Abortion Is Not About Abortion | Devil's Cut w Dr. Kristin Lyerly

Summary

Truth in the Barrel: "Abortion Is Not About Abortion"

Devil's Cut with Dr. Kristin Lyerly Host(s): Amy McGrath, Denver Riggleman
Guest: Dr. Kristin Lyerly (OBGYN, health policy advocate)
Date: April 7, 2026

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Episode Overview

This episode takes an unflinching look at how post-Dobbs America has turned abortion and reproductive health from a matter of private medical care into a battleground for political grandstanding—with far-reaching consequences, from forced C-sections to IVF shutdowns. Dr. Kristin Lyerly joins hosts Amy McGrath and Denver Riggleman to dismantle the myths, explain the cascading effects on all women's health (not just abortion), and expose the ongoing threats to medical privacy, access, and affordability in the U.S. The conversation also delves into the crumbling state of rural health care, the pharmaceutical labyrinth, the military’s unique vulnerabilities, and the elusive quest for effective healthcare reform.

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Key Discussion Points and Insights

1. Post-Roe Reality: Medical Decisions Under Siege

• Freedom & Medical Privacy ([00:37]):
  Amy introduces the topic by citing a recent ProPublica story about courts forcing women into C-sections against their will:

  “ProPublica recently reported that courts are forcing women into C-sections against their will. What does this say about freedom in this country?” – Amy ([00:37])

• Threats Beyond Abortion ([01:01–02:30]):
  Dr. Lyerly laments that reproductive healthcare is being chipped away—now including birth control, miscarriage management, and basic choices in delivery methods:

  “It's not just abortion anymore, it's birth control. It's how we choose, like you said, how we choose to deliver our babies.” – Dr. Lyerly ([01:10])

• Patchwork Access ([02:30–03:38]):
  State laws dictate care. In states like California, patients have protections, but in Arkansas or Texas, access is drastically limited, often requiring patients to travel out of state for essential miscarriage or complication care:

  “Now all of this is in different states...if you live in Arkansas, things are tough...Women could not get care for complicated pregnancies and miscarriages—they had to travel out of state.” – Dr. Lyerly ([02:50])

2. Real-Life Impacts: Delays, Dangers, and Misunderstandings

• The Dangers of ‘Driving for Care’ ([03:49–04:27]):
  Ectopic pregnancies—a life-threatening condition—now sometimes mean women are turned away and forced to embark on hours-long car rides:

  “If that [ectopic pregnancy] ruptures inside your body while you're in the car, that's a death sentence.” – Dr. Lyerly ([04:12])

• Education Deficit ([06:01–06:59]):
  Laws are being drafted by the uninformed, sometimes based on medically impossible concepts:

  “He literally introduced a piece of legislation that if you had an ectopic pregnancy, you would have to take it and transplant it into the uterus...It is medically impossible. Science does not allow for that.” – Dr. Lyerly ([06:12])

3. IVF and Fertility Debate: Politicization and Practical Chaos

• Alabama’s IVF Crisis ([07:23–09:05]):
  The Alabama Supreme Court classified fertilized eggs as “persons,” causing clinics to close and derailing time-sensitive treatments:

  “It temporarily caused fertility clinics to shut down...when it is time for your transfer, it's time—you don't have three days.” – Dr. Lyerly ([08:03])

• Politicians’ Double Bind ([09:05–09:51]):
  Trump administration’s contradictory actions: public support for IVF, but hollow executive orders and lack of real help:

  “90 days later, when that order was due, there was nothing. It was crickets.” – Dr. Lyerly ([09:26]) “You could buy one fertility medication at a discounted price on Trump Rx. That was the big thing.” – Dr. Lyerly ([09:56])

4. Rural Healthcare Collapse & The Affordability Crisis

• Hospitals Closing and Staff Shortages ([12:44–14:14]):
  Dr. Lyerly describes firsthand how rural hospitals are being gutted, units are closing, and physicians are hard to come by:

  “Where I live in Wisconsin, there have been a number of rural hospitals that have shut down their labor and delivery units. We’ve lost over half of our obstetrical units in the past 20 years.” – Dr. Lyerly ([13:34])

• Premium Hikes and Unbearable Costs ([14:14–15:14]):
  Amy shares stories from constituents whose monthly healthcare premiums quadrupled after new legislation:

  “Their premiums have gone from 300 bucks last December to 1,300 bucks...we’re talking tens of thousands of dollars of out of pocket costs.” – Amy ([14:44])

• Family Planning Under Siege ([15:37–16:41]):
  Families decline standard prenatal care because they can’t afford multiple ultrasounds; medical debt is still owed on previous pregnancies:

  “Standard of care...now it's like every little piece is picked out and people are declining standard care because some of them haven't even paid off their last pregnancy yet.” – Dr. Lyerly ([15:44])

5. Military Families: Ordered Into Risk, Denied Care

• Unique Vulnerabilities ([18:48–20:20]):
  Military women, often stationed in restrictive states, have no option to seek care elsewhere:

  “As a woman in the military...you have to go there, and there is no recourse. You can't just pick up and take off and go somewhere else.” – Amy ([19:05]) “The Trump administration and Republicans don't want the VA to provide that care.” – Amy ([20:10])

6. Structural Issues: Transparency, AI Denials, and Systemic Barriers

• Opaque Pricing ([21:54–23:41]):
  Amy and Dr. Lyerly compare healthcare pricing opacity to the pre-label days of food packaging. The complexity and lack of transparency enable price gouging and drive patient confusion:

  “We as consumers have no idea. But also, as a physician, I kind of don't want to know...If you need some sort of care, you should be able to get that care and you shouldn't, as a consumer, have to shop around for it.” – Dr. Lyerly ([23:41])

• AI and Prior Authorization ([23:19]):
  Insurance companies now use AI to further deny medical claims:

  “Insurance companies are now using AI to deny a lot of this stuff right off the bat.” – Amy ([23:19])

7. Healthcare Reform: Medicare for All, Government’s Role, and Political Obstacles

• The Limits of Medicare for All ([25:11–28:25]):
  Dr. Lyerly expresses skepticism about a blanket government-run system, especially given administrative volatility and reimbursement challenges:

  “Medicare itself is really pretty broken. When you look at the Medicare reimbursement schedule, it doesn't begin to cover the cost of the services that we provide.” – Dr. Lyerly ([27:55]) “We need to fix healthcare for Americans. Every single one of us needs healthcare...It's the number one reason people go bankrupt in this country.” – Dr. Lyerly ([28:10])

8. Policy Recommendations & Hopeful Activism

• Doctors as Advocates ([28:46–30:30]):
  Dr. Lyerly highlights the importance of physician advocacy, naming organizations like KFF, ACOG, and Committee to Protect Health Care. She emphasizes the role of organized medical voices in shifting public perception and policy on reproductive rights.

  “The Committee to Protect Health Care can go into places...recognizing that these Supreme Court races make it possible for Wisconsinites to be able to get health care, reproductive health care.” – Dr. Lyerly ([29:37])

• The Power of Ballot Initiatives ([30:30–31:51]):
  Recent state-level referendums on abortion illustrate both potential and pitfalls; confusion and convoluted campaigns can backfire without clear communication.

  “People need to get involved. We need to pay attention. We need to know what we're voting for. The midterms this November are going to be essential for the future of this country.” – Dr. Lyerly ([31:36])

9. Connection, Community, and Whiskey: The Silver Linings

• Shared Hope and Activism ([34:04–35:11]):
  Dr. Lyerly finds hope in local organizing, mutual aid, and the growing realization that the status quo isn’t working:

  “It's supporting each other that gives me hope. And I know that we're going to overcome, and I know that you're going to win in November. And I know that Democrats are going to take over because Republicans are just failing at every step.” – Dr. Lyerly ([34:57])

• Brandy Old Fashioneds, Wisconsin Style ([35:44–37:39]):
  Lighthearted exchange about local whiskey culture underscores the importance of joy and community, even amid heavy topics.

  “We are old fashioned people, but we don't do old fashions with bourbon. We are brandy people...If you come to northeastern Wisconsin, what you want to order is a brandy old fashioned sweet with cherries.” – Dr. Lyerly ([36:01])

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Notable Quotes & Memorable Moments

• On Politicizing Women’s Health:
  “Abortion isn't about abortion. Abortion is a political word that politicians use to get people all worked up.” – Dr. Lyerly ([02:38])

• On the Power of Stories:
  “Most people have a story...If you can tap into that and help them understand how their loved one or they would not have been able to receive care in this situation...that can be really life changing.” – Dr. Lyerly ([05:10])

• On Government Catchphrases:
  “It's a slogan...just like pro-life. Medicare for All. I think people use that to say, I want to make sure that everybody has some kind of healthcare.” – Dr. Lyerly ([27:48])

• On the Current State of Care:
  “Healthcare is on its last leg in the United States of America, and I don't know how we're going to be able to sustain this.” – Dr. Lyerly ([14:01])

• On Hope:
  “This. Us talking, you know, you and me getting the word out, us talking with our neighbors, the momentum that’s building.” – Dr. Lyerly ([34:04])

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Important Timestamps

• [00:37] — Introduction to post-Dobbs reproductive rights and ProPublica’s forced C-section case
• [02:30] — Explanation of the patchwork of state laws post-Roe
• [03:49] — Life-threatening travel gaps for miscarriage/ectopic care
• [04:51] — How to approach these debates in conservative areas
• [06:01] — Medical ignorance fueling bad laws
• [07:23] — IVF, personhood, and the Alabama fallout
• [09:17] — Political “solutions” that are all headlines, no substance
• [13:34] — Rural hospital and maternity care collapse
• [14:44] — Massive increases in insurance premiums
• [15:44] — Young generations’ pessimism about family, home, and the future
• [18:48] — Military women and forced postings in restrictive states
• [21:54] — The challenge of bringing transparency to healthcare pricing
• [27:55] — Flaws in Medicare for All and government-run care
• [29:37] — Medical organizations mobilizing for policy change
• [34:04] — Finding hope through community
• [35:44] — Cultures of whiskey (and brandy) in Wisconsin

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Concluding Tone & Takeaways

The episode maintains an urgent, conversational, and accessible tone—unafraid of hard truths, but always circling back to practical ways forward. Dr. Lyerly and the hosts emphasize that the fight for reproductive justice is deeply entwined with overall healthcare justice in America, and that both require broad-based education, physician advocacy, and determined voter engagement. The episode ends on a hopeful note, celebrating resilience and local traditions as small but significant sources of strength.

Transcript

[A]

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[B]

In the post Dobbs era, the issues of medical privacy and decisions are at the forefront of our conversations, particularly around reproductive health. In fact, ProPublica recently reported that courts are forcing women into C sections against their will. What does this say about freedom in this country? We're going to talk about that and more with our guest today, Dr. Kristin Lierle. Welcome to Truth in the Devil's Cut.

[C]

Well, thanks so much for having me, Amy. I'm so excited to talk about this because, you know, like we were just saying, the world is on fire and it feels like it's always something and it's so hard to keep up with all the little things. And sometimes reproductive healthcare just gets lost, even though it's a really important topic. We're not talking about it the way that we have in the past, but the threats are there. They're very real. And we are finding that our ability to access health care is being picked away at. And it's not just abortion anymore, it's birth control. It's how we choose, like you said, how we choose to deliver our babies. I mean, the ProPublica story about the woman who was in the hospital and they brought a court, a judge into the hospital, she had no representation and they literally forced her to have her baby by C section. As an OBGYN doctor, I can't even imagine.

[B]

I was just doing a panel for women's history just yesterday here in Kentucky. And the initial question on the panel to all the panelists was, where do you see the state of sort of women in the country? And my answer was because a lot of the other panelists were very positive about things. And I'm positive, too. I've seen a lot of good changes. But I almost feel like it's, and this is the case with reproductive health as well, and women's rights is it's two steps forward, one step back. And that, do you, do you have that sort of general assessment of, of where we're at Here in America, it

[C]

feels like one step forward, two steps back. Right now, depending on where you live. You know, after Roe v. Wade fell and we no longer had that national protection for abortion care. Abortion isn't about abortion. Abortion is a political word that politicians use to get people all worked up because people, people land in one camp or another, typically. But in my life, abortion is part of the spectrum of fertility care. So it's tied in with miscarriage management and infertility and definitely people who have complicated pregnancies. You can't legislate this stuff. So now instead of having this national protection, now all of this is in different states and it depends on your state and your state legislature and your governor. So if you live in a place like California, you've got a lot of protections. And if you live in Arkansas, things are tough. And I mean, there's recently been a lawsuit filed by four women and a physician in Arkansas because these women could not get care for complicated pregnancies and miscarriages. They had to travel out of state to get what they should be able to get in their own backyard. That's where the state of health care is for women right now.

[B]

Is that what is happening? And women are having to, you know, pack up in the car and go across state lines really, just to get care, just to get seen for certain complications.

[C]

Yeah, there are story after story, and it's not just post abortion care. It is truly miscarriage care. It is ectopic pregnancies. Ectopic pregnancies are pregnancies that implant in a place where they can't grow and survive. Usually it's in the fallopian tube. These are life threatening situations. These pregnancies will not survive. It needs to be treated. It needs to be watched very carefully. And people are being put back in their car and told to drive. This happened in Texas. There are a number of documented cases. You drive. Texas is a big state. To get from Texas to New Mexico, you're driving for hours. If that ruptures inside your body while you're in the car, that's a death sentence.

[B]

How do you talk about this, particularly this issue in sort of more conservative areas? I mean, just kind of the way you said it or. Because the politics here can be really complicated. People, you know, a lot of people don't understand what that pregnancy is, what, what it means, and they just think of abortion as like, well, this, this is birth control. And I'm against that.

[C]

Yeah, well, this is how politicians are telling us to think about it. And if you don't have a personal story, then you don't really understand. You don't have anything to tie it to. So there will always be those people who are going to be anti abortion and they don't even, they can't even have the conversation. But what I find is that most people have a story and it's either their own story or it's a story about somebody they love. And if you can tap into that and help them understand how their loved one or they would not have been able to receive care in this situation, in these circumstances, that can be really life changing. And for a lot of men, that is really how we have to talk to men. Because, you know, for women, if we're having periods, if we're having sex and we're concerned that we could get pregnant, we've all had this thought in the back of our mind, like, what would I do if. But for men, it's a really different experience. So you have to bring it to them in a little bit of a different way.

[B]

And I also, I'm laughing here, but I also find that a lot of men don't even understand the basic reproductive organs of women. You know, so you're sort of, you know, talking when you talk about those types of pregnancies, it's. Sometimes it goes way over people's heads.

[C]

A lot of women don't understand. Yeah, you know, we don't. That's part of the plan is to not educate people so that they don't know what they're talking about, so you can control them. Did you hear about the piece of legislation that was introduced in Ohio a couple years ago by an old white guy in the House who literally introduced a piece of legislation that if you had an ectopic pregnancy, you would have to take it and transplant it into the uterus in order for the embryo to survive. So newsflash, that doesn't happen. It is medically impossible. Science does not allow for that. But it was still something that this guy who didn't know anything about anything introduced because he was told to do it by some lobbyist with an agenda. I mean, think about it. If that would have passed and in an information vacuum, something like that feasibly could pass. What are we supposed to do? We can't do that. Like it's impossible. Yeah. So, yeah, more education, I think is so important.

[B]

We need it and. Well, can I ask you a little bit about IVF and how that fertility care. Because IVF has been something. You know, we have a president who said, didn't he say he was like the fertility president at one point, you know, father of ivf. Yep. But all of that sort of interconnected, right? I mean, what do people misunderstand about some of this stuff?

[C]

It's totally interconnected. Ivf. We are putting a sperm and an egg together and growing it, and then often testing these blastocysts to see what their genetic makeup is, because a lot of people who have infertility also have genetic issues. And then we're making a decision about how to implant this. And what do we do with the leftover embry. It is very sciencey, it is very ethical. It is very rooted in the personhood movement, because if you believe that there's a life when a sperm and an egg come together, then you've got a lot of those floating around in freezers all across the country. So IVF was really dragged into the abortion debate when in Alabama, the Supreme Court said that a sperm and an egg coming together, a fertilized egg is a person. It temporarily caused fertility clinics to shut down, which even a days, if your fertility clinic is shut down, because the fertility process is so time dependent, like when it is time for your. When it is time to go, when it's time for your transfer, it's time you can. You don't have three days. So this was really devastating for a lot of families, and it really made people understand, hey, wait a minute, we're trying to start a family and you're not wanting us to do that. And this is when the Trump administration got involved and tried to walk that very fine line between the antis who don't want IVF because they think IVF is actually worse than abortion and the will of the public. Most Americans do want IVF and recognize that this is important science. So this will be a very interesting thing to watch the GOP navigate as they are trying to please both sides of their party.

[B]

Right. And so how are they doing that right now? I mean, you know, we have this Trump administration, and what are they doing at the moment? Are they just sort of like, hey, I hope this goes away and nobody talks about it?

[C]

Well, that's kind of how they do things. You know, they put a headline out there, and then people get excited about the headline and there aren't any details. So when this first happened, Trump knew he had to do something. He was the fertilization president. So he issued an executive order that said that they would look at potential policies to improve IVF access. And 90 days later, when that order was due, there was Nothing. It was crickets. So they started to get pressure from the public. You know, people who are waiting to have babies are enthusiastic, like they, they,

[B]

they had hope, promised something and didn't deliver. Oh, my gosh. Shocking.

[C]

Can you imagine? Well, then he did come out with a second executive order and it had a great headline. It was like, donald J. Trump improves access to ivf. But then actually in the fine print, it was that you could buy one fertility medication at a discounted price on Trump Rx. That was the big thing. And then there was also, like a suggestion that large employers cover IVF treatment. But, but really there were, there were no teeth there. The medication that they offered is going to be helpful for some people, but it is not the panacea that a lot of people were hoping for. So, I mean, right now there's nothing going on. They are. We're seeing a lot of fights with mifepristone, with the FDA reexamination of mifepristone that was started a few months ago and then stalled because we know that medication abortion is very popular amongst the American public. And they knew that this would be a bad issue going toward the midterms, so they stalled it until after the midterms. But then we started to see pressure from the extreme right. Senator Josh Hawley just a couple weeks ago introduced legislation to just outright ban mifepristone to take away the FDA approval. So they're getting a lot of pressure and they're trying very carefully not to talk about it.

[B]

Yeah. And still with regards to ivf, you still have states like Alabama, who I'm assuming you can't, you can't have it there. You can't do it there.

[C]

Well, it's really tricky because they, the Supreme Court ruled that a fertilized egg is a person. But then the legislature, recognizing what a liability this was, went back and said, but you can't criminally or civilly prosecute doctors who are doing this kind of work. But there's still a big gap, there's a big gray area, because what happens in between those two things? So are there opportunities for antis to go after doctors who are practicing this kind of medicine? And the answer is yes. So some people still are practicing in these environments. I have a good friend in Mississippi and Louisiana because people need care, people need hope, people want to start their families. We need to be able to do that in an ethical way that is patient centered. And that is not what's happening right now in this country.

[B]

Yeah. I want to ask you about this big ugly bill from last summer that I think, well, I know for Kentucky, it's terrible in terms of health care. It guts our rural health care in my state. It guts Medicaid in my state, which puts rural hospitals at risk. There was just another article that came out yesterday about how many hospitals around the country rural hospitals are at risk because of this. I want to ask you what damage you have seen after the passage of this bill or what you are concerned about when it fully goes into effect.

[C]

I'm an OBGYN doctor who works in rural hospitals, and I was working in a rural hospital in northern Minnesota prior to this bill passing, and it was already tough. This was one of the hospitals that was on the University of North Carolina's list of hospitals that would be in danger if this bill passed. They struggle to recruit physicians. They struggle to recruit nurses. There are times when the cafeteria isn't even open and all you can get is a sandwich in a bag for the patients. It is really, really. It was really, really hard already, and now it's harder. Where I live in Wisconsin, there have been a number of rural hospitals that have shut down their labor and delivery units. We've lost over half of the of our obstetrical units in the past 20 years, our rural obstetrical units. People are having to drive further to deliver their babies. People are having to drive further to get the care that they need, and they can't afford the care that they need. I mean, Amy, these ACA subsidy cuts and the data out of KFF about how people can't even afford to pay their premiums, that's just your premium, and then you've got this giant deductible, and then people aren't going to seek care. They're not even getting preventive care. We're seeing things being diagnosed at a later stage, which is harder to treat with worse outcomes. Health care is on its last leg in the United States of America, and I don't know how we're going to be able to sustain this.

[B]

I've always said, you know, healthcare, the health care system was never perfect. But what these guys did, what these guys in Washington did, these Republicans, is they made a system that was bad to begin with, much, much worse. With this bill, I have texts from people who have shown me their bills. Their. Their premiums have gone from 300 bucks last December to 1300 bucks. I speak just yesterday. I speak with men and women all the time around Kentucky who have seen their premiums just skyrocket. They're in the thousands. And then you add in the deductibles, which we don't talk about enough. We talk about the premium's 1200 bucks. That's unaffordable. Then when they need care or their kid needs care or therapy or something like that, we're talking tens of thousands of dollars of out of pocket costs. Yeah.

[C]

And they're like, am I gonna put food on the table or am I gonna send my kid to the doctor for the infection that I think he has because he's had a fever for three days.

[B]

Yeah. That's where we're at.

[C]

Yeah.

[B]

In America, supposed to be one of the richest countries on earth and we're spending a million dollars a day in a war of choice in Iran. And you know, people can't get basic healthcare that's affordable.

[C]

Yeah. And in the meantime, our pregnant moms are saying no to standard of care ultrasounds in their course of care because they can't afford to pay for another ultrasound. You know, it used to be that if you had a baby, all of that was bundled together and at the end of your pregnancy, after you had the baby, you'd pay the bill. But now it's like every little piece is picked out and people are denying they're declining standard care because some of them haven't even paid off their last pregnancy yet. This is a system. This is a country where we want people to have babies. Show me a policy or anything that we are doing that our Republican leaders are supporting that actually nurtures a family, encourages people to have babies. My kids are Gen Z age and they're looking at the future and they're like, how am I ever going to buy a home? How am I ever going to save for retirement? They just don't even like it is not even something they can understand because it is so far gone for them. Yeah.

[B]

We talk about. Republicans like to call themselves the pro life party. And it always just struck me as so hypocritical because their policies are just not supporting life. They're not supporting quality of life for people.

[C]

It's a slogan.

[B]

Yeah. Let me go back a little bit to abortion care. Republicans say that it's really good now that this is left to the states. And you talked about, hey, maybe, maybe not so much. Is it mostly because of the traveling? And we have some states that just, you know, don't allow it at all and other states that do and that's causing the. Or are there any other issues that. Where we don't see the care that

[C]

we need here Abortion is healthcare. You cannot take abortion out of health care. I know politicians are trying and they're saying it can happen, but it's impossible. So people need healthcare in their communities. And yeah, people can't afford to travel. They can't afford to find somebody to take care of their kids. A lot of these people have kids already who are in school or at home and need assistance. They have to take time off of work. They just can't walk away from their lives. Think of any doctor's appointment that you need to make space for in your day. And now add having to travel to another state to go get it. Oh, and by the way, your insurance might not cover your care in that other state, depending on the health care system that you are involved with. So. And if you live in the Southeast, especially like the Deep south, where are you going to go? Illinois. I mean, you're going to have to fly somewhere to get care, so there's another layer of burden for you. It is so unbelievable to me that we are making women do this. This doesn't happen to men, but women have to travel, have to find all of these additional resources in order just to. To get standard basic health care.

[B]

Yeah. And the other thing about this, I, I know it's a very small group, but, you know, I'm, I'm somebody who spent 24 years in the military.

[C]

Yes.

[B]

And as a woman in the military, we have, depending on the service, anywhere from, from 15 to 30% of our military are, are filled with women, women of childbearing age. And those women in the military, they get orders to places like Alabama, they get orders to places like Texas. You have to go there, and there is no recourse. You can't just pick up and take off and go somewhere else. And that is why during the last administration, we had some policies that allowed women in the military to get reproductive care. This administration has just gotten rid of all of that, including policies on veteran care. You know, if you're, you're a woman who served and you get out after your four years, you might be 23 years old, 24 years old. And the, you, the VA owes you the government, that Uncle Sam owes you medical care. You served your country, but now the VA doesn't want to provide that reproductive. It's not the va. I shouldn't say the VA doesn't want to. The Trump administration and Republicans don't want the VA to provide that care. They don't want the military to be able to provide that care. And I just think that that is Also crazy, because those, those women are ordered to be there and they can't leave.

[C]

This is the Trump administration saying, we love our veterans, we love our military, but when it comes to actually helping, they are not there at all. And the people in the military are so. And you know this better than anybody, Amy. They can't speak up. They just get what they get and they just have to suffer with it. People get pregnant in the military. People need infertility services in the military. People need abortion care in the military. And trying to find those kinds of services in the places where they are is incredibly challenging. Our women in the military are suffering.

[B]

I want to ask you about something that I hear on the campaign trail a lot because I talk about, you know, I have discussions with voters all the time about health care and people. It seems like such a big system. How do we make it better? There's lots of different ideas. Something that continues to come up is transparency in billing in services. And I know you've talked about this because you've talked about price gouging in healthcare. How do we fix this? I often talk, I try to do it in simple terms where I feel like 50 years ago you bought a can of Coke and it didn't have, you know, that the outline of what was in there, how many carbohydrates, how many grams of sodium. And we passed a law in this country that had some transparency with the foods that you get. I feel like, can we do something like that with health care?

[C]

Well, we could if we had the will to, but it's just like abortion. You know, they use socialized medicine as the slogan and it gets people very worked up. And then they start talking about how terrible things are in Canada and we wouldn't want that, would we? It's so much worse here than it is anywhere else in any other developed nation. Our healthcare is the most expensive and we have the worst outcomes, especially for women. And there are plenty of other models that we could draw from. Canada, France, Germany, Japan, England, you name it. Everybody else has health care available to their citizens, so we absolutely could be doing better. And there's some really low hanging fruit. Prior authorizations is a great example. I don't know if you've gotten any healthcare recently, Amy, but anytime you go to the doctor and they recommend a medication or a surgery or some sort of a treatment, it goes through this prior authorization process. And more often than not, insurance companies block it and say no. And then the doctor's office has to go back and argue for why they think this is important. Most patients give up because they think if something is stopping it, maybe they don't need it. So people are suffering and they're dying unnecessarily, not because their doctor didn't want them to get the treatment, but because their insurance company said no. Here's another barrier. Because if you get this treatment, we're going to have to pay for it. And if you don't get this treatment, we're not going to have to pay for it. And that's better for our bottom line.

[B]

And insurance companies are now using AI to deny a lot of this stuff right off the bat. But how do you get the connection between just transparency in how much something costs, how, how would that help things? And who, who would be against that? I feel like insurance companies would be against that. I'm, I'm assuming.

[C]

I think hospital systems would probably be against it because they can set whatever price they want. Their contracts are very opaque. So if you have, you know, insurance company A, you're, you pay, you have this contract with your medical care provider. If you have insurance company B, you have a totally different contract. We as consumers have no idea. But also, as a physician, I kind of don't want to know. Like, if you need some sort of care, you should be able to get that care and you shouldn't, as a consumer have to shop around for it. You know, it's like when I think about prescription drugs, it is so confusing for the average person who needs a prescription drug, because if you go to Walgreens, you're going to pay this much, and if you go to cvs, you're going to pay that much. And if you go through your mail in pharmacy provider, you're going to pay this much much. And if you go to Trumprx, you're going to pay this much. And if you go to Goodrx, you might get a coupon that's going to give you a discount. How do people navigate this system, especially people who are cognitively impaired or don't have somebody who understands how the system is working or thinks that the system is currently working the way that it used to, which was much better than the way that it is right now.

[B]

Yeah. When you ran for Congress, you said you were skeptical of Medicare for All. Yeah. Can you talk about that? Because I, I've often said if we had Medicare for All right now, who would be in charge of it? RFK freaking Junior. Right.

[C]

And Dr.

[B]

Us, Dr. Oz. I mean, that's just scared the living out of everybody. And, and, and that's the problem I have. And I also bring up the VA because the VA is, you know, run by the government and look at what they're doing right now. Well, look at what the Trump administration and Republicans do when they're in charge of the va. We finally knew we had mental health. Veterans needed mental health care in a higher standard of care for many years, decades. We finally, over the last decade, Kristin got the VA to get it and we started getting more mental health counselors, psychiatrists, psychologists within the VA day and it started to get better. Trump administration comes in, Republicans come in and they fire them all. Yeah. You know, and, and, and now you. I've just talked to a, a, a veteran last night at an event who said, I, I can't get the care that I need. I have to drive, you know, four hours to get the care that I need and I can't get anybody on the phone. So my, my point in saying that is government run systems are at the whim of some of people who are running government. If those people are not great at their jobs, then people suffer. And so I want to get your take on this.

[C]

Well, I'll tell you, mental health for veterans is a personal issue for me. My cousin who was a veteran actually took his life just a little over a year ago because he couldn't get access. And his brother, who's also a veteran, is still struggling. So, yeah, this is very real and it's getting worse for our veterans. But to your point about the government running things, not the most efficient machine. It's a different kind of beast. You know, when we've got capitalism and insurance companies running things, that's, that's a different problem. I'm betting there's probably some sort of a compromise where there's a little, a little tension there that would be good for, for the American people. And that's, this is the problem I have with Medicare for All. It sounds great. Just like pro life. It's a slogan, Medicare for All. I think people use that to say, I want to make sure that everybody has some kind of health care. But Medicare itself is really pretty broken. When you look at the Medicare reimbursement fee or reimbursement schedule, it's not, it doesn't begin to cover the cost of the services that we provide. So healthcare has really gotten itself to a point where we are so out on a limb and we're just patching, patching, patching. We need to fix health care for Americans. Every single one of us needs health care. Every single one of us. Why is it that only the people who are entitled, who have access, who have some sort of a route to get health care are getting it. And people who really ought to have health care are walking away are saying no and then getting stuck and ending up in bankruptcy? It's the number one reason people go bankrupt in this country is they have some sort of a health issue. They can't afford to pay for it. Bankruptcy, like really, again, we're the wealthiest country on earth. Why is this happening?

[B]

Yeah, who do you follow in this area that maybe has some good ideas? Maybe there's a think tank or a person or somebody that's out there and you're like, wow, that, that, that. Man, if we had the political will, this is, this is a good idea. Not a, not a, you know, never going to happen idea, but something, some reasonable stuff.

[C]

Well, you know that there are experts who study these things. So there definitely are some great plans out there. There is not one size, a one size fits all plan. KFF is a great organization. KFF.org they do a lot of this policy work. It is not Republican work. It is not Democrat work. It is work for the American people. That's really where I turn for the data and the information that I need. But as an ob GYN doctor, I work very closely with the American College of Outcome Obstetricians and Gynecologists. They are our national professional organization and I serve on the executive board there. So we are very tied into what we need to do to be able to take care of our patients and to support our profession. And then I also work with the Committee to Protect Health Care. I chair the board there. This is a national organization, over 40,000 doctors, all different specialties, all in every single state. They're more political and that's really necessary because the big professional organizations are doing that, like really standard foundational work. But the Committee to Protect Health Care can go into places like, for example, Wisconsin, where I am right now. We've got a big supreme court race on April 7. We had one last year, you might remember, because it made national news. It was the most expensive Supreme Court race in history in this country. We had one the year before. The Committee to Protect Health Care is there recognizing that these Supreme Court races make it possible for Wisconsinites to be able to get health care, reproductive health care. So the committee puts doctors in places where they need to be in the media, writing up ads on tv talking about what health care means to Americans and to Wisconsinites. We need more of those voices More healthcare providers stepping up and sharing their professional experiences, their personal experiences. Because when we organize, that is how we're going to get out of this hole.

[B]

Yeah, that's. And we saw that in Kentucky, not to the same degree, but we had a constitutional amendment here in this state that was put on the ballot by the total far right extremist Republicans that are here and control the state house and Senate here in Kentucky. And they wanted the constitution be changed to basically ban all abortion care. And we put in an effort to make sure that voters knew what that meant. And Kentucky voters said no. And that was a win for Kentucky.

[C]

That's been so tricky all across the country because we've seen a lot of these referendums pop up in states like Ohio and Kansas. In Nebraska, a similar thing happened where both the pro and the anti abortion groups had referendums on the ballot and the campaigns got so confusing and so convoluted that people didn't know what to vote for. So it ended up not turning out well for Nebraskans. But this is, it just speaks to how people need to get involved. We need to pay attention. We need to know what we're voting for. The midterms this November are going to be essential for the future of this country. The direction that we take.

[B]

Well, this Wisconsin election that you're talking about is on Tuesday, April 7, is that correct?

[C]

That's correct.

[B]

Okay, for the, for the state Supreme Court. Is that also where in the primary elections are for, for Wisconsin, for the midterms?

[C]

No, Wisconsin's primaries aren't until August, so they're very late. Which makes it tricky because you are competing, you know, amongst your, the people on your side and then suddenly you have to pivot and start competing in the other direction. But that's okay. It gives us lots of time to campaign. Wisconsin is a swing state. There are a lot of independent voters here that are able to be won over. And they're people who. Wisconsin has a very progressive tradition. This is the home of fighting. Bob La Follette Earth Day came out of Wisconsin. Gaylord Nelson. This was where we started. Workers comp and state income taxes. We are a state that works together historically. Fifteen years ago, Scott Walker, who was elected governor, ruined all of that when he crushed collective bargaining. But it's coming back. It has been coming back for the past few years and it's really started with the Supreme Court. Now we've got new maps. The gerrymandering has almost entirely been broken and the people of Wisconsin can see the light on the horizon. So I feel very hopeful for the Tuesday election. I feel very hopeful for the midterms.

[B]

Well, and you have run for Congress before. Are you thinking about running again?

[C]

Not this time. I'm doing a lot of work in the, you know, in the Dr. Space, in the healthcare advocacy space. And I think healthcare is going to be the essential thing across the country. So that's where I'm focusing my attention. But, I mean, Amy, I'm six generations deep in this part of Wisconsin, and I'm in northeastern Wisconsin. I'm in the Green Bay area, so I'm not in the population centers. I love these people. We have so many connections, and I know that these people are not mega. What MAGA is saying does not represent the people where I live. So I feel like it is my obligation to my heritage and to my neighbors just to help people understand what's happening and what the consequences are.

[B]

Yeah, well, you do it in such a clear way that makes sense. So it's wonderful to talk with you today. What keeps you hopeful right now in politics or healthcare or just anything?

[C]

This. Us talking, you know, you and me getting the word out, us talking with our neighbors, the momentum that's building. Donald Trump is really great at one thing. He's really great at selling you something. That something often is nothing. It's a headline, it's some sort of a product that doesn't work, but it appeals to the American public. And we have been tricked for a long time, but I think people are starting to understand that what he sold us is broken. It doesn't work for us. So it's finding those people, pulling them in, helping them. All the mutual aid groups that are popping up and the community care and the hate against immigrants and all of these folks, disabled people. I just can't even believe what some of the disabled folks in my community are dealing with as a result of the Medicaid cuts and some of the political ugliness. So it's supporting each other that gives me hope. And I know that we're going to overcome, and I know that you're going to win in November. And I know that Democrats are going to take over because Republicans are just failing at every step.

[B]

Yeah, I mean, I think a lot of people are seeing the results of their failed leadership in so many areas and the promises that particularly that this president made, he's doing the opposite. And people are seeing that more and more. So it's great to have you on. This is a show where sometimes we talk about bourbon because it is truth in the barrel. And I wanted to ask you before we left, do you have a favorite bourbon or whiskey? Is there a Wisconsin one, perhaps?

[C]

I will tell you that I'm a little disappointed that we're taping at 8am because I was hoping that we could maybe drink while we were taping. But that's fine. Yeah. I am from Wisconsin. We happen to be the drunkest state in the country. I don't say that proudly. Just as like acknowledgement. I've got a big bottle of Woodford downstairs. That is my go to bourbon. But what we drink here is we are old fashioned people, but we don't do old fashions with bourbon. We are brandy people. It's a brandy old fashioned and then you pick your sweet or sour. Typically people go sweet and they garnish with cherries. So if you come to northeastern Wisconsin, what you want to order is a brandy old fashioned sweet with cherries. It's not what you'll get in Kentucky or New York. It's very different.

[B]

Well, I'd love that. And I love old fashions. That's, you know, and that's kind of my go to. If my husband and I go out to eat or something and I'm, you know, gone off to the bathroom and he always orders a drink and he always orders an old Fashioned for me because he knows that I love it. So when we come to Wisconsin, that's what I like to do. And the other thing I've learned about Wisconsin is you all have some good bike trails.

[C]

We've got amazing bike trails.

[B]

Yeah. Because I've seen like trips where you can go up there and just bike around for a while. You know, almost like when I think of biking around, I think about going to Ireland or something like that. But you could, we could go right to Wisconsin and do the same thing.

[C]

Oh yeah. And our roads are great for that because we've got great farming roads. You know, we've got to get the, we've got so much great agriculture. We've got to be able to get the crops out and the milk out. And the weather is not great in the winter, so they have to be good roads that are reliable. But Madison is a haven for biking. Milwaukee, we've got trails all over the place. Rails to trails started in Wisconsin so you can be on the first rail to trail, trail. And then up in northern Wisconsin especially, we've got some great mountain biking way up by Lake Superior. So yeah, come ride your bike. I love biking. Amy, do you ride, do you want to ride together?

[B]

I love biking and you know, I'm kind of busy right now, but, you know, when this campaign is over and we've done what we need to do, at some point, I'm going to be out there on the bike doing a. Doing a nice trip. So.

[C]

Yeah.

[B]

Well, it's been amazing to talk to you, such an informative discussion about what's going on in our country and also a discussion that really matters because a lot of this stuff, with everything else that's going on right now, we're not talking about this enough. It's not reaching the front pages the way that it should. And so I really appreciate you coming on.

[C]

Kristin, thank you so much for elevating this issue and for having me on today.

[B]

All right.

[A]

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