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A medical brain drain out of Texas
Jun 22, 2023
Episode 951

A medical brain drain out of Texas

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Health care providers are leaving states that have banned abortion and gender-affirming care.

Since Roe v. Wade was overturned nearly a year ago, conservative-led states, including Texas, have passed a slew of bans on abortion and gender-affirming health care. Now, many medical students and doctors are choosing to work elsewhere. We’ll get into it. India has become a top customer for Russian oil. We’ll explain what that means for the global oil supply and regional geopolitics. Plus, a device that makes water out of thin air, and the head of Turkey’s central bank makes the hosts smile.

Here’s everything we talked about today:

Join us tomorrow for Economics on Tap. The YouTube livestream starts at 3:30 p.m. Pacific time, 6:30 p.m. Eastern. We’ll have news, drinks, a game and more.

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Make Me Smart June 22, 2023 Transcript

**Note: Marketplace podcasts are meant to be heard, with emphasis, tone and audio elements a transcript can’t capture. Transcripts are generated using a combination of automated software and human transcribers, and may contain errors. Please check the corresponding audio before quoting it.

Kimberly Adams

I am good to go when y’all are.

Kai Ryssdal

Okay!

Kimberly Adams

Hello, I’m Kimberly Adams. Welcome back to make me smart where we make today make sense. It is June 22.

Kai Ryssdal

I’m Kai Ryssdal. Thanks for joining us today. We’re gonna do some news. I’m gonna do the smile thing. And then we will move briskly on about our day. So we’ll do some news items. Why don’t you go first?

Kimberly Adams

Yes, indeed. So there’s been a lot of great reporting coming out around the one year anniversary of the Dobbs decision at the Supreme Court, which you know, as everyone probably knows, overturned Roe vs. Wade, and the 19th has been just spot on, on so much of its coverage over the last week. Last year, sorry, the last year about the fallout of this decision. And they have a piece about abortion bans and gender affirming care bans in different parts of the country and how it’s doing. These, these bans are doing exactly what people in the medical profession predicted would happen, which is that it’s making doctors leave the states and communities and bringing fewer medical medical students willing to do residencies, fewer medical students applying to jobs there or applying to college there. And they’ve got some really interesting statistics I’m going to read some of them starting in 2022, months after the state, this is Texas by the way, the state six-week abortion ban took effect, “the number of medical students applying to Texas-based OBGYN residencies fell by 10.4%. The trend has continued in 2023: Texas saw a 5.4% decrease in applicants to its medical residency programs with a 6.4% decrease for OBGYN specifically. Both of those are significantly larger decreases than the national average.” There’s some really heartbreaking stories in this piece about, you know, people who’ve had very severe complications because of the lack of access to care. But currently, this is from the piece also, Texas only has in terms of the ratio of adolescent medicine providers to patients is much lower in Texas than the rest of the country. This is related to the gender affirming care stuff. “Currently, Texas has only 0.5 providers per every 100,000 potential pediatric patients in the entire state. For contrast, Massachusetts has 3.2 such providers per 100 100,000 patients.” So, “despite having less than a third of the number of people as Texas, Massachusetts is home to more adolescent medicine clinicians.” Yeah, it’s it’s, it’s, it’s, this piece is great, you should read it. And Shefali Luthra, the health reporter over at the 19th wrote it. And you know, this was all predicted, literally, right when the decision came down, and it’s having real life consequences for people.

Kai Ryssdal   

Yeah, I would also say this all was predicted, but it’s an object lesson in the law of unintended consequences, right? Because the Supreme Court, if you remember, in that Dobbs decision said “We now return the question of abortion to the states.” And what is happening is unequal treatment. It is denial of services on an equal basis. There’s a lot of things that I don’t think anybody thought was going to happen other than the big denial of service thing that are really bad, that are really bad.

Kimberly Adams   

I mean, I feel like a lot of the pro-abortion advocates certainly predicted this and warned in even in some of the briefs for the case, were warning about this stuff potentially happening. And so, like it was definitely predicted, but just not as loudly and I mean, we talked about this before. I think so many of us just didn’t seriously think that Roe would be overturned that we probably didn’t give it enough attention beforehand.

Kai Ryssdal   

All right. So mine is sorry, I was gonna close the door because they’re mowing the lawn next door. Anyway, mine is a piece by the New York Times today, a big interactive piece and a data journalism piece from the New York Times by Ana Swanson and a bunch of other staffers, on Indian oil imports. And I mentioned that number one, because Prime Minister Modi is in town today. But number two, we’ve talked a bunch of times on this podcast, specifically back when the invasion first happened last year about American and Western efforts to limit Russian oil flow and sales into the wider world. And what we’ve seen since and what the New York Times reports on in great depth and detail today is that what’s happened is Indian Oil, Chinese sorry, Indian oil purchases and to some degree Chinese as well. But this article is mostly about India, India is buying a ton of Russian oil, right. And you say to yourself, well, that’s bad, we don’t want the Russians to be able to sell their oil. But what is happening is twofold. Number one, the Russians aren’t getting the price they used to for their oil, so they are getting less revenue, which is a good thing, and which is what the Western allies wanted when they put sanctions on. But number two — and this is a little counterintuitive, but let’s remember that oil is a global market — what the West wanted to do was punish the Russians to some degree, but also to keep Russian oil flowing. Because we need Russian oil globally, right, we use basically every drop of oil that we produce every day, we use that up in this economy. So if we had taken Russian oil completely out of circulation, it would have meant higher prices for the rest of the world, economic shock. And you can see where that’s going. So what has happened is that as a result of Western sanctions, the Indians are buying more oil from the Russians, which, okay, fine, but the Russians are getting less money for it. And that Russian oil is displacing Middle Eastern oil that the Indians would have otherwise bought, and thus used up that global share. So it’s really interesting piece, it’s a little bit of a connect the dots thing. But the Western sanctions, I think you can argue, are kind of working, they’re kind of doing what they were supposed to do or what people wanted them to do. And that’s I thought that was interesting.

Kimberly Adams 

And India’s getting a good deal on oil out of it. Like they’re able to buy that oil, so much cheaper. And I imagine that’s helpful for their economic growth, even if it’s fueling, literally, the war in Ukraine. I did not mean to make that a pun. Yes, it was interesting. Today in the press conference, you know, people were asking about this, and you know, but Biden said that it came up. And, you know, this idea that, and this was in some of the reporting elsewhere, this idea that the US can’t press India too hard on this issue, or human rights for that matter, because they really need, we really need India’s cooperation on China, because the US and India are pretty aligned and being concerned about the threat of Chinese influence and China’s role in that region. And so the US can’t really say that much. I mean, they could, they won’t. But anyway,

Kai Ryssdal  

Yeah, anyway, Drew let’s go

Kimberly Adams

Okay, since I just gave all those horrible statistics from Texas, I wanted to bring a fun story or a good story, a positive story out of Texas, which comes by way of Spectrum News 1, or at least that’s where I found it. I’m sure it’s one of Spectrum News broadly or nationally. But anyway, we’ll have a link to it in the show notes. There is a guy in Texas, Moses West, who is founder of a company called Atmospheric Water Generator Contracting LLC, who has basically created these machines that turn air into drinking water, which it’s effectively what a dehumidifier does, like you know, you have a dehumidifier and it collects water from the air to make your house you know less humid, but then you usually just like throw it out, water your plants with it, whatever. But he’s created these systems that then run that water pulled from the air through a filtration system and you know, distributes water and he’s set these up, you know, helping hurricane Maria victims in Puerto Rico. He’s planning to install them for folks in Flint, Michigan. Let’s see where else? And they’re manufactured in Wisconsin. And it says just one of these units provides a city with hundreds of gallons of water at no cost to residents. And he has been working with a group called the Water Rescue Foundation to cover the cost and you know, according to the video, that’s with it, he was saying that it doesn’t really take that much energy. And these can be set up, you know, all over the world. They basically look like long, like shipping containers and got a little spout on the side. It’s pretty cool. So that made me smile.

Kai Ryssdal 

Yeah, no, that’s good. Okay, mine is a little, a little dorky, a little geeky, but it follows the news of the day, which if you listened to Marketplace today, you would have heard me talk about Central Banks raising interest rates all over the world today, the Norwegian Central Bank, the Bank of England, the Central Bank of Switzerland, and also the Turkish Central Bank, and I am making this my make me smile for two reasons. Number one, it appears that some kind of economic sanity has returned to Turkey, because for a long time, a very long time, under the prior Central Bank governor, President Recep Tayyip Erdogan, was cutting interest rates in the face of inflation that is, as of today at 39%. And if you know anything about interest rates and inflation, you know that cutting interest rates in the face of inflation at 40% is a recipe for disaster. And in point of fact, that’s what happened because inflation goes up, people have less purchasing power. And there’s a burgeoning economic crisis in Turkey. So there’s that. So the Turkish Central Bank today raised its interest rate from 8.5% to 15%, just about doubling. So number one that’s dorky and interesting, just in a straight-up economic sense. But here’s why they did it. They have a new central bank governor. Her name Hafize Gaye Erkan. She is a Princeton-trained expert in financial risk management and a former person at First Republic Bank and Goldman Sachs. So now they have an honest to god person who knows what’s going on in the Turkish economy, in charge of the central bank. And that’s a good thing. And it made me smile, because Turkey for as much of a pain in the patootie as it can be to the United States and other Western allies, is really important. It’s geo-strategically critical. It’s a member of NATO. Thank you. Hello, Article Five, “an attack on one is an attack on all.” So it’s really a critical country that that honestly kind of gets short shrift. And it’s good to see that there’s some economic stability and common sense returning. Thank you for coming to my TED Talk.

Kimberly Adams

I’m just visualizing her sort of going into Erdogan’s office, right, with white poster boards with like graphs and things like they used to do with Trump, where they had to, like put things on one pagers or on big charts to like, get him to agree to stuff. And I wonder if she had to do something like that. Like, let me draw it out for you. We’re screwed. Yep. Okay. Absolutely, totally. That is it for us for today. I will be back tomorrow with Meghan McCarty Carino, for Economics On Tap. Please join us, we will be live streaming on YouTube starting at 3:30 Pacific 6:30 Eastern.

Kai Ryssdal

And if you want to find out what our team is reading and drinking this week, sign up for the Make Me Smart newsletter out every Friday morning. You can find it and all the other marketplace newsletters marketplace.org/newsletters. That’s where we go with that.

Kimberly Adams

Make Me Smart is produced by Courtney Bergsieker. Today’s episode was engineered by Drew Jostad. Ellen Rolfes writes our newsletter. Our intern is Nilou Shahbandi.

Kai Ryssdal 

Marissa Cabrera is our senior producer. Bridget Bodnar is the director of podcasts. And Francesca Levy is the executive director of Digital and on demand enterprise. Your enterprise. Enterprises.

Kimberly Adams

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