ABOUT THE SPEAKER
Jeanne Pinder - Journalist
Jeanne Pinder asks why it's so hard to make sense of US healthcare bills -- and suggests what we might do about it.

Why you should listen

Lifelong journalist Jeanne Pinder is founder and CEO of ClearHealthCosts, a digital media startup that demands price transparency from the US healthcare system. After taking a buyout from the New York Times, where she worked for more than 20 years, she won a Shark Tank-style competition with her ClearHealthCosts pitch and hasn't looked back.

Since its founding in 2011, ClearHealthCosts has won a slew of journalism grants and prizes and has reported on and crowdsourced health price data in partnership with prestigious newsrooms in New Orleans, Philadelphia, Miami, San Francisco, Los Angeles, New York and elsewhere. This work has won numerous journalism prizes -- a national Edward R. Murrow award, a Society for Professional Journalists public service gold medal and a spot as a finalist for a Peabody Award, among others. 

Pinder and the company have won grants from the John S. and James L. Knight Foundation, the International Women's Media Foundation, the Tow Center for Digital Journalism at Columbia University, the Tow-Knight Center for Entrepreneurial Journalism at the CUNY Graduate School of Journalism and others.   

Previously, in her native Iowa, Pinder worked at The Des Moines Register and the Grinnell Herald-Register, a twice-weekly newspaper that her grandfather bought in 1944.
 
Pinder speaks fluent but rusty Russian. In a previous lifetime, she lived in what was then the Soviet Union, a place almost as mysterious as the US healthcare marketplace.

More profile about the speaker
Jeanne Pinder | Speaker | TED.com
TED Residency

Jeanne Pinder: What if all US health care costs were transparent?

Jeanne Pinder: E se os custos dos planos de saúde nos Estados Unidos fossem transparentes?

Filmed:
1,875,298 views

Nos Estados Unidos, o mesmo exame de sangue pode custar US$ 19 em uma clínica e US$ 522 em outra apenas algumas quadras de distância uma da outra, e ninguém sabe a diferença até receber a conta semanas depois. A jornalista Jeanne Pinder nos diz que não precisa ser assim. Ela construiu uma plataforma colaborativa que revela os custos reais de procedimentos médicos e distribui publicamente os dados, mostrando os segredos dos preços nos planos de saúde. Aprenda como ter a noção dos custos previamente poderia nos deixar mais saudáveis, economizar dinheiro e consertar um sistema falho.
- Journalist
Jeanne Pinder asks why it's so hard to make sense of US healthcare bills -- and suggests what we might do about it. Full bio

Double-click the English transcript below to play the video.

00:12
So, a little while ago,
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Há pouco tempo,
00:14
members of my family
had three bits of minor surgery,
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alguns familiares meus tiveram
que fazer três pequenas cirurgias,
00:17
about a half hour each,
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meia hora para cada uma,
00:19
and we got three sets of bills.
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e recebemos três contas a pagar.
00:22
For the first one, the anesthesia bill
alone was 2,000 dollars;
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Na primeira,
cobravam somente pela anestesia US$ 2 mil.
00:26
the second one, 2,000 dollars;
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Na segunda, US$ 2 mil.
00:28
the third one, 6,000 dollars.
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E na terceira, US$ 6 mil.
00:32
So I'm a journalist.
I'm like, what's up with that?
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Sou jornalista e me perguntei:
"O que é isso?"
00:37
I found out that I was actually,
for the expensive one,
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Descobri que era minha
a conta mais cara,
00:40
being charged 1,419 dollars
for a generic anti-nausea drug
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sendo cobrada US$ 1.419 por um
medicamento genérico contra náuseas
00:45
that I could buy online
for two dollars and forty-nine cents.
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que poderia ter comprado
on-line por US$ 2,49.
00:50
I had a long and unsatisfactory
argument with the hospital,
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Tive uma longa e frustrada
discussão com o hospital,
00:53
the insurer and my employer.
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com o plano de saúde e meu empregador.
00:56
Everybody agreed
that this was totally fine.
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Todos concordavam que estava tudo certo.
Isso me fez pensar e, quanto mais falava
com as pessoas, mais me dava conta
00:59
But it got me thinking, and the more
I talked to people, the more I realized:
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de que não temos a menor ideia
dos custos envolvidos na saúde.
01:03
nobody has any idea
what stuff costs in health care.
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01:06
Not before, during or after
that procedure or test
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Nem antes, nem durante ou após
um procedimento ou exame
01:09
do you have any idea
what it's going to cost.
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você vai ficar sabendo
quanto tudo custou.
01:11
It's only months later that you get
an "explanation of benefits"
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Somente meses após, quando receber
uma "explicação dos benefícios",
01:15
that explains exactly nothing.
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a qual não explica coisa nenhuma.
01:17
So this came back to me
a little while later.
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Após um tempo,
essa situação retornou a mim.
01:20
I had volunteered for a buyout
from the New York Times,
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Eu me ofereci para uma aquisição
do "The New York Times",
01:23
where I had worked for more than
20 years as a journalist.
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para o qual trabalhei por mais de 20 anos.
01:26
I was looking for my next act.
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Estava procurando por um novo caminho.
01:28
It turned out that next act
was to build a company
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Acontece que meu novo caminho
foi criar uma empresa
01:31
telling people what stuff costs
in health care.
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que esclarecesse os custos
dentro dos planos de saúde.
01:34
I won a "Shark Tank"-type
pitch contest to do just that.
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Cheguei a ganhar um concurso
para fazer exatamente isso.
01:37
Health costs ate up almost 18 percent
of our gross domestic product last year,
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Custos de saúde devoraram
quase 18% do nosso PIB ano passado,
01:42
but nobody has any idea what stuff costs.
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e ninguém sabe sobre os custos envolvidos.
01:45
But what if we did know?
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E se soubéssemos?
01:48
So we started out small.
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Então começamos pequenos.
01:49
We called doctors and hospitals
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Ligamos para doutores e hospitais
01:51
and asked them what they would accept
as a cash payment for simple procedures.
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e perguntamos quanto dinheiro aceitariam
para alguns procedimentos simples.
01:57
Some people were helpful.
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Algumas pessoas foram prestativas.
01:58
A lot of people hung up on us.
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Muitas desligaram na nossa cara.
02:00
Some people were just plain rude.
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Outras foram diretamente grossas.
02:02
They said, "We don't know,"
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Disseram: "Não sabemos",
02:04
or, "Our lawyers won't
let us tell you that,"
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ou: "Nossos advogados não permitem
que revelemos isso",
02:07
though we did get a lot of information.
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mas mesmo assim conseguimos
muitas informações.
02:10
We found, for example,
that here in the New York area,
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Descobrimos, por exemplo,
que aqui em Nova Iorque,
02:12
you could get an echocardiogram
for 200 dollars in Brooklyn
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você consegue realizar um ecocardiograma
por apenas US$ 200 no Brooklyn
02:17
or for 2,150 dollars in Manhattan,
just a few miles away.
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ou por US$ 2.150 em Manhattan,
em clínicas bem perto uma da outra.
02:22
New Orleans, the same simple blood test,
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Em Nova Orleans,
um simples exame de sangue,
02:25
19 dollars over here,
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US$ 19 em um lugar,
02:27
522 dollars just a few blocks away.
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US$ 522 bem perto de lá.
02:31
San Francisco, the same MRI,
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Em São Francisco, a mesma
ressonância magnética por US$ 475
02:34
475 dollars
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02:36
or 6,221 dollars just 25 miles away.
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ou US$ 6,221 a 40 km de distância.
02:42
These pricing variations existed
for all the procedures
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Essas variações de preço existem
em todos os procedimentos
02:46
and all the cities that we surveyed.
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e em todas as cidades onde pesquisamos.
02:49
Then we started to ask people
to tell us their health bills.
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Começamos então a pedir às pessoas
que revelassem suas contas médicas.
02:52
In partnership with public radio station
WNYC here in New York,
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Em parceria com uma rádio local
aqui em Nova Iorque,
02:56
we asked women to tell us
the prices of their mammograms.
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perguntamos às mulheres
sobre os preços de uma mamografia.
02:59
People told us nobody would do that,
that it was too personal.
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Disseram-nos que ninguém revelaria nada,
que o assunto é muito pessoal.
03:03
But in the space of three weeks,
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Porém, no decorrer de três semanas,
03:05
400 women told us about their prices.
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400 mulheres revelaram
os preços que pagaram.
03:09
Then we started to make it easier
for people to share their data
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E começamos assim a facilitar
o compartilhamento de dados
03:12
into our online searchable database.
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dentro de nossa base de dados on-line:
a combinação de um site
de busca de passagens aéreas
03:15
It's sort of like a mash-up of Kayak.com
and the Waze traffic app for health care.
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e um aplicativo de GPS para nossa saúde.
03:20
(Laughter)
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(Risos)
03:21
We call it a community-created
guide to health costs.
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Chamamos isso de um guia
comunitário de custos de saúde.
03:24
Our survey and crowdsourcing work
grew into partnerships
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Nossa pesquisa e trabalho conjunto
cresceu e nos juntamos
03:26
with top newsrooms nationwide --
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às maiores salas de imprensa do país.
03:28
in New Orleans, Philadelphia,
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Em Nova Orleans, na Filadélfia,
03:30
San Francisco, Los Angeles,
Miami and other places.
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São Francisco, Los Angeles,
Miami e muitos outros lugares.
03:35
We used the data to tell stories
about people who were suffering
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Usamos os dados para contar histórias
sobre pessoas que estavam sofrendo
03:39
and how to avoid that suffering,
to avoid that "gotcha" bill.
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e para evitar esse sofrimento
na surpresa de uma conta alta.
03:44
A woman in New Orleans saved
nearly 4,000 dollars using our data.
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Uma mulher em Nova Orleans economizou
quase US$ 4 mil com nossos dados.
03:49
A San Francisco contributor
saved nearly 1,300 dollars
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Um contribuinte de São Francisco
economizou em torno de US$ 1,3 mil
03:52
by putting away his insurance card
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saindo do plano de saúde
e pagando em dinheiro.
03:54
and paying cash.
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03:56
There are a lot of people
who are going to in-network hospitals
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Existem muitas pessoas
que pagam por um plano de saúde
03:59
and getting out-of-network bills.
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e recebem outras contas para pagar.
Um hospital continuou a cobrar
um indivíduo que já estava morto.
04:01
And then there was the hospital
that continued to bill a dead man.
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Descobrimos que milhares de pessoas
queriam nos contar os preços que pagam.
04:05
We learned that thousands of people
wanted to tell us their prices.
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04:08
They want to learn what stuff costs,
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Querem aprender sobre os custos,
saber como refutar uma conta a pagar,
04:10
find out how to argue a bill,
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querem nos ajudar a solucionar
este problema que afeta a elas
04:11
help us solve this problem that's hurting
them and their friends and families.
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e seus amigos e familiares.
04:15
We talked to people who had
to sell a car to pay a health bill,
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Algumas pessoas tiveram que vender
um carro para pagar uma conta,
04:18
go into bankruptcy,
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algumas faliram,
04:20
skip a treatment because of the cost.
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outras nem se trataram por conta do custo.
04:23
Imagine if you could afford the diagnosis
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Imagine se você pudesse pagar
por um diagnóstico
04:25
but not the cure.
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mas não pela cura.
04:29
We set off a huge conversation about costs
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Começamos uma grande conversa
sobre estes custos,
04:31
involving doctors and hospitals, yes,
but also their patients,
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envolvendo doutores, hospitais
e claro, os pacientes deles,
04:35
or as we like to call them, people.
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ou como gostamos de chamá-los: pessoas.
04:37
(Laughter)
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(Risos)
04:41
We changed policy.
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Mudamos políticas.
04:42
A consumer protection bill
that had been stalled
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Uma lei de proteção ao consumidor
que estava parada
04:45
in the Louisiana legislature for 10 years
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no legislativo de Louisiana por dez anos
foi aprovada após nosso lançamento.
04:47
passed after we launched.
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04:50
Let's face it:
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Reconheçamos:
04:51
this huge, slow-rolling
public health crisis
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essa enorme crise de saúde pública
04:54
is a national emergency.
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é uma emergência nacional.
04:56
And I don't think government's
going to help us out anytime soon.
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Eu não acredito que o governo
irá nos ajudar tão cedo.
05:00
But what if the answer was really simple:
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Porém, e se a resposta fosse bem simples?
05:02
make all the prices public all the time.
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Tornar públicos todos os preços
e o tempo todo!
05:06
Would our individual bills go down?
Our health premiums?
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Nossas contas iriam diminuir?
Nossos custos de saúde?
05:11
Be really clear about this:
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Esteja certo quanto a isso:
05:13
this is a United States problem.
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esse é um problema dos Estados Unidos.
05:15
In most of the rest
of the developed world,
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Na maioria do mundo desenvolvido,
05:17
sick people don't have
to worry about money.
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pessoas doentes não precisam
se preocupar com dinheiro.
05:20
It's also true that price transparency
will not solve every problem.
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É verdade também que a transparência
de preço não resolverá todos os problemas.
05:24
There will still be expensive treatments,
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Ainda teremos procedimentos caros
05:27
huge friction from our insurance system.
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e muito atrito com os planos de saúde.
05:29
There will still be fraud
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Ainda haverá fraude
05:31
and a massive problem
with overtreatment and overdiagnosis.
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e um grande problema com excessos
de tratamentos e diagnósticos.
05:35
And not everything is shoppable.
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Nem tudo é comprado com dinheiro.
05:38
Not everybody wants
the cheapest appendectomy
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Nem todos querem
a apendicectomia mais barata
05:40
or the cheapest cancer care.
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ou o tratamento de câncer de menor custo.
05:43
But when we talk
about these clear effects,
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Porém, quando falamos sobre os resultados,
05:45
we're looking at a real issue
that's actually very simple.
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estamos olhando para um problema real
que na verdade é muito simples.
05:50
When we first started calling for prices,
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Quando começamos a pesquisar preços,
sentimos como se pudéssemos ser presos.
05:52
we actually felt like
we were going to be arrested.
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05:55
It seemed kind of transgressive
to talk about medicine and health care
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Parecia ser algo disruptivo falar sobre
medicina e planos de saúde ao mesmo tempo.
05:58
in the same breath,
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06:00
and yet it became liberating,
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Mesmo assim, foi esclarecedor,
06:01
because we found not only data
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pois não achamos apenas os dados,
06:04
but also good and honest people
out there in the system
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mas também achamos pessoas boas
e honestas no sistema
06:06
who want to help folks
get the care they need
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que querem ajudar as pessoas
a terem o que precisam,
06:08
at a price they can afford.
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por um preço que possam pagar.
06:11
And it got easier to ask.
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Agora ficou mais fácil de perguntar.
06:13
So I'll leave you with some questions.
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Então gostaria de deixar aqui
algumas perguntas.
06:15
What if we all knew what stuff cost
in health care in advance?
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E se soubéssemos os custos
de um tratamento antes de passar por ele?
06:19
What if, every time
you Googled for an MRI,
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E se, toda vez que pesquisássemos
por uma ressonância magnética,
06:23
you got drop-downs telling you
where to buy and for how much,
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encontrássemos onde fazer
e por qual preço,
06:26
the way you do when
you Google for a laser printer?
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assim como quando procuramos
pelo preço de uma impressora?
06:30
What if all of the time and energy
and money that's spent hiding prices
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E se todo o dinheiro e energia gastos
em esconder os preços da saúde
06:34
was squeezed out of the system?
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fossem retirados do sistema?
06:37
What if each one of us could pick
the $19 test every time
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E se todos nós pagássemos os justos
US$ 19 toda vez ao invés de US$ 522?
06:40
instead of the $522 one?
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06:43
Would our individual bills go down?
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Nossas contas iriam diminuir?
06:45
Our premiums?
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Nossos custos?
06:46
I don't know, but if you don't ask,
you'll never know.
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Eu não sei, mas se não perguntarmos,
nunca saberemos.
06:49
And you might save a ton of money.
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Poderíamos economizar muito dinheiro.
06:51
And I've got to think that a lot of us
and the system itself
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E acredito que muitos de nós,
assim como o próprio sistema,
06:55
would be a lot healthier.
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seríamos muito mais saudáveis.
06:57
Thank you.
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Obrigada.
06:58
(Applause)
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(Aplausos) (Vivas)
Translated by Mario Gioto
Reviewed by Maricene Crus

▲Back to top

ABOUT THE SPEAKER
Jeanne Pinder - Journalist
Jeanne Pinder asks why it's so hard to make sense of US healthcare bills -- and suggests what we might do about it.

Why you should listen

Lifelong journalist Jeanne Pinder is founder and CEO of ClearHealthCosts, a digital media startup that demands price transparency from the US healthcare system. After taking a buyout from the New York Times, where she worked for more than 20 years, she won a Shark Tank-style competition with her ClearHealthCosts pitch and hasn't looked back.

Since its founding in 2011, ClearHealthCosts has won a slew of journalism grants and prizes and has reported on and crowdsourced health price data in partnership with prestigious newsrooms in New Orleans, Philadelphia, Miami, San Francisco, Los Angeles, New York and elsewhere. This work has won numerous journalism prizes -- a national Edward R. Murrow award, a Society for Professional Journalists public service gold medal and a spot as a finalist for a Peabody Award, among others. 

Pinder and the company have won grants from the John S. and James L. Knight Foundation, the International Women's Media Foundation, the Tow Center for Digital Journalism at Columbia University, the Tow-Knight Center for Entrepreneurial Journalism at the CUNY Graduate School of Journalism and others.   

Previously, in her native Iowa, Pinder worked at The Des Moines Register and the Grinnell Herald-Register, a twice-weekly newspaper that her grandfather bought in 1944.
 
Pinder speaks fluent but rusty Russian. In a previous lifetime, she lived in what was then the Soviet Union, a place almost as mysterious as the US healthcare marketplace.

More profile about the speaker
Jeanne Pinder | Speaker | TED.com

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