You shouldn't have to choose between filling your prescriptions and paying bills | Kiah Williams

Translator: Alba Méndez Reviewer: Xosé María Moreno

Every day in this country,

A diario neste país

families are forced to make impossible choices

moitas familias son obrigadas a tomar decisións imposibles

cando se trata da atención médica.

when it comes to their health care.

Like Kimberly, who said,

Como Kimberly, que dixo:

"There was times I had to choose between my food and my pills.

''Houbo veces que tiven que escoller entre a comida ou as pastillas.

It wasn't luxury stuff, because I didn't make that much.

Non eran luxos porque non gañaba tanto.

It was like, 'Can I get shampoo or conditioner?'

Era como, 'Podo mercar xampú ou acondicionador?'

Things you take for granted."

Cousas que dás por sentado''.

And Debbie, who said,

E Debbie, que dixo:

"You put your medicine in one hand,

''Pos o medicamento nunha man,

your living costs in the other.

os teus gastos diarios na outra

OK. Well, what am I going to do?

Que fago?

Am I going to get my medicine

Vou polo medicamento

or am I going to pay my bills?

ou pago as facturas?

Well, I can't live without my medicine,

Non podo vivir sen o medicamento

but I can't live if I don't pay my bills."

tampouco se non pago as facturas''.

Ten thousand people die every month in this country,

Dez mil persoas morren cada mes no país

because they don't take the medicine that they need.

por non tomaren o medicamento que necesitan.

More people die from not taking medications

Morre máis xente por non medicarse

than opioid overdoses and car accidents combined.

que por sobredoses de opiáceos e accidentes de coche xuntos.

But you can't take medicine if you can't afford it.

Pero non podes tomar o medicamento se non podes pagalo.

Today, the average household spends 3,000 dollars a year

Hoxe, o fogar medio gasta 3000 dólares ao ano

on medications.

en medicamentos.

About a third of folks who are uninsured

Preto dun terzo das persoas non teñen seguro médico

said that they stopped taking medicine as prescribed

dixeron que pararon de tomar os medicamentos prescritos

because of cost.

por culpa do que custaban.

Even folks with insurance,

Mesmo entre as persoas con seguro

if they make under 35,000 dollars a year,

se gañan menos de 35 000 dólares ao ano

half of them report skipping the medications

moitos din non tomar os medicamentos

if their insurance doesn't cover it.

se o seu seguro non os cobre.

So there are 10 million adults like Kimberly and like Debbie

Así que hai dez millóns de adultos como Kimberly e Debbie

who are forced to make impossible choices every day.

que son obrigados a tomar decisións imposibles cada día.

We all know that prescription drug prices are too high.

Sabemos que os prezos das receitas son moi altos.

And our health care system,

E o noso sistema de saúde

that makes some folks uninsured and other folks underinsured,

onde uns teñen seguro e outros teñen un seguro deficiente

doesn't prioritize people who need access now

non prioriza a xente que precisa coidados xa

and need medications now.

e que precisa medicamentos xa.

Ten million -- it's a big number,

Dez millóns é unha cifra grande

but it's also a solvable number,

pero tamén mellorable

because there's also 10 billion dollars

porque hai dez mil millóns de dólares

of perfectly good, unused medication

en medicamentos sen usar e en perfecto estado

that goes to waste.

que van ó lixo.

So this is an injustice on two sides:

Iso é inxusto por dous motivos:

people not getting the medicine that they need to survive and to thrive,

a xente non ten os medicamentos que necesita para vivir

and that very same medication being sent to a medical waste incinerator

e esa mesma medicación é levada a incineradores de residuos médicos

to be destroyed.

para ser destruída.

This waste is unconscionable, but it also offers an opportunity.

Isto é intolerable, pero tamén ofrece unha oportunidade.

I started SIRUM,

Fundei SIRUM

a not-for-profit technology company, with my cofounders Adam and George,

unha empresa tecnolóxica sen fin de lucro, xunto con Adam e George

to turn discarded medications into a lifeline,

para converter os medicamentos descartados nun salvavidas

just like the medications in this warehouse.

coma os que están neste almacén.

We may not be able to fix

Pode que non poidamos remediar

all the ways in which our health care system is failing us,

todas as formas en que fracasa o noso sistema de saúde

but we can fix this one.

pero podemos remediar esta.

Medications come from manufacturers and wholesalers who have safety stock,

Os medicamentos veñen do stock de seguridade de fabricantes e grosistas,

and when it's short-dated, they destroy it.

e cando están a piques de vencer, destrúenos.

It also comes from health care facilities

Tamén veñen de centros sanitarios

like hospitals, pharmacies and nursing homes,

como hospitais, farmacias e asilos

who end up with surplus when a patient stops taking medication

do excedente restante cando un paciente deixa de tomalos

or when they pass away.

ou falece.

We can use this untapped source of medications

Podemos recorrer a estes medicamentos sen usar

to supply all 10 million people who need medications.

para fornecer a dez millóns de persoas que necesitan medicamentos.

And we can do this today.

E podemos facelo hoxe.

SIRUM gets surplus medications

SIRUM consegue os medicamentos sobrantes

by putting recycling bins into these hundreds of facilities

poñendo colectores de reciclaxe dentro dos centos de instalacións

that have surplus.

que teñen excedentes.

They fill the bin, and when the box is full,

Alí enchen os colectores e, unha vez cheos

SIRUM initiates a courier pickup to pick up that medication,

SIRUM recolle os medicamentos

and we handle the shipping, the tracking, the manifests and the tax receipt.

encárgase do envío, seguimento, xustificantes e recibos fiscais.

Medicine donors want to donate because it's actually cheaper and easier

Os doadores fano porque é máis barato e sinxelo

than the highly regulated medicine destruction process.

que o proceso tan regulado de destrución de medicamentos.

And there are strong tax incentives to actually donate.

E hai grandes incentivos fiscais para facer doazóns.

We then deliver those donated medications to people who need it.

Logo, enviamos os medicamentos doados á xente que os precisa.

A new prescription comes in,

Unha receita entra no noso sistema

and our platform matches that patient need with the inventory that's available.

e relaciona o que precisa o paciente co inventario dispoñible.

Our platform then generates a warehouse pick list,

A nosa plataforma crea unha lista,

the medications are picked and the prescriptions filled.

selecciónanse os medicamentos e despáchase a receita.

We are building the 21st-century pharmacy experience

Estamos creando a farmacia do século XXI

that low-income families deserve.

que merecen as familias de ingresos baixos.

Patients can register in under five minutes

Os pacientes poden rexistrarse en menos de cinco minutos

and have access to over 500 different medications,

e acceder a preto de 500 medicamentos,

a stable list of medications for everything from heart disease

unha lista de medicamentos para todo, dende enfermidades do corazón

to mental health conditions,

ata doenzas psíquicas,

actually representing over 75 percent of all prescriptions prescribed

que representa neste momento o 75 % de todas as receitas

prescritas nos EUA.

in the United States today.

We also partner with a network of doctors, nurses and case managers

Tamén colaboramos con médicos, enfermeiros e traballadores sociais

at community health centers and free clinics

en centros médicos comunitarios e clínicas gratuítas

that refer patients to the service.

que remiten pacientes ao noso servizo.

We make it as easy for these health care providers

Facemos que sexa tan fácil para os provedores de atención médica

to have a prescription filled with donated medications

cubrir unha receita con medicamentos doados

as it is to send a prescription to a local pharmacy.

como mandar a receita á farmacia local.

And patients can pick up medications on-site at one of our partners

Os nosos socios poden darlle os medicamentos aos pacientes

or have medications delivered directly to their home.

ou remitírllelos directamente á súa casa.

By circumventing the traditional supply chain,

Ao evitar a cadea tradicional de fornecemento

we're able to offer flat, transparent pricing --

somos capaces de ofrecer prezos fixos e transparentes,

about two dollars for a month's supply of most medications.

arredor de 2 $ pola subministración mensual

da maior parte dos medicamentos.

And that allows a predictable, affordable price

E iso permite ofrecer un prezo previsible e asumible

that folks can actually budget for.

que a xente pode pagar.

We've already supplied enough medication for 150,000 people.

Xa abastecemos os medicamentos que precisan 150 000 persoas.

But we can do more.

Pero podemos facer máis.

Our goal is to reach one million people

A nosa meta é chegar ao millón de persoas

with approaching a billion dollars of unused medicine

con preto de mil millóns de dólares en medicamentos sen usar

in the next five years,

nos próximos cinco anos,

scaling our program to 12 states.

ampliando o noso programa a 12 estados.

At this scale, we can actually cover communities that are home

A esa escala, podemos cubrir comunidades

to 40 percent of the 10 million people

que abranguen un 40 % dos dez millóns de persoas

who lack consistent, affordable access.

que carecen dun servizo permanente e accesible.

Our direct service to one million people

Este servizo, dirixido a un millón de persoas

will drive price competition for so many more.

impulsará a competencia de prezos.

Walmart launched one of the only price innovations in pharmacy

Walmart lanzou unha das únicas innovacións de prezos en farmacia

in 2006,

en 2006.

by offering a limited list of medications

Ofreceron unha lista, ben limitada, de medicamentos

for a flat fee of four dollars.

por un prezo fixo de 4 $.

This sparked incredible change.

Isto provocou cambios incribles.

It sparked competitors to offer other lists

Provocou que a competencia se ofrecese

and price match guarantees.

a igualar listas e prezos.

By targeting transparent, affordable medications

Levando medicacións transparentes e accesible

into these new states,

a eses outros estados

we can actually drive regional price competition

podemos impulsar unha competencia rexional

that drives down the prices for entire low-income communities.

que baixe os custos para comunidades enteiras con ingresos baixos.

Our health care system is complex.

O noso sistema de saúde é complexo.

It is daunting.

É desalentador.

It feels impossible to make headway.

Asemella imposible avanzar.

But we can completely reimagine medicine access.

Pero podemos reimaxinar por completo o acceso aos medicamentos.

By using surplus medications as a beachhead to force change

Ao usar o excedente de medicamentos como avanzada para lograr un cambio

into this multibillion dollar industry,

nesta industria multimillonaria

we can create radical access to medications

podemos crear un acceso radical aos medicamentos

based on a fundamental belief

baseados na crenza fundamental

that people who live in one of the wealthiest nations in the world

de que quen vive nunha das nacións máis ricas do mundo

can and should have access to medicine that they need

pode e debe ter acceso aos medicamentos que necesite

to survive and to thrive.

para sobrevivir e prosperar.

I do not pretend to have all of the answers

Non pretendo ter todas as respostas

to fix all of the problems in our health care system.

para acabar cos problemas no noso sistema de saúde.

But getting medications to the millions of people

Pero fornecerlles medicamentos aos millóns de persoas que os precisan

who need it to live a healthy life,

para ter unha vida sa

saving medicine to save lives --

salvar medicamentos para salvar vidas

that is something we can do today.

é algo que podemos facer hoxe.

Thank you.

Grazas.