TED Residency
Jeanne Pinder: What if all US health care costs were transparent?
Jeanne Pinder: Ingekuwaje kama gharama za afya Marekani zingekuwa wazi?
Filmed:
Readability: 3.7
1,875,298 views
Marekani, kipimo cha damu cha kimoja, kinaweza kugharimu $19 katika kliniki moja na $522 katika kliniki nyingine majengo machache baadaye -- na hakuna ajuaye tofauti mpaka baada ya wiki moja wanapopata bili. Mwanahabari Jeanne Pinder anasema haihitaji kuwa hivi. Alijenga jukwaa ambalo linakusanya taarifa za gharama halisi za huduma za afya na kuweka taarifa wazi kwa wote, likifichua siri za bei za huduma za afya. Jifunze jinsi kujua gharama za vitu mapema kunavyoweza kutufanya tuwe na afya zaidi, na kuokoa pesa -- na kusaidia kurekebisha mfumo mbovu.
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. Full bio
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,
0
815
2052
Kitambo kidogo hapo nyuma,
00:14
members of my family
had three bits of minor surgery,
had three bits of minor surgery,
1
2891
3043
watu wa familia yangu
walikuwa na upasuaji mdogo mara 3 hivi,
walikuwa na upasuaji mdogo mara 3 hivi,
00:17
about a half hour each,
2
5958
1565
wa kama nusu saa kwa kila mmoja,
00:19
and we got three sets of bills.
3
7547
2077
na tulipata seti tatu za bili.
00:22
For the first one, the anesthesia bill
alone was 2,000 dollars;
alone was 2,000 dollars;
4
10011
4226
Kwa ule wa kwanza, madai ya nusukaputi
pekee yalikuwa dola 2,000;
pekee yalikuwa dola 2,000;
00:26
the second one, 2,000 dollars;
5
14261
2380
ule wa pili, dola 2,000;
00:28
the third one, 6,000 dollars.
6
16665
2769
ule wa tatu, dola 6,000.
00:32
So I'm a journalist.
I'm like, what's up with that?
I'm like, what's up with that?
7
20311
3878
Sasa mimi ni mwanahabari.
Nikawa kama, sasa kuna nini kwani?
Nikawa kama, sasa kuna nini kwani?
00:37
I found out that I was actually,
for the expensive one,
for the expensive one,
8
25022
3074
Nikagundua kuwa, nilipewa gharama za juu,
00:40
being charged 1,419 dollars
for a generic anti-nausea drug
for a generic anti-nausea drug
9
28120
5819
kulipishwa dola 1,419
kwa dawa ya nusukaputi ya kawaida
kwa dawa ya nusukaputi ya kawaida
00:45
that I could buy online
for two dollars and forty-nine cents.
for two dollars and forty-nine cents.
10
33963
3553
ambayo ningeweza kununua mtandaoni
kwa dola mbili na senti arobaini.
kwa dola mbili na senti arobaini.
00:50
I had a long and unsatisfactory
argument with the hospital,
argument with the hospital,
11
38782
3115
Nilikuwa na mabishano marefu na
yasiyoridhisha na hospitali,
yasiyoridhisha na hospitali,
00:53
the insurer and my employer.
12
41921
2600
mtoa bima na mwajiri.
00:56
Everybody agreed
that this was totally fine.
that this was totally fine.
13
44545
2789
Kila mmoja alikubali kuwa
hii ilikuwa sawa kabisa.
hii ilikuwa sawa kabisa.
00:59
But it got me thinking, and the more
I talked to people, the more I realized:
I talked to people, the more I realized:
14
47855
3663
Lakini ilinifanya nifikirie, na kadri
nilivyoongea na watu, niligundua zaidi:
nilivyoongea na watu, niligundua zaidi:
01:03
nobody has any idea
what stuff costs in health care.
what stuff costs in health care.
15
51542
2707
hakuna anayefahamu
gharama za vitu katika huduma za afya.
gharama za vitu katika huduma za afya.
01:06
Not before, during or after
that procedure or test
that procedure or test
16
54273
3086
Siyo kabla, katikati,
au baada ya huduma au vipimo
au baada ya huduma au vipimo
01:09
do you have any idea
what it's going to cost.
what it's going to cost.
17
57383
2276
una wazo lolote
nini itakuwa gharama.
nini itakuwa gharama.
01:11
It's only months later that you get
an "explanation of benefits"
an "explanation of benefits"
18
59683
3435
Ni baada tu ya miezi kadhaa ndipo
utapata "maelezo ya mafao"
utapata "maelezo ya mafao"
01:15
that explains exactly nothing.
19
63142
2157
ambayo hayaelezei chochote.
01:17
So this came back to me
a little while later.
a little while later.
20
65801
2604
Kwa hiyo hili lilikuja tena kwangu
baadaye kidogo
baadaye kidogo
01:20
I had volunteered for a buyout
from the New York Times,
from the New York Times,
21
68429
2606
Nilijitolea kuacha kazi kwa malipo
kutoka New York Times
kutoka New York Times
01:23
where I had worked for more than
20 years as a journalist.
20 years as a journalist.
22
71059
2833
ambapo nilifanya kazi kwa zaidi
ya miaka 20 kama mwanahabari.
ya miaka 20 kama mwanahabari.
01:26
I was looking for my next act.
23
74254
2093
Nilikuwa natafuta shughuli nyingine.
01:28
It turned out that next act
was to build a company
was to build a company
24
76705
2645
Ikaotokea kuwa shughuli nyingine
ni kuunda kampuni
ni kuunda kampuni
01:31
telling people what stuff costs
in health care.
in health care.
25
79374
2376
kuwaambia watu gharama za vitu
kwenye huduma za afya
kwenye huduma za afya
01:34
I won a "Shark Tank"-type
pitch contest to do just that.
pitch contest to do just that.
26
82128
3306
Nilishinda shindano la simulizi
kama "Shark Tank" ili kufanya hivyo.
kama "Shark Tank" ili kufanya hivyo.
01:37
Health costs ate up almost 18 percent
of our gross domestic product last year,
of our gross domestic product last year,
27
85826
4272
Gharama za afya zimepanda hadi asilimia 18
ya pato la taifa kwa mwaka jana,
ya pato la taifa kwa mwaka jana,
01:42
but nobody has any idea what stuff costs.
28
90122
2713
lakini hakuna anayefahamu gharama za vitu.
01:45
But what if we did know?
29
93225
1682
Lakinii ingekuwaje tungefahamu?
01:48
So we started out small.
30
96145
1659
Kwahiyo tulianza kidogo.
01:49
We called doctors and hospitals
31
97828
1745
Tuliita madaktari na mahospitali
01:51
and asked them what they would accept
as a cash payment for simple procedures.
as a cash payment for simple procedures.
32
99597
4493
na kuwauliza wangekubali kiasi gani
pesa taslim kwa ajili ya matibabu madogo.
pesa taslim kwa ajili ya matibabu madogo.
01:57
Some people were helpful.
33
105075
1790
Watu wengine walikuwa na msaada.
01:58
A lot of people hung up on us.
34
106889
1853
Wengi walitukatia mawasiliano.
02:00
Some people were just plain rude.
35
108766
2111
Wengine walikuwa jeuri tu.
02:02
They said, "We don't know,"
36
110901
1922
Walisema, "Hatujui,"
02:04
or, "Our lawyers won't
let us tell you that,"
let us tell you that,"
37
112847
2542
au, "Wanasheria wetu hawawezi kuturuhusu
kuwaambia,"
kuwaambia,"
02:07
though we did get a lot of information.
38
115899
1874
ingawa tulipata taarifa nyingi.
02:10
We found, for example,
that here in the New York area,
that here in the New York area,
39
118207
2674
tuligundua, kwa mfano,
kuwa hapa eneo la New York,
kuwa hapa eneo la New York,
02:12
you could get an echocardiogram
for 200 dollars in Brooklyn
for 200 dollars in Brooklyn
40
120905
4090
unaweza kupata kipimo cha moyo
kwa dola 200 Brooklyn
kwa dola 200 Brooklyn
02:17
or for 2,150 dollars in Manhattan,
just a few miles away.
just a few miles away.
41
125019
4970
au kwa dola 2,150 Manhattan,
maili chache tu pembeni.
maili chache tu pembeni.
02:22
New Orleans, the same simple blood test,
42
130961
2519
New Orleans, vipimo hivyo hivyo
rahisi vya damu,
rahisi vya damu,
02:25
19 dollars over here,
43
133504
2272
dola 19 hapa,
02:27
522 dollars just a few blocks away.
44
135800
3205
dola 522 vitalu vichache tu pembeni.
02:31
San Francisco, the same MRI,
45
139755
2715
San Francisco, kipimo cha MRI,
02:34
475 dollars
46
142494
2317
dola 475
02:36
or 6,221 dollars just 25 miles away.
47
144835
4860
au dola 6,221 maili 25 tu pembeni.
02:42
These pricing variations existed
for all the procedures
for all the procedures
48
150822
3268
Tofauti hizi za bei zilikuwepo
kwa matibabu ya aina zote
kwa matibabu ya aina zote
02:46
and all the cities that we surveyed.
49
154114
2045
na miji yote iliyofanyiwa utafiti.
02:49
Then we started to ask people
to tell us their health bills.
to tell us their health bills.
50
157165
2853
Kisha tukaanza kuwauliza watu
watuambie madai ya ya matibabu.
watuambie madai ya ya matibabu.
02:52
In partnership with public radio station
WNYC here in New York,
WNYC here in New York,
51
160512
3753
Kwa kushirikiana na redio stesheni
ya kijamii WNYC hapa New York,
ya kijamii WNYC hapa New York,
02:56
we asked women to tell us
the prices of their mammograms.
the prices of their mammograms.
52
164289
2932
tuliuliza wanawake watuambie
bei za kipimo cha saratani ya matiti.
bei za kipimo cha saratani ya matiti.
02:59
People told us nobody would do that,
that it was too personal.
that it was too personal.
53
167624
3279
Watu walituambia hakuna atakayesema,
ilikuwa jambo binafsi sana.
ilikuwa jambo binafsi sana.
03:03
But in the space of three weeks,
54
171490
1779
Lakini ndani ya wiki tatu,
03:05
400 women told us about their prices.
55
173293
3171
wanawake 400 walituambia juu ya bei zake,
03:09
Then we started to make it easier
for people to share their data
for people to share their data
56
177272
3084
Kisha tukaanza kufanya kuwa rahisi
kwa watu kutoa taarifa zao
kwa watu kutoa taarifa zao
03:12
into our online searchable database.
57
180380
2702
katika kanzi data yetu ya mtandaoni
inayopekulika.
inayopekulika.
03:15
It's sort of like a mash-up of Kayak.com
and the Waze traffic app for health care.
and the Waze traffic app for health care.
58
183106
5138
Ni mfano wa Kayak.com na zana tumizi ya
Waze pamoja kwa ajili ya huduma za afya.
Waze pamoja kwa ajili ya huduma za afya.
03:20
(Laughter)
59
188268
1049
(Kicheko)
03:21
We call it a community-created
guide to health costs.
guide to health costs.
60
189341
2907
Tunaiita mwongozo wa jumuiya
wa gharama za matibabu.
wa gharama za matibabu.
03:24
Our survey and crowdsourcing work
grew into partnerships
grew into partnerships
61
192272
2635
Utafiti wetu na ukusanyaji taarifa
kutoka uma ukapelekea ubia
kutoka uma ukapelekea ubia
03:26
with top newsrooms nationwide --
62
194931
1866
na vyombo vikubwa vya habari kitaifa
03:28
in New Orleans, Philadelphia,
63
196821
2072
ndani ya New Orleans, Philadelphia,
03:30
San Francisco, Los Angeles,
Miami and other places.
Miami and other places.
64
198917
3711
San Francisco, Los Angeles,
Miami na sehemu nyingine.
Miami na sehemu nyingine.
03:35
We used the data to tell stories
about people who were suffering
about people who were suffering
65
203212
3923
Tulitumia data kusimulia juu ya watu
waliokuwa wakiteseka
waliokuwa wakiteseka
03:39
and how to avoid that suffering,
to avoid that "gotcha" bill.
to avoid that "gotcha" bill.
66
207159
3820
na jinsi gani kuepuka mateso hayo,
kuepuka madai ya "nimekudaka".
kuepuka madai ya "nimekudaka".
03:44
A woman in New Orleans saved
nearly 4,000 dollars using our data.
nearly 4,000 dollars using our data.
67
212579
3842
Mwanamke mmoja wa New Orleans aliokoa
karibu dola 4,000 kwa kutumia data zetu.
karibu dola 4,000 kwa kutumia data zetu.
03:49
A San Francisco contributor
saved nearly 1,300 dollars
saved nearly 1,300 dollars
68
217147
3311
Mchangiaji wa San Francisco aliokoa
karibu dola 1,300
karibu dola 1,300
03:52
by putting away his insurance card
69
220482
1801
kwa kuiweka mbali kadi yake ya bima
03:54
and paying cash.
70
222307
1450
na kulipa pesa taslimu.
03:56
There are a lot of people
who are going to in-network hospitals
who are going to in-network hospitals
71
224513
3028
Kuna watu wengi wanaokwenda
kwenye hospitali zililizo mtandaoni
kwenye hospitali zililizo mtandaoni
03:59
and getting out-of-network bills.
72
227565
1629
na kupata bili za nje ya mtandao.
04:01
And then there was the hospital
that continued to bill a dead man.
that continued to bill a dead man.
73
229838
3209
Na pia kuna hospitali ambazo ziliendelea
kudai mtu aliyekufa.
kudai mtu aliyekufa.
04:05
We learned that thousands of people
wanted to tell us their prices.
wanted to tell us their prices.
74
233071
3152
Tulijifunza kuwa maelfu ya watu
walitaka kutuambia bei zao.
walitaka kutuambia bei zao.
04:08
They want to learn what stuff costs,
75
236247
1729
Wanataka kujua gharama za vitu,
04:10
find out how to argue a bill,
76
238000
1634
kujua namna kuhoji juu ya bili,
04:11
help us solve this problem that's hurting
them and their friends and families.
them and their friends and families.
77
239658
4270
kutusaidia kutatua hili tatizo
linaloumiza wao, rafiki na familia zao.
linaloumiza wao, rafiki na familia zao.
04:15
We talked to people who had
to sell a car to pay a health bill,
to sell a car to pay a health bill,
78
243952
2976
Tuliongea na watu waliofikia kuuza gari
ili kulipa bili ya afya,
ili kulipa bili ya afya,
04:18
go into bankruptcy,
79
246952
1387
na kufilisika
04:20
skip a treatment because of the cost.
80
248363
2273
kuacha matibabu kwa sababu ya gharama.
04:23
Imagine if you could afford the diagnosis
81
251230
2660
Fikiria ungeweza kumudu
gharama za uchunguzi
gharama za uchunguzi
04:25
but not the cure.
82
253914
1516
lakini siyo matibabu.
04:29
We set off a huge conversation about costs
83
257589
2162
Tulianzisha majadiliano makubwa
juu ya gharama
juu ya gharama
04:31
involving doctors and hospitals, yes,
but also their patients,
but also their patients,
84
259775
3751
tukihusisha madaktari, mahospitali, ndiyo,
na wagonjwa wao,
na wagonjwa wao,
04:35
or as we like to call them, people.
85
263550
2191
au tunavyopenda kuwaita, watu.
04:37
(Laughter)
86
265765
1904
(Kicheko)
04:41
We changed policy.
87
269519
1151
Tulibadili sera.
04:42
A consumer protection bill
that had been stalled
that had been stalled
88
270694
2326
Mswada wa kulinda walaji
ambao ulikuwa umesimama
ambao ulikuwa umesimama
04:45
in the Louisiana legislature for 10 years
89
273044
2123
katika bunge la Louisiana kwa miaka 10
04:47
passed after we launched.
90
275191
1842
ulipita baada ya sisi kuzindua.
04:50
Let's face it:
91
278797
1151
Tukabiliane nayo:
04:51
this huge, slow-rolling
public health crisis
public health crisis
92
279972
2395
janga hili kubwa na linalokuwa
taratibu la afya ya jamii
taratibu la afya ya jamii
04:54
is a national emergency.
93
282391
1867
ni dharura ya kitaifa.
04:56
And I don't think government's
going to help us out anytime soon.
going to help us out anytime soon.
94
284649
3146
Na sidhani kama serikali itatusaidia
wakati wowote hivi karibuni.
wakati wowote hivi karibuni.
05:00
But what if the answer was really simple:
95
288652
2148
Lakini vipi jibu lingekuwa rahisi sana:
05:02
make all the prices public all the time.
96
290824
3020
fanya bei zote wazi wakati wote.
05:06
Would our individual bills go down?
Our health premiums?
Our health premiums?
97
294605
3666
Je bili zetu zitapungua?
Ada ya bima ya afya?
Ada ya bima ya afya?
05:11
Be really clear about this:
98
299749
1722
Kuwa wazi juu ya hili:
05:13
this is a United States problem.
99
301495
1910
hili ni tatizo la Marekani.
05:15
In most of the rest
of the developed world,
of the developed world,
100
303429
2055
Katika nchi nyingi nyingine zilizoendelea,
05:17
sick people don't have
to worry about money.
to worry about money.
101
305508
2759
wagonjwa hawahitaji kuwa na wasiwasi
juu ya pesa.
juu ya pesa.
05:20
It's also true that price transparency
will not solve every problem.
will not solve every problem.
102
308291
4018
Ni kweli pia kuwa uwazi wa bei
hautatatua kila tatizo.
hautatatua kila tatizo.
05:24
There will still be expensive treatments,
103
312333
2806
Bado kutakuwa na matibabu ya gharama,
05:27
huge friction from our insurance system.
104
315163
2692
msuguano mkubwa na mfumo wetu wa bima.
05:29
There will still be fraud
105
317879
1680
Bado kutakuwa na udanganyifu
05:31
and a massive problem
with overtreatment and overdiagnosis.
with overtreatment and overdiagnosis.
106
319583
3371
na tatizo kubwa la matibabu yaliyozidi
na uchunguzi uliopitiliza.
na uchunguzi uliopitiliza.
05:35
And not everything is shoppable.
107
323537
2615
Na si kila kitu kinanunulika.
05:38
Not everybody wants
the cheapest appendectomy
the cheapest appendectomy
108
326176
2454
Si kila mtu anataka upasuaji kidoletumbo
wa bei rahisi
wa bei rahisi
05:40
or the cheapest cancer care.
109
328654
1851
au matibabu saratani ya bei rahisi.
05:43
But when we talk
about these clear effects,
about these clear effects,
110
331513
2155
Lakini tunapoongelea
athari hizi za wazi,
athari hizi za wazi,
05:45
we're looking at a real issue
that's actually very simple.
that's actually very simple.
111
333692
3527
tunaangalia jambo la halisi kabisa
ambalo ni rahisi sana
ambalo ni rahisi sana
05:50
When we first started calling for prices,
112
338394
1954
Tulipoanza kuulizia bei,
05:52
we actually felt like
we were going to be arrested.
we were going to be arrested.
113
340372
2479
tulihisi kabisa kama tungekuja kukamatwa.
05:55
It seemed kind of transgressive
to talk about medicine and health care
to talk about medicine and health care
114
343162
3592
Ilionekana kama ni kwenda kinyume
kuongelea dawa na huduma za afya
kuongelea dawa na huduma za afya
05:58
in the same breath,
115
346778
1345
kwa pamoja,
06:00
and yet it became liberating,
116
348147
1552
na bado ilileta ukombozi,
06:01
because we found not only data
117
349723
2312
sababu tulipata siyo taarifa tu
06:04
but also good and honest people
out there in the system
out there in the system
118
352059
2641
bali pia watu wazuri na waaminifu
katika mfumo uliopo
katika mfumo uliopo
06:06
who want to help folks
get the care they need
get the care they need
119
354724
2144
ambao wanataka kusaidia watu
kupata huduma wanazohitaji
kupata huduma wanazohitaji
06:08
at a price they can afford.
120
356892
1418
katika bei wanazoweza kuzimudu.
06:11
And it got easier to ask.
121
359631
1875
Na ilizidi kuwa rahisi kuuliza.
06:13
So I'll leave you with some questions.
122
361530
2081
Hivyo, nitawaacha na maswali.
06:15
What if we all knew what stuff cost
in health care in advance?
in health care in advance?
123
363635
3329
Ingekuwaje kama wote tungejua gharama
za huduma za afya mapema?
za huduma za afya mapema?
06:19
What if, every time
you Googled for an MRI,
you Googled for an MRI,
124
367983
3187
Ingekuwaje, kila wakati ungetafuta MRI
kwa google,
kwa google,
06:23
you got drop-downs telling you
where to buy and for how much,
where to buy and for how much,
125
371194
3400
ungepata orodha ya wapi ununue
na kwa kiasi gani,
na kwa kiasi gani,
06:26
the way you do when
you Google for a laser printer?
you Google for a laser printer?
126
374618
2457
namna unavyokua unatafuta
kichapishi kupitia google?
kichapishi kupitia google?
06:30
What if all of the time and energy
and money that's spent hiding prices
and money that's spent hiding prices
127
378094
4244
Ingekuwaje kama muda wote na nguvu
na pesa inayotumika kuficha bei
na pesa inayotumika kuficha bei
06:34
was squeezed out of the system?
128
382362
1984
vingeondolewa kwenye mfumo.
06:37
What if each one of us could pick
the $19 test every time
the $19 test every time
129
385188
3199
Ingekuwaje kama kila mmoja wetu
angechagua uchunguzi wa $19 kila wakati
angechagua uchunguzi wa $19 kila wakati
06:40
instead of the $522 one?
130
388411
2337
badala ya ule wa $522?
06:43
Would our individual bills go down?
131
391384
1738
Je bili zetu zingepungua?
06:45
Our premiums?
132
393146
1403
Ada za bima?
06:46
I don't know, but if you don't ask,
you'll never know.
you'll never know.
133
394573
2848
Sijui, lakini usipouliza,
hutojua kamwe.
hutojua kamwe.
06:49
And you might save a ton of money.
134
397445
1870
Na unaweza kuokoa pesa nyingi.
06:51
And I've got to think that a lot of us
and the system itself
and the system itself
135
399767
3539
Na nimekuwa nikifikiria kuwa wengi wetu
na mfumo wenyewe
na mfumo wenyewe
06:55
would be a lot healthier.
136
403330
1582
tungekuwa na afya zaidi.
06:57
Thank you.
137
405676
1188
Asanteni.
06:58
(Applause)
138
406888
3828
(Makofi)
ABOUT THE SPEAKER
Jeanne Pinder - JournalistJeanne 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.
Jeanne Pinder | Speaker | TED.com