questions with the provision
Speaker 1: of prenatal care that's next on the John Girardi Show.
Speaker 1: A lot of people have had a lot of critiques
Speaker 1: for the pro life movement ever since Row was overturned
Speaker 1: in twenty twenty two, we've lost various state ballot initiatives
Speaker 1: about whether abortions should be legal or not, even in
Speaker 1: deep deep red states like Missouri, Ohio. We manage barely
Speaker 1: to successfully beat back pro abortion ballid initiatives in Florida,
Speaker 1: which thankfully that was only because Florida requires a sixty
Speaker 1: percent majority to amend its constitution. Uh And in Kansas. Now,
Speaker 1: I think one of the things we need is a
Speaker 1: more intelligently messaging pro life movement. There are very few
Speaker 1: pro lifers in California who are pointing out this problem
Speaker 1: with medical that basically women have nowhere to go. And
Speaker 1: pro lifers have established so many like pregnancy resource clinics
Speaker 1: that do wonderful work, and I think it's because of
Speaker 1: you know, I don't know that pro lifers have necessarily
Speaker 1: the money to start massive you know, obgyn clinics. Pregnancy
Speaker 1: resource clinics do a lot of really good work and
Speaker 1: help people in a lot of ways, but they're not
Speaker 1: necessarily a replacement for obgyn clinics. And that is what
Speaker 1: is needed is more and more pro lifers providing OBG yancare.
Speaker 1: So if you want to help one of those in
Speaker 1: the Fresno area and go to Obria three six five
Speaker 1: dot org. Obria three six five dot org. You can
Speaker 1: can donate there and go to our fundraiser this Friday
Speaker 1: at the Toka Maderra Winery. Should be a great time.
Speaker 1: You can actually help women in really serious need of
Speaker 1: prenatal care. That'll do it. John girolready shows you next
Speaker 1: time on Power Talk