Latest / Single Payer Health Care / Single Payer Radio Senator Reginald Thomas Medicaid Cuts 08-07-26 Final

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Single Payer Radio Senator Reginald Thomas Medicaid Cuts 08-07-26 Final · Single Payer Health Care

0:00
Speaker 1: Hello, and welcome to Single Pair Radio. I'm Paul Hoppe,
0:03
broadcasting from the Abram Building in Louisville on the WFMP 106.5
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program because we believe healthcare is a human right. We
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advocate for a national, not-for-profit, publicly funded, single-payer healthcare system,
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commonly known as Medicare for All. It would cover dental, vision, hearing, prescriptions,
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Speaker 2: On Wednesday.
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Speaker 1: We also stream our show on SoundCloud, Apple Podcasts, and
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others so you can listen anytime. And remember, this is
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an all-volunteer radio station and relies on your ideas and
1:10
donations to keep us on the air. Before today's show,
1:14
I'd like to take a moment to remind you that
1:16
on November 3rd, we are going to have what may
1:18
be the most consequential election in our lifetime. It could
1:23
very well be that the survival of our democracy is
1:26
at stake. So be prepared to vote and encourage others
1:29
to do the same. Once again, Drs. Mike Flynn and
1:34
Jeanne Shively join me as co-hosts with their special guest.
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So let's get started.
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Speaker 3: Dr.
1:40
Speaker 2: Flynn? Yes, thank you.
1:42
Speaker 3: This is Michael Flynn, retired surgical oncologist from the University
1:47
of Louisville Surgery Department. Let me begin with the usual
1:51
disclaimer that any comments I make represent my personal views
1:57
and do not represent the views of the Department of
1:59
Surgery of the University of Louisville.
2:02
Speaker 1: Gene?
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Speaker 4: My name is Eugene Shoffley. I'm a retired general surgeon
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in Campbellsville, Kentucky. I've been on the clinical staff at
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the University of Louisville ever since I started practice and
2:15
have had a close relationship with them. Whatever I say
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does not reflect the Department of Surgery of the University
2:23
of Louisville, nor Taylor Regional Hospital in Campbellsville, Kentucky. North
2:27
Jane Todd Crawford Hospital in Greensboro, Kentucky.
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Speaker 3: So our topic today are Medicaid issues and the consequence
2:37
of the so-called Big Beautiful Bill, reproductive rights, and some
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issues related to the dysfunctional health care system that exists
2:48
in this country. We have a very special guest, which
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I will introduce in just a moment. but at first
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I would just like to challenge our listeners to double check.
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Speaker 2: The facts that occur in this discussion.
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Speaker 3: And there are multiple sources that have articles on Medicaid
3:13
issues and reproductive rights in the Journal of the American
3:17
Medical Association, New England Journal of Medicine, Wikipedia, And I
3:24
can just get on Google and put in whatever the
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topic is and get to a number of sources. So
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our special guest today is Senator Reginald Thomas. He is
3:36
a Democrat from Lexington, represents the 13th Senate District, which.
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Speaker 2: Includes part of Fayette County.
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Speaker 3: He was educated in Dartmouth College and Harvard Law School.
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Senator Thomas, thank you very much for coming on, and
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we're looking forward to a discussion with you about these issues,
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which are really important these days for many of the
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rural hospitals as well as the population of rural Kentucky.
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As we have done with our previous guests, we're going
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to give you an opportunity to make whatever comments you'd
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like to make about these issues for as long as
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you'd like to make them and then we'll begin the conversation.
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So Senator Thomas, the floor is yours.
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Speaker 5: Well, thank you for having me. And I will tell
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you that I can't imagine a more significant and more
4:35
timely topic, probably no more important topic regarding where we're
4:43
going to go after the 2026 election than this one.
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I never refer to it as Trump has called it.
4:53
I think the Republican bill that was passed last year,
4:58
an issue of Medicaid, did its most damage with health care.
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The Congressional Budget Office has already stated, and that's an
5:07
independent watchdog group, no party affiliation, has said that Medicaid's
5:16
going to lose $ 1. 1 trillion over the next 10 years.
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I mean, just think about that. That's over $ 100 billion
5:27
each year that's going to be removed from the Medicaid budget.
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That's going to have significant consequences to the people of
5:37
Kentucky because we're a state that receives significant amounts of
5:43
money from Medicaid. And and and we're going to because
5:48
of because of our situation and because of our heavy
5:52
dependence on Medicaid, that's going to impact a number of
5:57
different issues regarding just access to health care, maternal care,
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behavioral health issues, all of all of those kinds of
6:10
routine health care issues. occurrences are going to suffer as
6:14
a result of that reduction. That's just unacceptable. I think
6:23
healthcare is a moral right. I think morality says that
6:29
everybody should have the ability to see a doctor, to
6:34
get treated for their sickness, to get proper treatment so
6:41
that they can be well or comforted or whatever steps
6:46
can be taken to try to heal them. To just
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say cavalierly that we're going to just take, in Kentucky's case,
6:55
thousands of people off Medicaid, in America's case, millions of
6:59
people off Medicaid, and now that they have access to
7:01
health care, it's just unacceptable. That has not happened in
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a civilized society. So that's why I say this is
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an important issue. I'll close by this and let you
7:15
ask me questions. I do believe that we need to
7:20
develop a national health insurance system in this country. We
7:25
see it in a number of different other countries that
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are aligned with us democratically. We see this in Canada.
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I don't know of anyone in Canada saying, oh, I've
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got to move to the United States because I can't
7:37
get quality health care in Canada. Canada has a very
7:40
effective national health care system. We can do that here.
7:44
We can eventually have Medicare for all. I do believe
7:47
in that principle. We probably can't do it all at once,
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but I don't see any reason why we can't do
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it incrementally, say reduce Medicare or begin Medicare coverage at
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begin at $ 8. 55 rather than $ 8. 65. There's nothing magical about
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doing that. And again, we're not talking about about free
8:07
health care. People have to pay for it. When you're
8:09
on Medicare, you have to pay for that. And so
8:15
reducing the age limit so that we can get more
8:20
people on Medicare sooner is going to have to be
8:23
paid for by the taxpayers. But that's fine. It's a lot.
8:31
cheaper and more accessible than what we have now. And
8:35
those costs have passed across millions of people rather than
8:38
just a few. And Medicare works. Nobody's calling for the
8:41
end of Medicare. Nobody's saying Medicare doesn't work. It works
8:44
very effectively. So we need to move toward a national
8:47
health insurance program in this country. And I'll close with that.
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Speaker 2: Well, thank you. We absolutely agree with you.
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Speaker 3: And that's why we've been doing this program for the
8:57
last four years. We are the only first world country
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that does not have a government-run healthcare system that provides
9:09
access to healthcare for all of its citizens. Gene, you
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want to start the conversation off? Gene, you've got some
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data about how much money in healthcare is spent on
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healthcare and how much money is spent on other aspects
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of the healthcare the healthcare industry in this country. Maybe
9:33
you could start with that a little bit, and then
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we can go on with the conversation.
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Speaker 5: Okay.
9:39
Speaker 4: Well, we spend over $ 5 trillion on healthcare in America,
9:47
and that's about twice as much as any other developed
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country in the world. And I've, several years ago, looked up.
10:01
those numbers, and this is a gross estimate, but I
10:06
think there are other people who agree that approximately a
10:09
third of that money is wasted. For example, the for-profit
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health system, we're the only country in the world that
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uses for-profit insurance. If we went to non-for-profit insurance, we
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could say at least 15%, 15% of $ 5 trillion is
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a lot of money. We pay more for drugs than
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any country in the world. I was talking to a
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lady last night who had a new drug for migraine headaches,
10:45
and it was costing about $ 600 a her peel fortunately
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she was able to manipulate around and getting that paid
10:54
for right now and then we have a phenomenal administrative
11:00
bureaucracy that's uh uh just incredible um a lot of
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that is stimulated by our private insurance so uh and
11:12
then and there's more and more um that we waste.
11:16
For example, we're the only country in the world that
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allows physicians and hospitals and pharmaceuticals to advertise. And this
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is a tremendous cost. And then we have this problem
11:32
with polypharmacy. So I think if we could cut out
11:37
some of that waste, we could probably reduce our cost
11:43
tremendously and maybe reduce it to the point that we
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wouldn't have to increase taxes and we could cover everyone
11:53
for insurance. Senator, I'd like to ask you, what effect
11:57
do you think getting rid of the for-profit health care
12:03
system and the outrageous pharmaceutical costs in America, and particularly Kentucky,
12:11
would go toward... reducing our costs and providing care for
12:16
everyone else?
12:19
Speaker 5: Well, again, I want to say two things. One, I
12:25
think we need to minimize any profit that exists in
12:32
creating a barrier for someone getting health care. I think
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it's wise for us to try to reduce the need
12:42
for health insurance in this country. Uh, when you have
12:44
for-profit companies being the middleman in terms of deciding whether
12:49
someone gets, gets a, a screening or, uh, receives a, a, um,
12:56
some kind of, uh, pharmaceutical, um, pharmaceutical care, uh, or, uh, uh,
13:06
gets to see a doctor, I think that's wrong. Uh,
13:08
I think those decisions need to be made between the
13:11
patient and the physician, um, Again, I think given our
13:16
current system, this is not something that just can be
13:19
done overnight. But incrementally, we definitely need to get there.
13:25
I strongly believe and I don't think that insurance companies
13:30
should stand in the way between a patient and their
13:34
doctor and their treatment. That's not the insurance company's call.
13:37
That's the doctor's call.
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Speaker 3: Senator, let me make a make a comment, and then
13:45
ask you to respond to it. And I've said this
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on a number of occasions on this program. About 20
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years ago, there was a Louisville surgeon who had some
13:55
visual issues. He had to retire from surgery and ran
13:59
for public office and became a representative from one of the,
14:04
the House of Representatives, one of.
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Speaker 2: The Louisville, eastern Louisville districts.
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Speaker 3: He gave a talk at the Louisville Surgical Society and
14:13
made two very important points, one of which was that
14:17
making laws are like making sausage, and we've all heard
14:21
that before, and you probably know much more about that
14:24
than I do. And the other thing that he said,
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and this is what I would like to hear your response,
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was that most politicians do not understand the healthcare and
14:36
all of the issues related to it, which you obviously do. Now,
14:42
my question to you, how is this still true in
14:49
the legislature in Kentucky, where they're passing, you know, Medicaid
14:56
restriction laws on top of the so-called big, beautiful bill,
15:02
passed anti-abortion laws, legislation that is so confusing that obstetricians
15:12
trying to treat the complications of pregnancy.
15:16
Speaker 2: Can't do that.
15:18
Speaker 3: So again, what is the awareness of the issues, the
15:23
healthcare issues in the legislature, aside from yourself and maybe
15:29
others that may have a healthcare background?
15:34
Speaker 5: Well, let me say this. I'm not one who, obviously
15:39
maybe it's because I'm a lawmaker, criticizes politicians and lawmakers.
15:43
That's not something I generally do. So I'm going to
15:47
begin by saying this. Let's not forget that back when
15:52
the Affordable Care Act was passed in 2010, Kentucky, under
15:56
leadership of the first Governor Beshear, was the first southern
16:00
state to pass that expansion. So let's give some Kentucky
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credit here. Let's give Kentucky some credit here and its
16:07
lawmakers credit here, particularly Governor Beshear. We did that. And overnight,
16:16
we increased care for 95% of all Kentuckians under Medicaid.
16:22
Increased that care. From 2011 to by the end of 2012,
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you had... Of all the Medicaid recipients, 95% of them
16:34
had better health care than they had before we adopted
16:39
the ACA expansion. So Kentucky deserves some credit there. Now,
16:43
on the flip side, however, what we did this past
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much later session, when we basically took $ 290 million and
16:52
put it in a so-called lockbox, rather than appropriating that
16:56
money directly to Medicaid, I mean, that cost us, when
17:01
you look at what the match is, that costs about
17:04
a billion dollars in funding. And the only way we
17:09
can unlock that $ 290 million and put that back into
17:13
the Medicaid budget is by law. We have to go
17:15
back in the next session and pass a law to
17:19
release that $ 290 million and allocate it to the Medicaid budget. Now, that's,
17:27
as you know, not having that money has caused a
17:30
lot of concern and some consternation because it was being
17:36
threatened that you had a clinic in Louisville that was
17:39
about ready to close. Well, thankfully and wisely, Governor Brashear
17:44
stepped in and said, I'm not going to let that happen.
17:47
I'm going to fund that money out of resources that
17:49
I have to keep it afloat. And he did that.
17:53
So I guess it depends on what year and what
17:58
governor and who's making the decisions to determine whether you
18:04
want to be critical or applaud the actions of government
18:11
officials and politicians. But I will say that at least
18:14
from the standpoint of the first Governor Beshear and the
18:17
second Governor Beshear, that they've been staunch advocates for promoting
18:22
health care for all citizens here in Kentucky. and have
18:26
done everything that they could do to increase healthcare access
18:30
for those individuals.
18:32
Speaker 2: Oh, yes, I absolutely agree.
18:36
Speaker 3: We had Jason Smith, who was the CEO of UofL
18:40
Health on, and when the first Governor Beshear advanced and
18:46
expanded access to Medicaid, the non-paying patients at University Hospital
18:53
went from 20% down to five percent which made a
18:58
huge difference in in the in the resources available for
19:02
that not-profit system to to to carry out uh you
19:07
know other issues and they have some serious concerns about
19:12
what the future holds uh gene i'm sorry i didn't
19:15
mean to interrupt you i think you're about to say something.
19:18
Speaker 4: Yeah yeah i wanted to make one statement um um
19:22
A lot of people are going to say that we
19:25
are advocating for this, we're socialists. Well, if you look
19:31
at the history of Western civilization, there are three groups
19:36
of professionals who have always provided care for their clients
19:44
or patients or people in their parish regardless of their
19:50
ability to pay. Those are lawyers, those in the ministries,
19:56
and those in medicine. It's always been tradition that we
20:01
are a group of highly educated people who have knowledge
20:06
that other people don't have, but we are responsible to
20:11
take care of people regardless of their ability to pay.
20:15
So I don't think that saying that providing care for
20:19
people is a socialization.
20:23
Speaker 5: It's different.
20:24
Speaker 4: Medicine should not be included in capitalism. We're all for
20:29
capitalistic programs. We know from experience that, In the last
20:36
100 years, capitalism works, but it does not work very
20:41
well in health care or any other profession, including law
20:47
and ministry. What would you think if you had to
20:53
pay a priest for advice or a minister advice? So
21:00
this is outside of socialism. I want to ask one
21:04
other question to the senator. You talked about some money
21:07
being put in a lockbox. Can you explain where that
21:11
money went and what it's doing?
21:15
Speaker 5: Well, you said so much. Let me answer your latter
21:19
question first. By putting it in a lockbox, that money
21:24
remains as part of the Budget Reserve Trust Fund, what
21:27
people normally call the Rainy Day Fund. That's where it
21:31
is right now. To release it, it would take a
21:35
bill from the legislature to release it and reallocate that
21:39
money back to the Medicaid budget. That's the question. Now,
21:45
I think you asked the question of the day regarding
21:49
socialism versus capitalism. You're right. There are going to be
21:53
people who say that promoting Medicare for all is a
21:59
socialist program, that that person is a socialist. Well, you know,
22:04
we can't stop people from saying whatever they want to say.
22:08
They certainly have that First Amendment right. But I don't
22:14
know that watching someone not have health care and die
22:22
is a socialist or capitalist issue. I think that's a
22:25
humanitarian issue. I don't think you'll find anyone who believes
22:30
in a capitalist system more than I do. Uh, certainly
22:33
some of my practices just as a person are considered
22:37
capitalist practices. I'm a, I'm a business attorney. So I
22:40
work with people all the time who have an entrepreneurial
22:42
spirit and who believe in, in the capitalist society. But,
22:47
but I don't think saying that we ought to provide
22:51
healthcare access and offer healthcare, a government healthcare insurance to people, uh,
23:00
is an anti-capitalist program. No, that's a humanitarian program. That's
23:04
a program that believes in treating all people the same,
23:08
that shows care and love for all people. I think
23:12
that's more of a Christian value than being anti-capitalist. That's
23:19
my opinion. That's Reginald Thomas speaking. So that's my viewpoint.
23:27
Speaker 2: I agree. Go ahead, Gene. I'm sorry.
23:31
Speaker 4: I was just saying I agree 100% with that.
23:35
Speaker 3: Senator, we've done two programs with a Medicaid recipient, a
23:44
woman who didn't want her last name used, and she
23:48
has outlined some of the really difficult issues that Medicaid
23:54
recipients have to go through in order to establish and
23:59
maintain their eligibility. The simple process of trying to keep,
24:10
do this work requirements thing, most Medicaid recipients are either
24:16
working or taking care of family members or children, and
24:22
they're not only they're working, they don't have jobs that provide.
24:31
Speaker 2: Health insurance.
24:32
Speaker 3: And this is one of the major concerns. One of
24:35
the things I learned from her is that companies like
24:39
Walmart and Kroger's who are making billions of dollars have
24:44
people working there in a category that doesn't provide them
24:50
with health insurance. Have you got some thoughts about that?
24:55
Or is that something you're aware of? I certainly was
24:58
not aware of this until we had this program and
25:04
recognized that how many people in corporate America are not
25:12
being provided healthcare because they're put in a category that doesn't,
25:17
they're not even full-time employees.
25:21
Speaker 5: Oh, I am aware of that. I am aware. And
25:25
that's problematic because what you have in those situations are
25:32
private businesses basically misaligning their workers. They're treating them more
25:43
as independent contractors than employees, although they look like employees.
25:49
And because of that, and because even they are employees,
25:56
their salaries are really low, they have to qualify or
26:03
they do qualify for Medicaid so that you have the
26:06
government essentially supplementing costs that should be picked up by
26:13
those private employers. So, yes, I'm aware of this.
26:17
Speaker 3: Well, is there any indication or any interest in the
26:20
legislature to address this in some way that would have
26:28
an impact on access to health care for these Medicaid recipients?
26:36
Speaker 5: I think the legislature is aware of it. I just
26:42
don't think right now there's a will for them to
26:45
do something about this. One of the ways that I
26:49
have proposed for the last several years and will propose
26:55
again this coming session is that we need to increase
26:59
the minimum wage. We need to increase the minimum wage
27:04
now to about $ 15 an hour. That would put more
27:07
money in the hands of working people so that they
27:12
would be able to have at least some additional funding
27:18
to get some basic health care. And it would require
27:24
workers to pay these people more money. So that doesn't
27:30
directly address the problem, but that's one way to alleviate
27:34
it some is by giving workers higher wages.
27:39
Speaker 3: Well, some of the issues that were brought up were
27:43
simple things like requiring eligibility recognition every six months is
27:56
an extensive administrative burden for some of these people. They
28:03
send them a postcard to a place where they last
28:06
had the They may not live there anymore. They often
28:11
don't have computers.
28:13
Speaker 2: They may not even have cars.
28:16
Speaker 3: And the difficulties of dealing with all of these administrative,
28:19
this administrative burden puts a lot of eligible Medicaid recipients
28:27
off Medicaid. And again, these are, these are, these are
28:33
regulations that are put in place by the, by the legislature.
28:42
Speaker 5: Again, I think what you say is true.
28:45
Speaker 2: I know this isn't something you're doing.
28:51
Speaker 3: I'm just bringing this up because these are important issues.
28:56
Speaker 1: Right.
28:57
Speaker 5: I just have to reiterate what I said before. I
29:00
just don't think there's a will in the legislature to
29:07
look at primarily how we misaligned employees versus independent contractors
29:15
and the fact that we don't pay these employees significant
29:19
or sufficient salaries so that they can get access to
29:24
health care or required employers to provide health insurance to them.
29:33
That is a legislative fix there, but I don't think
29:38
there's a legislative will to do that.
29:42
Speaker 4: Would it be legal for the legislature to pass a
29:49
law saying that if you work for a big company
29:55
that you have to pay their health insurance?
30:02
Speaker 5: I think the legislature could do that. Yes, I think
30:08
they could do that. I would not be opposed to that,
30:15
but I think that's a heavy lift right now. And
30:18
I'm not talking just about Kentucky. I think that's a
30:20
heavy lift in Congress. Congress has never done that. And
30:30
I don't know that Congress has the ability, and I'm
30:33
talking about in terms of the votes, to do that.
30:36
It'll be interesting to see after this next election cycle
30:39
whether that comes to the table as an issue. Yes,
30:43
that can be done, but whether that will be done
30:47
is a whole other level of concern. of politics and
30:56
lobbying and decision-making.
31:01
Speaker 3: Could you give us a sense of what the recognition
31:04
is or what the thoughts are by the legislature about
31:09
the consequences of this so-called big, beautiful bill? And I'm
31:15
not going to use the four-letter words that I often describe,
31:20
but the rural hospital issue in Kentucky is really a concern.
31:27
The hospitals, nursing homes, Gene's talked about this a lot,
31:32
but I guess I'm kind of curious about how you
31:39
see your co-legislators dealing with this.
31:47
Speaker 5: Well, let me tell you what I think we need
31:49
to do, okay? We need to understand that a rural
31:54
hospital is more than just a healthcare facility. That's his
31:58
primary concern. But it's also an employer. It's a purchaser
32:05
of local goods in the community. And it's a training
32:09
site for future healthcare workers. Primarily though, it is the
32:15
reason why people live in that community and able to
32:18
continue to live in that community because it's a central
32:21
health care provider. You take away a rural hospital from
32:28
a community and you automatically endanger that community in terms
32:36
of its livelihood. As I said at the beginning of
32:41
this program, just getting health care for minor matters such as,
32:48
and I don't say minor, that might be the wrong term,
32:51
but what we consider relatively routine matters like colds or flus.
33:00
Maternity costs are being threatened when you move or move
33:05
a rural hospital. Issues like getting treatment for accidents car crashes, burns,
33:19
there's a loss of that kind of treatment. I mean,
33:24
it really devastates the lifeblood of that county or the
33:30
surrounding counties when you remove a rural hospital. So it
33:34
has a tremendous impact on us as a state and
33:38
as a people. So yeah, we need to always take...
33:45
take care to make sure that our rural hospitals are sustained. Now,
33:49
what we haven't talked about here, and I don't want
33:52
this program to end without my mentioning this. Excuse me.
34:00
That was sort of a tongue twister for me. But
34:05
there's something that's passed Congress called the Rural Health Transformation Program.
34:11
And Kentucky's going to get about $ 200 million from that program.
34:15
And that's going to help some providing services and much
34:20
needed revenues for our rural hospitals. But that doesn't replace
34:24
what's being taken away by the Republican bill of 2025. Uh,
34:30
because it, it, while it's a, it's a one time
34:33
infusion of cash, it, it, it doesn't address the need
34:37
for continuing revenue, uh, and, and, and continuing, uh, uh, uh,
34:45
costs that's incurred, uh, by the rural hospitals. And that's
34:51
what we want. That's what we want to sustain the hospitals.
34:53
We need, we need continuing revenue there that covered the
34:56
necessary costs to keep that hospital afloat.
35:01
Speaker 2: But so many of.
35:02
Speaker 3: These hospitals are, uh, Jane knows better than I do
35:06
are dependent on, on Medicaid.
35:10
Speaker 2: To keep them, to keep them going.
35:12
Speaker 4: Uh, Jane, uh, Well, our hospital is approximately 70 plus
35:20
percent Medicare and Medicaid. That's true of most hospitals in
35:25
our area. If you get up in Appalachia, it may
35:28
go up to 90 percent. So if you cut those programs,
35:35
it's going to be very, very difficult for them to
35:39
stay open. I was looking through the list of the
35:43
35 hospitals that were on the list, and some of
35:49
them are very, very significant. For example, the hospital at Madisonville,
35:59
the hospital in Henderson, and the hospital in Moorhead. I mean,
36:05
those are very important facilities And if you close those places,
36:12
it would dramatically affect health care in their area. And
36:17
there are a lot of very poor people that live
36:20
in that area. And transportation is a problem. We have
36:25
patients who absolutely have no way to get to Louisville
36:31
or Lexington. And not only that... They don't want to
36:35
go that far. I'll give you a classic example that
36:39
I was involved in. When I came here, we worked
36:45
for probably 15 or 20 years to try to establish
36:50
a cancer center. And we eventually started a center where
36:58
we could give chemotherapy. But we had to send patients
37:04
For complicated chemotherapy and for radiation therapy to Louisville, we
37:09
had a van service. So we had four or five
37:11
people riding a van every day, 90 miles to Louisville
37:15
at the Brown Cancer Center. And they would get their
37:18
radiation or chemo and then have to wait. They would
37:21
be sick. They felt terrible and nauseated. And finally, we
37:26
got our own cancer center. And now we can take
37:28
care of approximately 90% of those patients. And we worked
37:35
back and forth with the University of Kentucky at the
37:38
Markey Cancer Center and the Brown Cancer Center. And we
37:41
got a correlated program. And we essentially solved the problem
37:47
of disparity of care and cancer care. So we got
37:51
to keep that. And the University of Kentucky has done
37:56
a phenomenal job. of setting up cancer centers in rural
38:01
areas and affiliating with those cancer centers. And it's really
38:06
changed the outcomes in cancer care in the state of Kentucky.
38:10
And the state of Iowa is trying to reproduce that.
38:14
And other states are interested in what we've done. So
38:18
we've got to keep that. And if we cut Medicaid back,
38:22
we may lose it and it'll be a real disaster.
38:27
Speaker 3: Senator, maybe we could just change the subject a little bit.
38:31
And I was wondering if you could maybe help our
38:37
listeners and probably us understand some of the details of
38:43
some of the anti-abortion legislation that was passed.
38:49
Speaker 2: In Kentucky.
38:52
Speaker 5: Well, let me say this. Kentucky virtually now is a
38:57
state where you cannot get an abortion. Right now, you
39:06
are limited to just six weeks. You can only terminate
39:11
pregnancy within six weeks. After six weeks, if you're pregnant,
39:15
then you can't have that in Kentucky. I think that
39:26
I understand the moral issue, but here's what I believe.
39:30
I believe that healthcare is fundamentally a woman's right. I
39:36
certainly believe that if a woman feels like, for whatever reason,
39:42
that she does not want to be a mother and
39:44
finds herself in an unwanted pregnancy situation, she should be,
39:49
within a reasonable period of time, be allowed to have,
39:54
to terminate that pregnancy. Whether we're talking about an abortion
39:59
in 20 weeks, 18 weeks, or certainly something longer than
40:05
six weeks, she should be allowed to make that decision.
40:08
I'm very much a pro-choice individual. Now, obviously, at some point,
40:15
when you get far along in the pregnancy, that becomes
40:23
a bit more of a question mark and certainly more
40:27
challenging in terms of whether the pregnancy should be terminated
40:30
or not. But to my mind, anything less than 20 weeks,
40:35
because that's considered the time when a child cannot live
40:41
outside the womb, a woman should be able to have
40:43
that choice to terminate the pregnancy. That's my position. It's
40:47
been my position since I came to the Senate. It
40:50
was my position even before I came to the Senate.
40:53
And so I find Kentucky's current abortion laws to be
40:58
overly restrictive.
41:01
Speaker 3: Well, I didn't have an obstetrician or gynecologic background, but
41:10
the issues and the way the laws are written and
41:14
how confusing they are. It makes it very difficult for
41:19
an obstetrician or gynecologist to treat a woman who has
41:25
a miscarriage and ruptures her membranes and is at risk
41:31
of infection or bleeding. And if there's a flicker in
41:37
the ultrasound of the of the, of the embryo, it's
41:43
not a fetus, but an embryo, they, they, they often
41:48
can't treat this, which the normal treatment would be to
41:52
evacuate the contents of the uterus. And again, I'm not
41:59
blaming you for this, but I was, I was just
42:02
hoping you could help our listeners understand, um, how these
42:08
laws work, because they really do make it very difficult
42:12
to manage the consequences of a pregnancy.
42:19
Speaker 5: Well, they're so restrictive now that in the situation you describe,
42:23
an obstetrician would be at risk of criminal liability if
42:32
he made the decision, the medical decision, that the pregnancy
42:37
ought to be terminated because of the threat to the
42:43
woman's life or that the fetus was no longer viable,
42:48
that decision by him could result in criminal liability under
42:52
our current laws. No opposition ought to be put in
42:56
that decision where he thinks it's in the best interest
43:01
that the pregnancy be aborted. It's And it's really harmful
43:11
to the woman and to, in my mind, to society
43:15
at large that these kinds of decisions cannot be made
43:20
by a woman. Again, it's her body, it's her life.
43:24
These are choices that she should make and that society
43:28
should not make for her.
43:30
Speaker 4: Let me ask you a question. Is it possible in
43:34
our current legislature that we can keep the abortion law
43:46
for normal pregnancy, but we could change the law where
43:53
an obstetrician could take care of the complications of pregnancy
43:59
without a criminal prosecution? For example, if you had ruptured
44:08
membranes and the obstetrician felt that we had to do
44:14
an abortion to prevent the mother from getting a life-threatening
44:19
infection and sepsis, is it possible under our current legislature
44:24
that we could change that law without abortion? The other
44:29
abortion law.
44:31
Speaker 5: Yes, we could make that change. The legislature could do that.
44:36
I don't think in this current makeup, the legislature will
44:39
do that. But yes, the legislature could do that. Let me,
44:47
I'm doing some research here. So let me say this.
44:51
There is one medical exception.
44:54
Speaker 1: Okay. Okay.
44:55
Speaker 5: Under the statute, the law does read that a licensed
44:58
physician may act, that is, to terminate the pregnancy when,
45:05
in reasonable medical judgment, the procedure is necessary to prevent
45:09
the pregnant patient's death or substantial risk of death due
45:15
to a physical condition or a serious impairment of a
45:18
life-sustaining organ. So that's the only time a physician has.
45:25
A safeguard to abort a child is if in the
45:33
physician's reasonable judgment, he believes that continuing the pregnancy would
45:39
terminate or cause death to the mother.
45:44
Speaker 4: Okay. It seems as though a lot of physicians are
45:48
still worried about that. I know we've had some patients
45:51
that were sent out of state because of a They
45:56
were worried about prosecution. I know a lot of people
46:03
argue that this is... that the law is clear, but
46:10
apparently we need to make it clear so we can
46:13
get all this done. You could even put in there...
46:19
require a second opinion so that you could prevent... further
46:27
litigation and prosecution?
46:31
Speaker 5: Well, again, it hinges on what's considered reasonable medical judgment.
46:42
Those are good legal terms, but in a specific situation,
46:50
one person's reasonable judgment might not be another. So You
46:55
have that inconclusive legal analysis that obviously makes some obstetricians concerned, worried.
47:06
They don't want to have to deal with that. So
47:08
they move out of Kentucky. And what's the result of that?
47:12
Is that we have less access to maternal care for
47:16
women because the number of obstetricians and OBGYNs, they're fewer.
47:23
in this state. And that's not a good position to
47:26
be in.
47:28
Speaker 2: Yeah, you're absolutely right about that.
47:30
Speaker 3: The issues, you know, I think Idaho is a maternal
47:35
desert because the obstetricians and gynecologists in training have to
47:44
leave the state in order to get the kind of
47:48
abortion education that they need to pass the American Board
47:55
of Obstetrics and Gynecology. Then the problem is, as you
48:00
very well recognized, they don't necessarily come back. They don't
48:06
want to come back and practice in a state like this.
48:09
And the obstetricians and gynecologists in the state often end
48:14
up retiring early just because of all the difficulties of, of, of,
48:20
of dealing with these kind of vague and confusing anti-abortion
48:25
laws that make it very difficult to treat the complications
48:29
of pregnancies and some of the other occur. Another example
48:38
that is my understanding that if a woman has a
48:42
fetal anomaly, an encephalic fetus, that's a fetus that doesn't
48:48
have a brain, that that cannot be removed and allow
48:54
this person to go back home, get pregnant again, and
48:59
hopefully have a normal child, that the way the laws
49:03
are written in Kentucky, she has to carry this to
49:08
birth and then have it die. This is just remarkable stuff.
49:17
Speaker 5: Well, Michael, you're right about that. Again, from the language
49:23
of the statute, which I just read to you, if
49:29
the condition of the fetus does not threaten the safety
49:34
or welfare of the mother's life, The horrific description that
49:39
you just described, where a woman would be required to
49:43
carry that fetus for nine months, knowing that that fetus
49:48
is not going to live, that it's going to die
49:50
upon her birth. For her to have to do that
49:53
and endure that kind of medical condition, pain, mental anguish,
50:01
it's just beyond sanity. I mean, that's that is about
50:09
as cruel an action as one could take. And to
50:13
say we would require that, I don't know how someone who, again,
50:22
espouses himself as being human could allow that. I don't
50:28
have words, I don't have sufficient words to describe how
50:32
that can be allowed.
50:34
Speaker 1: You know, but But Senator, you know, your colleagues that
50:38
you have to work with, the majority of them actually
50:41
support that. I don't know how you can actually day
50:45
in and day out work with those people. It's amazing.
50:52
Speaker 5: You're right. That's all I can say. You're right.
50:56
Speaker 3: Well, let me, we're getting close to the end here.
50:58
Let me change the topics just a little bit. and
51:03
get you some of your thoughts about, and maybe Jean,
51:06
maybe we'll make a comment about this as well. That's
51:09
my understanding, and I have limited actual knowledge about this,
51:13
that large numbers of nursing homes in not only the
51:19
state of Kentucky, but in the country, are run by
51:23
private equity companies. These are companies that are focused on profiting. They...
51:34
change the structure of nursing homes, reduce the staff, and
51:39
their goal is to make as much money as possible
51:42
for four or five years and then sell it. I
51:46
wonder what your thoughts about that are. Gene, do you
51:51
want to make a comment before we ask the Senator
51:53
to give us his views about this?
51:58
Speaker 4: All the nursing homes in South Central Kentucky I'm talking
52:04
about Taylor County and surrounding counties are owned by private equity.
52:11
An interesting thing is most people don't even know that
52:16
when they get bought out, they don't change the name
52:21
and it's not publicized. It's owned by a group out
52:26
of town and run by a group out of town.
52:30
And so it's never mentioned. And other things that happen
52:36
is they will often change the personnel, like the doctors
52:42
who are the medical directors. I know one nursing home
52:48
just 11 miles from where I live where they changed
52:53
the nurse practitioner and the doctor, who was a local doctor,
52:58
very well known, and brought in someone from out of
53:02
town that nobody knew. Now, you know, that makes a difference.
53:07
Somebody's been taking care of your grandmother in the nursing
53:11
home for years, and you have respect and trustworthy, and
53:16
then they bring in a new doctor they don't know.
53:19
So this is a major problem, and it's causing a
53:26
lot of problems that people don't even know about.
53:32
Speaker 5: Well, Gina, Michael, let me tell you where I am
53:35
on this issue. I'm not opposed to for-profit companies owning
53:43
nursing homes. Let me begin there. I'm not opposed to that. However,
53:48
I do think we ought to have a couple of
53:50
regulations in place. One, I think there needs to be
53:53
some staffing ratios. And I've actually filed legislation on this
53:57
in the past, not recently, but in the past. that
54:00
says something to the effect that for every patient you
54:06
have in there, you have to have at least one
54:11
healthcare worker, or maybe, I think it was something like
54:15
three to one, you know, three orderlies or three assistants,
54:22
but you need to have staffing ratios sufficient to make
54:27
sure that you don't have issues with bed bugs or
54:31
bed sores, or the person can get up and walk around.
54:35
There needs to be sufficient staffing levels. I don't think
54:37
it was one-to-one, but it's like three-to-one or four-to-one.
54:40
Speaker 1: Senator, if I could interrupt it, if it were three-to-one,
54:44
that would cover 24 hours a day with one attendant.
54:49
Speaker 5: Well, that makes sense. Right now, we don't have staffing ratios.
54:54
You have to have staffing ratios. Sufficient, again, to make
54:59
sure that the patients don't have the kind of issues
55:03
that we see occur in nursing homes, like bed sores,
55:07
bed bugs, the lack of mobility, the patient get out
55:13
and walk around the nursing home during the day. And
55:17
then secondly, you have.
55:19
Speaker 1: To have- Excuse me, I need to interrupt here again.
55:21
I'm sorry, but we're at the two minute warning now.
55:23
So we're just about out of time.
55:26
Speaker 5: Quickly, you need to have a medical director on-site at
55:31
least 14 to 16 hours a day from 7 a.m.
55:37
to like 10 p.m. There needs to be a doctor
55:42
there during the day to provide on-site treatment. I think
55:48
you need at least those two types of regulations in
55:51
place because you're right, for-profit nursing homes are concerned about
55:57
their bottom line and making money. And where they can
56:00
cut personnel costs, which is the highest cost they incur,
56:03
they will do that. But that's not the safety of
56:06
the residents.
56:07
Speaker 3: We're about out of time here. I want to thank
56:10
you for coming on. I am impressed with your knowledge
56:16
of the health care issues. And I wish everybody else
56:21
in the legislature had your same thoughts and views about
56:25
all these things. So I think we're at the end
56:27
of our program. Paul, you want to take us out?
56:34
Speaker 1: Yeah, I think we, you know, does anybody have any
56:38
other urgent questions they want to get out here first
56:41
before we go? I mean, I can always adjust the time.
56:45
Speaker 2: No, Senator, would you like to make any final comments?
56:49
Speaker 5: Now, I'm glad you're having this discussion. As I said
56:53
at the beginning of this radio interview, I think the
56:59
number one topic that has to be addressed following this
57:05
2026 election, and I hope it goes the way it
57:08
seems to be going, keep my fingers crossed, is that
57:11
we have to improve our healthcare problem. We need to
57:20
move closer toward a national insurance program. That's the first
57:26
step we've got to take. So this topic that you're
57:29
promoting is number one, in my opinion.
57:34
Speaker 2: Well, again, thank you again for coming on.
57:37
Speaker 1: Yes, thank you so much.
57:38
Speaker 5: We appreciate it. Thank you, and I wish you gentlemen
57:41
a very wonderful Labor Day weekend.
57:44
Speaker 4: Thank you very much, Senator Thomas, and thank you for
57:47
coming on.
57:49
Speaker 2: All right.
57:49
Speaker 1: So, guys, good program. I think it's going to be
57:53
well received.
57:55
Speaker 2: I think so, too. Thank you.
57:58
Speaker 1: For more information on today's program and others like it,
58:02
visit our webpage at kyhealthcare.org. Once again, this is Paul
58:06
Hoppe thanking you so much for tuning in. Have a
58:09
wonderful rest of your day.