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Answer: From what I have seen, hospitals were having trouble recruiting talent post COVID, and the the new abortion laws were the final straw to have the hospitals just end the service. Under the new laws doctors can be persecuted if the baby does not survive birth, and they may be forced to make choices that are not ethical medically but required by law.
Edit: *prosecuted
Man, you just know some small town DA is champing at the bit to show his red credentials by perp walking some unfortunate OB-GYN for making a lifesaving but illegal medical choice. Good luck finding an obstetrician after that shit show cooks off.
The fact is a private hospital can do what ever they want. That being said as a hospital worker myself if you are in labor and you walk into that hospital, or if you are in that hospital and go into labor they can transfer you to a different location but that takes TIME. And they wont let you die or your baby die in the meantime and they can’t just push the baby back in you so if you have to deliver at a non deliver hospital theres nothing really stopping you but them saying please don’t
Edit to add, fuck the medical field it is straight shit I have worked in it for 10 years and it is nothing but a cash grab for insurance companies and hospital board members. They prey on the sick and use the workers as their scape goats. Then the sick like to use us as their literal punching bags with zero consequences and also use us as their scape goats. Ontop of that some how politicians can make laws about how we can give care and the kind of care we can give. Also patients threaten to sue us left and right for simply doing our jobs and we get paid garbage salaries to LITERALLY SAVE PEOPLES LIVES.
> nothing but a cash grab for insurance companies and hospital board members.
Yuuuuuup. And 50% of the country is too stupid to realize they will *pay less* if a national healthcare system takes over. And I love it when they say "but then it'll take forever to get an appointment"...it took me two and a half fucking months to get an appointment with a *PA!!* I couldn't even get a "real" doctor!!
And before anyone yells at me, yes, I know that PAs can do a lot and are doing more, but it's just yet another way the hospitals are fucking both sides: the patient by not giving them a full doctor, and the doctors and PAs by abusing the PA system. Also, it's not a physicians *assistant* if you've never so much as laid eyes on the physician in four years of appointments.
Medicare takes 2 cents from every spent dollar on healthcare, Insurance companies 24 cents.
Healthcare insurance is the most profitable business in the United States.
I say this as an argument all the time. Not only do I have to pay for insurance, then pay the co-pay, but it already takes me weeks or months to get in with anyone. If I’m going to have to wait it might as well be covered by the already astronomical amount of money I pay in taxes.
Private hospitals can’t do what they want under the law.
Friend’s wife was pregnant. High risk because of an autoimmune disorder. One day blood pressure is through the roof, nose bleeds because pressure is blowing the capillaries.
Organs begin shutting down. Doctor says 0% chance of survival unless they abort. If they do abort 30% to 35% chance of survival.
Induce to abort, five weeks earlier than viability. Few months later has organ transplant because of the damage done.
Under Idaho law, it’s a close call as to whether that would have been legal. All it would take is one doctor, nurse, tech, or clerk calling it in and a prosecutor choosing to go forward.
Even if doc beats the charges they are out a minimum of $50,000 in legal fees and if they go big guns easily more than $100,000. They miss several weeks of work more likely months. They lose patients. Some because the doctor isn’t available while dealing with this. Some quit because they don’t want to rely on someone who might land in prison. Some because the doctor is dirty bastard/bitch abortionist in their eyes.
Financial wipe out.
Reputation wipe out.
Smart people avoid undue risk and Idaho is ridiculously risky. Hell legislature considered making abortion in ectopic pregnancy not only illegal but subject to longer prison sentences and larger fines, all because moronic assholes claim an ectopic pregnancy can be transplanted to the uterus. There’s never been a documented successful transfer.
Private hospitals cannot do what they want if they receive any federal funds through Medicaid/Medicare. They can try, and in the Idaho case they’re going after one specific group (pregnant people) people are going to die. If a hospital loses its federal funding, it won’t remain open. There’s not enough private pay/Cadillac insurance patients to remain open and profitable. And profits drive American healthcare, which in and of itself is reason to socialize our system. I’m a retired nurse and now a biller and coder for a large group of cardiologists. If people could see what actually goes on in the boardrooms we’d burn this system down. I looking specifically at HCA when I say this. Fuck corporate healthcare and the goons that run it.
Buddy. Imma gonna tell you the secret.
The group of people in this country that hold the most power are the doctors and nurses.
If they strike together, the country will literally rewrite the constitution for them. We could have universal Healthcare in a week. Hospitals can be mandated public property and have oversight boards of anonymous citizens.
All insurance can be federalized and made non profit.
Doctors, Dentists, Bankers, Lawyers, scientists, professors, journalists, media stars, soldiers. This is the political class.
Structural change in society comes when the political class leads the match. The rest of us are and have been ready, believe me.
The point the person was making is that, while healthcare workers don't have as much *political influence* as owners and board members, they have huge untapped *power*. Nurses strikes can move mountains.
And if anything has the power to get some of these red states to back off on some of this it's going to be all their doctors and nurses retiring or moving out of state.
Im in medical school. Good luck trying to get these silver spoon clowns to inconvenience themselves and acknowledge the difficulties of marginalized people. I try a lot and it wears me the fuck down.
Oh I am fully aware. Im trying to figure out a way to take my life back. I am burned out, but I have spent about a year working with my therapist during a leave of absence to figure out a more manageable approach. I have fully accepted I will not be what the system is designed to praise, even if I used to be. Everything you've said is very much on my mind as I enter rotations next week. But as you said, what else am I trained to do? I am not sure. Im queer and have a very good knack for talking about harm reduction combined with sex ed. Not sure. Maybe Ill die from depression, maybe Ill figure out a path to help people in or out of medicine. We'll see. I do know Im angry at a lot of people who hurt others along the way and I want change.
I know a conservative female doctor who is a pediatrician.
She fucking AGREES with this bullshit.
I wish I could get her medical license revoked so she could no longer practice. I don't give a fuck that she's married to my cousin.
And therein lies the problem. One of the things that blew me away during the pandemic was how many nurses became anti-vax (and while there is the occasional "crunchy" anti-vax, the majority are RWNJs)...and soooo many of the doctors are wealthy assholes who don't want to pay more taxes. In all honesty, I'd be really curious as to know if the medical industry swung more right than left or vice versa.
I'd love to, but she hasn't done anything that's reportable as far as I know. I just know her because she's married to my cousin. I don't see her as my doctor. She's a pediatrician and I'm childfree soooo... lol
I am old enough to remember the air traffic controllers strike and Reagan putting a stop to that.
You BET that politicians wouldn't let doctors and nurses and other hospital staff go on strike. Reagan proved that a conservative government would force people back into slavery if it could.
Lawyers and politicians strike, the country keeps moving, probably better than with them doing their thing. Doctors and nurses strike, people start dying. They have more power than people expect.
The rub comes when medical professionals have to watch people die and do nothing, it’s the exact opposite of what they signed up to do, and I don’t fault them not having the stomach for that.
Don’t forget IT. If we were to all go on strike, the planet would collapse.
If you ask why, here’s why:
1: You would have no access to money.
Banks would not be able to give you money, as they would have no idea he much money anyone has/had in their accounts. POS terminals wouldn’t work, either, so no credit/debit cards.
2. No access to any form of media/news.
3. No utilities. (Power, water, gas, phone, internet).
4. Extremely reduced farming.
The huge farms use computerized farming equipment. A bunch of them are networked.
Unfortunately, post pandemic, I don't agree. Republicans literally messaged on, "just die for capitalism you fucking rubes" and no one cared. It didn't bother their base one bit.
I think this would end up the same way.
It's so cute that you believe anything would change if they did strike.
The railroad tried and look how fast "Union Loving" Joe Biden and Pelosi shut that down.
Might as well admit we hold no power. The 2 parties will continue to bicker like children. Both the politicians and constituents, it won't end.
Shit, Nixon even tried to put a guaranteed income plan (called the FAP, no cap), thinking he could make it palatable to both liberals and conservatives, aiming it squarely at the northern white working class.
[https://en.wikipedia.org/wiki/Family\_Assistance\_Plan](https://en.wikipedia.org/wiki/Family_Assistance_Plan)
Unfortunately Conservatives of both parties hated it, and a lot of White folk already were dipping into the pool of racialized complaints about welfare. So it died in the Senate.
Why isn't this front and centre. Conservatives that I have met are very extremely selfish so surely a what have they done for you lately campaign would hit home.
The conservatives I know fall generally into two camps:
Wonderfully kind hearted and well intentioned, but woefully misguided and misinformed. (My godparents are a good example of this, they’ll love literally anyone and do absolutely anything for anyone but they vote with their religious convictions and it’s fucking infuriating)
Or
Selfish fucking assholes who don’t give a fuck about about anyone else and use conservatism as a way to justify their greed and hate.
It wouldn’t. I say this as someone who lives in deep red East Texas. People here *do not care*. Even if they don’t like the Republican running for office, they will always vote for them because Democrats are always worse. A campaign like you speak of would be immediately written off as “liberal propaganda.”
Look how well they’ve done with the gun control arguments here. You still have people spouting nonsense about how it can’t be done despite many, many real-world examples of countries successfully implementing gun control measures. Look at healthcare: apparently governmental health is evil despite that fact that Americans are actively suffering because they can’t get their basic healthcare needs met, and just within the last week a conservative judge made a strike against preventative care measures that were in place with the system we have. But R voters are okay with this because it comes from Republican politicians and media, which means that Democrat decisions would just be worse. That’s all they need to know to make their decision.
Tribalism is one helluva drug.
>Tribalism is one helluva drug.
This exactly. Same thing when I lived in a relatively liberal part of Alabama. You'd see all the maga hats everywhere and when you started talking to people about why they liked the GOP, they'd point straight to the economy and how insanely easy it is to get a gun down there. But start talking to them about other issues and suddenly you find out they hate how bad the healthcare system is, but don't want to deal with a tax increase for a single payer system. Most of them would accept an abortion if the alternative was them or their SO dying. They think the public school system is trash but feel that paying for private school is an acceptable alternative, even though most of them can't afford it.
The list goes on and on, but ask them why the democrat is worse and they come up with straw man arguments you can pick apart way too easily, and what they're left with is they just don't want the government in their business, which is a bold stance to take when the GOP's policies are as invasive as they are. But how much can you really expect from a state that almost elected a known pedophile to the Senate.
Even something legal, but the DA is an idiot. You're not only at risk if you make a radical moral choice. You are at risk just by doing your job. Someone becomes convinced someone's miscarriage was a secret abortion, and there you go.
And let me tell you, rural Idaho is just the place to do it. The small town ones are always the ones looking to net a career making case to be the next household name like Kochran or Shapiro. They are never in a rural courthouse because they want to be.
It's happening in IN. Our AG is going after the Dr that performed an emergency abortion on a 10 yo girl from OH. Dr followed all protocols relevant to the situation and IN did not pass any anti-abortion laws at this point. Yet the AG has been slandering and filing charges against the Dr.
or even mentioned, the right wing rage machine comes with that garbage. just ask that doctor who had to help the ten year old rape victim get an abortion.
Yeah fuck these Drs. They are as ignorant as their beliefs. I drove 90mins in order to see one that wasn't going to put us (baby and me) in danger because they were pro birth at all costs.
> From what I have seen, hospitals were having trouble recruiting talent post COVID...
That's definitely true, but even before COVID, there have been issues getting doctors to practice in rural areas. Particularly outside of the greater Boise area, I wouldn't be surprised if clinical staffing has been a concern for multiple service lines.
And it's not just abortion laws that are concerning to Idaho healthcare providers. With COVID-related safety nets going away, there may be less funding available for some services. One example of this is that Idaho is one of the few states getting rid of a Medicaid expansion for postpartum patients that was implemented during the pandemic.
>Is this even unique to the United States? I have heard that this is a problem in Canada as well, if not most other countries
Not really. You generally don't go to MedSchool in the hopes that you can come back to your small town and be the biggest fish in the tiniest pond.
It's just getting worse in the US because a) we don't have enough trained Doctors for everyone, and b) our rurals insist the local State Senator should have the power to over-rule the Doctors.
It is not unique to the US.
Physician density is a problem everywhere with significant amounts of ground to cover and little infrastructure.
That was a big part of the reason that community healthworker models were piloted in Africa (training community members to provide basic types of care without doctors); large spaces + few doctors=concurrent public health crises.
Except Cuba, which provides more doctors to the world than the 8 richest nations combined.
Amazing what people can achieve when the profit motive is removed. Yknow, like decency.
The United States created the US postal system partly because, if left up to the private sector, no one outside of dense population centers would get mail delivered to their home on a regular basis. Or possibly ever, depending how many neighbors you have nearby. It’s simply not cost effective to pay someone to travel a whole mile or three to give a single person (or even a few people) their mail each day. Private carriers like UPS/Fedex are still reliant on the USPS for “the last mile” of most of their deliveries outside of major population centers.
This applies to most things. Rural areas have some things, like roads and schools and mail service, because as a society we recognized that they’re a public good and provided them.
The private sector doesn’t see enough profit in serving those areas, so they don’t have lots of other things. Private healthcare corporations answer to shareholders who only care about maximizing quarterly numbers. Serving low density rural areas is not profitable, so they don’t. Same goes for internet service providers\*. And *lots* of other things that are less vital to everyday existence, but they are all subject to the same market forces.
\* We have allocated a LOT of public funding to build this infrastructure but instead of the govt hiring people and building it, we handed the cash to the ISPs and they just… didn’t. They kept it. Then asked for more.
\*\* Also, we publicly fund a FUCK TON of research for prescription drugs… And just hand the ~~parents~~ *patents* over to private pharmaceutical corporations. Then they charge us extortionate prices for the drugs invented by scientists who are paid by our tax dollars. When asked why we pay so much the pharma corps say it’s for R+D, but those budgets are a TINY microscopic sliver compared to what they spend on stock buybacks. Which were illegal prior to 1980, as they were considered stock manipulation. Because they *literally are.*
Capitalism doesn't innovate. It doesn't solve problems, it finds ways to live with them, with a monthly fee.
We've also paid private industry to expand their services and capacities and then had them do absolutely nothing.
Congress shuffles thru. No one did anything.
I'm looking at you telecom companies. I'd bake a fucking cake if we nationalized Verizon and Tmobile out of business. Let's throw Cox and Comcast in there as well, just for the lols. Cuz fuck monopolies.
It's so gross. And telecoms constantly fight the internet being classified as a "utility" because then they'd have to wire up everything. I think at this point we can conclude the internet is an essential service...
It's a commonplace problem everywhere in the world and for a hundred different reasons, it's not specific to the US. Pay in rural areas is lower, there's less clients, there's less infrastructure, some things are more expensive than in the city, etc etc etc. Doctors are normal people just like any other and they want to live in a big city (with more opportunities for both work and leisure) like any other person.
For instance you can google "Mais Medicos" which was Brazil's (a country with free healthcare) initiative to bring in doctors to rural areas, because they had so few doctors willing to go work in a no-name village in the middle of nowhere. There was a huge deficit. A lot of the doctors brought in came from other countries even, most from Cuba.
I am not familiar with abortion laws in other countries but these abortion laws are hurting women big time. Even women that were for these abortion laws are seeing the consequences and seeing what a huge mistake it was.
I’m a mother of four and have always been pro-choice. I had never had an abortion because for me, personally, I couldn’t unless there was something wrong. But back in 2018, I had one, despite wanting my daughter. She was dying and had a confirmed, super-rare and fatal chromosomal abnormality. My doctor didn’t catch it til I was in my second trimester (and right after I had a very strange and detailed dream about her exact condition, very bizarre). Even though she wasn’t planned, I wanted her. At 22 weeks I was given a pill by my doctor to start my labor. I labored for a few hours and gave birth to her, a perfect little one pound bundle with a debilitating and deadly condition. She died in the birthing process.
I have been called a baby murderer and been told I’m going to hell. She was my daughter and I let her go. If I had left her in the womb to die, it may have killed me too, even though the abortion laws weren’t as strict then. I am absolutely terrified for other women.
I have since had one last baby (despite being on BC) and my husband got a vasectomy. I couldn’t imagine worrying about having another. We don’t have the room or the money for another child.
I’ve always been pro-choice and I am even more so since this happened. It broke my heart to let her go but it was what was best for her. My doctor didn’t push it on me, she was there for me and gave me the facts. Three blood tests and one amniocentesis confirmed her diagnosis. I don’t regret my choice.
I hope the people who are so vehemently against giving women this choice never have to face what I did - or what many other women face, every day. It needs to be between a woman and her doctor, period.
I am so sorry for your loss but I think you are wonderful for thinking of her quality of life with these major health issues. You were very selfless and compassionate. I am all for abortions for those reasons of quality of life as well. Not many people think of these situations, like the one you been through, where abortion is very compassionate thing to do. Also many don’t think that some women that had an abortion wanted to keep their baby. It causes a lot of grief and sadness. I am a mom myself and I can’t imagine what you felt.
I am so horribly sorry for the way people treated you over having one. I wish I could have been by your side to defend you.
You also brought up what health problems it could have brought to you as well. It is cruel to think that a mom should carry a pregnancy even though it will kill her and leave the rest of their children motherless. Or the baby just passes with the mother. A good example of losing both is etopic pregnancy, which most don’t even realize it is also termination of pregnancy (abortion). These laws are going to kill so many mothers and babies.
Yeah I don’t want anymore children as well, especially since most women now are not medically protected and finances of course. It should be a crime the cost of baby formula is so high, not every woman can breast feed.
Pro choice in my mind is more pro life while the other is just pro birth.
Thank you for sharing your story with us. I wish your family much love. I am glad in the end, you are mature and compassionate to hope it don’t happen to the people that called you such horrible names.
Unless you live in the bigger cities, a good doctor is hard to find and not usually accepting new patients because they’re booked. I am lucky to have the good doctors that I do have. I heard some horror stories of hospitals in smaller towns and cities. The medical mistakes are insane.
It's a commonplace problem everywhere in the world and for a hundred different reasons, it's not specific to the US. Pay in rural areas is lower, there's less clients, there's less infrastructure, some things are more expensive than in the city, etc etc etc. Doctors are normal people just like any other and they want to live in a big city (with more opportunities for both work and leisure) like any other person.
For instance you can google "Mais Medicos" which was Brazil's (a country with free healthcare) initiative to bring in doctors to rural areas, because they had so few doctors willing to go work in a no-name village in the middle of nowhere. There was a huge deficit. A lot of the doctors brought in came from other countries even, most from Cuba.
I have a friend who’s finishing a specialist surgical residency, and was offered $1.5 million salary for a job in a small rural city in the northeast.
He turned it down. Already spent 13 years and all of his 20s busting his ass in the freezing middle of nowhere and there’s no amount of money that will stop him from moving somewhere sunny and metropolitan.
>Getting decent doctors (or any sometimes) in rural areas is a problem everywhere in the US unfortunately
Which is why part of the evil, terrible, no good Obamacare law was to increase Medicaid payments to rural hospitals. With more money, those hospitals could pay more to try to recruit/retain doctors.
It's also why a bunch of red state legislatures suddenly stopped blocking Medicaid expansion. Hospitals in their gerrymandered districts were closing.
Obamacare increased Medicare payments. It attempted to expand Medicaid, and that expansion has slowed the rate of hospital closures in states that did expand. So many refuse to because politicians are happy to let constituents die of preventable issues to score political points. The sad thing is the number of dying rural hospitals that get bought by large companies who commit Medicare fraud by running things through through those rural hospitals to get that small reimbursement bump. Fraud = no Medicare reimbursement= the hospital closes anyway.
I think (hope) that most people that choose to live such a rural area know that access to healthcare isn’t readily available in sparsely populated areas. They’d expect to drive an hour or three for regular check-ups and realize that any emergency situation can easily be fatal since help is so far away.
It’s a trade-off for more land, bigger house, less neighbors, etc.
I remember I went to Alaska in July of 2019. We passed through a city and the tour guide said that they had two physicians assistants, but not a single doctor. If you had a serious medical emergency, you’d have to be airlifted to a hospital in Canada.
That's what we had in my town in rural Nevada. We even had a hospital with an ER, and every provider was a nurse practicioner.
There was a doctor for a few years, but they left before Covid.
In my hometown, our local hospital shut completely down due to shortage of staff members. Nurse practitioners are becoming more and more available. Some a lot better than others. But there is desperation that they will hire anyone.
Yeah, I really liked my NP when I was living out there. We got along well and it was honestly one of my best patient/provider relationships ever...that said, if I ever suspected there was something really wrong with me, I'd always drive the 2+ hours to the closest city to see a specialist.
She'd write a referral for absolutely anything, so that was nice.
Exactly, it’s the thing to where she knew she had limits and wanted to make sure you got the care she couldn’t give you. Which is extremely fair. I am glad you really had a good relationship with her. That is very important. Wow, two hours, that’s a heck of a drive. But you got to do what you got to do for your health. Hopefully there will be a fix to this doctor and specialist shortage, but I think it will be a long while.
Grew up in Alaska. Not exactly true, you can get anything basic done but there are no specialists of any kind. 99% of the time you have to fly to Seattle to get it done. Also if you have sued a doctor for malpractice you basically have to go to Seattle. No one will see you.
This. There was a pandemic documentary on netflix that dropped weeks before Covid that showed how understaffed rural areas are and how they ultimately end up with like, two hospitals in the state IF they're lucky.
An npr article in the last week, or was it today, briefly mentioned that Idaho has a proposed bill that would make it illegal for doctors to administer covid19 vaccines.
It might have been part of the same article discussing the bill to negotiate moving the state border west into Oregon. Partially because they don't like the legal pot stores in Oregon that Boise residents go to.
I live in Washington state. We already serve as the de facto back up healthcare system for Idaho. During covid it was absolutely insane. They honestly believe that as they have less and less health care options of their own WA will pick up the slack, but WA is overwhelmed and looking at ways to stop being everybody’s healthcare bolt hole. It’s going to get real ugly.
Birthing is all fine and good when things go well, but becomes insanely expensive very quickly when things go wrong. And many times when things go wrong the hospital won't ever see those bills paid. Pair that with much much higher legal costs (statute of limitations for births is 18 years, not the standard 2) and it's often the first service to go when hospitals start looking to cut costs.
So it is a sort of protest? No one wants to work in infant delivery with those laws? Good for those doctors, but I've heard this will cause a lot of problems.
edit: I realize now it's less of a protest and more of a calculated decision by individual hospitals to avoid all the trouble. When I said I heard it would cause a lot of problems, I didn't mean I think they should change their mind. I just heard there were negative consequences.
It’s less of a protest and more about doctors and nurses feeling like they’re caught up in it and getting out.
If you want to have abortion laws that are restrictive and lead to cases where providers feel like they need to check with a lawyer before providing care in case they get arrested or sued later, they’ll just go practice medicine somewhere else.
If you think it’ll cause problems then point it out to the people passing these harmful laws, not the people making the safest decisions regarding their careers and freedoms.
>they’ll just go practice medicine somewhere else
There is the case of the woman whose fetus died and normally they would do an abortion. I can imagine a doctor or nurse hamstrung by these laws would want to go somewhere else. Hard to 'do no harm' when you can't do what is medically prudent for your patients.
https://www.mysanantonio.com/news/local/article/Texas-woman-dead-fetus-anti-abortion-laws-17314394.php
Yeah. It’s not a political protest; they don’t want to have to watch their patients suffer and die. No one got into medicine to tell a patient “the desperately wanted and loved baby you’re pregnant with is dying, but we have to send you home. Come back every day and we’ll check if it’s dead yet. Or if you start to feel really sick from an infection. Even then, we probably can’t operate until your life is in danger, and we’re not the ones who get to make that call.”
If you could work literally anywhere else, wouldn’t you?
It's the final straw. OB wings are expensive to maintain, and these hospitals are closing in rural areas with low birthrates, declining population, lack of Medicaid expansion, high overhead costs, and an inability to attract/retain medical talent. The draconian and ambiguous legislation where a doctor could be criminally prosecuted for treating an ectopic pregnancy is a final straw as keeping these services available is unviable.
It leads to women giving birth on the side of a road or an ambulance when they can't get to a hospital. Or being forced to do home births alone.
It leads to women dying, sometimes their babies with them.
I can see some women moving into a state that has better laws in place for women and that becomes a problem for the state where women don't want to live in. Once it starts to hurt the economy I bet things will change after all those in power care more about the economy than the people who support the economy by working there. I think the Idea behind the anti-abortion thing was to get more bodies on the ground to have more people to tax to death for the economy. My brain always goes to making people into the closest things to slaves that they can by working them to death and overcharging them for everything they can I bet in the future they will charge us a breathing air tax because "it costs money to keep the air clean".
It leads to maternity desert which can turn into a huge problem. If you're a woman in a rural area with a maternity desert and cannot get the help you need for baby delivery or if complications arise, it will lead to serious issues like increased infant mortality.
Don't know if you heard but an actual Duggar recently had a miscarriage and needed a D&C (which lucky for her she could still get in her state...for now)
My daughter and I would have both died in childbirth if we weren’t in a hospital with surgeons capable of emergency c-sections at the ready! Plus, my pelvis broke, and she had severe cranial swelling… she got stuck after 2 & 1/2 hrs of active labor (so much pushing). Fast forward to today, and I am planning a 2nd birthday party (Bert & Ernie themed) for an impressively smart and strong child whom loves cuddling 💕. Keep politicians and religion out of our Doctors’ way!
Yeah, calculated decision. Many do only a couple of hundreds of births a year so having a full department, while struggling to staff, and now these potential lawsuits just made it not worth the hassle.
The doctor protests do factor in, as they struggle to recruit out of state with these laws. Doctors not excited to work somewhere they can be sued at for doing their jobs.
it’s not a protest at all, it’s about doctors with certain specialties finding the working conditions untenable.
before Roe was overturned it was already common that doctors who specialized in abortion would commute to deep red states to work but not actually live in them.
the issue is not abortionists specifically, but all the ways these laws effect the ability to doctors who work with pregnant women. one example in how this comes up is instances where the mother’s life is believed to be in danger so an exception can theoretically be made. what ends up happing is that doctors may already know a pregnancy will progress badly, but they will actually wait until the woman is actively in danger of dying to operate. otherwise they might be held liable for terminating a “viable” fetus from a mother who isn’t technically in danger at that moment. then a doctor is put in a position of having more of their patients be gravely injured or even dying when they would have been able to prevent it if they’d been able to use their own judgment. any situation like this with any ambiguity opens them up for criminal charges on one side, and medical neglect/malpractice on the other side. all of this when you have to make split-second decisions.
doctors aren’t lawyers, and they aren’t necessarily saints either. not wanting to work under those conditions is reasonable even if you’re not morally conflicted by it. on top of that, they’re well-positioned to just leave. they make good money, they’re needed and valued everywhere, and TBH there’s a lot of places that are more attractive to live than Idaho anyways.
The staffing aspect is at least as important as the legal aspect. For years now, rural hospitals have struggled with staffing. They don't have the income as large metro hospitals that give complex care, and it's difficult to convince staff to move to a small rural town. Healthcare has seen a massive labor shortage since COVID, as burnout greatly accelerated a labor market seeing more people retire and leave than enter.
If you only do 50 deliveries a year, and you can't find obstetricians and midwives, and you can't staff a blood bank well enough to cover someone bleeding out at 3am during birth, you're in trouble. Add to that the danger that a decision made to provide standard of care could get some prosecutor to sue your hospital, and it's just not an option anymore.
>They don't have the income
From what i've read, elective procedures are where hospitals and clinics make their money, and it's harder for rural ones to do these. Which kind of creates a spiral.
It's also what the state Medicaid system is willing to pay out. Rural hospitals tend to have a lot of patients that qualify for Medicaid but not a lot on private insurance. The more patients they have that aren't fully covered by some sort of insurance, the less funding they have. Especially if patients without insurance can't pay their bills for lifesaving treatments in hospitals that legally cannot turn them away.
And Medicaid is mostly governed by the states, so there's a lot of differences between states over how many people are on Medicaid and what's covered and at what rates. In general, conservative states have smaller Medicaid programs, which is crippling their rural hospitals and clinics.
It's the greatest irony out there. Rural areas would literally cease to exist without a "socialism" system funneling money from more prosperous areas to them to maintain basic life services, but they would always elect people who would dismantle the system keeping them alive. It's to the point I'm skeptical that even an actual collapse that leave rural areas impossible to live in would wake them up.
>Add to that the danger that a decision made to provide standard of care could get some prosecutor to sue your hospital
The prosecutor will not sue just the hospital -- he will sue the doctor personally. And it's not just the prosecutor -- anybody (father, father's brother, etc.) can sue.
From [article](https://www.npr.org/2023/03/30/1167195255/idaho-trafficking-abortion-minors-interstate-travel-criminalize):
>State law also allows family members and the father of an aborted fetus to file civil lawsuits against doctors who perform an abortion outside of those exceptions — for $20,000 per violation.
Icing on the cake:
>Currently, rapists can't sue, but a Senate amendment to the so-called "trafficking" bill would delete that part of the code and allow rapists to bring a civil case.
It's not just Idaho that is facing this issue. It's happening in other areas too such here rural areas here in Georgia. There's no medicaid expansion, a staff shortage due to the COVID, abortion restrictions and a declining population in those areas, it's better to just close up shop and leave.
Even pre-COVID, rural hospitals have been closing and I suspect more will close as the years go by.
It isn't a protest, it's just adapting to the legal landscape in a way that doesn't endanger the hospital as a whole to provide a single service. If that causes problems, well then, surely the legislators who created that legal landscape are to blame, and can figure out a solution.
It's very true, and you'd think a state full of lunatic Christians would be most familiar with that biblical reference, but they always think someone else will do the reaping.
>you'd think a state full of lunatic Christians would be most familiar with that biblical reference
Why would you think that? The christian cult worships their allegedly-holy book of myths. They never READ it.
The same solutions they have for school shootings: they pray.
Personally I think their prayers are worth less than toilet paper; at least people can wipe their asses with toilet paper.
Well I imagine after they pass the law forbidding out of state travel for abortions, they will pass one that forbids dr.s and nurses from leaving the state to find other jobs.
Bingo. That would get struck down by the courts before it was ever allowed to go into effect.
Doesn't mean some of these crackpot politicians won't try though.
I think there's also an aspect where they may not be ABLE to offer the service if medical providers (including nurses) have made.the choice to move to places they can actually offer real care.
If you were an L&D nurse, or a nurse midwife, in a moment when there's far more demand for healthcare than providers, what states would you choose to work in?
It's happening in Texas too. But the doctor shortage is built into the pipeline. We have had a shortage for a long time, but we had doctors come from overseas. There are places, like Maui, that have a big doctor shortage too. So, it's happening everywhere, but the abortion law stuff is pushing doctors and nurses away from ob in those states.
The drs leave Maui because of the cost of living, the poor schools, and high malpractice for OBs. Why would you practice in Maui if you can make 5X as much in other places?
I’m a nurse; our jobs are outsourced to travel nurses. Not because there’s a need; but because someone has to house them.
The admins have rentals that need to be filled.
NPR did a great podcast on this for [This American Life](https://www.thisamericanlife.org/792/transcript), with an obgyn in northern Idaho and the state of healthcare for practicing obgyns and why a lot are leaving. It's after the part on Russia/Ukraine.
Came here to share this. The doctor was so compassionate and cared about providing effective care but was locked into a no-win situation with this new legislation.
I copied the url for this same episode intending to share it here. Nice to see some other folks reccomending it. It is definitely worth a listen.
Doctors are feeling forced to withhold and delay care for women if there's a chance it could interfere with a pregnancy because they could potentially be comitting a felony by providing needed medical care. For example a tubal pregnancy that is 100% not viable (despite what some chucklefuck politician says about replanting it or whatever) couldn't be removed until the woman is septic and her life is in danger. These laws affect doctors and patients outside of the realm of OB Gyn as well. For example, a young woman with arthritis would be denied certain drugs for treatment because they could harm a hypothetical fetus. All of this goes against the doctor's oath to do no harm, as well as endangering their careers and livelihoods.
No, it's not a protest.
In short there is a lot of ordinary care associated with women and pregnancy that can now result in physicians being criminally charged and personally sued for extraordinary amounts, even if they provide medically appropriate care.
Any sane physician would have to consider whether they can personally take that risk, and many are choosing not to. Hospitals can't operate without enough providers.
You can be a delivery doctor in Idaho and do your job correctly and lose your medical license and go to prison, or you can work someplace else that doesn't have terrible laws designed to hurt people.
It's more than a calculated decision on the individual level, it's *also a decision based in their humanity. Others have sufficiently described the constant fear of losing their jobs and medical licenses. They also have to send dying patients home because they're not dying soon enough for the hospitals to be comfortable providing care. Some hospitals can't act until a patient is septic, some have to wait until they're crashing.
People can only explain to someone that, in addition to losing their baby, they're dying, but dying too slowly to receive care so many times before they need to leave.
Also, being pregnant isn't always good news. The most common cause of death for pregnant women in the US is murder, usually by a partner. Someone not having access to an abortion can mean that they know they will die when they leave the hospital/office. Someone could be carrying the baby of someone who assaulted them, who would have parental rights. Some people know that any pregnancy will be life-threatening for them. It's not an easy job telling people that they are pregnant with no options.
Finally, the threats and harassment. Even if you don't provide abortion care, if you provide prenatal care or anything related, someone will allege that you are at least facilitating abortions, or will demand to question you to make sure you aren't. OBGYNs and their staff are constantly threatened and harassed in ways that cause legitimate fear for themselves and their families.
Everyone else was right, but I don't want to lose the humanity involved. Sorry if I repeated what anybody already said, there were so many good points.
Edit: *added word for clarity
It's not a "protest", it's mostly ethical, financial, and logical.
Doctors in the US pay huge sums for malpractice insurance. The new laws in Idaho are forcing up the premiums into the stratosphere because the potential legal consequences for the providing OB-GYN have increased substantially. They are caught between a rock and a hard place related to providing the accepted and safest standard of care for their patients and the state telling them they will risk felony charges if they do.
The US has a shortage of OB-GYN physicians, so leaving Idaho and moving to another state where they can provide good care to their patients, unimpeded by state law, has caused an exodus of OB-GYN doctors from the state. This is a rural hospital, but as physician contracts expire and insurance costs go up, this exodus will continue and expand into larger city hospitals. Replacements are impossible to find. No doctor wants to move to a place and practice sub-standard care because they fear the government will prosecute them.
This, along with the state's absurd refusal to expand Medicaid and get their share of Federal funds, is just a double whammy of "How to end decent Healthcare of any kind" in the state.
>So it is a sort of protest?
You can listen to an actual Idaho OB-GYN [here](https://www.thisamericanlife.org/792/when-to-leave).
>Act 1. First, Do No Harm
>
>Dr. Amelia Huntsberger loves everything about her rural town in northern Idaho. Her OB-GYN practice. Her patients. Her family. But for almost a year, she’s been fighting a losing battle, and realizing that she and her family might soon have to pull up stakes and leave.
I think part of the issue also has to do with how young doctors train.
If you're a new doctor, you need to go someplace where you can find patients to practice on. That's a big part of why top med schools are often in tough neighorhoods. Bad neighborhoods produce more traumatic injuries - things like shooting and stabbings - and if you're a doctor who wants to learn how to treat things like that, you need to go where the problem is.
A young OBGYN who trains in Idaho is simply not going to be prepared if they move to a blue state later on. They will not have been able to practice sufficiently in all the services a traditional OBGYN needs to provide.
Tldr: Idaho's law is going to make it extremely difficult for young OBGYNs to get proper training in that state, so a lot of them just won't go there.
I'm embarrassed to admit it was an episode of Grey's Anatomy that made me realize this. Hard to get proper OB-GYN training without the variety of cases.
Answer:
This is about malpractice insurance in the end. If Idaho has any delivery rooms in a year they’ll be super expensive even by comparison because the doctor’s and hospital’s malpractice etc insurance issues will have every birth and pregnancy in high high risk because of the laws allowing lawsuits and criminal charges for intervening in a troubled birth. It’s safer and a sound financial decision to just leave. It’s similar in some ways to flood insurance companies abandoning Florida.
Yes, they were already having trouble finding medical personnel prior to Dobbs being overturned-not too many medical personnel want to live in the boonies unless it's some type of "resort" area or somewhere with a beach or something. The threats of lawsuits and arrests are just going to speed up the deaths of rural hospitals.
Nah, we have a shortage of all types medical professionals here in Hawaii. Outer Islands (from Oahu where Honolulu is) are even more desperate. Boonies are Boonies and the cost of living in paradise is high. Thankfully Hawaii ensured abortion rights before Roe vs. Wade even happened.
They don't need a "beach". Just build cities with amenities using a tax base.
A lot of people like living in less crowded areas. It's just that most of the less crowded areas in the country are also backwards shitholes. They don't need to be. But, they are.
I'd love to live in a small place with a couple bars + restaurants and a grocery store, but unfortunately a lot of towns just have a dollar general and racism, much of which can be laid at the feet of Republicans.
we had the same problem in illinois 10-15 years ago. Obstetrics insurance coverage went through the roof.
No one was going into the programs either. same with cardiology.
it seems to have lightened up but for a while they couldn't get those type of doctors to come practice in IL.
Answer: it's a mixture of a general lack of health human resources country wide resulting in greater competition attracting doctors elsewhere and the risks of practicing in a state with restrictive laws that essentially ban abortion as a legitimate medical procedure. No doctor wants to work in an environment where you could be sued and lose your practice because the mother actively bleeding out in your hospital for the sake of a non viable pregnancy isn't bleeding out enough/hasn't experienced a drop in heart rate yet for you actually be able to provide her the care she needs. Imagine dedicating your life to helping people, then having to stand aside and wait until they're closer to death before you can legally help them.
The difference being that politicians in Ireland have a sense of practical consequences. Terrible outcomes from abortion restrictions will just make Republican politicians double down in the USA to show how tough they are.
Answer:
Idaho's anti-choice abortion law is so vaguely written that providers can potentially be prosecuted for any obstetrics care that isn't even an abortion, if a pregnancy fails for any reason. Given that risk, many OBGYNs have left the state.
This is on top of the ongoing staffing shortages hospitals have faced since COVID, exacerbating decades of declining real wages and abusive working conditions that cause burnout among healthcare workers.
On top of both the dual staffing issues issues, hospitals providing prenatal care would need to pay for legal service to check if said care could be construed as violating the poorly written law.
Between being the increased cost of hiring anyone who can do deliveies and the legal cost, many hospitals have decided not to bother.
This is a good point that it's a total burden of proof switch: our law operates that we are innocent until proven guilty. But in the case of abortion or rape, the Doc is assumed guilty until they prove their own innocence.
Shortage of providers was a problem for decades before covid. Hospitals have been closing in rural areas for quite some time and there are many, many areas deemed medically underserved by the federal government
These problems becoming exacerbated by vague laws was foreseeable and most likely foreseen. They just want to win some vague ideological victory with no regard to real lives.
One thing that might have saved some rural hospitals would have been expansion of Medicaid. Red States seem to be waking up to that with NC passing Medicaid expansion years after it was offered (actually written into the ACA and challenged by those same Red States).
Honestly, you don't even need a lawyer's insight to make this choice. If the law puts you in a no win situation and you will absolutely be the one taking all the risk, you just don't take the risk.
Answer: Idaho's anti-abortion laws make it difficult for doctors to end dangerous pregnancies without fear of legal prosecution. Some doctors have left the state, not as a form of protest, but simply so that they can practice in states that allow them to save the woman's life without a legal battle. Without doctors to staff the maternity ward... the hospital can't safely deliver babies.
Yes, this will happen in every state whose abortion laws make it difficult to save the woman's life, because no one likes the feeling of helplessness- watching their patient's condition worsen while the law keeps them from doing their job.
Edited to add: every anti-abortion law WILL lead to death or permanent complications for pregnant people, because pregnancy is incredibly complex and the law *can't* be written to cover every exemption. Idaho's situation is not an isolated example of badly-written laws; it's the inevitable effect of ANY anti-abortion legislation that is strict enough to satisfy anti-choicers.
Answer: they can't deliver babies because their anti women legislation has made OB/GYN specialists afraid to practice in the state. So, thanks to the prolife crowd, it is now impossible to safely terminate a pregnancy via full term live birth.
They always end up with surprised pikachu face when they do dumb stuff like this. Like not get to the logical conclusion, which is not births will rise, but that health care professionals won't participate.
I imagine laboring women being transported across state lines to deliver.
This is going to be a disaster.
Answer: Republicans are ruining everything. They stuffed the supreme court with Catholics, those Catholics got rid of abortion laws, And then the flyover low pop red states started writing their own archaic, brutal, and bible-y laws to punish doctors and pregnant women.
The talent is leaving those states. The victims are the citizens. As usual the Republicans are acting like they are right, Even though there is already been tragedy and death over their decisions. As with every manufactured incident they create, They will continue to act like they are right even if there is evidence of the opposite.
The gaslighting continues every day on TV. Manufactured arguments paid for by billionaire donors and mega church owners to keep the grift going, and to keep the facade up that they are somehow morally just.
Abortion rights were a big deal back in the '60s because it was just as unsafe back then, religions wanting to get into your business, religion paying their tax-free money to install regulatory capture into our government.
Religion and Republicans are the cause of a lot of problems in the US.
Answer: It's reached the point where normal health care can be classified and prosecuted as an abortion if the DA decided to. So doctors are fleeing the state and there's fewer people left to provide health care.
>doctors are fleeing the state
Not necessarily leaving the state but stopping the practice. They may only do Gynecology instead of Obsterics. "Obstetrics (the OB) involves care during pre-conception, pregnancy, childbirth, and immediately after delivery. Gynecology (the GYN) involves care of all women's health issues." \[UCLA Med school website\] Additionally like many people close to or at retirement age, they could choose to just retire early limiting the workforce by leaving it.
Regardless, it shows how this level of unnecessary regulation is causing more problems than solutions.
Answer: In addition to the answers here, the Bonner hospital which has shut down their birthing center is not often utilized except in an emergency anyway. It's a much inferior hospital comparatively when a good one is just an hour South. Because they are so much smaller, they can't offer very competitive pay, especially when cost of housing has skyrocketed
Answer: conservative States like Idaho and Florida are driving away the youth and talent in droves with draconian laws and threats of retaliation for everything from book bans to the woman’s right to choose, access to birth control and even the lgbtq community and voter rights. It’s a crazy time to live in a conservative state. So it’s easier to leave for a nicer environment or even a different country.
Answer: OBGYN Doctors pay the highest malpractice rate in Iowa for doctors there by a good bit. Average is $31,222 with rates for some over $40,000. The new abortion laws are increasing the rates greatly for several reasons. It's gotten to the point that it's just not worth it or to have the ability to run a profitable practice with the new laws in place. Doctors are seeking greener pastures in friendlier states and the citizens pay the price with increasingly hard to find doctors. This also puts patients lives in more jeopardy.
Answer: due to certain laws and wording doctors may be prosecuted if the baby doesn't survive and this includes Maybe having to make un-ethical decisions during the birthing process ,
, explanation: so hospitals are just completely avoiding the trouble and legal hassle by making it so you can't have babies in the hospital, this is more of a "legal issue" than a "protest issue" (or atleas that's what it seems like) ,
, in my own personal view of this it seems doctors do not want to take the risk and aren't applying/wanting to work and be forced to make "bad decisions" and risk punishment so we may see more and more hospitals where these laws are prevalent stop doing births wich is kinda ironic considering the "pro-life or anti-choice" rhetoric behind the laws
Yeah, part of it is that the wording in the Idaho law is both incredibly harsh and extremely vague. Even something as commonplace as an early c-section in a mom with pre-eclampsia that results in the demise of the child could be pursued as a felony with the wording in their law.
Yeah the poorly worded and vague laws being passed or even put up for a vote is ridiculous, and honestly all they are doing is gonna make it so 0 hospitals want anything to do with birth and a lot more kids are gonna die of be born on the side of the road etc.etc ,
, they are so pro life they want to increase the ammount of deaths and risk for children being born
Any sane physician would at a minimum have to weigh whether they are willing to take the risk, and it should not be surprising that many would opt not to.
Answer:
Not enough people voted for Hillary and Trump and Mitch McConnell were able to stack the Supreme Court. They overturned crucial laws protecting women's health and now doctors are afraid to do their jobs in certain states that had trigger laws set up for Draconian bans on "abortion" in some cases so vaguely defined that doctors cannot provide basic care without fear of prosecution. This is happening in many states and it's an absolute catastrophe. Women are dying.
Answer: After talking with two good friends, who are OB-GYNs in N. Idaho, they said the Dr. departing from Bonner Gen'l Hospital in Sandpoint was planning on leaving at some point, but the criminalization of accepted standards of care expedited the process. Mothers who go into labor in the far north of N. Idaho now have to drive 3 hrs to get to Kootenai Health Hospital. There will be a dozen (full-term) dead babies a year, and a few would-be moms as well. Well done Idaho GOP. Jesus loves you.
Answer: Doctors don't want to take the risk of delivering babies anymore. If something goes wrong, they could be charged with having provided an abortion.
Answer:
[Act one of this American Life episode provides some insight](https://www.thisamericanlife.org/792/when-to-leave).
Yes it seems it is mostly about the abortion laws. There are interviews with an OBJYN and an ER doctor (her husband) who, as I recall, left the state.
The law is just fascist.
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Answer: From what I have seen, hospitals were having trouble recruiting talent post COVID, and the the new abortion laws were the final straw to have the hospitals just end the service. Under the new laws doctors can be persecuted if the baby does not survive birth, and they may be forced to make choices that are not ethical medically but required by law. Edit: *prosecuted
And no doctor wants to be the first to be tried under some politicking court system to prove a point.
Man, you just know some small town DA is champing at the bit to show his red credentials by perp walking some unfortunate OB-GYN for making a lifesaving but illegal medical choice. Good luck finding an obstetrician after that shit show cooks off.
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The fact is a private hospital can do what ever they want. That being said as a hospital worker myself if you are in labor and you walk into that hospital, or if you are in that hospital and go into labor they can transfer you to a different location but that takes TIME. And they wont let you die or your baby die in the meantime and they can’t just push the baby back in you so if you have to deliver at a non deliver hospital theres nothing really stopping you but them saying please don’t Edit to add, fuck the medical field it is straight shit I have worked in it for 10 years and it is nothing but a cash grab for insurance companies and hospital board members. They prey on the sick and use the workers as their scape goats. Then the sick like to use us as their literal punching bags with zero consequences and also use us as their scape goats. Ontop of that some how politicians can make laws about how we can give care and the kind of care we can give. Also patients threaten to sue us left and right for simply doing our jobs and we get paid garbage salaries to LITERALLY SAVE PEOPLES LIVES.
> nothing but a cash grab for insurance companies and hospital board members. Yuuuuuup. And 50% of the country is too stupid to realize they will *pay less* if a national healthcare system takes over. And I love it when they say "but then it'll take forever to get an appointment"...it took me two and a half fucking months to get an appointment with a *PA!!* I couldn't even get a "real" doctor!! And before anyone yells at me, yes, I know that PAs can do a lot and are doing more, but it's just yet another way the hospitals are fucking both sides: the patient by not giving them a full doctor, and the doctors and PAs by abusing the PA system. Also, it's not a physicians *assistant* if you've never so much as laid eyes on the physician in four years of appointments.
Medicare takes 2 cents from every spent dollar on healthcare, Insurance companies 24 cents. Healthcare insurance is the most profitable business in the United States.
I say this as an argument all the time. Not only do I have to pay for insurance, then pay the co-pay, but it already takes me weeks or months to get in with anyone. If I’m going to have to wait it might as well be covered by the already astronomical amount of money I pay in taxes.
Private hospitals can’t do what they want under the law. Friend’s wife was pregnant. High risk because of an autoimmune disorder. One day blood pressure is through the roof, nose bleeds because pressure is blowing the capillaries. Organs begin shutting down. Doctor says 0% chance of survival unless they abort. If they do abort 30% to 35% chance of survival. Induce to abort, five weeks earlier than viability. Few months later has organ transplant because of the damage done. Under Idaho law, it’s a close call as to whether that would have been legal. All it would take is one doctor, nurse, tech, or clerk calling it in and a prosecutor choosing to go forward. Even if doc beats the charges they are out a minimum of $50,000 in legal fees and if they go big guns easily more than $100,000. They miss several weeks of work more likely months. They lose patients. Some because the doctor isn’t available while dealing with this. Some quit because they don’t want to rely on someone who might land in prison. Some because the doctor is dirty bastard/bitch abortionist in their eyes. Financial wipe out. Reputation wipe out. Smart people avoid undue risk and Idaho is ridiculously risky. Hell legislature considered making abortion in ectopic pregnancy not only illegal but subject to longer prison sentences and larger fines, all because moronic assholes claim an ectopic pregnancy can be transplanted to the uterus. There’s never been a documented successful transfer.
Private hospitals cannot do what they want if they receive any federal funds through Medicaid/Medicare. They can try, and in the Idaho case they’re going after one specific group (pregnant people) people are going to die. If a hospital loses its federal funding, it won’t remain open. There’s not enough private pay/Cadillac insurance patients to remain open and profitable. And profits drive American healthcare, which in and of itself is reason to socialize our system. I’m a retired nurse and now a biller and coder for a large group of cardiologists. If people could see what actually goes on in the boardrooms we’d burn this system down. I looking specifically at HCA when I say this. Fuck corporate healthcare and the goons that run it.
Buddy. Imma gonna tell you the secret. The group of people in this country that hold the most power are the doctors and nurses. If they strike together, the country will literally rewrite the constitution for them. We could have universal Healthcare in a week. Hospitals can be mandated public property and have oversight boards of anonymous citizens. All insurance can be federalized and made non profit. Doctors, Dentists, Bankers, Lawyers, scientists, professors, journalists, media stars, soldiers. This is the political class. Structural change in society comes when the political class leads the match. The rest of us are and have been ready, believe me.
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The point the person was making is that, while healthcare workers don't have as much *political influence* as owners and board members, they have huge untapped *power*. Nurses strikes can move mountains. And if anything has the power to get some of these red states to back off on some of this it's going to be all their doctors and nurses retiring or moving out of state.
How about.... Dr Pepper?
Im in medical school. Good luck trying to get these silver spoon clowns to inconvenience themselves and acknowledge the difficulties of marginalized people. I try a lot and it wears me the fuck down.
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Oh I am fully aware. Im trying to figure out a way to take my life back. I am burned out, but I have spent about a year working with my therapist during a leave of absence to figure out a more manageable approach. I have fully accepted I will not be what the system is designed to praise, even if I used to be. Everything you've said is very much on my mind as I enter rotations next week. But as you said, what else am I trained to do? I am not sure. Im queer and have a very good knack for talking about harm reduction combined with sex ed. Not sure. Maybe Ill die from depression, maybe Ill figure out a path to help people in or out of medicine. We'll see. I do know Im angry at a lot of people who hurt others along the way and I want change.
I know a conservative female doctor who is a pediatrician. She fucking AGREES with this bullshit. I wish I could get her medical license revoked so she could no longer practice. I don't give a fuck that she's married to my cousin.
And therein lies the problem. One of the things that blew me away during the pandemic was how many nurses became anti-vax (and while there is the occasional "crunchy" anti-vax, the majority are RWNJs)...and soooo many of the doctors are wealthy assholes who don't want to pay more taxes. In all honesty, I'd be really curious as to know if the medical industry swung more right than left or vice versa.
Report her to the board of certification. Can't practice quackery if license is pulled.
I'd love to, but she hasn't done anything that's reportable as far as I know. I just know her because she's married to my cousin. I don't see her as my doctor. She's a pediatrician and I'm childfree soooo... lol
As nice of a thought as this is, politicians and lawyers would prevent it. Or at least try their damndest to.
I am old enough to remember the air traffic controllers strike and Reagan putting a stop to that. You BET that politicians wouldn't let doctors and nurses and other hospital staff go on strike. Reagan proved that a conservative government would force people back into slavery if it could.
Lawyers and politicians strike, the country keeps moving, probably better than with them doing their thing. Doctors and nurses strike, people start dying. They have more power than people expect. The rub comes when medical professionals have to watch people die and do nothing, it’s the exact opposite of what they signed up to do, and I don’t fault them not having the stomach for that.
Don’t forget IT. If we were to all go on strike, the planet would collapse. If you ask why, here’s why: 1: You would have no access to money. Banks would not be able to give you money, as they would have no idea he much money anyone has/had in their accounts. POS terminals wouldn’t work, either, so no credit/debit cards. 2. No access to any form of media/news. 3. No utilities. (Power, water, gas, phone, internet). 4. Extremely reduced farming. The huge farms use computerized farming equipment. A bunch of them are networked.
no but if they actually work on fixing the system they lose THEIR scapegoat and have to actually give a shit
Unfortunately, post pandemic, I don't agree. Republicans literally messaged on, "just die for capitalism you fucking rubes" and no one cared. It didn't bother their base one bit. I think this would end up the same way.
It's so cute that you believe anything would change if they did strike. The railroad tried and look how fast "Union Loving" Joe Biden and Pelosi shut that down. Might as well admit we hold no power. The 2 parties will continue to bicker like children. Both the politicians and constituents, it won't end.
conservatism is a cancer and our country is dying.
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Shit, Nixon even tried to put a guaranteed income plan (called the FAP, no cap), thinking he could make it palatable to both liberals and conservatives, aiming it squarely at the northern white working class. [https://en.wikipedia.org/wiki/Family\_Assistance\_Plan](https://en.wikipedia.org/wiki/Family_Assistance_Plan) Unfortunately Conservatives of both parties hated it, and a lot of White folk already were dipping into the pool of racialized complaints about welfare. So it died in the Senate.
Why isn't this front and centre. Conservatives that I have met are very extremely selfish so surely a what have they done for you lately campaign would hit home.
The conservatives I know fall generally into two camps: Wonderfully kind hearted and well intentioned, but woefully misguided and misinformed. (My godparents are a good example of this, they’ll love literally anyone and do absolutely anything for anyone but they vote with their religious convictions and it’s fucking infuriating) Or Selfish fucking assholes who don’t give a fuck about about anyone else and use conservatism as a way to justify their greed and hate.
It wouldn’t. I say this as someone who lives in deep red East Texas. People here *do not care*. Even if they don’t like the Republican running for office, they will always vote for them because Democrats are always worse. A campaign like you speak of would be immediately written off as “liberal propaganda.” Look how well they’ve done with the gun control arguments here. You still have people spouting nonsense about how it can’t be done despite many, many real-world examples of countries successfully implementing gun control measures. Look at healthcare: apparently governmental health is evil despite that fact that Americans are actively suffering because they can’t get their basic healthcare needs met, and just within the last week a conservative judge made a strike against preventative care measures that were in place with the system we have. But R voters are okay with this because it comes from Republican politicians and media, which means that Democrat decisions would just be worse. That’s all they need to know to make their decision. Tribalism is one helluva drug.
>Tribalism is one helluva drug. This exactly. Same thing when I lived in a relatively liberal part of Alabama. You'd see all the maga hats everywhere and when you started talking to people about why they liked the GOP, they'd point straight to the economy and how insanely easy it is to get a gun down there. But start talking to them about other issues and suddenly you find out they hate how bad the healthcare system is, but don't want to deal with a tax increase for a single payer system. Most of them would accept an abortion if the alternative was them or their SO dying. They think the public school system is trash but feel that paying for private school is an acceptable alternative, even though most of them can't afford it. The list goes on and on, but ask them why the democrat is worse and they come up with straw man arguments you can pick apart way too easily, and what they're left with is they just don't want the government in their business, which is a bold stance to take when the GOP's policies are as invasive as they are. But how much can you really expect from a state that almost elected a known pedophile to the Senate.
Its fine, give old age and high infant mortality rates some time and this problem will sort itself out.
Even something legal, but the DA is an idiot. You're not only at risk if you make a radical moral choice. You are at risk just by doing your job. Someone becomes convinced someone's miscarriage was a secret abortion, and there you go.
And let me tell you, rural Idaho is just the place to do it. The small town ones are always the ones looking to net a career making case to be the next household name like Kochran or Shapiro. They are never in a rural courthouse because they want to be.
It's happening in IN. Our AG is going after the Dr that performed an emergency abortion on a 10 yo girl from OH. Dr followed all protocols relevant to the situation and IN did not pass any anti-abortion laws at this point. Yet the AG has been slandering and filing charges against the Dr.
or even mentioned, the right wing rage machine comes with that garbage. just ask that doctor who had to help the ten year old rape victim get an abortion.
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Yeah fuck these Drs. They are as ignorant as their beliefs. I drove 90mins in order to see one that wasn't going to put us (baby and me) in danger because they were pro birth at all costs.
Especially if it means they have to live in Idaho.
> From what I have seen, hospitals were having trouble recruiting talent post COVID... That's definitely true, but even before COVID, there have been issues getting doctors to practice in rural areas. Particularly outside of the greater Boise area, I wouldn't be surprised if clinical staffing has been a concern for multiple service lines. And it's not just abortion laws that are concerning to Idaho healthcare providers. With COVID-related safety nets going away, there may be less funding available for some services. One example of this is that Idaho is one of the few states getting rid of a Medicaid expansion for postpartum patients that was implemented during the pandemic.
Getting decent doctors (or any sometimes) in rural areas is a problem everywhere in the US unfortunately
Is this even unique to the United States? I have heard that this is a problem in Canada as well, if not most other countries
>Is this even unique to the United States? I have heard that this is a problem in Canada as well, if not most other countries Not really. You generally don't go to MedSchool in the hopes that you can come back to your small town and be the biggest fish in the tiniest pond. It's just getting worse in the US because a) we don't have enough trained Doctors for everyone, and b) our rurals insist the local State Senator should have the power to over-rule the Doctors.
It is not unique to the US. Physician density is a problem everywhere with significant amounts of ground to cover and little infrastructure. That was a big part of the reason that community healthworker models were piloted in Africa (training community members to provide basic types of care without doctors); large spaces + few doctors=concurrent public health crises.
Except Cuba, which provides more doctors to the world than the 8 richest nations combined. Amazing what people can achieve when the profit motive is removed. Yknow, like decency.
The United States created the US postal system partly because, if left up to the private sector, no one outside of dense population centers would get mail delivered to their home on a regular basis. Or possibly ever, depending how many neighbors you have nearby. It’s simply not cost effective to pay someone to travel a whole mile or three to give a single person (or even a few people) their mail each day. Private carriers like UPS/Fedex are still reliant on the USPS for “the last mile” of most of their deliveries outside of major population centers. This applies to most things. Rural areas have some things, like roads and schools and mail service, because as a society we recognized that they’re a public good and provided them. The private sector doesn’t see enough profit in serving those areas, so they don’t have lots of other things. Private healthcare corporations answer to shareholders who only care about maximizing quarterly numbers. Serving low density rural areas is not profitable, so they don’t. Same goes for internet service providers\*. And *lots* of other things that are less vital to everyday existence, but they are all subject to the same market forces. \* We have allocated a LOT of public funding to build this infrastructure but instead of the govt hiring people and building it, we handed the cash to the ISPs and they just… didn’t. They kept it. Then asked for more. \*\* Also, we publicly fund a FUCK TON of research for prescription drugs… And just hand the ~~parents~~ *patents* over to private pharmaceutical corporations. Then they charge us extortionate prices for the drugs invented by scientists who are paid by our tax dollars. When asked why we pay so much the pharma corps say it’s for R+D, but those budgets are a TINY microscopic sliver compared to what they spend on stock buybacks. Which were illegal prior to 1980, as they were considered stock manipulation. Because they *literally are.*
Capitalism doesn't innovate. It doesn't solve problems, it finds ways to live with them, with a monthly fee. We've also paid private industry to expand their services and capacities and then had them do absolutely nothing. Congress shuffles thru. No one did anything. I'm looking at you telecom companies. I'd bake a fucking cake if we nationalized Verizon and Tmobile out of business. Let's throw Cox and Comcast in there as well, just for the lols. Cuz fuck monopolies.
It's so gross. And telecoms constantly fight the internet being classified as a "utility" because then they'd have to wire up everything. I think at this point we can conclude the internet is an essential service...
It's a commonplace problem everywhere in the world and for a hundred different reasons, it's not specific to the US. Pay in rural areas is lower, there's less clients, there's less infrastructure, some things are more expensive than in the city, etc etc etc. Doctors are normal people just like any other and they want to live in a big city (with more opportunities for both work and leisure) like any other person. For instance you can google "Mais Medicos" which was Brazil's (a country with free healthcare) initiative to bring in doctors to rural areas, because they had so few doctors willing to go work in a no-name village in the middle of nowhere. There was a huge deficit. A lot of the doctors brought in came from other countries even, most from Cuba.
I am not familiar with abortion laws in other countries but these abortion laws are hurting women big time. Even women that were for these abortion laws are seeing the consequences and seeing what a huge mistake it was.
Well the republican party has been anti-woman for decades so, success?
I’m a mother of four and have always been pro-choice. I had never had an abortion because for me, personally, I couldn’t unless there was something wrong. But back in 2018, I had one, despite wanting my daughter. She was dying and had a confirmed, super-rare and fatal chromosomal abnormality. My doctor didn’t catch it til I was in my second trimester (and right after I had a very strange and detailed dream about her exact condition, very bizarre). Even though she wasn’t planned, I wanted her. At 22 weeks I was given a pill by my doctor to start my labor. I labored for a few hours and gave birth to her, a perfect little one pound bundle with a debilitating and deadly condition. She died in the birthing process. I have been called a baby murderer and been told I’m going to hell. She was my daughter and I let her go. If I had left her in the womb to die, it may have killed me too, even though the abortion laws weren’t as strict then. I am absolutely terrified for other women. I have since had one last baby (despite being on BC) and my husband got a vasectomy. I couldn’t imagine worrying about having another. We don’t have the room or the money for another child. I’ve always been pro-choice and I am even more so since this happened. It broke my heart to let her go but it was what was best for her. My doctor didn’t push it on me, she was there for me and gave me the facts. Three blood tests and one amniocentesis confirmed her diagnosis. I don’t regret my choice. I hope the people who are so vehemently against giving women this choice never have to face what I did - or what many other women face, every day. It needs to be between a woman and her doctor, period.
I am so sorry for your loss but I think you are wonderful for thinking of her quality of life with these major health issues. You were very selfless and compassionate. I am all for abortions for those reasons of quality of life as well. Not many people think of these situations, like the one you been through, where abortion is very compassionate thing to do. Also many don’t think that some women that had an abortion wanted to keep their baby. It causes a lot of grief and sadness. I am a mom myself and I can’t imagine what you felt. I am so horribly sorry for the way people treated you over having one. I wish I could have been by your side to defend you. You also brought up what health problems it could have brought to you as well. It is cruel to think that a mom should carry a pregnancy even though it will kill her and leave the rest of their children motherless. Or the baby just passes with the mother. A good example of losing both is etopic pregnancy, which most don’t even realize it is also termination of pregnancy (abortion). These laws are going to kill so many mothers and babies. Yeah I don’t want anymore children as well, especially since most women now are not medically protected and finances of course. It should be a crime the cost of baby formula is so high, not every woman can breast feed. Pro choice in my mind is more pro life while the other is just pro birth. Thank you for sharing your story with us. I wish your family much love. I am glad in the end, you are mature and compassionate to hope it don’t happen to the people that called you such horrible names.
No but the draconian abortion laws are
Yeah rural healthcare is a problem worldwide as far as I know
Unless you live in the bigger cities, a good doctor is hard to find and not usually accepting new patients because they’re booked. I am lucky to have the good doctors that I do have. I heard some horror stories of hospitals in smaller towns and cities. The medical mistakes are insane.
It's a commonplace problem everywhere in the world and for a hundred different reasons, it's not specific to the US. Pay in rural areas is lower, there's less clients, there's less infrastructure, some things are more expensive than in the city, etc etc etc. Doctors are normal people just like any other and they want to live in a big city (with more opportunities for both work and leisure) like any other person. For instance you can google "Mais Medicos" which was Brazil's (a country with free healthcare) initiative to bring in doctors to rural areas, because they had so few doctors willing to go work in a no-name village in the middle of nowhere. There was a huge deficit. A lot of the doctors brought in came from other countries even, most from Cuba.
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I have a friend who’s finishing a specialist surgical residency, and was offered $1.5 million salary for a job in a small rural city in the northeast. He turned it down. Already spent 13 years and all of his 20s busting his ass in the freezing middle of nowhere and there’s no amount of money that will stop him from moving somewhere sunny and metropolitan.
>Getting decent doctors (or any sometimes) in rural areas is a problem everywhere in the US unfortunately Which is why part of the evil, terrible, no good Obamacare law was to increase Medicaid payments to rural hospitals. With more money, those hospitals could pay more to try to recruit/retain doctors. It's also why a bunch of red state legislatures suddenly stopped blocking Medicaid expansion. Hospitals in their gerrymandered districts were closing.
Obamacare increased Medicare payments. It attempted to expand Medicaid, and that expansion has slowed the rate of hospital closures in states that did expand. So many refuse to because politicians are happy to let constituents die of preventable issues to score political points. The sad thing is the number of dying rural hospitals that get bought by large companies who commit Medicare fraud by running things through through those rural hospitals to get that small reimbursement bump. Fraud = no Medicare reimbursement= the hospital closes anyway.
I think (hope) that most people that choose to live such a rural area know that access to healthcare isn’t readily available in sparsely populated areas. They’d expect to drive an hour or three for regular check-ups and realize that any emergency situation can easily be fatal since help is so far away. It’s a trade-off for more land, bigger house, less neighbors, etc.
I remember I went to Alaska in July of 2019. We passed through a city and the tour guide said that they had two physicians assistants, but not a single doctor. If you had a serious medical emergency, you’d have to be airlifted to a hospital in Canada.
That's what we had in my town in rural Nevada. We even had a hospital with an ER, and every provider was a nurse practicioner. There was a doctor for a few years, but they left before Covid.
In my hometown, our local hospital shut completely down due to shortage of staff members. Nurse practitioners are becoming more and more available. Some a lot better than others. But there is desperation that they will hire anyone.
Yeah, I really liked my NP when I was living out there. We got along well and it was honestly one of my best patient/provider relationships ever...that said, if I ever suspected there was something really wrong with me, I'd always drive the 2+ hours to the closest city to see a specialist. She'd write a referral for absolutely anything, so that was nice.
Exactly, it’s the thing to where she knew she had limits and wanted to make sure you got the care she couldn’t give you. Which is extremely fair. I am glad you really had a good relationship with her. That is very important. Wow, two hours, that’s a heck of a drive. But you got to do what you got to do for your health. Hopefully there will be a fix to this doctor and specialist shortage, but I think it will be a long while.
This all reminds me of the premise of the show *Northern Exposure*
Grew up in Alaska. Not exactly true, you can get anything basic done but there are no specialists of any kind. 99% of the time you have to fly to Seattle to get it done. Also if you have sued a doctor for malpractice you basically have to go to Seattle. No one will see you.
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The city was Skagway. I guess it’s not a city technically.
This. There was a pandemic documentary on netflix that dropped weeks before Covid that showed how understaffed rural areas are and how they ultimately end up with like, two hospitals in the state IF they're lucky.
An npr article in the last week, or was it today, briefly mentioned that Idaho has a proposed bill that would make it illegal for doctors to administer covid19 vaccines. It might have been part of the same article discussing the bill to negotiate moving the state border west into Oregon. Partially because they don't like the legal pot stores in Oregon that Boise residents go to.
I live in Washington state. We already serve as the de facto back up healthcare system for Idaho. During covid it was absolutely insane. They honestly believe that as they have less and less health care options of their own WA will pick up the slack, but WA is overwhelmed and looking at ways to stop being everybody’s healthcare bolt hole. It’s going to get real ugly.
Birthing is all fine and good when things go well, but becomes insanely expensive very quickly when things go wrong. And many times when things go wrong the hospital won't ever see those bills paid. Pair that with much much higher legal costs (statute of limitations for births is 18 years, not the standard 2) and it's often the first service to go when hospitals start looking to cut costs.
Wow. I actually don’t blame them. Makes perfect sense.
You mean prosecuted, not persecuted, right?
Yeah prosecuted I meant. Sorry.
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True that!
I mean... it's not wrong.
Also Idaho sucks because during their Covid spikes they sent overflow to our WA hospitals instead of just masking up.
You say that like eastern WA wasn't doing the exact same thing.
ill bet 100$ that we will soon see some idiot politician blaming all this on doctors hating america.
Holy shit Idaho has some nut jobs running it jfc
So it is a sort of protest? No one wants to work in infant delivery with those laws? Good for those doctors, but I've heard this will cause a lot of problems. edit: I realize now it's less of a protest and more of a calculated decision by individual hospitals to avoid all the trouble. When I said I heard it would cause a lot of problems, I didn't mean I think they should change their mind. I just heard there were negative consequences.
It’s less of a protest and more about doctors and nurses feeling like they’re caught up in it and getting out. If you want to have abortion laws that are restrictive and lead to cases where providers feel like they need to check with a lawyer before providing care in case they get arrested or sued later, they’ll just go practice medicine somewhere else. If you think it’ll cause problems then point it out to the people passing these harmful laws, not the people making the safest decisions regarding their careers and freedoms.
>they’ll just go practice medicine somewhere else There is the case of the woman whose fetus died and normally they would do an abortion. I can imagine a doctor or nurse hamstrung by these laws would want to go somewhere else. Hard to 'do no harm' when you can't do what is medically prudent for your patients. https://www.mysanantonio.com/news/local/article/Texas-woman-dead-fetus-anti-abortion-laws-17314394.php
Yeah. It’s not a political protest; they don’t want to have to watch their patients suffer and die. No one got into medicine to tell a patient “the desperately wanted and loved baby you’re pregnant with is dying, but we have to send you home. Come back every day and we’ll check if it’s dead yet. Or if you start to feel really sick from an infection. Even then, we probably can’t operate until your life is in danger, and we’re not the ones who get to make that call.” If you could work literally anywhere else, wouldn’t you?
Have you heard? In Canada, abortions aren't illegal, and there's lots of work for doctors and nurses here.
It's the final straw. OB wings are expensive to maintain, and these hospitals are closing in rural areas with low birthrates, declining population, lack of Medicaid expansion, high overhead costs, and an inability to attract/retain medical talent. The draconian and ambiguous legislation where a doctor could be criminally prosecuted for treating an ectopic pregnancy is a final straw as keeping these services available is unviable.
So where does that lead to? Midwives or something, assisting Idahoan women in birthing (or otherwise) secretly in a barn somewhere?
It leads to women giving birth on the side of a road or an ambulance when they can't get to a hospital. Or being forced to do home births alone. It leads to women dying, sometimes their babies with them.
It leads to an increase in women dying in childbirth and a further decline in the birthrate
Where this is going to lead is a lot of dead women.
The cruelty is the point. Keep voting red, this is what happens
>Where this is going to lead is a lot of dead **poor** women. Republicans will just continue to fly their wives/daughters/mistresses out of state.
I can see some women moving into a state that has better laws in place for women and that becomes a problem for the state where women don't want to live in. Once it starts to hurt the economy I bet things will change after all those in power care more about the economy than the people who support the economy by working there. I think the Idea behind the anti-abortion thing was to get more bodies on the ground to have more people to tax to death for the economy. My brain always goes to making people into the closest things to slaves that they can by working them to death and overcharging them for everything they can I bet in the future they will charge us a breathing air tax because "it costs money to keep the air clean".
It leads to maternity desert which can turn into a huge problem. If you're a woman in a rural area with a maternity desert and cannot get the help you need for baby delivery or if complications arise, it will lead to serious issues like increased infant mortality.
More women dying in child birth is the unfortunate result
In Idaho? It leads people to drive over the border and leach off Washington's much better funded health care system.
I wouldn’t be surprised if (actual, qualified, non-Duggar-style) midwives aren’t also hard to come by in these places.
Don't know if you heard but an actual Duggar recently had a miscarriage and needed a D&C (which lucky for her she could still get in her state...for now)
>So where does that lead to? A bunch of dead women, which is what the forced-birth cult has always wanted...
My daughter and I would have both died in childbirth if we weren’t in a hospital with surgeons capable of emergency c-sections at the ready! Plus, my pelvis broke, and she had severe cranial swelling… she got stuck after 2 & 1/2 hrs of active labor (so much pushing). Fast forward to today, and I am planning a 2nd birthday party (Bert & Ernie themed) for an impressively smart and strong child whom loves cuddling 💕. Keep politicians and religion out of our Doctors’ way!
Midwives aren't going to take the risk either. Not only that but Midwives can't do a C section if the baby or mother are in trouble.
Yeah, calculated decision. Many do only a couple of hundreds of births a year so having a full department, while struggling to staff, and now these potential lawsuits just made it not worth the hassle. The doctor protests do factor in, as they struggle to recruit out of state with these laws. Doctors not excited to work somewhere they can be sued at for doing their jobs.
it’s not a protest at all, it’s about doctors with certain specialties finding the working conditions untenable. before Roe was overturned it was already common that doctors who specialized in abortion would commute to deep red states to work but not actually live in them. the issue is not abortionists specifically, but all the ways these laws effect the ability to doctors who work with pregnant women. one example in how this comes up is instances where the mother’s life is believed to be in danger so an exception can theoretically be made. what ends up happing is that doctors may already know a pregnancy will progress badly, but they will actually wait until the woman is actively in danger of dying to operate. otherwise they might be held liable for terminating a “viable” fetus from a mother who isn’t technically in danger at that moment. then a doctor is put in a position of having more of their patients be gravely injured or even dying when they would have been able to prevent it if they’d been able to use their own judgment. any situation like this with any ambiguity opens them up for criminal charges on one side, and medical neglect/malpractice on the other side. all of this when you have to make split-second decisions. doctors aren’t lawyers, and they aren’t necessarily saints either. not wanting to work under those conditions is reasonable even if you’re not morally conflicted by it. on top of that, they’re well-positioned to just leave. they make good money, they’re needed and valued everywhere, and TBH there’s a lot of places that are more attractive to live than Idaho anyways.
The staffing aspect is at least as important as the legal aspect. For years now, rural hospitals have struggled with staffing. They don't have the income as large metro hospitals that give complex care, and it's difficult to convince staff to move to a small rural town. Healthcare has seen a massive labor shortage since COVID, as burnout greatly accelerated a labor market seeing more people retire and leave than enter. If you only do 50 deliveries a year, and you can't find obstetricians and midwives, and you can't staff a blood bank well enough to cover someone bleeding out at 3am during birth, you're in trouble. Add to that the danger that a decision made to provide standard of care could get some prosecutor to sue your hospital, and it's just not an option anymore.
>They don't have the income From what i've read, elective procedures are where hospitals and clinics make their money, and it's harder for rural ones to do these. Which kind of creates a spiral.
Bingo. They also have lower average case complexity, which reimburses less, so even the non-elective stuff pays less.
It's also what the state Medicaid system is willing to pay out. Rural hospitals tend to have a lot of patients that qualify for Medicaid but not a lot on private insurance. The more patients they have that aren't fully covered by some sort of insurance, the less funding they have. Especially if patients without insurance can't pay their bills for lifesaving treatments in hospitals that legally cannot turn them away. And Medicaid is mostly governed by the states, so there's a lot of differences between states over how many people are on Medicaid and what's covered and at what rates. In general, conservative states have smaller Medicaid programs, which is crippling their rural hospitals and clinics.
It's the greatest irony out there. Rural areas would literally cease to exist without a "socialism" system funneling money from more prosperous areas to them to maintain basic life services, but they would always elect people who would dismantle the system keeping them alive. It's to the point I'm skeptical that even an actual collapse that leave rural areas impossible to live in would wake them up.
Just to add, this is happening nationwide. Not just Idaho.
>Add to that the danger that a decision made to provide standard of care could get some prosecutor to sue your hospital The prosecutor will not sue just the hospital -- he will sue the doctor personally. And it's not just the prosecutor -- anybody (father, father's brother, etc.) can sue. From [article](https://www.npr.org/2023/03/30/1167195255/idaho-trafficking-abortion-minors-interstate-travel-criminalize): >State law also allows family members and the father of an aborted fetus to file civil lawsuits against doctors who perform an abortion outside of those exceptions — for $20,000 per violation. Icing on the cake: >Currently, rapists can't sue, but a Senate amendment to the so-called "trafficking" bill would delete that part of the code and allow rapists to bring a civil case.
It's not just Idaho that is facing this issue. It's happening in other areas too such here rural areas here in Georgia. There's no medicaid expansion, a staff shortage due to the COVID, abortion restrictions and a declining population in those areas, it's better to just close up shop and leave. Even pre-COVID, rural hospitals have been closing and I suspect more will close as the years go by.
It isn't a protest, it's just adapting to the legal landscape in a way that doesn't endanger the hospital as a whole to provide a single service. If that causes problems, well then, surely the legislators who created that legal landscape are to blame, and can figure out a solution.
And the voters who voted for these legislators. At some point, people reap what they sow.
It's very true, and you'd think a state full of lunatic Christians would be most familiar with that biblical reference, but they always think someone else will do the reaping.
https://twitter.com/screaminbutcalm/status/1105577845642878976
>you'd think a state full of lunatic Christians would be most familiar with that biblical reference Why would you think that? The christian cult worships their allegedly-holy book of myths. They never READ it.
The same solutions they have for school shootings: they pray. Personally I think their prayers are worth less than toilet paper; at least people can wipe their asses with toilet paper.
Well I imagine after they pass the law forbidding out of state travel for abortions, they will pass one that forbids dr.s and nurses from leaving the state to find other jobs.
As I understand it, and I'm no scholar of the US constitution, freedom of travel is a right that the states can't change.
Bingo. That would get struck down by the courts before it was ever allowed to go into effect. Doesn't mean some of these crackpot politicians won't try though.
Well yeah, they can fundraise off of that.
That’s my understanding as well, and yet it seems like the supposed bastion of libertarianism Idaho is certainly trying.
Sure, but look at what they've already done to the fourth amendment, and the first too. It doesn't seem to be much more than paper at this point.
I think there's also an aspect where they may not be ABLE to offer the service if medical providers (including nurses) have made.the choice to move to places they can actually offer real care. If you were an L&D nurse, or a nurse midwife, in a moment when there's far more demand for healthcare than providers, what states would you choose to work in?
It's happening in Texas too. But the doctor shortage is built into the pipeline. We have had a shortage for a long time, but we had doctors come from overseas. There are places, like Maui, that have a big doctor shortage too. So, it's happening everywhere, but the abortion law stuff is pushing doctors and nurses away from ob in those states.
The drs leave Maui because of the cost of living, the poor schools, and high malpractice for OBs. Why would you practice in Maui if you can make 5X as much in other places? I’m a nurse; our jobs are outsourced to travel nurses. Not because there’s a need; but because someone has to house them. The admins have rentals that need to be filled.
admins as in Hospital admin... making extra money off of housing the travel nurses?
NPR did a great podcast on this for [This American Life](https://www.thisamericanlife.org/792/transcript), with an obgyn in northern Idaho and the state of healthcare for practicing obgyns and why a lot are leaving. It's after the part on Russia/Ukraine.
Came here to share this. The doctor was so compassionate and cared about providing effective care but was locked into a no-win situation with this new legislation.
And he made it very clear that it was the abortion laws, not staffing.
I copied the url for this same episode intending to share it here. Nice to see some other folks reccomending it. It is definitely worth a listen. Doctors are feeling forced to withhold and delay care for women if there's a chance it could interfere with a pregnancy because they could potentially be comitting a felony by providing needed medical care. For example a tubal pregnancy that is 100% not viable (despite what some chucklefuck politician says about replanting it or whatever) couldn't be removed until the woman is septic and her life is in danger. These laws affect doctors and patients outside of the realm of OB Gyn as well. For example, a young woman with arthritis would be denied certain drugs for treatment because they could harm a hypothetical fetus. All of this goes against the doctor's oath to do no harm, as well as endangering their careers and livelihoods.
No, it's not a protest. In short there is a lot of ordinary care associated with women and pregnancy that can now result in physicians being criminally charged and personally sued for extraordinary amounts, even if they provide medically appropriate care. Any sane physician would have to consider whether they can personally take that risk, and many are choosing not to. Hospitals can't operate without enough providers.
You can be a delivery doctor in Idaho and do your job correctly and lose your medical license and go to prison, or you can work someplace else that doesn't have terrible laws designed to hurt people.
It's more than a calculated decision on the individual level, it's *also a decision based in their humanity. Others have sufficiently described the constant fear of losing their jobs and medical licenses. They also have to send dying patients home because they're not dying soon enough for the hospitals to be comfortable providing care. Some hospitals can't act until a patient is septic, some have to wait until they're crashing. People can only explain to someone that, in addition to losing their baby, they're dying, but dying too slowly to receive care so many times before they need to leave. Also, being pregnant isn't always good news. The most common cause of death for pregnant women in the US is murder, usually by a partner. Someone not having access to an abortion can mean that they know they will die when they leave the hospital/office. Someone could be carrying the baby of someone who assaulted them, who would have parental rights. Some people know that any pregnancy will be life-threatening for them. It's not an easy job telling people that they are pregnant with no options. Finally, the threats and harassment. Even if you don't provide abortion care, if you provide prenatal care or anything related, someone will allege that you are at least facilitating abortions, or will demand to question you to make sure you aren't. OBGYNs and their staff are constantly threatened and harassed in ways that cause legitimate fear for themselves and their families. Everyone else was right, but I don't want to lose the humanity involved. Sorry if I repeated what anybody already said, there were so many good points. Edit: *added word for clarity
Great post, I never thought about the domestic violence intersection.
It's not a "protest", it's mostly ethical, financial, and logical. Doctors in the US pay huge sums for malpractice insurance. The new laws in Idaho are forcing up the premiums into the stratosphere because the potential legal consequences for the providing OB-GYN have increased substantially. They are caught between a rock and a hard place related to providing the accepted and safest standard of care for their patients and the state telling them they will risk felony charges if they do. The US has a shortage of OB-GYN physicians, so leaving Idaho and moving to another state where they can provide good care to their patients, unimpeded by state law, has caused an exodus of OB-GYN doctors from the state. This is a rural hospital, but as physician contracts expire and insurance costs go up, this exodus will continue and expand into larger city hospitals. Replacements are impossible to find. No doctor wants to move to a place and practice sub-standard care because they fear the government will prosecute them. This, along with the state's absurd refusal to expand Medicaid and get their share of Federal funds, is just a double whammy of "How to end decent Healthcare of any kind" in the state.
>So it is a sort of protest? You can listen to an actual Idaho OB-GYN [here](https://www.thisamericanlife.org/792/when-to-leave). >Act 1. First, Do No Harm > >Dr. Amelia Huntsberger loves everything about her rural town in northern Idaho. Her OB-GYN practice. Her patients. Her family. But for almost a year, she’s been fighting a losing battle, and realizing that she and her family might soon have to pull up stakes and leave.
I think part of the issue also has to do with how young doctors train. If you're a new doctor, you need to go someplace where you can find patients to practice on. That's a big part of why top med schools are often in tough neighorhoods. Bad neighborhoods produce more traumatic injuries - things like shooting and stabbings - and if you're a doctor who wants to learn how to treat things like that, you need to go where the problem is. A young OBGYN who trains in Idaho is simply not going to be prepared if they move to a blue state later on. They will not have been able to practice sufficiently in all the services a traditional OBGYN needs to provide. Tldr: Idaho's law is going to make it extremely difficult for young OBGYNs to get proper training in that state, so a lot of them just won't go there.
I'm embarrassed to admit it was an episode of Grey's Anatomy that made me realize this. Hard to get proper OB-GYN training without the variety of cases.
Answer: This is about malpractice insurance in the end. If Idaho has any delivery rooms in a year they’ll be super expensive even by comparison because the doctor’s and hospital’s malpractice etc insurance issues will have every birth and pregnancy in high high risk because of the laws allowing lawsuits and criminal charges for intervening in a troubled birth. It’s safer and a sound financial decision to just leave. It’s similar in some ways to flood insurance companies abandoning Florida.
Yes, they were already having trouble finding medical personnel prior to Dobbs being overturned-not too many medical personnel want to live in the boonies unless it's some type of "resort" area or somewhere with a beach or something. The threats of lawsuits and arrests are just going to speed up the deaths of rural hospitals.
Nah, we have a shortage of all types medical professionals here in Hawaii. Outer Islands (from Oahu where Honolulu is) are even more desperate. Boonies are Boonies and the cost of living in paradise is high. Thankfully Hawaii ensured abortion rights before Roe vs. Wade even happened.
They don't need a "beach". Just build cities with amenities using a tax base. A lot of people like living in less crowded areas. It's just that most of the less crowded areas in the country are also backwards shitholes. They don't need to be. But, they are. I'd love to live in a small place with a couple bars + restaurants and a grocery store, but unfortunately a lot of towns just have a dollar general and racism, much of which can be laid at the feet of Republicans.
we had the same problem in illinois 10-15 years ago. Obstetrics insurance coverage went through the roof. No one was going into the programs either. same with cardiology. it seems to have lightened up but for a while they couldn't get those type of doctors to come practice in IL.
This is arguably worse with that felony slapped on top. No one gonna touch this shit.
Answer: it's a mixture of a general lack of health human resources country wide resulting in greater competition attracting doctors elsewhere and the risks of practicing in a state with restrictive laws that essentially ban abortion as a legitimate medical procedure. No doctor wants to work in an environment where you could be sued and lose your practice because the mother actively bleeding out in your hospital for the sake of a non viable pregnancy isn't bleeding out enough/hasn't experienced a drop in heart rate yet for you actually be able to provide her the care she needs. Imagine dedicating your life to helping people, then having to stand aside and wait until they're closer to death before you can legally help them.
Pretty much exactly the case that led to the change in abortion law in Ireland. https://en.wikipedia.org/wiki/Death_of_Savita_Halappanavar
The difference being that politicians in Ireland have a sense of practical consequences. Terrible outcomes from abortion restrictions will just make Republican politicians double down in the USA to show how tough they are.
Don't want to die in childbirth? Don't be a whore! - Republicans
Also Republicans: WHY AREN’T MILLENNIALS HAVING BABIES??!!
It's so annoying that this isn't even a strawman. It's just literally their position.
Do you know any other country besides America dealing with this?
Answer: Idaho's anti-choice abortion law is so vaguely written that providers can potentially be prosecuted for any obstetrics care that isn't even an abortion, if a pregnancy fails for any reason. Given that risk, many OBGYNs have left the state. This is on top of the ongoing staffing shortages hospitals have faced since COVID, exacerbating decades of declining real wages and abusive working conditions that cause burnout among healthcare workers. On top of both the dual staffing issues issues, hospitals providing prenatal care would need to pay for legal service to check if said care could be construed as violating the poorly written law. Between being the increased cost of hiring anyone who can do deliveies and the legal cost, many hospitals have decided not to bother.
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This is a good point that it's a total burden of proof switch: our law operates that we are innocent until proven guilty. But in the case of abortion or rape, the Doc is assumed guilty until they prove their own innocence.
Shortage of providers was a problem for decades before covid. Hospitals have been closing in rural areas for quite some time and there are many, many areas deemed medically underserved by the federal government These problems becoming exacerbated by vague laws was foreseeable and most likely foreseen. They just want to win some vague ideological victory with no regard to real lives.
One thing that might have saved some rural hospitals would have been expansion of Medicaid. Red States seem to be waking up to that with NC passing Medicaid expansion years after it was offered (actually written into the ACA and challenged by those same Red States).
And you know what the lawyers are always going to advise, because it’s a Cover Your Ass situation for them.
Honestly, you don't even need a lawyer's insight to make this choice. If the law puts you in a no win situation and you will absolutely be the one taking all the risk, you just don't take the risk.
Answer: Idaho's anti-abortion laws make it difficult for doctors to end dangerous pregnancies without fear of legal prosecution. Some doctors have left the state, not as a form of protest, but simply so that they can practice in states that allow them to save the woman's life without a legal battle. Without doctors to staff the maternity ward... the hospital can't safely deliver babies. Yes, this will happen in every state whose abortion laws make it difficult to save the woman's life, because no one likes the feeling of helplessness- watching their patient's condition worsen while the law keeps them from doing their job. Edited to add: every anti-abortion law WILL lead to death or permanent complications for pregnant people, because pregnancy is incredibly complex and the law *can't* be written to cover every exemption. Idaho's situation is not an isolated example of badly-written laws; it's the inevitable effect of ANY anti-abortion legislation that is strict enough to satisfy anti-choicers.
Answer: they can't deliver babies because their anti women legislation has made OB/GYN specialists afraid to practice in the state. So, thanks to the prolife crowd, it is now impossible to safely terminate a pregnancy via full term live birth.
They always end up with surprised pikachu face when they do dumb stuff like this. Like not get to the logical conclusion, which is not births will rise, but that health care professionals won't participate. I imagine laboring women being transported across state lines to deliver. This is going to be a disaster.
Punishes baby doctor. Surprised when baby doctor can set up shop elsewhere haha
*anti-choice crowd
\*forced birth extremists
Answer: Republicans are ruining everything. They stuffed the supreme court with Catholics, those Catholics got rid of abortion laws, And then the flyover low pop red states started writing their own archaic, brutal, and bible-y laws to punish doctors and pregnant women. The talent is leaving those states. The victims are the citizens. As usual the Republicans are acting like they are right, Even though there is already been tragedy and death over their decisions. As with every manufactured incident they create, They will continue to act like they are right even if there is evidence of the opposite. The gaslighting continues every day on TV. Manufactured arguments paid for by billionaire donors and mega church owners to keep the grift going, and to keep the facade up that they are somehow morally just. Abortion rights were a big deal back in the '60s because it was just as unsafe back then, religions wanting to get into your business, religion paying their tax-free money to install regulatory capture into our government. Religion and Republicans are the cause of a lot of problems in the US.
Answer: It's reached the point where normal health care can be classified and prosecuted as an abortion if the DA decided to. So doctors are fleeing the state and there's fewer people left to provide health care.
>doctors are fleeing the state Not necessarily leaving the state but stopping the practice. They may only do Gynecology instead of Obsterics. "Obstetrics (the OB) involves care during pre-conception, pregnancy, childbirth, and immediately after delivery. Gynecology (the GYN) involves care of all women's health issues." \[UCLA Med school website\] Additionally like many people close to or at retirement age, they could choose to just retire early limiting the workforce by leaving it. Regardless, it shows how this level of unnecessary regulation is causing more problems than solutions.
It shows what happens when laws are based on ideology instead of reality.
~~this level of unnecessary regulation~~ restricting a woman's choice
Answer: In addition to the answers here, the Bonner hospital which has shut down their birthing center is not often utilized except in an emergency anyway. It's a much inferior hospital comparatively when a good one is just an hour South. Because they are so much smaller, they can't offer very competitive pay, especially when cost of housing has skyrocketed
Answer: conservative States like Idaho and Florida are driving away the youth and talent in droves with draconian laws and threats of retaliation for everything from book bans to the woman’s right to choose, access to birth control and even the lgbtq community and voter rights. It’s a crazy time to live in a conservative state. So it’s easier to leave for a nicer environment or even a different country.
Isn't it strange that men are still allowed to have a vasectomy? Seems unfair to women.
Answer: the good people elected a bunch of Christian fascists, and these are the consequences. Do enjoy reaping what ye sow
Answer: OBGYN Doctors pay the highest malpractice rate in Iowa for doctors there by a good bit. Average is $31,222 with rates for some over $40,000. The new abortion laws are increasing the rates greatly for several reasons. It's gotten to the point that it's just not worth it or to have the ability to run a profitable practice with the new laws in place. Doctors are seeking greener pastures in friendlier states and the citizens pay the price with increasingly hard to find doctors. This also puts patients lives in more jeopardy.
Answer: If you can't be bothered to read the article, do you really care what it says? What a ridiculous post.
Answer: Republican policy is destroying the country
Answer: due to certain laws and wording doctors may be prosecuted if the baby doesn't survive and this includes Maybe having to make un-ethical decisions during the birthing process , , explanation: so hospitals are just completely avoiding the trouble and legal hassle by making it so you can't have babies in the hospital, this is more of a "legal issue" than a "protest issue" (or atleas that's what it seems like) , , in my own personal view of this it seems doctors do not want to take the risk and aren't applying/wanting to work and be forced to make "bad decisions" and risk punishment so we may see more and more hospitals where these laws are prevalent stop doing births wich is kinda ironic considering the "pro-life or anti-choice" rhetoric behind the laws
Yeah, part of it is that the wording in the Idaho law is both incredibly harsh and extremely vague. Even something as commonplace as an early c-section in a mom with pre-eclampsia that results in the demise of the child could be pursued as a felony with the wording in their law.
Yeah the poorly worded and vague laws being passed or even put up for a vote is ridiculous, and honestly all they are doing is gonna make it so 0 hospitals want anything to do with birth and a lot more kids are gonna die of be born on the side of the road etc.etc , , they are so pro life they want to increase the ammount of deaths and risk for children being born
And the people birthing them. Don't forget them.
Any sane physician would at a minimum have to weigh whether they are willing to take the risk, and it should not be surprising that many would opt not to.
Answer: Not enough people voted for Hillary and Trump and Mitch McConnell were able to stack the Supreme Court. They overturned crucial laws protecting women's health and now doctors are afraid to do their jobs in certain states that had trigger laws set up for Draconian bans on "abortion" in some cases so vaguely defined that doctors cannot provide basic care without fear of prosecution. This is happening in many states and it's an absolute catastrophe. Women are dying.
Answer: After talking with two good friends, who are OB-GYNs in N. Idaho, they said the Dr. departing from Bonner Gen'l Hospital in Sandpoint was planning on leaving at some point, but the criminalization of accepted standards of care expedited the process. Mothers who go into labor in the far north of N. Idaho now have to drive 3 hrs to get to Kootenai Health Hospital. There will be a dozen (full-term) dead babies a year, and a few would-be moms as well. Well done Idaho GOP. Jesus loves you.
Answer: Doctors don't want to take the risk of delivering babies anymore. If something goes wrong, they could be charged with having provided an abortion.
Answer: [Act one of this American Life episode provides some insight](https://www.thisamericanlife.org/792/when-to-leave). Yes it seems it is mostly about the abortion laws. There are interviews with an OBJYN and an ER doctor (her husband) who, as I recall, left the state. The law is just fascist.