WEBVTT 00:00:00.000 --> 00:00:02.879 Welcome, everyone. It's really great to have 00:00:02.879 --> 00:00:06.139 you with us today. We have, well, a really fascinating 00:00:06.139 --> 00:00:08.439 deep dive lined up for you. Yeah, we do. Our 00:00:08.439 --> 00:00:11.500 mission today is to explore a singular, highly 00:00:11.500 --> 00:00:14.099 detailed compilation of research surrounding 00:00:14.099 --> 00:00:17.820 an organization called Plan C. And this is a 00:00:17.820 --> 00:00:20.239 nonprofit and public health campaign that's entirely 00:00:20.239 --> 00:00:23.100 focused on providing information and educational 00:00:23.100 --> 00:00:26.239 resources about accessing abortion pills by mail 00:00:26.239 --> 00:00:28.690 in the United States. Right. And before we get 00:00:28.690 --> 00:00:31.269 into the mechanics of how this organization operates, 00:00:31.489 --> 00:00:33.649 we really need to pause and establish a very 00:00:33.649 --> 00:00:36.070 important ground rule for today's deep dive. 00:00:36.210 --> 00:00:38.130 Absolutely. We are looking at source material 00:00:38.130 --> 00:00:40.070 that covers abortion access and reproductive 00:00:40.070 --> 00:00:43.509 rights. And this is a highly politically charged, 00:00:43.829 --> 00:00:46.909 deeply personal topic for many people. So we're 00:00:46.909 --> 00:00:48.689 going to make something crystal clear to you, 00:00:48.789 --> 00:00:50.829 the listener. Neither of us is taking a political 00:00:50.829 --> 00:00:53.289 side here. No, not at all. We aren't here to 00:00:53.289 --> 00:00:56.390 endorse any viewpoints, advocate for any policies 00:00:56.390 --> 00:00:59.979 or... or condemn any practices. Right. Our job 00:00:59.979 --> 00:01:01.920 is strictly to act as your guides through the 00:01:01.920 --> 00:01:03.960 research, just bringing you the facts of the 00:01:03.960 --> 00:01:06.879 case. Exactly. We are looking at this strictly 00:01:06.879 --> 00:01:09.379 through the lens of organizational history, digital 00:01:09.379 --> 00:01:12.299 networking, and healthcare logistics. We're going 00:01:12.299 --> 00:01:15.379 to impartially convey the factual history, the 00:01:15.379 --> 00:01:18.099 operational mechanics, and the stated objectives 00:01:18.099 --> 00:01:21.140 of the Plan C organization exactly as they are 00:01:21.140 --> 00:01:23.939 presented in our sources. Nothing more, nothing 00:01:23.939 --> 00:01:26.180 less. I'm glad we laid that out because it lets 00:01:26.180 --> 00:01:29.060 us focus entirely on the operational mechanics, 00:01:29.280 --> 00:01:31.659 which are, I mean, honestly, they're mind -blowing. 00:01:31.799 --> 00:01:34.099 They really are. Okay, let's unpack this. Because 00:01:34.099 --> 00:01:36.480 if you are sitting there wondering why this specific 00:01:36.480 --> 00:01:39.219 deep dive matters to you, consider this. Whether 00:01:39.219 --> 00:01:40.980 you're studying the evolution of health care 00:01:40.980 --> 00:01:44.019 technology, tracking modern legal history, or 00:01:44.019 --> 00:01:46.540 if you're just insanely curious about how digital 00:01:46.540 --> 00:01:49.799 information networks adapt in real time to physical 00:01:49.799 --> 00:01:52.799 roadblocks. This is a masterclass. It is a masterclass. 00:01:52.920 --> 00:01:55.519 It's an incredible look at how a single organization 00:01:55.519 --> 00:01:58.260 utilized telehealth, digital directories, and 00:01:58.260 --> 00:02:01.099 the U .S. postal system to navigate a constantly 00:02:01.099 --> 00:02:03.719 shifting medical landscape. So let's start with 00:02:03.719 --> 00:02:06.090 the blueprint. What exactly is Plan C? Well, 00:02:06.170 --> 00:02:08.550 the foundation was laid in 2015 by three founders, 00:02:08.810 --> 00:02:11.469 Francine Coetho, Elisa Wells, and Amy Merrill. 00:02:11.650 --> 00:02:14.550 And structurally, it operates as a campaign that 00:02:14.550 --> 00:02:18.210 is fiscally sponsored by a 501c3 nonprofit called 00:02:18.210 --> 00:02:20.789 Possibility Labs. And just to clarify what that 00:02:20.789 --> 00:02:22.750 means for anyone unfamiliar with the nonprofit 00:02:22.750 --> 00:02:26.490 world, physical sponsorship basically means Possibility 00:02:26.490 --> 00:02:28.949 Labs handles all the heavy lifting regarding 00:02:28.949 --> 00:02:32.129 tax -exempt status. Right, the legal compliance, 00:02:32.310 --> 00:02:34.389 the financial administration. Yeah, all that 00:02:34.389 --> 00:02:36.639 back office stuff. This is a common strategy 00:02:36.639 --> 00:02:39.780 because it frees up the Plan C founders to focus 00:02:39.780 --> 00:02:42.759 entirely on executing their actual mission rather 00:02:42.759 --> 00:02:45.039 than getting bogged down in administrative paperwork. 00:02:45.340 --> 00:02:47.280 Which is crucial when you have a mission as complex 00:02:47.280 --> 00:02:49.500 as theirs. And their mission is driven by four 00:02:49.500 --> 00:02:51.719 main goals. Let's break those down. What are 00:02:51.719 --> 00:02:53.930 they actually trying to achieve day to day? So 00:02:53.930 --> 00:02:56.129 the first goal is all about data gathering and 00:02:56.129 --> 00:02:58.530 sharing. They research and publicly share information 00:02:58.530 --> 00:03:01.050 about how people are accessing the two medications 00:03:01.050 --> 00:03:04.550 used for abortions, mifepristone and misoprostol 00:03:04.550 --> 00:03:06.650 in the U .S. And to give a very quick baseline 00:03:06.650 --> 00:03:09.590 here, these two medications are used in tandem 00:03:09.590 --> 00:03:12.780 as a regimen to end an early pregnancy. Exactly. 00:03:12.900 --> 00:03:15.580 So Plan C's goal is to gather domestic and global 00:03:15.580 --> 00:03:18.479 evidence about the safety and efficacy of accessing 00:03:18.479 --> 00:03:20.639 these pills, especially outside of traditional 00:03:20.639 --> 00:03:22.879 clinic settings. So they aren't just an advocacy 00:03:22.879 --> 00:03:25.120 group making noise. They are actually functioning 00:03:25.120 --> 00:03:28.280 like a data gathering research hub. That's a 00:03:28.280 --> 00:03:29.919 great way to put it. They're heavily data driven. 00:03:30.139 --> 00:03:32.520 And building on that data, their second goal 00:03:32.520 --> 00:03:35.120 is connection. They actively collaborate with 00:03:35.120 --> 00:03:37.319 reproductive health organizations and technology 00:03:37.319 --> 00:03:39.680 innovators. To build bridges, essentially. Right. 00:03:39.800 --> 00:03:42.120 Connecting individuals directly to the telehealth 00:03:42.120 --> 00:03:44.439 providers or services that actually facilitate 00:03:44.439 --> 00:03:47.259 medication abortion. Then the third goal moves 00:03:47.259 --> 00:03:50.599 into the cultural space, which is advocacy. They 00:03:50.599 --> 00:03:53.439 actively push for the destigmatization of self 00:03:53.439 --> 00:03:56.460 -managed abortion, and they advocate for over 00:03:56.460 --> 00:03:59.539 -the -counter access. And the fourth goal? Disruption. 00:04:00.039 --> 00:04:03.020 They want to dismantle what they view as unjust 00:04:03.020 --> 00:04:06.039 barriers to medical abortion access with the 00:04:06.039 --> 00:04:08.340 ultimate objective of putting agency back in 00:04:08.340 --> 00:04:10.620 the hands of individuals. It's a highly structured 00:04:10.620 --> 00:04:13.500 four -part strategy, but the fascinating part 00:04:13.500 --> 00:04:16.600 is how they actually execute this. Because the 00:04:16.600 --> 00:04:19.360 main tool they built to achieve these goals is 00:04:19.360 --> 00:04:21.740 something called the Plan C Guide. Yes. Think 00:04:21.740 --> 00:04:25.319 of this guide like a highly specialized geotargeted 00:04:25.319 --> 00:04:28.689 search engine. Or maybe a super robust medical 00:04:28.689 --> 00:04:31.009 directory, almost like a Yelp for telehealth. 00:04:31.129 --> 00:04:34.089 It provides detailed state -specific information 00:04:34.089 --> 00:04:36.709 so a user can understand their exact logistical 00:04:36.709 --> 00:04:39.290 options based on the specific state they live 00:04:39.290 --> 00:04:41.720 in. And the level of categorization within this 00:04:41.720 --> 00:04:44.519 guide really highlights how complex the current 00:04:44.519 --> 00:04:46.839 medical landscape is. They've had to map out 00:04:46.839 --> 00:04:49.319 an incredibly fragmented system. Let's run through 00:04:49.319 --> 00:04:50.819 the categories they've built into this directory 00:04:50.819 --> 00:04:52.699 because it really paints a picture. First, you 00:04:52.699 --> 00:04:55.220 have U .S.-based telehealth clinics that mail 00:04:55.220 --> 00:04:57.240 pills. That's your standard domestic virtual 00:04:57.240 --> 00:04:59.959 doctor's office. Right. Next, they list international 00:04:59.959 --> 00:05:02.120 online clinics. These are international providers 00:05:02.120 --> 00:05:04.199 that ship medications directly into the United 00:05:04.199 --> 00:05:07.360 States operating across borders. Then there's 00:05:07.360 --> 00:05:09.709 a category called websites that sell pills. And 00:05:09.709 --> 00:05:12.089 those are sites offering the pills by mail without 00:05:12.089 --> 00:05:14.449 a prescription. They often market themselves 00:05:14.449 --> 00:05:17.750 as online pharmacies, and Plan C's guide actively 00:05:17.750 --> 00:05:19.810 tracks their pricing and their shipping reliability. 00:05:20.370 --> 00:05:22.949 What's fascinating here is how this guide takes 00:05:22.949 --> 00:05:27.029 highly decentralized and honestly very confusing 00:05:27.029 --> 00:05:29.870 medical and legal information and wrestles it 00:05:29.870 --> 00:05:33.029 into a centralized, usable hub. What's fascinating 00:05:33.029 --> 00:05:35.170 here is that they don't stop at just listing 00:05:35.170 --> 00:05:37.910 where to buy pills. The guide also tracks community 00:05:37.910 --> 00:05:41.089 networks that mail pills. Wow. So like grassroots 00:05:41.089 --> 00:05:43.790 operations. Exactly. These are peer -to -peer 00:05:43.790 --> 00:05:46.430 community -based support networks where everyday 00:05:46.430 --> 00:05:48.870 people help discreetly route medication to those 00:05:48.870 --> 00:05:51.569 who need it. They also include in -person clinics 00:05:51.569 --> 00:05:54.110 for local care. And crucially, they have an entire 00:05:54.110 --> 00:05:56.930 section dedicated to legal and safety guidance. 00:05:57.149 --> 00:05:58.870 Which has to be incredibly important for the 00:05:58.870 --> 00:06:02.139 user, given the shifting laws. understand potential 00:06:02.139 --> 00:06:04.379 legal risks and digital privacy considerations 00:06:04.379 --> 00:06:06.519 when searching for this kind of care online. 00:06:06.819 --> 00:06:09.199 Right. Because the logistics of getting a package 00:06:09.199 --> 00:06:11.779 in the mail is only half the battle. Understanding 00:06:11.779 --> 00:06:14.360 the legal landscape of your specific zip code 00:06:14.360 --> 00:06:17.180 is the other half. And they also integrate direct 00:06:17.180 --> 00:06:19.740 support resources right into the directory. Like 00:06:19.740 --> 00:06:22.139 hotlines. Yeah. They provide contact information 00:06:22.139 --> 00:06:25.560 for a live phone and tech support hotlines, specifically 00:06:25.560 --> 00:06:28.620 the M plus A hotline and IAC Contigo, which offer 00:06:28.620 --> 00:06:30.620 confidential medical and emotional assistance. 00:06:31.079 --> 00:06:33.920 So it's a living, breathing document of access. 00:06:34.399 --> 00:06:37.040 But to really understand how a digital directory 00:06:37.040 --> 00:06:39.560 of this magnitude came to be, we have to look 00:06:39.560 --> 00:06:42.389 at the timeline. And the roots of this project 00:06:42.389 --> 00:06:44.790 actually go all the way back to the 1990s. The 00:06:44.790 --> 00:06:46.949 background context is vital here. Two of the 00:06:46.949 --> 00:06:50.009 founders, Elisa Wells and Francine Coetho, didn't 00:06:50.009 --> 00:06:52.850 just wake up in 2015 and decide to map out internet 00:06:52.850 --> 00:06:56.209 pharmacies. No. Back in the 90s, they were heavily 00:06:56.209 --> 00:06:58.470 involved in the massive effort to get Plan B, 00:06:58.529 --> 00:07:00.949 the morning after pill, approved by the FDA for 00:07:00.949 --> 00:07:02.870 over -the -counter sale. Which means they already 00:07:02.870 --> 00:07:05.149 had decades of experience navigating the intersection 00:07:05.149 --> 00:07:08.209 of medication logistics, FDA regulations, and 00:07:08.209 --> 00:07:10.670 public access campaigns before the idea. for 00:07:10.670 --> 00:07:13.790 Plan C even existed. They knew exactly how regulatory 00:07:13.790 --> 00:07:16.649 frameworks operate. So when they officially launched 00:07:16.649 --> 00:07:19.930 the Plan C website in 2016, they approached it 00:07:19.930 --> 00:07:22.629 with a very rigorous, almost academic mindset. 00:07:23.129 --> 00:07:25.329 They didn't just throw up a list of hyperlinks 00:07:25.329 --> 00:07:28.649 and call it a day. They began with strict quality 00:07:28.649 --> 00:07:31.470 control. This might be one of the wildest details 00:07:31.470 --> 00:07:34.329 in the research. Imagine being these founders 00:07:34.329 --> 00:07:37.910 in 2016. You're basically acting as rogue quality 00:07:37.910 --> 00:07:41.120 control agents. They started identifying these 00:07:41.120 --> 00:07:43.040 random websites that called themselves online 00:07:43.040 --> 00:07:45.040 pharmacies and claimed to sell abortion pills. 00:07:45.199 --> 00:07:47.240 Right. And instead of just trusting the marketing, 00:07:47.339 --> 00:07:49.759 the founders actually ordered the pills through 00:07:49.759 --> 00:07:51.879 the mail themselves. They used their own credit 00:07:51.879 --> 00:07:54.339 cards, waited for the packages to arrive from 00:07:54.339 --> 00:07:57.160 these unverified sites, and then evaluated what 00:07:57.160 --> 00:07:59.060 actually showed up in their mailboxes. They were 00:07:59.060 --> 00:08:01.699 testing it firsthand. Yes. Were the pills real? 00:08:01.860 --> 00:08:03.560 Did they arrive on time? Was there any hidden 00:08:03.560 --> 00:08:05.920 tracking? It was essentially a consumer protection 00:08:05.920 --> 00:08:09.180 initiative for a very specific high stakes type 00:08:09.180 --> 00:08:12.319 of medication. They took all that data and published 00:08:12.319 --> 00:08:14.579 their findings in something they called the Plan 00:08:14.579 --> 00:08:17.680 C report card. It was a way to verify the digital 00:08:17.680 --> 00:08:19.759 supply chain for the public. Which is brilliant 00:08:19.759 --> 00:08:22.019 because anyone looking for this kind of care 00:08:22.019 --> 00:08:25.800 online is incredibly vulnerable to scams. And 00:08:25.800 --> 00:08:28.660 that intense focus on verification leads perfectly 00:08:28.660 --> 00:08:31.610 into what happened in 2018. They took that same 00:08:31.610 --> 00:08:34.730 rigorous approach and applied it to formal academia. 00:08:35.070 --> 00:08:38.389 In 2018, Plan C played a significant role in 00:08:38.389 --> 00:08:40.629 the launch of a major academic study called the 00:08:40.629 --> 00:08:43.450 CHAT study, which stands for California Home 00:08:43.450 --> 00:08:46.370 Abortion by Telehealth. This was a rigorous study 00:08:46.370 --> 00:08:48.429 conducted by researchers at the University of 00:08:48.429 --> 00:08:50.490 California, San Francisco. Why was an academic 00:08:50.490 --> 00:08:53.250 study so critical for a directory website? Because 00:08:53.250 --> 00:08:55.450 up until that point, telehealth for this specific 00:08:55.450 --> 00:08:57.710 procedure was largely viewed as an edge case 00:08:57.710 --> 00:09:01.360 or a theoretical alternative. The UCSF researchers 00:09:01.360 --> 00:09:03.879 wanted to gain a deep, documented understanding 00:09:03.879 --> 00:09:06.759 of the experiences of individuals utilizing virtual 00:09:06.759 --> 00:09:09.179 clinics across the United States. To see if it 00:09:09.179 --> 00:09:11.940 actually works safely at scale. Exactly. Plan 00:09:11.940 --> 00:09:14.159 C's involvement was crucial because it wasn't 00:09:14.159 --> 00:09:16.159 just about normalizing telehealth. It was about 00:09:16.159 --> 00:09:18.259 generating hard data on its effectiveness and 00:09:18.259 --> 00:09:21.320 safety. It was about validating telehealth as 00:09:21.320 --> 00:09:24.700 a genuinely viable, medically sound option through 00:09:24.700 --> 00:09:27.490 rigorous, peer -reviewed academic study. They 00:09:27.490 --> 00:09:29.850 were building a fortress of tested data and academic 00:09:29.850 --> 00:09:32.649 validation. And you can see the results of that 00:09:32.649 --> 00:09:35.909 foundation by 2019. The scale of what they were 00:09:35.909 --> 00:09:38.129 building was starting to become undeniable. By 00:09:38.129 --> 00:09:41.309 2019, the Plan C website was receiving over 50 00:09:41.309 --> 00:09:43.809 ,000 visitors every single month. That's huge. 00:09:44.090 --> 00:09:46.350 With traffic coming from all 50 states. That 00:09:46.350 --> 00:09:49.009 is a massive number for a highly specialized 00:09:49.009 --> 00:09:51.669 medical directory. And it's an incredibly important 00:09:51.669 --> 00:09:54.450 data point when we look at the timeline. It proves 00:09:54.450 --> 00:09:57.190 that a massive nationwide demand for this specific 00:09:57.190 --> 00:10:00.149 digital resource already existed before the huge 00:10:00.149 --> 00:10:02.450 global and national disruptions that we're about 00:10:02.450 --> 00:10:04.769 to hit. People across the entire country were 00:10:04.769 --> 00:10:07.289 actively searching for ways to bypass traditional... 00:10:07.309 --> 00:10:09.549 clinics and get these pills by mail. And speaking 00:10:09.549 --> 00:10:11.490 of those disruptions, here's where it gets really 00:10:11.490 --> 00:10:14.649 interesting, because you have this steady, organized 00:10:14.649 --> 00:10:18.269 buildup, and then April 2020 hits, the onset 00:10:18.269 --> 00:10:20.850 of the COVID -19 pandemic. Everything changed 00:10:20.850 --> 00:10:23.350 overnight. The pandemic was the ultimate stress 00:10:23.350 --> 00:10:25.649 test for the entire global health care system, 00:10:25.769 --> 00:10:29.149 but especially for telehealth. It forced an immediate, 00:10:29.269 --> 00:10:31.769 dramatic shift in how medicine was delivered 00:10:31.769 --> 00:10:34.720 across the board. Almost immediately. The medical 00:10:34.720 --> 00:10:37.039 community had to expedite the adoption of no 00:10:37.039 --> 00:10:40.590 -test protocols. To put that simply, it meant 00:10:40.590 --> 00:10:43.210 doctors could prescribe certain medications virtually 00:10:43.210 --> 00:10:45.590 without requiring patients to come into a physical 00:10:45.590 --> 00:10:48.330 clinic for prior ultrasounds or blood work. It 00:10:48.330 --> 00:10:50.730 removed the physical barrier to entry. Completely. 00:10:50.929 --> 00:10:53.450 This spurred the creation of new telehealth startups 00:10:53.450 --> 00:10:55.850 and allowed existing clinics to suddenly serve 00:10:55.850 --> 00:10:58.409 patients entirely online. And remember the context 00:10:58.409 --> 00:11:01.389 of early 2020. You had the majority of the country 00:11:01.389 --> 00:11:03.970 living under safer -at -home orders, severely 00:11:03.970 --> 00:11:06.649 restricting access to basic medical care. In 00:11:06.649 --> 00:11:09.009 some states, abortions were deemed non -essential 00:11:09.009 --> 00:11:11.690 medicine during the lockdowns. Right. So in response 00:11:11.690 --> 00:11:14.490 to that unprecedented public health crisis, the 00:11:14.490 --> 00:11:17.389 FDA temporarily lifted its longstanding restrictions 00:11:17.389 --> 00:11:20.830 on shipping Mifepristone through the mail. That 00:11:20.830 --> 00:11:22.590 temporary lifting of the shipping restriction 00:11:22.590 --> 00:11:25.590 was like opening a floodgate. And Plan C didn't 00:11:25.590 --> 00:11:27.909 just sit back and watch. During this specific 00:11:27.909 --> 00:11:30.649 window, they actively issued a call to providers. 00:11:30.889 --> 00:11:33.830 They broadcasted to the medical community that 00:11:33.830 --> 00:11:36.830 there was a massive, growing need, a new legal 00:11:36.830 --> 00:11:39.789 window, and an opportunity to serve patients 00:11:39.789 --> 00:11:42.110 through telehealth. They leveraged their position 00:11:42.110 --> 00:11:44.509 as a central hub to essentially recruit doctors 00:11:44.509 --> 00:11:46.710 and entrepreneurs into the space. And it worked. 00:11:46.990 --> 00:11:49.470 This call to action led directly to several new 00:11:49.470 --> 00:12:00.899 providers launching startups. If we connect this 00:12:00.899 --> 00:12:03.059 to the bigger picture, the pandemic accelerated 00:12:03.059 --> 00:12:05.259 the infrastructure of telehealth by a decade 00:12:05.259 --> 00:12:08.279 in the span of a few months. But that rapid expansion 00:12:08.279 --> 00:12:10.799 was really just a warm -up. The ultimate test 00:12:10.799 --> 00:12:13.360 of that new infrastructure, the crisis they had 00:12:13.360 --> 00:12:16.159 unwittingly been preparing for, came a couple 00:12:16.159 --> 00:12:21.590 of years later, moving into 2022 and 2023. The 00:12:21.590 --> 00:12:24.929 2022 Dobbs v. Jackson decision, which officially 00:12:24.929 --> 00:12:27.669 overturned Roe v. Wade. With that Supreme Court 00:12:27.669 --> 00:12:29.870 ruling, the legal landscape in the United States 00:12:29.870 --> 00:12:32.730 fractured entirely. Access to abortion was no 00:12:32.730 --> 00:12:35.490 longer federally protected, and individual states 00:12:35.490 --> 00:12:37.730 immediately began implementing widely different 00:12:37.730 --> 00:12:41.169 laws, bans, and restrictions. Plan C suddenly 00:12:41.169 --> 00:12:43.549 had to adapt its directory to a reality where 00:12:43.549 --> 00:12:46.240 the map was constantly changing. And they responded 00:12:46.240 --> 00:12:48.500 by expanding their directory to heavily feature 00:12:48.500 --> 00:12:51.519 a concept called advanced provision. This is 00:12:51.519 --> 00:12:53.980 such a fascinating logistical workaround. Advanced 00:12:53.980 --> 00:12:56.159 provision basically means ordering the pills 00:12:56.159 --> 00:12:58.480 before you even need them, just in case. It's 00:12:58.480 --> 00:13:01.659 a risk mitigation strategy. It creates the option 00:13:01.659 --> 00:13:04.080 for someone to consult with a provider and order 00:13:04.080 --> 00:13:06.500 the medication in advance so it is already sitting 00:13:06.500 --> 00:13:08.919 safely in their medicine cabinet if a need arises 00:13:08.919 --> 00:13:11.620 in the future. Completely bypassing the panic 00:13:11.620 --> 00:13:14.340 of navigating a sudden legal or logistical hurdle. 00:13:14.519 --> 00:13:17.679 Exactly. The Plan C website immediately began 00:13:17.679 --> 00:13:20.179 listing specific organizations that had the capacity 00:13:20.179 --> 00:13:22.879 to offer this advanced service. They highlighted 00:13:22.960 --> 00:13:26.059 providers like Aid Access, Carafum, Women on 00:13:26.059 --> 00:13:28.580 Web, and the Massachusetts Medication Abortion 00:13:28.580 --> 00:13:32.200 Access Project. And as we moved into 2023, they 00:13:32.200 --> 00:13:34.879 vastly increased the resources available on their 00:13:34.879 --> 00:13:37.279 site to help people understand the safety and 00:13:37.279 --> 00:13:39.840 mechanics of managing this process at home. They 00:13:39.840 --> 00:13:42.320 evolved from mapping the landscape to actively 00:13:42.320 --> 00:13:45.440 helping users preemptively navigate it. But while 00:13:45.440 --> 00:13:47.740 the legal and logistical adaptations are incredible, 00:13:48.059 --> 00:13:50.039 there is another impact they had that is almost 00:13:50.039 --> 00:13:53.100 entirely unexpected. As we look at the data from 00:13:53.100 --> 00:13:56.220 2024, we see a completely different kind of consequence, 00:13:56.600 --> 00:13:59.220 an economic consequence. This part blew my mind. 00:13:59.539 --> 00:14:03.019 Because the Plan C guide became the premier go 00:14:03.019 --> 00:14:05.559 -to resource for anyone searching for this information, 00:14:05.899 --> 00:14:08.679 it inadvertently created a hyper -competitive 00:14:08.679 --> 00:14:11.519 free market. Providers naturally wanted to be 00:14:11.519 --> 00:14:13.519 listed at the very top of Plan C's directory. 00:14:13.950 --> 00:14:16.070 It's the basic principle of market competition 00:14:16.070 --> 00:14:18.690 and digital visibility. But it's playing out 00:14:18.690 --> 00:14:21.370 within the framework of a nonprofit health directory. 00:14:21.710 --> 00:14:24.090 Because providers were competing to rank in those 00:14:24.090 --> 00:14:26.809 first few results, they had to incentivize users. 00:14:27.070 --> 00:14:29.289 And the primary way to do that was by lowering 00:14:29.289 --> 00:14:32.629 their prices. Digital visibility single -handedly 00:14:32.629 --> 00:14:35.309 forced free market price corrections in a healthcare 00:14:35.309 --> 00:14:37.230 sector. Let me give you the exact numbers because 00:14:37.230 --> 00:14:40.590 they are staggering. By 2024, because of this 00:14:40.590 --> 00:14:43.639 intense competition on the directory, The cost 00:14:43.639 --> 00:14:46.139 for abortion pills by mail without a clinician 00:14:46.139 --> 00:14:50.240 consultation dropped between $25 and $28. Wow. 00:14:50.659 --> 00:14:52.860 And if you wanted the pills by mail with a telehealth 00:14:52.860 --> 00:14:55.419 consultation from a U .S.-based clinician, the 00:14:55.419 --> 00:14:58.700 average cost fell to $150. Which is already a 00:14:58.700 --> 00:15:00.580 significant reduction compared to traditional 00:15:00.580 --> 00:15:03.440 in -clinic costs. But wait, it gets crazier. 00:15:03.639 --> 00:15:06.279 The lowest -cost telehealth provider on the directory 00:15:06.279 --> 00:15:09.000 began offering their service across all 50 states 00:15:09.000 --> 00:15:14.110 for a minimum payment of just $5. $5. That is 00:15:14.110 --> 00:15:16.730 a profound shift in healthcare economics. It 00:15:16.730 --> 00:15:19.789 completely redefines accessibility. It highlights 00:15:19.789 --> 00:15:22.909 how a centralized digital ecosystem, simply having 00:15:22.909 --> 00:15:25.370 a trusted website that aggregates and ranks options, 00:15:25.629 --> 00:15:28.590 can directly and drastically slash the out -of 00:15:28.590 --> 00:15:30.690 -pocket costs for a patient in the physical world. 00:15:31.039 --> 00:15:33.259 It's a wild example of how digital structures 00:15:33.259 --> 00:15:35.779 can manipulate physical markets. And clearly, 00:15:35.879 --> 00:15:38.919 this level of rapid adaptation, the sheer scale 00:15:38.919 --> 00:15:41.320 of the operation, and the dramatic impact on 00:15:41.320 --> 00:15:43.059 the healthcare market caught the attention of 00:15:43.059 --> 00:15:45.179 the wider culture. It did. The efforts of the 00:15:45.179 --> 00:15:47.240 organization actually became the subject of a 00:15:47.240 --> 00:15:49.500 feature -length documentary film, appropriately 00:15:49.500 --> 00:15:52.679 titled Plan C. It was directed by Tracy Drozd 00:15:52.679 --> 00:15:55.419 -Tragos and premiered at the 2023 Sundance Film 00:15:55.419 --> 00:15:57.879 Festival. The documentary really focuses on the 00:15:57.879 --> 00:16:01.259 human element. The grassroots efforts to expand 00:16:01.259 --> 00:16:04.659 this access via the Internet and the mail, while 00:16:04.659 --> 00:16:06.820 the legal ground was shifting beneath their feet. 00:16:07.460 --> 00:16:09.779 But the cultural footprint didn't stop at film 00:16:09.779 --> 00:16:13.960 festivals. In 2024, the film and the campaign 00:16:13.960 --> 00:16:17.139 actually won a Webby Award. And a Webby Award 00:16:17.139 --> 00:16:19.759 specifically honors excellence on the Internet. 00:16:20.000 --> 00:16:22.519 Exactly. They won it for their creative use of 00:16:22.519 --> 00:16:25.399 social media for advocacy. Which is so fitting 00:16:25.399 --> 00:16:27.080 when you think about it. It proves they aren't 00:16:27.080 --> 00:16:29.039 just a static medical directory sitting on a 00:16:29.039 --> 00:16:31.340 server somewhere. It synthesizes everything we've 00:16:31.340 --> 00:16:34.019 been discussing. Plan C operates on multiple 00:16:34.019 --> 00:16:36.519 overlapping levels. Yes, it's a medical directory. 00:16:36.639 --> 00:16:38.899 Yes, it's a research hub that partners with academic 00:16:38.899 --> 00:16:41.980 institutions. But it's also a highly active cultural 00:16:41.980 --> 00:16:44.299 and media campaign. Utilizing every channel. 00:16:44.440 --> 00:16:46.639 They use every digital tool available to them, 00:16:46.720 --> 00:16:49.539 from SEO rankings that drive down market prices, 00:16:49.580 --> 00:16:53.000 to documentary filmmaking, to social media algorithms, 00:16:53.200 --> 00:16:55.059 all to... further their stated goals and reach 00:16:55.059 --> 00:16:57.139 the public. So what does this all mean? When 00:16:57.139 --> 00:16:58.919 we look back at the journey of this organization, 00:16:59.179 --> 00:17:02.179 we see the incredible evolution of a single website. 00:17:02.860 --> 00:17:05.680 It started with founders who took their 1990s 00:17:05.680 --> 00:17:08.299 experience with Plan B and applied it to the 00:17:08.299 --> 00:17:11.029 internet age. They launched a site to literally 00:17:11.029 --> 00:17:14.930 act as secret shoppers, testing and grading sketchy 00:17:14.930 --> 00:17:17.430 online pharmacies. Then they partnered with major 00:17:17.430 --> 00:17:20.130 universities to academically validate telehealth. 00:17:20.250 --> 00:17:22.589 Right. They took the terrifying stress test of 00:17:22.589 --> 00:17:25.609 the 2020 pandemic and used the regulatory shifts 00:17:25.609 --> 00:17:28.869 to encourage a whole new ways of medical startups. 00:17:29.170 --> 00:17:31.789 They adapted to the massive earthquake of the 00:17:31.789 --> 00:17:34.630 post -Roe legal landscape by promoting advanced 00:17:34.630 --> 00:17:37.490 provision and through sheer organized market 00:17:37.490 --> 00:17:43.619 competition on their platform. It is a remarkable 00:17:43.619 --> 00:17:46.119 trajectory. They transformed from a simple information 00:17:46.119 --> 00:17:48.900 portal into a major central node in a highly 00:17:48.900 --> 00:17:51.539 complex international network. They managed to 00:17:51.539 --> 00:17:53.720 connect international supply chains, peer -to 00:17:53.720 --> 00:17:56.079 -peer community networks, and domestic telehealth 00:17:56.079 --> 00:17:59.440 into one streamlined user experience. All while 00:17:59.440 --> 00:18:01.559 navigating some of the most profound legal and 00:18:01.559 --> 00:18:04.190 global health shifts of the 21st century. And 00:18:04.190 --> 00:18:06.230 for you, the listener, the value of understanding 00:18:06.230 --> 00:18:08.869 this story is immense. Whether you are studying 00:18:08.869 --> 00:18:11.410 supply chain logistics, legal frameworks, or 00:18:11.410 --> 00:18:15.069 internet culture, this is a real -world, highly 00:18:15.069 --> 00:18:18.069 documented example of how digital networks adapt 00:18:18.069 --> 00:18:21.210 in real time to physical and systemic changes. 00:18:21.890 --> 00:18:25.349 It shows that when physical avenues close, Digital 00:18:25.349 --> 00:18:28.009 information finds a way to reroute and rebuild 00:18:28.009 --> 00:18:30.349 the infrastructure. It certainly does. And it 00:18:30.349 --> 00:18:32.150 leaves us with a lot to think about regarding 00:18:32.150 --> 00:18:34.769 the future of medicine, technology, and governance. 00:18:35.150 --> 00:18:37.670 This raises an important question, one that builds 00:18:37.670 --> 00:18:39.390 on everything we've explored today. Let's hear 00:18:39.390 --> 00:18:42.230 it. We've seen how a decentralized network of 00:18:42.230 --> 00:18:44.829 telehealth platforms, international mail services, 00:18:45.049 --> 00:18:47.869 and community peer -to -peer support can successfully 00:18:47.869 --> 00:18:50.410 create an alternative infrastructure for abortion 00:18:50.410 --> 00:18:54.109 access. So how might these exact same digital 00:18:54.109 --> 00:18:56.970 and postal workarounds be applied to other restricted 00:18:56.970 --> 00:18:59.349 or highly regulated areas of medicine in the 00:18:59.349 --> 00:19:02.390 future? When physical geographic borders clash 00:19:02.390 --> 00:19:04.950 with the completely borderless nature of digital 00:19:04.950 --> 00:19:07.529 information, which one ultimately dictates the 00:19:07.529 --> 00:19:10.089 future of human health care? That is a brilliant 00:19:10.089 --> 00:19:12.369 and heavy question to end on. Definitely something 00:19:12.369 --> 00:19:14.569 for you to mull over as you go about your day. 00:19:14.920 --> 00:19:16.740 Thank you so much for joining us on this deep 00:19:16.740 --> 00:19:18.960 dive. We hope it gave you some valuable insights 00:19:18.960 --> 00:19:21.019 and new perspectives on how information networks 00:19:21.019 --> 00:19:24.920 operate. Keep questioning, keep exploring, and 00:19:24.920 --> 00:19:26.460 most importantly, stay curious.