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

Translator: Miguel Guisantes Reviewer: Xusto Rodriguez

So, a little while ago,

Hai algún tempo,

members of my family had three bits of minor surgery,

familiares meus necesitaron tres pequenas cirurxías

about a half hour each,

de preto de media hora cada unha.

and we got three sets of bills.

E recibimos tres facturas.

For the first one, the anesthesia bill alone was 2,000 dollars;

Na primeira, só a anestesia xa eran 2000 dólares;

the second one, 2,000 dollars;

na segunda outros 2000 dólares;

the third one, 6,000 dollars.

pero na terceira foron 6000 dólares.

So I'm a journalist. I'm like, what's up with that?

Son xornalista e pensei, como é posible?

I found out that I was actually, for the expensive one,

Descubrín que na máis cara

being charged 1,419 dollars for a generic anti-nausea drug

cobraran 1419 dólares por un xenérico antináuseas

that I could buy online for two dollars and forty-nine cents.

que eu mesma podía comprar por 2,49 dólares.

I had a long and unsatisfactory argument with the hospital,

Tiven unha discusión longa e insatisfactoria co hospital,

the insurer and my employer.

o seguro e o meu xefe.

Everybody agreed that this was totally fine.

Todos estaban de acordo coa factura.

But it got me thinking, and the more I talked to people, the more I realized:

Canto máis falaba coa xente, máis conta me daba dunha cousa:

nobody has any idea what stuff costs in health care.

ninguén sabe de verdade o prezo que ten a sanidade.

Not before, during or after that procedure or test

Nin antes, nin durante, nin despois de calquera proceso médico

do you have any idea what it's going to cost.

sabemos cal vai ser o seu custo.

It's only months later that you get an "explanation of benefits"

Só uns meses despois recibes a "explicación de prestacións"

que non dá demasiadas explicacións.

that explains exactly nothing.

So this came back to me a little while later.

Este pensamento volveu a min un pouco despois.

I had volunteered for a buyout from the New York Times,

Ofrecinme para unha saída voluntaria do New York Times

where I had worked for more than 20 years as a journalist.

no que traballara como xornalista máis de 20 anos.

I was looking for my next act.

Estaba xa pensando no meu seguinte paso.

It turned out that next act was to build a company

E este novo paso foi crear unha empresa

telling people what stuff costs in health care.

que dixera cal é o custo dos coidados sanitarios.

I won a "Shark Tank"-type pitch contest to do just that.

E gañei un concurso, tipo Shark Tank, para facer xusto iso.

Health costs ate up almost 18 percent of our gross domestic product last year,

Os custos da sanidade eran case o 18% do PIB o ano pasado

but nobody has any idea what stuff costs.

pero ninguén sabe canto custan as cousas.

Pero, e se o soubésemos?

But what if we did know?

So we started out small.

E comezamos por un pequeno proxecto.

We called doctors and hospitals

Chamamos a médicos e a hospitais

and asked them what they would accept as a cash payment for simple procedures.

e preguntamos se en procedementos

simples aceptarían pago en efectivo.

Some people were helpful.

Algunhas persoas quixeron axudar.

A lot of people hung up on us.

Outras colgaban.

Some people were just plain rude.

E algunhas outras enfadáronse.

They said, "We don't know,"

Dicían: "Non sabemos"

or, "Our lawyers won't let us tell you that,"

ou "os nosos avogados non nos deixan falar diso".

though we did get a lot of information.

E inda así conseguimos moita información.

We found, for example, that here in the New York area,

Descubrimos, por exemplo, que aquí en Nova York

you could get an echocardiogram for 200 dollars in Brooklyn

podes facer un ecocardiograma por preto de 200 $ en Brooklyn

ou por 2150 $ en Manhattan, estando a moi poucos quilómetros.

or for 2,150 dollars in Manhattan, just a few miles away.

New Orleans, the same simple blood test,

En Nova Orleáns a mesma análise de sangue sinxela

19 dollars over here,

19 $ nun lugar e 522 $ noutro moi preto.

522 dollars just a few blocks away.

San Francisco, the same MRI,

En San Francisco, 475 $ por unha resonancia magnética

475 dollars

or 6,221 dollars just 25 miles away.

ou 6221 $ noutro lugar a só 40 km.

These pricing variations existed for all the procedures

Estas diferenzas de prezo existen en todos os procedementos

and all the cities that we surveyed.

e en todas as cidades que enquisamos.

Entón empezamos a preguntarlle á xente polas súas facturas médicas.

Then we started to ask people to tell us their health bills.

In partnership with public radio station WNYC here in New York,

En colaboración coa radio pública de aquí, de Nova York,

we asked women to tell us the prices of their mammograms.

pedímoslles ás mulleres que nos deran os prezos das súas mamografías.

People told us nobody would do that, that it was too personal.

Dicíannos que ningunha o faría, que era demasiado persoal.

But in the space of three weeks,

Pero en tres semanas,

400 women told us about their prices.

400 mulleres falaran con nós dos seus prezos.

Then we started to make it easier for people to share their data

Nese momento, comezamos a promover

que a xente compartise os seus datos na nosa plataforma en Internet.

into our online searchable database.

É unha mestura entre kayak.com e a aplicación Waze pero para a saúde.

It's sort of like a mash-up of Kayak.com and the Waze traffic app for health care.

(Laughter)

(Risas)

We call it a community-created guide to health costs.

Chamámoslle guía comunitaria dos custos da saúde.

Our survey and crowdsourcing work grew into partnerships

O noso traballo de enquisa e colaboración aberta

with top newsrooms nationwide --

medrou ao asociarnos con redaccións de todo o país:

in New Orleans, Philadelphia,

Nova Orleáns, Filadelfia,

San Francisco, Los Angeles, Miami and other places.

San Francisco, Os Ánxeles, ou Miami, entre outros.

We used the data to tell stories about people who were suffering

Usamos os datos para contar as historias das persoas que sofren,

and how to avoid that suffering, to avoid that "gotcha" bill.

como evitar isto e tamén evitar estas facturas.

A woman in New Orleans saved nearly 4,000 dollars using our data.

Unha muller en Nova Orleáns aforrou uns 4000 $ grazas aos nosos datos.

A San Francisco contributor saved nearly 1,300 dollars

Un colaborador de San Francisco, case 1300 $

by putting away his insurance card

renunciando á súa póliza de seguros

and paying cash.

e facendo o pago en metálico.

There are a lot of people who are going to in-network hospitals

Hai moitas persoas que van á súa rede de hospitais

and getting out-of-network bills.

pero que reciben facturas de fóra dela.

And then there was the hospital that continued to bill a dead man.

E mesmo había un hospital que facturaba a un home xa finado.

We learned that thousands of people wanted to tell us their prices.

Soubemos que milleiros de persoas nos querían dicir os seus prezos.

They want to learn what stuff costs,

Querían saber o que custan as cousas,

find out how to argue a bill,

saber como discutir unha factura,

help us solve this problem that's hurting them and their friends and families.

axudar a solucionar un problema que lles afecta a eles,

aos seus amigos e familias.

We talked to people who had to sell a car to pay a health bill,

Falabamos con persoas que tiveran que vender o coche

go into bankruptcy,

para pagar as facturas, que entraran en quebra,

skip a treatment because of the cost.

ou que deixaran o tratamento polo alto prezo.

Imagine if you could afford the diagnosis

Imaxinen que poidan pagar o diagnóstico

but not the cure.

pero non a cura.

We set off a huge conversation about costs

Comezamos unha enorme conversa sobre os custos

involving doctors and hospitals, yes, but also their patients,

con médicos e hospitais, si, pero tamén cos doentes.

or as we like to call them, people.

Ou como nos gusta chamalos, xente.

(Laughter)

(Risas)

We changed policy.

Cambiamos a política.

A consumer protection bill that had been stalled

Un proxecto de lei de protección ao consumidor,

parado 10 anos no lexislativo de Luisiana

in the Louisiana legislature for 10 years

passed after we launched.

foi aprobado tras o noso lanzamento.

Let's face it:

Sexamos sinceros,

this huge, slow-rolling public health crisis

esta gran e lenta crise da sanidade pública

is a national emergency.

é unha emerxencia nacional.

And I don't think government's going to help us out anytime soon.

E non creo que o goberno nos vaia axudarnos no curto prazo.

But what if the answer was really simple:

Mais, e se a resposta fose sinxela

make all the prices public all the time.

como facer que todos os prezos fosen públicos?

Would our individual bills go down? Our health premiums?

Baixarían as facturas? As primas?

Be really clear about this:

Teñan isto claro.

this is a United States problem.

É un problema dos EUA.

In most of the rest of the developed world,

En boa parte do mundo desenvolvido

sick people don't have to worry about money.

as persoas non se teñen que preocupar polo diñeiro.

It's also true that price transparency will not solve every problem.

Tamén é certo que a transparencia nos prezos non o resolve todo.

Aínda haberá tratamentos caros

There will still be expensive treatments,

e unha gran fricción no noso sistema de seguros.

huge friction from our insurance system.

There will still be fraud

Haberá fraude aínda

and a massive problem with overtreatment and overdiagnosis.

e un problema masivo de sobretratamento e sobrediagnóstico.

And not everything is shoppable.

E non todo se compra con diñeiro.

Not everybody wants the cheapest appendectomy

Non todo o mundo quere a apendicectomía

or the cheapest cancer care.

ou o tratamento para o cancro máis baratos.

But when we talk about these clear effects,

Mais cando falamos destes efectos claros,

we're looking at a real issue that's actually very simple.

vemos un problema que é realmente moi sinxelo.

When we first started calling for prices,

Cando comezabamos a chamar para pedir prezos,

we actually felt like we were going to be arrested.

sentíamos que nos ían arrestar.

It seemed kind of transgressive to talk about medicine and health care

Parecía infrinxir algunha norma falar de medicina e de asistencia sanitaria

in the same breath,

na mesma frase,

and yet it became liberating,

mais resultou liberador.

because we found not only data

Non só atopamos datos

but also good and honest people out there in the system

senón tamén boas persoas no sistema

who want to help folks get the care they need

que queren axudar á xente a ter os coidados que precisan

at a price they can afford.

e a un prezo que poidan pagar.

And it got easier to ask.

Fíxose máis fácil preguntar.

So I'll leave you with some questions.

Así que acabo con algunhas cuestións.

What if we all knew what stuff cost in health care in advance?

E se soubésemos todos o que custan os coidados médicos por adiantado?

What if, every time you Googled for an MRI,

Que pasaría se cando buscase en Internet "resonancia magnética"

you got drop-downs telling you where to buy and for how much,

se despregase un menú coa información sobre onde comprala e os prezos,

the way you do when you Google for a laser printer?

igual que pasa cando buscas unha impresora láser?

What if all of the time and energy and money that's spent hiding prices

Que pasaría se todo o tempo, enerxía e diñeiro que se gasta ocultando os prezos

was squeezed out of the system?

se eliminase do sistema?

What if each one of us could pick the $19 test every time

Que pasaría se cada un puidese escoller a proba de 19 $

instead of the $522 one?

en lugar da de 522 $?

Would our individual bills go down?

Baixarían as nosas facturas?

Our premiums?

As nosas primas do seguro?

I don't know, but if you don't ask, you'll never know.

Non o sei, mais se non se pregunta nunca o saberemos.

And you might save a ton of money.

E cada un poderíamos aforrar moitos cartos.

And I've got to think that a lot of us and the system itself

E teño que pensar que moitos de nós, e o propio sistema, seriamos máis sans.

would be a lot healthier.

Thank you.

Grazas.

(Applause)

(Aplausos)