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November 8, 2024 21 mins

Dr. Rob Davidson, Executive Director of the Committee to Protect Health Care, joined Danielle Moodie to discuss the very real - and now looming - threat of the next Trump administration completely repealing the Affordable Care Act.

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Speaker 1 (00:11):
Good morning, peeps, and welcome to OOKP Daily with me
your Girl, Daniel Moody pre recording from the Long Island Bunker. Folks.
As many of you know, my birthday comes up over
the weekend and there is just well, let's just say,
not a whole hell of a lot to celebrate. Nonetheless,

(00:35):
I'm going to be taking a couple of days for
some rest and restoration. But I'm leaving you all with
really fantastic pre recorded interviews that I have done to
prepare for this time. So coming up is a really
great conversation that I had with doctor Rob Davidson, who

(00:58):
is an emergency room doctor in West Michigan. And doctor
Davidson and I spoke before the election. We actually, I
think spoke on election day, so we didn't know the results.
But what he was laying out in this interview is

(01:19):
what the world looked like, what America looked like, I
should say, before the ACA, and what it can potentially
and what it will look like POSTACA, because as we know,
the Republicans one overwhelmingly every seed of power, and first
up on their agenda is to deport tens of millions

(01:43):
of people from this country. And then second up is
to ensure that tens of millions of people inside of
this country are sick and desperate. And so in this
conversation we talk about what a post ACA world will bring.
And you know, now we're here. Now we're here, so

(02:04):
there is no like, well, what if and what if?
It's not even a what if anymore. It is a
when you know, how long do people have in order
to get doctor's appointments and take care of themselves and
their families. So coming up next my conversation with doctor

(02:27):
Rob Davidson, Folks, I am excited to welcome to WOKF
Daily doctor Rob Davidson, who is an er doctor in
West Michigan and is the executive director of the Committee
to Protect Healthcare, whose Twitter account went viral after creating

(02:50):
a thread to respond to speaker Mike Johnson's unearthed video
I guess we can call it of him claiming that
he is going to do away with the ACA and
that there will be no Obamacare. Doctor Davidson talk to

(03:12):
us about why the ACA is so important and how
it has transformed lives that you see on a regular basis.

Speaker 2 (03:26):
Absolutely, Danielle, and this is this is really important to me.
I've been in an emergency position for oh gosh, since
nineteen ninety eight when I graduated medical school, so I've
been at this a long time. I was probably about
half of my career before the Affordable Care Act, about
half of my career thus far after the Affordable Care Act,
and primarily you know where I am, a pretty poor

(03:48):
rural area, also worked in some urban areas in West Michigan,
and the medical expansion piece of the Affordable Charact has
been so incredible for the patients that I see. You
know that we have people who, for so much of
the time that I knew them, you know, working multiple jobs.
None of the jobs provide a health insurance. You know,
they didn't. They were were enough to quite qualify for Medicaid,

(04:10):
but they couldn't afford to buy health insurance, particularly people
with pre existing conditions, as insurance companies were able to
deny people coverage or price it so far out of
affordability that essentially they couldn't get coverage. And so many
of those people I'd see over and over in the
er with crazy high blood pressures, with blood sugars that

(04:31):
were off the charts, who couldn't get a doctor who
couldn't get insulin, who couldn't get blood pressure meds, and
we'd sort of patch them up in the er. We'd
get them maybe a month or two worth of their medication.
We'd refer them to somebody, but again, because they didn't
have insurance, they couldn't go see anybody. And it's certainly anecdotal,
but it is so incredibly profound to see since the

(04:53):
Affordable Career, how many more people have insured, how many
more people can go see a doctor, how they are
not dependent upon the er to get you know, reshills
of their blood pressure meds or their insulin, or waiting
until they're in a health crisis to be able to
manage those chronic conditions that then result in heart attacks
and strokes and kidney failure. So it's you know, having

(05:14):
that option, expanded Medicaid and then having the subsidies that
you know. Unfortunately, when President Trump was present the last time,
he undermined and he cut and President Biden and Vice
President Harris have now restored and strengthened and a placial
Reduction Act the subsidies, so people who don't quite qualify
for even expanded Medicaid can buy insurance, but do it

(05:35):
more affordably. I think those pieces have been so important
to my patients.

Speaker 1 (05:40):
Talk to us about like your reaction when you heard
that audio by Speaker Johnson just so smugly basically saying
that he's going to condemn tens of millions of American
two emergency rooms as their primary care facility. Talk to
us about what means you know, and saying that following

(06:04):
a global health pandemic, that if we had had that
global health pandemic, I would assume hit and we had
had no ACA. Just walk us through some of the
things that you would have seen.

Speaker 2 (06:18):
Right if we didn't have the ACA. Certainly, we had
people who couldn't earn a living the way they were
used to earning eleven, so their paychecks were down, and
then they needed health care right they and their families
needed to be able to go to the doctor or
having formid occasionally go to the emergency department when they
couldn't breathe when they had COVID. And that double whammy
of a health crisis and an economic crisis put so

(06:39):
many more people into that realm of requiring medicaid who
frankly still would likely not have followed by for Medicaid,
and we see in states where they don't have expanded Medicaid,
those folks had less access to care. And the folks
in states like Michigan Rye lived and about forty other
states that do have expanded Medicaid, those folks had access
to healthcare even though their paychecks were way down. When

(07:03):
I heard Speaker Johnson say that, you know, to say
I was surprise would be a lie. It's not surprising
to hear leaders on the Republican side do this. I
kind of thought the Republican Congress was kind of past this.
They had said, you know, when President Trump had suggested
he wanted to still do away with the APA, and
he had concepts of a plan, Republicans in Congress came out,

(07:24):
some of them at least, and said, well, this is
not on the agenda, and so we were certainly I
had been concerned about Trump winning and perhaps going after
the AC again like he did the last time. You
would then, but I thought, okay, well, maybe they've learned
their lesson when they couldn't get it through in twenty
seventeen and they had a backlash in twenty eighteen when
people you know, voted overwhelmingly for Democrats with the ACA,

(07:47):
you know, kind of as they're on their banners, as
they were marching for these folks, and then you hear
the now speaker and if they keep the ouse, future
speakers say yes, that's definitely going to happen. That's on
the it's sort of so crushing as a person who
provides care as an advocate. I'm the executive director of
an organization with you, twenty thousand doctors around the country

(08:09):
fighting for this kind of stuff. We're doing a big
play in Wisconsin, one of the few states with the
Democratic governor who still has an expanded medicaid because of
their jerrymandered Assembly and Senate. And now with new maps,
we're hoping we're going to get the Assembly or get
clothes and we think we can get expanded medicaid next
year in the matter state. And so with all of

(08:29):
that going on, and now you have a current speaker
and someone who could be the next president saying, yeah,
we still want to get rid of this thing. I
can't think of anything more important than voting against that.
If there wasn't enough out there to vote against, that's
certainly critical.

Speaker 1 (08:46):
Paint the picture for us of what would happen if
Medicaid is stripped away, if ACA is stripped away. Paint
the picture for us of what it would look like
inside this country, inside of hospitals, so that folks really understand.

Speaker 2 (09:06):
Well for where I practice, I practice in the emergency department, right,
That's my entire career, and so that's where people end
up when there's nowhere else to go. I thank God
for MTALA, And you know, the state of Idaho was
threatening m TALA when it came to abortion care, and
luckily the administration stepped in and they got that at
least kind of punted down the line. But I'm at

(09:27):
that intersection where people come where they have nowhere else
to go, and that undoubtedly will go up. I mean again,
the days of people coming in with blood pressures of
you know, too twenty over one twenty and having nowhere
to go to get follow up and getting a month
or two is worth of blood pressure met, those will
be back and forth. They don't just want to get
rid of the Affortable Care Act. They want to change Medicaid.

(09:47):
They want to kind of scale people away from Medicaid.
They want to require work for Medicaid instead of giving
people health care so that then they are able to
be healthy in work, which is what we've seen in
our state. People get medicaid. Guess what, they are healthier,
they can work, they're more productive, not the other way around.
And so all of that's on the table. We're going
to go back to the battle days. Listen, it's not

(10:09):
perfect now. Health care still costs way too much, and
our organization and others, and certainly the administration has done
is a lot to try to put a dent in
that with prescription drug costs, with subsidies for health insurance,
and we have a long way to go. But boy,
this backslide into the days before the ADA and scaling
back medicaid would it would cost lots and in non

(10:32):
expansion states. I believe between the time of Medicaid expansion
and now there's been twenty plus thousand excess deaths that
could have been averted had they expanded medicaid in these
other states. I mean, it's real flesh and blood, and
our patients will pay the price.

Speaker 1 (10:48):
You know. I actually want to go back to something
that you said with regard to m Tala, which is
the ability for patients to undergo abortion care in cases
of emerging, and we have seen that brought back up
to the Supreme Court, who then kicked it back down
to the lower courts. And we are watching as women

(11:08):
in places like Texas and Georgia are in the headlines
for losing their lives because of untreated miscarriages that led
to not only the death of the fetus but also
their deaths. Can you talk to us a bit. I
know that you're not an abortion doctor, but about what
it has been like to be a doctor in America

(11:33):
when the profession itself has been weaponized from covid on.
I don't think that we have seen such a turn
away from doctors, from science right and the politicization of that.
So can you just speak to what it has been
like to kind of be in the throes of that

(11:55):
misinformation disinformation tornado that has placed targets on hospitals. I mean,
hospitals have received bomb threats, right like. I mean, to
think about that is outrageous. So what has that been
like for you and for your colleagues?

Speaker 2 (12:12):
You know, I think there's a lot of bad and
then also some good. There's a sliver of pope there.
Certainly the bad is that people are being fed disinformation
started a lot with COVID with them President Trump being
kind of the chief purveyor of the misinformation and disinformation.
And people will come in and accuse you of giving
them COVID when you put a swab in their nose,
accuse you of giving them the vaccine when you are

(12:34):
giving them treatment. You know, simple thing like steroids, which
we give to people for all sorts of things. That
was one of the treatments for people get to get
amitted with COVID accusing you of doing that and you
having to defend that, right, you having to just say, hey, listen,
I've been in your community at that point in my
career for over a two decades about and I've been
treating you and your family members for heart attacks and

(12:55):
strokes and appendentitis and any number of emergencies, and all
of a sudden, you think I'm trying to do something
to you against your will or something that may harm you.
I mean, it's sort of a gut punch. I think
there's been quite a bit of burnout in the field,
both with physicians and with nurses and other allied health professionals.
So that's been a real challenge. I think when it
comes to abortion care, I mean m talents. The Emergency

(13:17):
Medicine Treatment of Active Labor Act came around in nineteen
eighty six, signed by a Republican president, Ronald Reagan, and
that basically says, you can go to the er with
an emergency. We will not ask you your insurance status
or your ability of pay, and we will treat your emergency.
And if that emergency includes bleeding to death because you
are having a miscarriage or an incomplete miscarriage, even if

(13:37):
it still has a faint heartbeat. In some of these states,
like you said, Georgia, Texas, others, women have died because
attorneys general and prosecutors have said we're going to prosecute
doctors who provide basic emergency care. It's terribly disheartening, and
it's driving doctors of all stripes, but certainly Obgyan's out
of these states. These are becoming Obgyan deserts sor of

(14:00):
hope that I see is that it has inspired many, many,
many doctors to become active and to become activists and
advocates on behalf of our patients. Because we are put
in a privileged place in society. We work hard. You
go to school. But we all do fairly well in
our computerit use right, and we're in a position of
power in a doctor patient relationship, and we can now

(14:20):
use that to advocate on behalf of our patient who
frankly are just become victims of a system, victims of dobbs,
victims of the abortion bands in those cases without anything
they can do about it, right, I guess they can move.
That's an economic deficsion for some people. They can go
to another state to get care. But many folks who
are the poorest among us, they can't do that. They

(14:42):
can't take off of work, they can't afford the cost,
you know. And so we have seen a massive upswing
and activism trump physicians on behalf of patients, certainly in
our organization and other organizations. And we've seen those voices
come out in Unison pushing back against the NCALA crisis
that we what we had when the Supreme Court finally
did punt it back. It's still not settled, right, but

(15:04):
at least MTALA is still intact in Idaho and Texas.
We've seen that activism come out in COVID where doctors
giving testimonials on Twitter and Facebook and Instagram. And going
on TV and telling the stories of what we're seeing
so that folks can see what's going on out there.
And again it's on behalf of our patients. It helps

(15:25):
us for sure, because the practice of medicine's a lot
better when you know you can actually help people. But
it really is in service to those folks that come
to us in the broken system in some ways and
just are asking us to help them.

Speaker 1 (15:40):
What kills me is that you take an oath to
do no harm as doctors and nurses and medical professionals,
and you enter into the field because you want to
provide care. And the way that politics has intervened in
such a draconian way for you to now have to
deny people care because of the legalities that you're facing

(16:03):
or the criminalization yourself and persecution in that way is
so unconscionable and terrible. And I wonder you know you
speak about your colleagues, you know some becoming activists and
advocating on behalf of patients. Do you ever speak to
younger doctors doctors that are just entering the field, are
in school right now, and if so, what are some

(16:25):
of their concerns as they enter into such a fraud
environment again with the sole purpose of wanting to help people.

Speaker 2 (16:34):
Yeah, I think it's It gives me hope because so
many of these people, I mean, medicine has become more
people of color, more women, trending younger right as people retire,
people age out, you know, more employees, less quote, business
owners that are positions, And as you look at the
positions in Congress, the majority of them are Republican and

(16:54):
they come from that business minded side of things. So
it gives me hope because they are the most vocal
and the most active. Now they have some constraints because
they also have student loans, and they have employers that
put sort of guardrails and what they can and fan do,
but they are among the most vocal folks that I see,
and it gives me hope for our practice of medicine,

(17:16):
for our patients, and for this whole system in this
country that we're going to move in the right direction.

Speaker 1 (17:21):
What do you want to tell people and say to
people who oftentimes don't necessarily, unfortunately, we don't really think
about our health care until something goes wrong. We don't
come from a culture of prevention, We come from a
culture of mitigation. That is generally driven by pharmaceutical companies
and their desire to make money. And so I wonder

(17:42):
what you say to people as again, healthcare will continually,
I feel, beyond the ballot, whether we're in an on
season for a presidential or an off season. So what
advice do you offer to people as they try and
continue to navigate are very fraught and imperfect system.

Speaker 2 (18:03):
I think, you know, from the political standpoint is that
healthcare has been politicized, which can be bad. But the
fact that we recognize it as a political issue, that
there are very clear differences between the two parties. Even
before trump Ism and Donald Trump, you know, there are
very clear differences starting with Reagan in the eighties, allowing
the privatization or more privatization of healthcare and things like

(18:27):
high deductible plans where people get insurance that is kind
of insurance if you have enough money to pay, you know,
four five thousand dollars when you need something done. But
for many people it's like having no insurance at all.
And that's the reality of where we are. I think
that the sooner we all recognize it, it is a
political issue. It is on the ballot. Every couple of years,

(18:47):
it's on the ballot in states. I know, our organization
has worked in states like Minnesota and Colorado pursuing prescription
drug affordability boards to lower the costs of prescription drugs
in these states. And you know, we work with govern
the Walls in Minnesota and got that pass and have
a board there to bring down costs. And it's unfortunately
become an extremely partisan issue. I have never been a partisan.

(19:11):
Organization is nonpartisan, but it's impossible to not state the
obvious and that you know, the Democratic Party has done
far more to bring down those costs of insurance, of healthcare,
of prescription drugs, and the Republican Party seems to want
to bring us back to an era where it's everyone
fighting for themselves. I've once heard my congressman say around

(19:32):
the time of ACA repeal efforts in twenty seventeen that
he thinks people should have skin in the game. And
I actually met up with them at a town all
and said, well, do you realize were our people. This
is literal flesh and blood. This is what you're talking about.
Having skinned the game for them is legit, and they,
unfortunately haven't ever put themselves in the position of somebody
who's looking at going to the er having chest pain.

(19:54):
I had a patient come in five days after starting
to have chess pain, had completed a heart attack and
was already in heart failure. We had about fifty percent
of their art function lab. Had they come in right
at the beginning, we could have gotten them off from
gotten a balloon, opened up an artery, and gotten them
back to normal. But they said, well, you know, not
having insurance, this is a big cost. Unfortunately, now they've
you know, someone now will end up on disability. They'll

(20:15):
get Medicare from that. You know that fifty some drill person.
This is pre ACA days. This is two thousand and
eight or nine somewhere in there. That's just the reality
for way too many people. I've had people tell me, well,
I sat out in the in the parking lot for
a while deciding whether or not I should come in,
but it got bad enough I decided I had to
come in. You know. So those are the people that

(20:36):
I'm looking out for. That I think so many of
my colleagues are looking out for. Definitely, now a majority
of physicians kind of in that camp of out there
fighting for voting for expanded healthcare you know, depending on
the specialty, it goes up and down a bit, but
it's probably I think I saw a couple of years
ago for the first time it's more than fifty percent
are kind of leading, voting and advocating on the side

(20:59):
of Democrat at policies. That's a shift and that's just
the reality we see every day that's caused the shift
that way.

Speaker 1 (21:07):
Well, I can't thank you enough, doctor Davidson for your work,
for your advocacy, for the use of your platform to
speak out and encouraging others to do the same. We're
living in extraordinary times and it is it is good
every once in a while to talk to good people
that are trying to move us in the right direction.
So really appreciate you.

Speaker 2 (21:29):
Well, I appreciate that, and I appreciate having the time
to talk with you.

Speaker 1 (21:32):
Thank you. That is it for me today. Dear friends
on Woke af as always, power to the people and
to all the people. Power, get woke and stay woke
as fuck.
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Danielle Moodie

Danielle Moodie

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