Advanced Conversation with Jennifer on Health Care in the U.S. 🩺

16,559 views ・ 2019-10-18

English with Jennifer


Please double-click on the English subtitles below to play the video.

00:00
Hi! I'm Jennifer from English with Jennifer, and I'm ready to share another current issue.
0
700
6440
00:07
If you'd like to communicate more confidently and effectively in English,
1
7140
4480
00:11
be sure to subscribe and get all my lessons.
2
11620
3680
00:15
And if you want to get the very most you can out of your studies here on YouTube,
3
15300
4560
00:19
then consider becoming a member of my channel. There are three different levels.
4
19860
4900
00:24
Click to view all the perks.
5
24760
2460
00:28
In this video, I'm going to share vocabulary and information related to health care in the U.S.
6
28820
5860
00:34
I'll do my best to give a balanced presentation. It's not my goal to promote a political agenda.
7
34680
6800
00:41
As an English language teacher, I'm here to offer the language support
8
41480
4660
00:46
that learners will need to follow and participate in discussions about health care.
9
46140
5100
00:53
So are you ready? Let's get started.
10
53300
4740
01:04
Health care refers to the services you get to prevent and treat medical problems.
11
64120
5940
01:10
When we talk about our health, we're referring to our physical and mental well-being.
12
70060
5600
01:17
In the U.S., we have many medical professionals and, in general, health care professionals
13
77260
5780
01:23
who provide services for our physical and mental health.
14
83040
4060
01:29
A health care provider isn't necessarily a doctor or a nurse.
15
89540
4040
01:33
Health care providers include therapists, counselors, and various technicians.
16
93580
6100
01:41
Note that "health care" can be written as one word or two. Just be consistent in your own writing.
17
101740
6580
01:49
The health care system in the U.S. can be confusing.
18
109700
4280
01:53
There are different ways you can get medical treatment, and basically any visit to any medical center
19
113980
6340
02:00
involves paperwork and some form of payment by someone.
20
120320
4980
02:06
Hospitals, clinics, and private practices need to get paid. Even after you get
21
126300
5440
02:11
treatment, you may have to worry about completing more paperwork and making additional payments.
22
131740
6700
02:19
Let's start with a fundamental question.
23
139940
2660
02:22
Is health care a basic human right or a privilege?
24
142600
4000
02:27
A human right is something everyone should have.
25
147280
3140
02:30
A privilege is a benefit -- something good and useful -- but not everyone receives it.
26
150420
6370
02:38
If we talk about getting a basic education, for example, every child in the
27
158200
4960
02:43
U.S. has access to public schools. It's their right to get an education from
28
163160
4980
02:48
kindergarten through 12th grade. Our public schools are paid for with tax
29
168140
6220
02:54
dollars. If you're a U.S. citizen or resident, you pay local, state, and federal taxes,
30
174360
7340
03:01
whether you have school-aged children or not. Tax money funds the
31
181700
4880
03:06
public school system. Families don't pay tuition at public schools.
32
186580
5320
03:13
Now with health care, we don't really have a free health care system for everyone.
33
193540
4760
03:18
You'll hear terms like "national health care system" or "universal health care."
34
198300
5560
03:24
We don't have that kind of program where services are free for everyone. However,
35
204020
8000
03:32
tax dollars are used to pay for federal and state medical programs that some people
36
212030
5340
03:37
participate in. I'll explain more a bit later.
37
217370
4490
03:59
I'd say the majority of Americans have health insurance, and most often it's
38
239480
5060
04:04
employer-based insurance. That means that people have health insurance policies
39
244550
5400
04:09
through their employers.
40
249950
2110
04:13
The policy is the agreement and terms. Health insurance
41
253840
4080
04:17
is a benefit employers can give. Employers pay most of the cost of the policy,
42
257920
6100
04:24
and then the remaining money is deducted or taken out of your paycheck.
43
264020
4700
04:30
A health insurance policy for one employee can cover that individual or an entire family.
44
270540
7560
04:38
For example, my husband has a full-time job with a company.
45
278100
4160
04:42
Health insurance is one of his benefits. He's the policyholder. As his spouse, I'm
46
282260
7140
04:49
insured. And our children are eligible dependents. "Eligible" means they meet all
47
289400
6450
04:55
the requirements to be considered dependents, so they're insured too.
48
295850
6610
05:02
We can talk about being insured or covered. It's the same thing.
49
302460
4740
05:07
Our family has insurance. We have coverage. Those are the nouns.
50
307560
5780
05:15
Even as a benefit, health insurance is expensive. I read that the average company
51
315800
5940
05:21
contributes 70 to 80 percent towards health insurance. The employee pays the
52
321740
6030
05:27
rest. If you have a family plan, more is deducted from your paycheck. Even after
53
327770
7730
05:35
those deductions, you still have copays and deductibles.
54
335500
4580
05:41
Getting confused by all the terminology? We can get confused, too, sometimes.
55
341820
5760
05:48
The premium is the total cost. It's the amount you pay in order to have a health insurance policy.
56
348620
6360
05:54
When you hear people talk about high premiums or premiums going up, they're talking about
57
354980
6360
06:01
high costs or costs going up. As I said, the employer usually covers most of the premium.
58
361340
8700
06:10
The rest you have to contribute as the employee. It's taken out of your paycheck.
59
370040
6120
06:17
"Copay" is short for copayment. This is the amount of money
60
377140
4720
06:21
that you have to pay when you visit a health care provider and receive some kind of service.
61
381860
6120
06:30
A copay is in addition to your premium. For example,
62
390080
4380
06:34
it may be 10 to 25 dollars when you visit your regular doctor, who we
63
394470
5070
06:39
call your primary care physician or your primary care provider.
64
399540
6880
06:48
But your copay to see a specialist will be even higher. Maybe 30 or 50 dollars.
65
408160
6580
06:55
And if you have to go to the emergency room, your copay may be as much as one, two, or even three hundred dollars.
66
415440
8100
07:05
Some argue that copays serve at least one purpose, and that's to reduce the use of services.
67
425300
4840
07:10
If you know you have a copay, then you're not so quick to seek medical attention for every little problem.
68
430140
8780
07:20
We also have copays for medicine at the pharmacy.
69
440300
4340
07:24
Your health insurance policy will usually cover a larger percentage
70
444640
4130
07:28
of the cost. Some of my copays are as low as $7, others $70.
71
448770
7550
07:37
Then there are things that you need, but they're not covered by insurance, like a back brace
72
457500
5540
07:43
or vitamins. You have to pay out-of-pocket. These things are an out-of-pocket expense.
73
463050
6600
07:49
For example, there's a little bottle of vitamins that I need. It lasts
74
469650
6190
07:55
for about three months. Each bottle is over a hundred dollars. That's not covered by my insurance.
75
475840
6920
08:04
Deductibles aren't to be confused with premiums.
76
484940
3720
08:08
The premium is the total cost of your plan. A deductible is the amount you have to pay
77
488660
5500
08:14
before your insurance will start covering your medical expenses.
78
494160
5840
08:21
Maybe you have a $500 deductible. That means you have to spend
79
501040
5080
08:26
$500 before the insurance company starts covering expenses.
80
506120
5800
08:33
You might have a high premium with a low deductible or a low premium
81
513600
4260
08:37
with a high deductible. In short, health insurance companies are running a
82
517860
5070
08:42
business, and they have to make money.
83
522930
3130
09:02
With premiums, deductibles, co-pays, and out-of-pocket expenses, you don't want to
84
542940
6120
09:09
get sick. It's expensive. Well, the good news is that many preventive health care
85
549060
5670
09:14
services are covered under a plan. For example, we don't have copays when we
86
554730
5370
09:20
get our flu shot, and we don't pay extra when we go for our yearly eye exam or
87
560100
6090
09:26
when we go for dental cleanings twice a year.
88
566190
3800
09:29
Keeping people healthy avoids bigger costs, right? But everyone gets sick now and then.
89
569990
6880
09:36
Injuries happen. Health problems arise, especially as you get older.
90
576870
7920
09:44
What do you do if you don't have private health insurance? We have one federal
91
584790
5970
09:50
program called Medicare. It's mainly for the elderly, so if you're over 65, you're
92
590760
5639
09:56
entitled to Medicare. And if you have some kind of disability, you can get
93
596399
6301
10:02
coverage from Medicare. Those over 65 likely contributed earlier when they
94
602700
7499
10:10
were younger and paid taxes, so coverage in retirement makes sense. Most everyone agrees.
95
610200
7400
10:19
Even on Medicare you'll have premiums, deductibles, and co-pays. At least, that's what I understand.
96
619740
6340
10:27
If you can't afford those additional expenses,
97
627880
2660
10:30
then there's Medicaid. Medicaid is another government program. It's a
98
630540
5190
10:35
federal and state program that offers financial assistance to low-income patients.
99
635730
4650
10:59
In the U.S., we have a law that allows everyone to get medical treatment in an
100
659240
2580
11:01
emergency situation, regardless of their ability to pay.
101
661820
7560
11:10
EMTALA stands for Emergency Medical Treatment and Labor Act. It's a law that says you have to
102
670540
7200
11:17
give a patient, any patient, access to emergency services.
103
677740
5100
11:24
So here's how I understand the law. Under EMTALA, Medicare-participating hospitals with emergency
104
684480
6360
11:30
services must screen all patients coming to the emergency room, the ER.
105
690840
6020
11:37
Then if there is an emergency condition, the hospital must treat and stabilize the patient.
106
697540
5780
11:43
So there should be no "patient dumping," but EMTALA does not necessarily
107
703330
5790
11:49
require ongoing care. Once a hospital has met its EMTALA obligations, it's no
108
709120
6220
11:55
longer obligated to provide services to that patient.
109
715340
4640
12:01
The challenge with this kind of law is funding. Costs and charges are two
110
721860
6000
12:07
different things. A hospital may not charge a patient for a service, but
111
727860
6690
12:14
there's still a cost to the hospital. How much can be given for free before a
112
734550
6120
12:20
hospital doesn't have enough money to cover its expenses and pay its employees?
113
740670
7220
12:27
The government has a set amount of money for health care. How should that money be managed?
114
747890
6550
12:35
The EMTALA law ties into the issue of ethics. Ethics has to do with
115
755880
4620
12:40
what is morally right and wrong. Health care is a business, and any business
116
760500
6960
12:47
faces the challenge of managing finances while still being ethical.
117
767480
6400
12:53
But can a health care facility stay in business if too many services are given for free?
118
773880
6120
13:17
Health care almost always makes the news headlines. There are often new policies,
119
797180
5170
13:22
new proposals, and new controversial cases that make us question how we can
120
802350
5750
13:28
improve our current health care system. Some believe the current system has some
121
808110
6060
13:34
good aspects, and it simply needs to be improved and fixed in certain areas.
122
814170
6140
13:40
Others say the current system doesn't work. It needs to be replaced with
123
820310
4710
13:45
universal healthcare for all residents in the U.S.
124
825020
3820
13:48
You'll hear these people talk about the need for a complete overhaul. That's a complete change.
125
828980
6240
13:57
Many of the 2020 U.S. Democratic presidential candidates have very progressive proposals.
126
837940
6280
14:04
A number of them want Medicare for All, a government-run program.
127
844220
4760
14:10
This would mean no more private insurance companies. Americans would pay taxes,
128
850760
5040
14:15
and taxes would cover medical services for everyone. Under Medicare for all,
129
855800
6600
14:22
hospitals, clinics, and pharmacies would receive payment from one payer: the government.
130
862410
5010
14:27
So you'll hear the term "single-payer health care."
131
867420
4940
14:33
Some candidates are proposing more moderate versions of this reform so that Americans could keep
132
873780
6400
14:40
their health insurance coverage through their employers and still work with
133
880180
4640
14:44
private insurance companies. So some are proposing Medicare for all who want it.
134
884820
6930
14:51
You'd still have the option to work with a private insurer. You'd still have the
135
891750
4530
14:56
option to keep insurance through your employer. The public option allows people
136
896280
6960
15:03
to buy in if they want to. At least that's how I understand it. Again, health care
137
903240
7220
15:10
is confusing, so I apologize for any inaccuracies. I'm explaining the concepts as I understand them.
138
910460
7040
15:19
We had a degree of reform under President Obama when the
139
919080
3300
15:22
Affordable Care Act was created. That was back in 2010.
140
922380
4780
15:27
And it was created to expand coverage to those who were without any.
141
927160
6630
15:33
One of the controversial ideas has been to require or mandate that everyone has to have insurance.
142
933790
5070
15:38
If you don't buy in, you have to pay a penalty. The logic is that
143
938860
6719
15:45
everyone has to buy in or pay the penalty, so there should be enough money
144
945579
5041
15:50
to cover the treatment of those who need it.
145
950620
3140
15:55
But this is one point that causes arguments.
146
955260
2600
15:57
The young and healthy have less need for health insurance and
147
957860
3620
16:01
medical services in general, so they may wish to live without insurance and avoid
148
961480
5430
16:06
unnecessary costs. Is it right to create a universal health care system and
149
966910
5460
16:12
require everyone to participate?
150
972370
3990
16:32
So I've mentioned the Medicare for All plan. It's a universal healthcare system,
151
992840
5600
16:38
and there are at least two ways of looking at it.
152
998440
2640
16:41
On the one hand, everyone gets coverage. Those who need medical services receive
153
1001080
5820
16:46
those services. On the other hand, everyone is required to buy in --
154
1006900
5610
16:52
to contribute tax dollars. So essentially, it also means that healthy people are
155
1012510
4680
16:57
paying for others' medical expenses.
156
1017190
3190
17:01
Arguments arise over how much each person should contribute. Should people
157
1021800
5140
17:06
with higher incomes pay more? How much more? What's fair? Low-income households
158
1026940
7890
17:14
aren't able to contribute as much, yet households with a higher income might
159
1034830
4470
17:19
argue that they're being asked to shoulder too much of the burden. This is
160
1039300
4680
17:23
especially true of the middle or upper-middle class.
161
1043980
4260
17:29
Some politicians argue that although people would be paying higher taxes, their health care costs would be lower.
162
1049300
6540
17:36
Would things balance out in the end?
163
1056360
2140
17:38
Would they be better? Would they be worse?
164
1058500
2960
17:43
Plenty of residents and citizens have come from other countries -- countries with
165
1063100
5320
17:48
state-run healthcare systems, and there are mixed opinions.
166
1068420
3980
17:53
On the one hand, countries with universal health care systems don't have to deal with all the
167
1073700
4980
17:58
paperwork and billing issues that we Americans do because of our private
168
1078680
4720
18:03
insurance companies. On the other hand, there are stories of longer wait times
169
1083400
4620
18:08
at the doctor's office or just to schedule appointments and services.
170
1088020
6080
18:15
There's a question of quality care. Would a government-run health care system be
171
1095140
5120
18:20
able to pay medical professionals well?
172
1100260
3220
18:24
If doctors and nurses and other health
173
1104140
2300
18:26
care professionals aren't paid well, will they have enough incentive to perform
174
1106440
5670
18:32
well every day and with every patient?
175
1112110
3610
18:37
I'll end here. There's a lot to think about.
176
1117880
2400
18:40
I welcome you to post opinions in the comments,
177
1120280
2910
18:43
but I ask that everyone express ideas respectfully. Let's be open to hearing
178
1123190
5250
18:48
different points of view as we continue this discussion.
179
1128440
4040
18:53
If you found this lesson useful, then please like this video and don't forget to subscribe.
180
1133140
6560
18:59
If you'd like to talk about health care or any other topic with me one-on-one, you can book
181
1139700
5300
19:05
a 30-minute lesson. The link is in the video description.
182
1145000
4120
19:09
As always, thanks for watching and happy studies!
183
1149120
4300
19:14
Follow me, and gain more practice on Facebook and Twitter. I also have new videos on Instagram.
184
1154280
7160
19:21
If you haven't already, subscribe to my channel so you get notification of every new video I upload to YouTube.
185
1161440
8560
About this website

This site will introduce you to YouTube videos that are useful for learning English. You will see English lessons taught by top-notch teachers from around the world. Double-click on the English subtitles displayed on each video page to play the video from there. The subtitles scroll in sync with the video playback. If you have any comments or requests, please contact us using this contact form.

https://forms.gle/WvT1wiN1qDtmnspy7