Rebecca Onie: What if our healthcare system kept us healthy?

152,453 views ใƒป 2012-06-12

TED


์•„๋ž˜ ์˜๋ฌธ์ž๋ง‰์„ ๋”๋ธ”ํด๋ฆญํ•˜์‹œ๋ฉด ์˜์ƒ์ด ์žฌ์ƒ๋ฉ๋‹ˆ๋‹ค.

00:00
Translator: Timothy Covell Reviewer: Morton Bast
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๋ฒˆ์—ญ: Sang Hun Song ๊ฒ€ํ† : Woo Hwang
00:15
So my freshman year of college
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๋Œ€ํ•™ ์‹ ์ž…์ƒ ์‹œ์ ˆ
00:17
I signed up for an internship in the housing unit
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์ „ ๋Œ€๋ณด์Šคํ„ด ๋ฒ•๋ฅ  ์ƒ๋‹ด์†Œ ์ฃผํƒ ๋ถ„์•ผ์—์„œ
00:19
at Greater Boston Legal Services.
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์ธํ„ด์‰ฝ์„ ์‹œ์ž‘ํ–ˆ์Šต๋‹ˆ๋‹ค.
00:22
Showed up the first day
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์ „ ์ฒซ๋‚  ์ถœ๊ทผํ•˜์—ฌ
00:23
ready to make coffee and photocopies,
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์ปคํ”ผ์™€ ๋ณต์‚ฌ๋ฅผ ํ•  ์ค€๋น„๋ฅผ ํ–ˆ๋Š”๋ฐ,
00:26
but was paired with this righteous, deeply inspired attorney
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์˜คํžˆ๋ ค ์ •์˜๋กญ๊ณ , ๋งค์šฐ ํƒ์›”ํ•œ ๋ณ€ํ˜ธ์‚ฌ
00:30
named Jeff Purcell,
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์ œํ”„ ํŽ„์…€๊ณผ ์ง์„ ์ด๋ฃจ์–ด
00:32
who thrust me onto the front lines
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์ฒซ๋‚ ๋ถ€ํ„ฐ ์ง์—… ์ตœ์ „์„ ์—
00:34
from the very first day.
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๋›ฐ์–ด๋“ค๊ฒŒ ๋˜์—ˆ์Šต๋‹ˆ๋‹ค.
00:36
And over the course of nine months
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๊ทธ๋ฆฌ๊ณ  ์ดํ›„ 9๊ฐœ์›”๋™์•ˆ
00:38
I had the chance
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์ €๋Š” ๋ณด์Šคํ†ค์— ์žˆ๋Š”
00:39
to have dozens of conversations
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์ €์ž„๊ธˆ ๊ฐ€์กฑ๋“ค๊ณผ
00:41
with low-income families in Boston
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์ˆ˜๋งŽ์€ ๋Œ€ํ™”๋ฅผ ๋‚˜๋ˆ„์—ˆ๊ณ ,
00:43
who would come in presenting with housing issues,
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๊ทธ๋“ค์€ ํ•ญ์ƒ ๊ฑฐ์ฃผ๋ฅผ ๋ฌธ์ œ ์‚ผ์•„ ์™”์ง€๋งŒ,
00:47
but always had an underlying health issue.
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์‹ค์ œ๋กœ๋Š” ๋งค๋ฒˆ ๊ทผ๋ณธ์ ์ธ ๊ฑด๊ฐ• ๋ฌธ์ œ๊ฐ€ ์žˆ์—ˆ์Šต๋‹ˆ๋‹ค.
00:50
So I had a client who came in,
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ํ•œ๋ฒˆ์€ ํ•œ ๊ณ ๊ฐ์ด ๋“ค์–ด์™”๋Š”๋ฐ,
00:52
about to be evicted because he hasn't paid his rent.
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๊ทธ๋Š” ์ง‘์„ธ๋ฅผ ๋‚ด์ง€ ์•Š์•„ ์ซ“๊ฒจ๋‚  ์œ„๊ธฐ์˜€์Šต๋‹ˆ๋‹ค.
00:54
But he hasn't paid his rent, of course,
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ํ•˜์ง€๋งŒ ๊ทธ๋Š” ์ง‘์„ธ๋ฅผ ๋‚ผ ์ˆ˜ ์—†์—ˆ๋˜ ๊ฒƒ์ด
00:57
because he's paying for his HIV medication
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๊ทธ๋Š” HIV(์—์ด์ฆˆ ๋ฐ”์ด๋Ÿฌ์Šค) ์•ฝ์— ๋ˆ์„ ์“ฐ๊ณ  ์žˆ์—ˆ๊ณ ,
00:59
and just can't afford both.
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๋„์ €ํžˆ ๋‘˜๋‹ค ๋‚ผ ์ˆ˜๋Š” ์—†์—ˆ๋˜ ๊ฑฐ์ฃ .
01:01
We had moms who would come in,
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์ €ํฌ์—๊ฒŒ ์˜ค๋Š” ์–ด๋จธ๋‹˜๋“ค์€,
01:03
daughter has asthma,
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๋”ธ์€ ์ฒœ์‹์ด ์žˆ๊ณ ,
01:04
wakes up covered in cockroaches every morning.
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๋งค์ผ ์•„์นจ ๋ฐ”ํ€ด๋ฒŒ๋ ˆ์— ๋’ค๋ฎ์—ฌ ์ผ์–ด๋‚˜๊ณ  ์žˆ์—ˆ์Šต๋‹ˆ๋‹ค.
01:07
And one of our litigation strategies
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์ €ํฌ์˜ ์†Œ์†ก ์ „๋žต ์ค‘ ํ•˜๋‚˜๋Š”
01:09
was actually to send me into the home of these clients
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์ œ๊ฐ€ ์ง์ ‘ ์ด๋Ÿฐ ๊ณ ๊ฐ๋“ค์˜ ์ง‘์—
01:12
with these large glass bottles.
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์ปค๋‹ค๋ž€ ์œ ๋ฆฌ๋ณ‘์„ ๋“ค๊ณ ๊ฐ€๋Š” ๊ฒƒ์ด์—ˆ์ฃ .
01:14
And I would collect the cockroaches,
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๊ทธ๋ฆฌ๊ณ  ์ „ ๋ฐ”ํ€ด๋ฒŒ๋ ˆ๋ฅผ ๋ชจ์•„,
01:16
hot glue-gun them to this poster board
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ํฌ์Šคํ„ฐ ๋ณด๋“œ์— ์ ‘์ฐฉ์ œ๋กœ ๋ถ™์—ฌ์„œ
01:19
that we'd bring to court for our cases.
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์žฌํŒ์— ๋“ค๊ณ  ๋‚˜ํƒ€๋‚ฌ์Šต๋‹ˆ๋‹ค.
01:21
And we always won
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์ €ํฌ๋Š” ํ•ญ์ƒ ์Šน์†Œํ–ˆ์Šต๋‹ˆ๋‹ค.
01:22
because the judges were just so grossed out.
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์™œ๋ƒ๋ฉด ๋งค๋ฒˆ ํŒ์‚ฌ๋“ค์ด ๋„ˆ๋ฌด ์—ญ๊ฒจ์›Œ ํ–ˆ์œผ๋‹ˆ๊นŒ์š”.
01:25
Far more effective, I have to say,
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์†”์งํžˆ ์ œ๊ฐ€ ๋กœ์Šค์ฟจ์—์„œ ๋ฐฐ์šด ์–ด๋–ค ๊ฒƒ๋ณด๋‹ค๋„
01:27
than anything I later learned in law school.
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ํ›จ์”ฌ ํšจ๊ณผ์ ์ธ ๋ฐฉ๋ฒ•์ด์—ˆ์Šต๋‹ˆ๋‹ค.
01:30
But over the course of these nine months,
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ํ•˜์ง€๋งŒ ์ด 9๊ฐœ์›”๋™์•ˆ ์ €๋Š”
01:33
I grew frustrated with feeling
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์ €ํฌ๊ฐ€ ๊ณ ๊ฐ๋“ค์˜ ์‚ถ์—
01:34
like we were intervening too far downstream
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๋„ˆ๋ฌด ๋Šฆ๊ฒŒ ๊ฐœ์ž…ํ•œ๋‹ค๋Š” ๋Š๋‚Œ์—
01:37
in the lives of our clients --
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๋ถˆํŽธํ•ด์ง€๊ธฐ ์‹œ์ž‘ํ–ˆ์Šต๋‹ˆ๋‹ค.
01:40
that by the time they came to us,
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์™œ๋ƒ๋ฉด ๊ทธ๋“ค์ด ์ €ํฌ์—๊ฒŒ ์˜ฌ๋•Œ์ฏค์ด๋ฉด,
01:41
they were already in crisis.
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์ด๋ฏธ ์œ„๊ธฐ ์ƒํ™ฉ์ด์—ˆ์œผ๋‹ˆ๊นŒ์š”.
01:44
And at the end of my freshman year of college,
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๊ทธ๋ฆฌ๊ณ  ์ œ๊ฐ€ ๋Œ€ํ•™ ์ฒซํ•ด๋ฅผ ๋งˆ์น  ๋ฌด๋ ต,
01:46
I read an article about the work
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ํ•œ ๊ธฐ์‚ฌ์—์„œ
01:48
that Dr. Barry Zuckerman was doing
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๋ฒ ๋ฆฌ ์ฃผ์ปค๋งจ์”จ๊ฐ€ ์†Œ์•„๊ณผ ์˜์žฅ์œผ๋กœ
01:50
as Chair of Pediatrics
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๋ณด์Šคํ„ด ๋ฉ”๋””์ปฌ ์„ผํ„ฐ์—์„œ
01:52
at Boston Medical Center.
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ํ•˜๋Š” ์ผ์„ ์ฝ์—ˆ์Šต๋‹ˆ๋‹ค.
01:53
And his first hire was a legal services attorney
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๊ทธ๋ฆฌ๊ณ  ๊ทธ๊ฐ€ ์ฒ˜์Œ์œผ๋กœ ๊ณ ์šฉํ•œ ์‚ฌ๋žŒ์€ ํ™˜์ž๋ฅผ ๋Œ€๋ณ€ํ• 
01:56
to represent the patients.
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๋ฒ•๋ฅ  ์ƒ๋‹ด ๋ณ€ํ˜ธ์‚ฌ์˜€์Šต๋‹ˆ๋‹ค.
01:58
So I called Barry,
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๊ทธ๋ž˜์„œ ์ „ ๋ฐฐ๋ฆฌ์—๊ฒŒ ์ „ํ™”๋ฅผ ๊ฑธ์–ด,
02:00
and with his blessing, in October 1995
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๊ทธ์˜ ๋„์›€์œผ๋กœ 1995๋…„ 10์›”
02:02
walked into the waiting room
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๋ณด์Šคํ†ค ๋ฉ”๋””์ปฌ ์„ผํ„ฐ ์†Œ์•„๊ณผ
02:04
of the pediatrics clinic at Boston Medical Center.
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๋Œ€๊ธฐ์‹ค์— ์ž…์„ฑํ•˜๊ฒŒ ๋˜์—ˆ์Šต๋‹ˆ๋‹ค.
02:07
I'll never forget,
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์•„์ง๋„ ์žŠ์„ ์ˆ˜ ์—†๋Š” ๊ฒƒ์ด,
02:09
the TVs played this endless reel of cartoons.
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ํ…”๋ ˆ๋น„์ „์—์„œ๋Š” ๋Š์ž„์—†์ด ๋งŒํ™”๋ฅผ ํ‹€์–ด์ฃผ์—ˆ๊ณ ,
02:12
And the exhaustion of mothers
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๋‘๋ฒˆ, ์„ธ๋ฒˆ, ๋•Œ๋ก  ๋„ค๋ฒˆ๊นŒ์ง€
02:15
who had taken two, three, sometimes four buses
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๋ฒ„์Šค๋ฅผ ํ™˜์Šนํ•˜์—ฌ ์•„์ด๋“ค์€
02:18
to bring their child to the doctor
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์˜์‚ฌ์—๊ฒŒ ๋ฐ๋ ค์˜จ ์–ด๋จธ๋‹˜๋“ค์˜ ํƒˆ์ง„์„
02:20
was just palpable.
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ํ”ผ๋ถ€๋กœ ๋Š๋‚„ ์ˆ˜ ์žˆ์„ ์ •๋„์˜€์œผ๋‹ˆ๊นŒ์š”.
02:22
The doctors, it seemed,
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์˜์‚ฌ๋“ค์€
02:23
never really had enough time for all the patients,
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๋ชจ๋“  ํ™˜์ž๋ฅผ ์œ„ํ•œ ์‹œ๊ฐ„์ด ์ถฉ๋ถ„ํ•˜์ง€ ์•Š์•˜์Šต๋‹ˆ๋‹ค.
02:25
try as they might.
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๋…ธ๋ ฅ์—๋„ ๋ถˆ๊ตฌํ•˜๊ณ ์š”.
02:26
And over the course of six months,
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๊ทธ๋ฆฌ๊ณ  ์ดํ›„ 6๊ฐœ์›” ๋™์•ˆ,
02:27
I would corner them in the hallway
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์ €๋Š” ์˜์‚ฌ๋“ค์€ ๋ณต๋„์—์„œ ๋งŒ๋‚˜๋ฉด
02:29
and ask them a sort of naive but fundamental question:
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๋‹ค์†Œ ์œ ์น˜ํ•˜์ง€๋งŒ ํ•ต์‹ฌ์ ์ธ ์งˆ๋ฌธ์„ ํ–ˆ์Šต๋‹ˆ๋‹ค:
02:33
"If you had unlimited resources,
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"๋งŒ์•ฝ ๋‹น์‹ ์—๊ฒŒ ๋ฌดํ•œ์˜ ์ž์›์ด ์žˆ๋‹ค๋ฉด,
02:35
what's the one thing you would give your patients?"
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ํ™˜์ž์—๊ฒŒ ์ค„ ๋‹จ ํ•œ๊ฐ€์ง€๋Š” ๋ฌด์—‡์ธ๊ฐ€์š”?"
02:38
And I heard the same story again and again,
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๊ทธ๋ฆฌ๊ณ  ์ „ ๋งค๋ฒˆ ๊ฐ™์€ ์ด์•ผ๊ธฐ๋ฅผ ๋“ค์—ˆ๊ณ 
02:41
a story we've heard hundreds of times since then.
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๊ทธ๋•Œ ์ดํ›„๋กœ๋„ ์ˆ˜๋ฐฑ๋ฒˆ์„ ๋“ค์—ˆ์Šต๋‹ˆ๋‹ค.
02:44
They said, "Every day we have patients that come into the clinic --
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๊ทธ๋“ค์€, "๋งค์ผ ์šฐ๋ฆฌ๋Š” ๋ณ‘์›์— ๋“ค์–ด์˜ค๋Š” ํ™˜์ž๋“ค ์ค‘
02:48
child has an ear infection,
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์•„์ด์˜ ๊ท€์— ๊ฐ์—ผ์ด ์žˆ์œผ๋ฉด
02:49
I prescribe antibiotics.
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์ „ ํ•ญ์ƒ์ œ๋ฅผ ์ฒ˜๋ฐฉํ•ฉ๋‹ˆ๋‹ค.
02:51
But the real issue is there's no food at home.
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ํ•˜์ง€๋งŒ ์ง„์งœ ๋ฌธ์ œ๋Š” ์ง‘์— ์Œ์‹์ด ์—†๋‹ค๋Š” ์ ์ด์ฃ .
02:54
The real issue
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์ง„์งœ ๋ฌธ์ œ๋Š”
02:56
is that child is living with 12 other people
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๊ทธ ์•„์ด๊ฐ€ 12๋ช…์˜ ๋‹ค๋ฅธ ์‚ฌ๋žŒ๋“ค๊ณผ ๊ฐ™์ด
02:58
in a two-bedroom apartment.
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๋ฐฉ ๋‘๊ฐœ์งœ๋ฆฌ ์•„ํŒŒํŠธ์— ์‚ฐ๋‹ค๋Š” ๊ฒ๋‹ˆ๋‹ค.
02:59
And I don't even ask about those issues
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๊ทธ๋ฆฌ๊ณ  ์ „ ์ด ๋ฌธ์ œ์— ๋Œ€ํ•ด ๋ฌผ์–ด๋ณด์ง€ ์•Š์Šต๋‹ˆ๋‹ค.
03:01
because there's nothing I can do.
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์™œ๋ƒ๋ฉด ์ œ๊ฐ€ ํ•  ์ˆ˜ ์žˆ๋Š” ๊ฒƒ์ด ์—†๊ฑฐ๋“ ์š”.
03:04
I have 13 minutes with each patient.
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์ „ ๊ฐ ํ™˜์ž์™€ 13๋ถ„์ด ์ฃผ์–ด์ ธ์žˆ์Šต๋‹ˆ๋‹ค.
03:06
Patients are piling up in the clinic waiting room.
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ํ™˜์ž๋Š” ๋ณ‘์› ๋Œ€๊ธฐ์‹ค์— ์Œ“์—ฌ๋งŒ ๊ฐ€๊ณ  ์žˆ์ฃ .
03:08
I have no idea where the nearest food pantry is.
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์ „ ๊ฐ€์žฅ ๊ฐ€๊นŒ์šด ์‹๋ฃŒํ’ˆ ์ €์žฅ์†Œ๊ฐ€ ์–ด๋””์žˆ๋Š”์ง€๋„ ๋ชฐ๋ผ์š”.
03:11
And I don't even have any help."
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๊ทธ๋ฆฌ๊ณ  ์ „ ์•„๋ฌด๋Ÿฐ ๋„์›€๋„ ๋ฐ›์ง€ ๋ชปํ•ฉ๋‹ˆ๋‹ค."
03:13
In that clinic, even today,
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์˜ค๋Š˜๋„ ๊ทธ ๋ณ‘์›์—๋Š”,
03:15
there are two social workers
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๋‹จ ๋‘๋ช…์˜ ์‚ฌํšŒ ๋ณต์ž์‚ฌ๊ฐ€
03:16
for 24,000 pediatric patients,
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24,000๋ช…์˜ ์†Œ์•„ ํ™˜์ž๋ฅผ ๋‹ด๋‹นํ•˜๊ณ  ์žˆ์Šต๋‹ˆ๋‹ค.
03:19
which is better than a lot of the clinics out there.
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์ด๋Š” ๊ทธ ์™ธ์— ์ˆ˜๋งŽ์€ ๋ณ‘์›๋ณด๋‹ค ๋‚˜์€ ์‹ค์ •์ด์ฃ .
03:22
So Health Leads was born of these conversations --
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<ํ—ฌ์Šค ๋ฆฌ๋“œ>๋Š” ์ด ๋Œ€ํ™”๋“ค์—์„œ ํƒ„์ƒํ–ˆ์Šต๋‹ˆ๋‹ค.
03:25
a simple model
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๊ฐ„๋‹จํ•œ ๋ชจ๋ธ๋กœ,
03:26
where doctors and nurses
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์˜์‚ฌ์™€ ๊ฐ„ํ˜ธ์‚ฌ๊ฐ€
03:28
can prescribe nutritious food,
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ํ™˜์ž๋ฅผ ์œ„ํ•ด ๊ฑด๊ฐ•ํ•œ ์Œ์‹์„,
03:30
heat in the winter
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๊ฒจ์šธ์—๋Š” ๋‚œ๋ฐฉ์„,
03:31
and other basic resources for their patients
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๊ทธ๋ฆฌ๊ณ  ๊ธฐํƒ€ ๊ธฐ์ดˆ์ ์ธ ์ž์›์„
03:34
the same way they prescribe medication.
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์•ฝ๊ณผ ๋™์ผํ•œ ๋ฐฉ๋ฒ•์œผ๋กœ ์ฒ˜๋ฐฉํ•  ์ˆ˜ ์žˆ๋Š” ์‹œ์Šคํ…œ์ž…๋‹ˆ๋‹ค.
03:36
Patients then take their prescriptions
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ํ™˜์ž๋“ค์€ ๊ทธ๋“ค์˜ ์ฒ˜๋ฐฉ์ „์„ ๋“ค๊ณ 
03:38
to our desk in the clinic waiting room
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๋Œ€๊ธฐ์‹ค์— ์ €ํฌ์—๊ฒŒ ์˜ค๋ฉด
03:41
where we have a core of well-trained college student advocates
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์ž˜ ํ›ˆ๋ จ๋œ ๋Œ€ํ•™์ƒ ๋ณ€ํ˜ธ์ธ๋“ค์ด
03:45
who work side by side with these families
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์ด ๊ฐ€์กฑ๋“ค๊ณผ ํ˜‘๋™ํ•˜์—ฌ
03:47
to connect them out
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๊ฐ ์ง€์—ญ์‚ฌํšŒ์˜ ์ž์›๋“ค๊ณผ ์—ฐ๊ฒฐํ•ด์ค๋‹ˆ๋‹ค.
03:48
to the existing landscape of community resources.
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๊ฐ ์ง€์—ญ์‚ฌํšŒ์˜ ์ž์›๋“ค๊ณผ ์—ฐ๊ฒฐํ•ด์ค๋‹ˆ๋‹ค.
03:52
So we began with a card table in the clinic waiting room --
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์ฒ˜์Œ์—” ๋ณ‘์› ๋Œ€๊ธฐ์‹ค์— ์ž‘์€ ์ ‘์ด์‹ ํƒ์ž์—์„œ ์‹œ์ž‘ํ–ˆ๋Š”๋ฐ
03:55
totally lemonade stand style.
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์™„์ „ํžˆ ๋ ˆ๋ชจ๋„ค์ด๋“œ ํŒ๋งค๋Œ€์™€ ๊ฐ™์•˜์ฃ .
03:57
But today we have a thousand college student advocates
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ํ•˜์ง€๋งŒ ์ง€๊ธˆ์€ ์ฒœ๋ช…์˜ ๋Œ€ํ•™์ƒ ๋ณ€ํ˜ธ์ธ๋“ค์ด ์žˆ์œผ๋ฉฐ
04:01
who are working to connect nearly 9,000 patients and their families
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9000๋ช…์— ๊ฐ€๊นŒ์šด ํ™˜์ž๋“ค๊ณผ ๊ทธ๋“ค์˜ ๊ฐ€์กฑ์„
04:05
with the resources that they need to be healthy.
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๊ฑด๊ฐ•์— ํ•„์š”ํ•œ ์—ฐ๊ฒฐํ•ด์ฃผ๋Š” ์—ญํ• ์„ ๋งก๊ณ  ์žˆ์Šต๋‹ˆ๋‹ค.
04:08
So 18 months ago
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18๊ฐœ์›” ์ „
04:10
I got this email that changed my life.
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์ €๋Š” ์ œ ์ธ์ƒ์„ ๋ฐ”๊ฟ”๋†“์€ ์ด๋ฉ”์ผ์„ ๋ฐ›์•˜์Šต๋‹ˆ๋‹ค.
04:12
And the email was from Dr. Jack Geiger,
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๋‹ฅํ„ฐ ์žญ ๊ฐ€์ด๊ฑฐ์”จ๊ฐ€ ๋ณด๋‚ธ ์ด๋ฉ”์ผ์ด์—ˆ๋Š”๋ฐ,
04:15
who had written to congratulate me on Health Leads
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<ํ—ฌ์Šค ๋ฆฌ๋“œ>๋ฅผ ์ถ•ํ•˜ํ•˜๋Š” ๋™์‹œ์—,
04:18
and to share, as he said,
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๊ทธ๊ธฐ ๋งํ•˜๊ธธ ์•ฝ๊ฐ„์˜ ์—ญ์‚ฌ์  ๋งฅ๋ฝ์„
04:19
a bit of historical context.
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์„ค๋ช…ํ•ด์ฃผ๊ธฐ ์œ„ํ•จ์ด์—ˆ์Šต๋‹ˆ๋‹ค.
04:22
In 1965 Dr. Geiger founded
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1965๋…„ ๋‹ฅํ„ฐ ๊ฐ€์ด๊ฑฐ์”จ๋Š”
04:25
one of the first two community health centers in this country,
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์ด ๋‚˜๋ผ์—์„œ ์ฒ˜์Œ์œผ๋กœ ์ƒ๊ธด ๋ณด๊ฑด์†Œ ๋‘๊ฐœ ์ค‘ ํ•˜๋‚˜๋ฅผ
04:28
in a brutally poor area in the Mississippi Delta.
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๋ฏธ์‹œ์‹œํ”ผ ์‚ผ๊ฐ์ฃผ ์ง€์—ญ์˜ ๊ทน ๋นˆ๊ณค ์ง€์—ญ์— ์„ค๋ฆฝํ–ˆ์Šต๋‹ˆ๋‹ค.
04:31
And so many of his patients came in
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๋„ˆ๋ฌด ๋งŽ์€ ํ™˜์ž๋“ค์ด
04:33
presenting with malnutrition
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์˜์–‘์‹ค์กฐ๋กœ ๋“ค์–ด์˜ค์ž
04:35
that be began prescribing food for them.
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๊ทธ๋Š” ์Œ์‹์„ ์ฒ˜๋ฐฉํ•˜๊ธฐ ์‹œ์ž‘ํ–ˆ์ฃ .
04:38
And they would take these prescriptions to the local supermarket,
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ํ™˜์ž๋“ค์€ ์ด ์ฒ˜๋ฐฉ์ „์„ ๋“ค๊ณ  ์ง€์—ญ ์Šˆํผ๋งˆ์ผ“์— ๊ฐ€๋ฉด
04:41
which would fill them
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์Œ์‹์„ ์ œ๊ณตํ•ด์ฃผ๊ณ 
04:42
and then charge the pharmacy budget of the clinic.
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์ดํ›„ ๋ณด๊ฑด์†Œ์˜ ์•ฝ์ œ ์˜ˆ์‚ฐ์— ์ฒญ๊ตฌ๋˜์—ˆ์Šต๋‹ˆ๋‹ค.
04:45
And when the Office of Economic Opportunity in Washington, D.C. --
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์ด ์‚ฌ์‹ค์„ ๋‹น์‹œ ๊ฐ€์ด๊ฑฐ์”จ์˜ ๋ณด๊ฑด์†Œ์— ์ž๊ธˆ์„ ์ œ๊ณตํ•˜๋˜
04:48
which was funding Geiger's clinic --
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์›Œ์‹ฑํ„ด D.C.์˜ ๊ฒฝ์ œ๊ธฐํšŒ๊ตญ์ด ์•Œ์•˜์„๋•Œ
04:50
found out about this,
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์›Œ์‹ฑํ„ด D.C.์˜ ๊ฒฝ์ œ๊ธฐํšŒ๊ตญ์ด ์•Œ์•˜์„๋•Œ
04:51
they were furious.
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๊ทธ๋“ค์€ ๋งค์šฐ ํ™”๊ฐ€ ๋‚ฌ์Šต๋‹ˆ๋‹ค.
04:52
And they sent this bureaucrat down
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๊ทธ๋ž˜์„œ ๊ทธ๋“ค์€ ํ•œ ๊ด€๋ฃŒ๋ฅผ ๋ณด๋‚ด์„œ
04:54
to tell Geiger that he was expected to use their dollars
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๊ฐ€์ด๊ฑฐ์”จ์—๊ฒŒ ๊ทธ๋“ค์˜ ๋ˆ์„ ์˜๋ฃŒ๋กœ ์‚ฌ์šฉํ•˜๊ธฐ ๋ฐ”๋ž€๋‹ค๊ณ 
04:57
for medical care --
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๋ง์„ ํ–ˆ์Šต๋‹ˆ๋‹ค.
04:58
to which Geiger famously and logically responded,
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์ด์— ๊ฐ€์ด๊ฑฐ์”จ๋Š” ์œ ๋ช…ํ•˜๊ณ  ๋…ผ๋ฆฌ์ ์œผ๋กœ ๋Œ€๋‹ตํ•˜๊ธฐ๋ฅผ,
05:02
"The last time I checked my textbooks,
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"์ œ๊ฐ€ ๋งˆ์ง€๋ง‰์œผ๋กœ ์ œ ๊ต๊ณผ์„œ๋ฅผ ํ™•์ธํ•ด๋ดค์„๋•Œ,
05:04
the specific therapy for malnutrition was food."
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์˜์–‘์‹ค์กฐ์˜ ์น˜๋ฃŒ๋Š” ์‹์‚ฌ๋กœ ์•Œ๊ณ  ์žˆ๋Š”๋ฐ์š”."
05:09
(Laughter)
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(์›ƒ์Œ)
05:10
So when I got this email from Dr. Geiger,
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์ œ๊ฐ€ ์ด ์ด๋ฉ”์ผ์„ ๋‹ฅํ„ฐ ๊ฐ€์ด๊ฑฐ์”จ์—๊ฒŒ ๋ฐ›์•˜์„ ๋•Œ,
05:13
I knew I was supposed to be proud
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์ €๋Š” ์ œ๊ฐ€ ์—ญ์‚ฌ์— ์ผ๋ถ€๋ถ„์ด๋ผ๋Š” ์ ์—
05:15
to be part of this history.
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์ž๋ž‘์Šค๋Ÿฌ์›Œํ•ด์•ผํ•œ๋‹ค๋Š” ๊ฒƒ์„ ์•Œ๊ณ  ์žˆ์—ˆ์Šต๋‹ˆ๋‹ค.
05:17
But the truth is
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ํ•˜์ง€๋งŒ ์‚ฌ์‹ค
05:18
I was devastated.
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์ „ ๋งค์šฐ ์ถฉ๊ฒฉ์„ ๋ฐ›์•˜์ฃ .
05:20
Here we are,
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์ง€๊ธˆ ์šฐ๋ฆฌ๋Š”
05:21
45 years after Geiger has prescribed food for his patients,
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๊ฐ€์ด๊ฑฐ์”จ๊ฐ€ ํ™˜์ž๋“ค์„ ์œ„ํ•ด ์Œ์‹์„ ์ฒ˜๋ฐฉํ•œ์ง€ 45๋…„์ด ์ง€๋‚˜
05:25
and I have doctors telling me,
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์—ฌ์ „ํžˆ ์˜์‚ฌ๋“ค์ด ์ €์—๊ฒŒ ๋งํ•ฉ๋‹ˆ๋‹ค.
05:27
"On those issues, we practice a 'don't ask, don't tell' policy."
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"์ด๋Ÿฐ ๋ฌธ์ œ์— ๋Œ€ํ•ด์„œ๋Š”, '๋ฌป์ง€๋„ ๋ง๊ณ  ๋งํ•˜์ง€๋„ ๋ง๋ผ' "
05:31
Forty-five years after Geiger,
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๊ฐ€์ด๊ฑฐ์”จ ์ดํ›„ 45๋…„์ด ์ง€๋‚˜,
05:34
Health Leads has to reinvent
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<ํ—ฌ์Šค ๋ฆฌ๋“œ>๋Š” ๊ธฐ์ดˆ ์ž์›์˜ ์ฒ˜๋ฐฉ์„
05:35
the prescription for basic resources.
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์žฌ๋ฐœ๋ช…ํ•ด์•ผ ํ–ˆ์Šต๋‹ˆ๋‹ค.
05:38
So I have spent hours upon hours
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์ „ ๋ช‡์‹œ๊ฐ„ ๋™์•ˆ์ด๋‚˜
05:41
trying to make sense of this weird Groundhog Day.
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์ด์ƒํ•˜๊ฒŒ๋„ ๋ฐ˜๋ณต๋˜๋Š” ์ด ์ผ์„ ์ดํ•ดํ•˜๋ ค ๋…ธ๋ ฅํ–ˆ์Šต๋‹ˆ๋‹ค.
05:45
How is it that if for decades
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๋„๋Œ€์ฒด ์™œ ์ˆ˜์‹ญ๋…„๋™์•ˆ
05:47
we had a pretty straightforward tool for keeping patients,
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๊ฝค ๊ฐ„๋‹จํ•˜๊ฒŒ ํ™˜์ž๋“ค์„ ๊ฑด๊ฐ•ํ•˜๊ฒŒ ํ•˜๋Š” ๋ฐฉ๋ฒ•์ด ์žˆ์Œ์—๋„,
05:50
and especially low-income patients, healthy,
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ํŠนํžˆ ์ €์ž„๊ธˆ ํ™˜์ž๋“ค์—๊ฒŒ ๋ง์ด์ฃ --
05:52
that we didn't use it?
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์™œ ์šฐ๋ฆฌ๋Š” ์ด๋ฅผ ์‚ฌ์šฉํ•˜์ง€ ์•Š์•˜์„๊นŒ์š”?
05:54
If we know what it takes to have a healthcare system
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๋งŒ์•ฝ ์šฐ๋ฆฌ๊ฐ€ ์งˆ๋ณ‘๊ด€๋ฆฌ ์‹œ์Šคํ…œ์ด์•„๋‹ˆ๋ผ
05:57
rather than a sick-care system,
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๊ฑด๊ฐ•๊ด€๋ฆฌ ์‹œ์Šคํ…œ์„ ์œ ์ง€ํ•˜๋Š” ๋ฐฉ๋ฒ•์„ ์•ˆ๋‹ค๋ฉด
06:00
why don't we just do it?
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์™œ ๊ทธ๋ƒฅ ํ•˜์ง€ ์•Š๋Š” ๊ฒƒ์ผ๊นŒ์š”?
06:02
These questions, in my mind,
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์ œ ๋จธ๋ฆฌ์†์— ์ด ๋ฌธ์ œ๋“ค์€
06:04
are not hard because the answers are complicated,
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๋‹ต์ด ๋ณต์žกํ•ด์„œ ์–ด๋ ค์šด ๊ฒƒ์ด ์•„๋‹ˆ๋ผ,
06:07
they are hard because they require that we be honest with ourselves.
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์ž์‹ ์—๊ฒŒ ์†”์งํ•ด์ ธ์•ผ ํ•˜๊ธฐ๋•Œ๋ฌธ์— ์–ด๋ ต์Šต๋‹ˆ๋‹ค.
06:12
My belief is that it's almost too painful
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์ œ ์ƒ๊ฐ์—” ๊ฑด๊ฐ•๊ด€๋ฆฌ ์‹œ์Šคํ…œ์„ ์œ„ํ•œ
06:15
to articulate our aspirations for our healthcare system,
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์—ผ์›์„ ํ‘œํ˜„ํ•˜๋Š” ๊ฑด, ํ˜น์€ ์—ผ์›์ด ์žˆ์Œ์„ ์ธ์ •ํ•˜๊ธฐ๋Š”
06:19
or even admit that we have any at all.
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๋„ˆ๋ฌด๋‚˜๋„ ๊ณ ํ†ต์Šค๋Ÿฝ์Šต๋‹ˆ๋‹ค.
06:21
Because if we did,
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์™œ๋ƒ๋ฉด ๋งŒ์•ฝ ํ‘œํ˜„์„ ํ•œ๋‹ค๋ฉด
06:23
they would be so removed
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์ง€๊ธˆ ์šฐ๋ฆฌ ํ˜„์‹ค๊ณผ๋Š”
06:24
from our current reality.
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๋„ˆ๋ฌด๋‚˜๋„ ๋™๋–จ์–ด์ ธ ์žˆ๊ธฐ ๋•Œ๋ฌธ์ด์ฃ .
06:26
But that doesn't change my belief
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ํ•˜์ง€๋งŒ ์ด ๋ฐฉ์—, ๊ทธ๋ฆฌ๊ณ  ๊ตญ๊ฐ€ ์ „์ฒด์—
06:29
that all of us, deep inside,
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๊ทธ๋ฆฌ๊ณ  ๊ตญ๊ฐ€ ์ „์ฒด์—
06:32
here in this room and across this country,
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์šฐ๋ฆฌ ๋ชจ๋‘๊ฐ€ ์†์œผ๋กœ๋Š”
06:36
share a similar set of desires.
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๊ฐ™์€ ๊ฒƒ์„ ์—ด๋งํ•œ๋‹ค๋Š” ์ œ ๋ฏฟ์Œ์€ ๋ณ€์น˜ ์•Š์Šต๋‹ˆ๋‹ค.
06:39
That if we are honest with ourselves
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๊ทธ๋ฆฌ๊ณ  ๋งŒ์•ฝ ์šฐ๋ฆฌ ์ž์‹ ์—๊ฒŒ ์†”์งํ•ด์ง€๊ณ 
06:41
and listen quietly,
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์กฐ์šฉํžˆ ๋“ฃ๋Š”๋‹ค๋ฉด,
06:43
that we all harbor
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๋งŒ์•ฝ ์šฐ๋ฆฌ๊ฐ€ ๋ชจ๋‘
06:45
one fiercely held aspiration for our healthcare:
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๊ฑด๊ฐ•๊ด€๋ฆฌ๋ฅผ ๊ฐ•ํ•˜๊ฒŒ ์—ด๋งํ•œ๋‹ค๋ฉด,
06:49
that it keep us healthy.
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์‹œ์Šคํ…œ์ด ์šฐ๋ฆฌ๋ฅผ ๊ฑด๊ฐ•ํ•˜๊ฒŒ ํ•ด์ค€๋‹ค ๋ง์ด์ฃ .
06:51
This aspiration that our healthcare keep us healthy
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๊ฑด๊ฐ•๊ด€๋ฆฌ ์‹œ์Šคํ…œ์ด ์šฐ๋ฆฌ๋ฅผ ๊ฑด๊ฐ•ํ•˜๊ฒŒ ํ•ด์ค€๋‹ค๋Š” ์ด ์—ผ์›์€
06:55
is an enormously powerful one.
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๊ต‰์žฅํžˆ ๊ฐ•๋ ฅํ•œ ๊ฒƒ์ž…๋‹ˆ๋‹ค.
06:57
And the way I think about this
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๊ทธ๋ฆฌ๊ณ  ์ œ๊ฐ€ ์ƒ๊ฐํ•˜๊ธฐ์—๋Š”
07:00
is that healthcare is like any other system.
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๊ฑด๊ฐ•๊ด€๋ฆฌ ์—ญ์‹œ ์—ฌํƒ€ ์‹œ์Šคํ…œ๊ณผ ๋งˆ์ฐฌ๊ฐ€์ง€ ์ž…๋‹ˆ๋‹ค.
07:02
It's just a set of choices that people make.
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๊ทธ์ € ์‚ฌ๋žŒ๋“ค์ด ์„ ํƒํ•œ ๊ฒƒ๋“ค์˜ ์ง‘ํ•ฉ์ฒด์ด์ฃ .
07:04
What if we decided
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์šฐ๋ฆฌ๊ฐ€ ๋‹ค๋ฅธ ์„ ํƒ์„ ํ•˜๊ธฐ๋กœ
07:06
to make a different set of choices?
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๋งˆ์Œ์„ ๋จน๋Š”๋‹ค๋ฉด ์–ด๋–จ๊นŒ์š”?
07:09
What if we decided to take all the parts of healthcare
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๋งŒ์•ฝ ๊ฑด๊ฐ•๊ด€๋ฆฌ ์‹œ์Šคํ…œ ์ค‘
07:12
that have drifted away from us
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์šฐ๋ฆฌ์™€ ๋ฉ€์–ด์ง„ ๋ถ€๋ถ„๋“ค์— ๋Œ€ํ•ด
07:13
and stand firm and say, "No.
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"์•ˆ๋ผ"๋ผ๊ณ  ๋งํ•œ๋‹ค๋ฉด ์–ด๋–จ๊นŒ์š”.
07:16
These things are ours.
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์ด๊ฒƒ์€ ์šฐ๋ฆฌ์˜ ๊ฒƒ์ž…๋‹ˆ๋‹ค.
07:18
They will be used for our purposes.
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์šฐ๋ฆฌ์˜ ๋ชฉ์ ์„ ์œ„ํ•ด ์‚ฌ์šฉ๋˜์–ด์•ผํ•˜์ฃ .
07:20
They will be used to realize
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์šฐ๋ฆฌ๋“ค์˜ ์—ผ์›์„ ์ด๋ฃจ๊ธฐ ์œ„ํ•ด
07:22
our aspiration"?
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์ด์šฉ๋˜์–ด์•ผํ•ฉ๋‹ˆ๋‹ค.
07:24
What if everything we needed
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๋งŒ์•ฝ ์šฐ๋ฆฌ๊ฐ€ ๊ฑด๊ฐ•๊ด€๋ฆฌ ์‹œ์Šคํ…œ์— ๋Œ€ํ•œ
07:26
to realize our aspiration for healthcare
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์—ผ์›์„ ์ด๋ฃจ๊ธฐ ์œ„ํ•œ ๋ชจ๋“  ๊ฒƒ๋“ค์ด
07:28
was right there in front of us
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๋ฐ”๋กœ ์šฐ๋ฆฌ ์•ž์— ์†Œ์œ ๊ถŒ์„ ์ฃผ์žฅํ•˜๊ธฐ๋งŒ์„
07:29
just waiting to be claimed?
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๊ธฐ๋‹ค๋ฆฌ๊ณ  ์žˆ๋‹ค๋ฉด ์–ด๋–จ๊นŒ์š”?
07:31
So that's where Health Leads began.
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์ด๊ฒŒ ๋ฐ”๋กœ <ํ—ฌ์Šค ๋ฆฌ๋“œ>์˜ ์‹œ์ž‘์ด์—ˆ์Šต๋‹ˆ๋‹ค.
07:33
We started with the prescription pad --
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์ €ํฌ๋Š” ์ฒ˜๋ฐฉ์ „ ๋ฉ”๋ชจ์ง€๋ถ€ํ„ฐ ์‹œ์ž‘ํ–ˆ์Šต๋‹ˆ๋‹ค
07:35
a very ordinary piece of paper --
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์•„์ฃผ ํ‰๋ฒ”ํ•œ ์ข…์ด์ง€์š”
07:37
and we asked, not what do patients need to get healthy --
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๊ทธ๋ฆฌ๊ณ  ํ™˜์ž๋“ค์ด ๊ฑด๊ฐ•ํ•ด์ง€๊ธฐ ์œ„ํ•ด์„œ ํ•„์š”ํ•œ ๊ฒƒ๋“ค์ด ์•„๋‹ˆ๋ผ--
07:41
antibiotics, an inhaler, medication --
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๊ฐ€๋ น ํ•ญ์ƒ์ œ, ํ˜ธํก๊ธฐ, ์ฒ˜๋ฐฉ์•ฝ ๋“ฑ --
07:44
but what do patients need to be healthy,
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๋ฐ˜๋Œ€๋กœ ํ™˜์ž๋“ค์ด ๊ฑด๊ฐ•ํ•˜๊ธฐ ์œ„ํ•œ,
07:47
to not get sick in the first place?
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์• ์ดˆ ์•„ํ”„์ง€ ์•Š๊ธฐ ์œ„ํ•œ ๊ฒƒ์ด ๋ญ˜๊นŒ์š”?
07:50
And we chose to use the prescription
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์ €ํฌ๋Š” ์ฒ˜๋ฐฉ์ „์„ ๊ทธ ์šฉ๋„๋กœ ์‚ฌ์šฉํ•˜๊ธฐ๋กœ
07:52
for that purpose.
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๊ณ„ํšํ–ˆ์Šต๋‹ˆ๋‹ค.
07:53
So just a few miles from here
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์—ฌ๊ธฐ์„œ๋ถ€ํ„ฐ ๊ณ ์ž‘ ๋ช‡ ๋งˆ์ผ์ฏค
07:54
at Children's National Medical Center,
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์–ด๋ฆฐ์ด ๊ตญ๊ฐ€ ์˜๋ฃŒ์„ผํ„ฐ์—์„œ
07:56
when patients come into the doctor's office,
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ํ™˜์ž๋“ค์ด ์ง„์ฐฐ์‹ค์— ๋“ค์–ด์˜ค๋ฉด,
07:59
they're asked a few questions.
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์งˆ๋ฌธ์„ ๋ช‡๊ฐ€์ง€ ํ–ˆ์Šต๋‹ˆ๋‹ค.
08:00
They're asked, "Are you running out of food at the end of the month?
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"์›”๋ง์ฏค์— ์Œ์‹์ด ๋–จ์–ด์ง€๋Š”์ง€?
08:03
Do you have safe housing?"
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์•ˆ์ „ํ•œ ๊ฑฐ์ฃผํ™˜๊ฒฝ์ด ์žˆ๋Š”์ง€?"
08:04
And when the doctor begins the visit,
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์˜์‚ฌ๊ฐ€ ๋ฐฉ๋ฌธ์„ ํ• ๋•Œ์ฏค์—”,
08:07
she knows height, weight, is there food at home,
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ํ‚ค, ๋ชธ๋ฌด๊ฒŒ, ์ง‘์— ์Œ์‹์ด ์žˆ๋Š”์ง€,
08:09
is the family living in a shelter.
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๊ฐ€์กฑ์ด ์‰ผํ„ฐ์— ์‚ฌ๋Š”์ง€๋ฅผ ์•Œ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
08:11
And that not only leads to a better set of clinical choices,
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์ด๋Š” ๋” ์ข‹์€ ์ž„์ƒ์  ์„ ํƒ์œผ๋กœ ์ด์–ด์งˆ ๋ฟ๋งŒ ์•„๋‹ˆ๋ผ,
08:14
but the doctor can also prescribe those resources for the patient,
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์˜์‚ฌ๊ฐ€ ์ž์›์„ ํ™˜์ž์—๊ฒŒ ์ฒ˜๋ฐฉํ•  ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
08:18
using Health Leads like any other sub-specialty referral.
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<ํ—ฌ์Šค ๋ฆฌ๋“œ>๋‚˜ ๋‹ค๋ฅธ ๋ณด์กฐ ๊ธฐ๊ด€์— ์œ„ํƒํ•ด์„œ ๋ง์ด์ฃ .
08:22
The problem is,
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๋ฌธ์ œ๋Š”,
08:24
once you get a taste of what it's like
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๊ฑด๊ฐ•๊ด€๋ฆฌ์— ๋Œ€ํ•œ ์—ผ์›์ด ๋ฌด์—‡์ธ์ง€
08:26
to realize your aspiration for healthcare,
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๋ง›๋ณด๊ธฐ ์‹œ์ž‘ํ•˜๋ฉด,
08:28
you want more.
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๋” ์›ํ•˜๊ฒŒ ๋ฉ๋‹ˆ๋‹ค.
08:30
So we thought,
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๊ทธ๋ž˜์„œ ์ƒ๊ฐ์ด ๋“ค์—ˆ์ฃ .
08:31
if we can get individual doctors
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๋งŒ์•ฝ ์˜์‚ฌ ๊ฐœ๊ฐœ์ธ์ด
08:32
to prescribe these basic resources for their patients,
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ํ™˜์ž๋“ค์—๊ฒŒ ๊ธฐ๋ณธ ์ž์›์„ ์ฒ˜๋ฐฉํ•  ์ˆ˜ ์žˆ๋‹ค๋ฉด,
08:35
could we get an entire healthcare system
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๊ฑด๊ฐ•๊ด€๋ฆฌ ์‹œ์Šคํ…œ ์ „์ฒด๊ฐ€
08:38
to shift its presumption?
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๊ทธ๋™์•ˆ ์˜ˆ์ƒํ•ด์˜ค๋˜ ์ถ”์ •์„ ๋ฐ”๊ฟ€์ˆ˜ ์žˆ์„๊นŒ์š”?
08:41
And we gave it a shot.
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ํ•œ๋ฒˆ ์‹œ๋„ํ•ด๋ดค์Šต๋‹ˆ๋‹ค.
08:42
So now at Harlem Hospital Center
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์ด์ œ ํ• ๋ ˜ ๋ณ‘์› ์„ผํ„ฐ์—์„œ๋Š”
08:43
when patients come in with an elevated body mass index,
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ํ™˜์ž๋“ค์ด ์‹ ์ฒด ์šฉ์  ์ง€์ˆ˜๊ฐ€ ์ƒ์Šน๋˜์„œ ์˜ค๋ฉด,
08:47
the electronic medical record
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์ „์‚ฐ ์˜๋ฃŒ ๊ธฐ๋ก์ด
08:49
automatically generates a prescription for Health Leads.
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์ž๋™์œผ๋กœ <ํ—ฌ์Šค๋ฆฌ๋“œ>๋กœ ์ฒ˜๋ฐฉ์„ ๋‚ด๋ฆฝ๋‹ˆ๋‹ค.
08:53
And our volunteers can then work with them
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๊ทธ๋Ÿฌ๋ฉด ์ €ํฌ ์ž์›๋ด‰์‚ฌ์ž๋“ค์ด ๊ทธ๋“ค๊ณผ ํ˜‘๋™ํ•˜์—ฌ
08:54
to connect patients to healthy food and excercise programs
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ํ™˜์ž๋“ค์„ ์ง€์—ญ๋‚ด ๊ฑด๊ฐ•ํ•œ ์Œ์‹๊ณผ ์šด๋™ ํ”„๋กœ๊ทธ๋žจ๊ณผ
08:58
in their communities.
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์—ฐ๊ฒฐํ•ด์ค๋‹ˆ๋‹ค.
08:59
We've created a presumption
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์šฐ๋ฆฌ๊ฐ€ ๋งŒ๋“ค์–ด๋‚ธ ์ถ”์ •์€
09:00
that if you're a patient at that hospital
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๋งŒ์•ฝ ๋‹น์‹ ์ด ์‹ ์ฒด ์šฉ์  ์ง€์ˆ˜๊ฐ€ ๋†’์€
09:02
with an elevated BMI,
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ํ™˜์ž๋ผ๋ฉด,
09:03
the four walls of the doctor's office
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์˜๋ฃŒ์‹ค์˜ ๋ฒฝ๋“ค ์•ˆ์—์„œ๋Š”
09:06
probably aren't going to give you everything
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๊ฑด๊ฐ•ํ•ด์ง€๊ธฐ ์œ„ํ•ด ๋‹น์‹ ์ด ์›ํ•˜๋Š” ๋ชจ๋“  ๊ฒƒ์„
09:07
you need to be healthy.
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์–ป์„ ์ˆ˜ ์—†์„ ๊ฒ๋‹ˆ๋‹ค.
09:09
You need more.
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๋” ํ•„์š”ํ•˜์ง€์š”.
09:10
So on the one hand,
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๊ทธ๋ž˜์„œ ์–ด๋–ป๊ฒŒ ๋ณด๋ฉด,
09:11
this is just a basic recoding
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์ด๊ฑด ๋‹จ์ˆœํžˆ ์ „์ž ์˜๋ฃŒ๊ธฐ๋ก์˜
09:12
of the electronic medical record.
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์žฌ๊ธฐ๋ก์— ๋ถˆ๊ณผํ•ฉ๋‹ˆ๋‹ค.
09:14
And on the other hand,
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๋ฐ˜๋ฉด์—๋Š”,
09:16
it's a radical transformation
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์ „์ž ์˜๋ฃŒ ๊ธฐ๋ก์˜
09:17
of the electronic medical record
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ํ˜์‹ ์ ์ธ ๋ณ€ํ™”์ž…๋‹ˆ๋‹ค.
09:20
from a static repository of diagnostic information
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์ •์ ์ธ ์ง„์ฐฐ ์ •๋ณด ๊ธฐ๋ก์—์„œ ๋ถ€ํ„ฐ
09:23
to a health promotion tool.
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๊ฑด๊ฐ• ์ด‰์ง„ ๊ธฐ๊ตฌ๋กœ ๋ง์ด์ฃ .
09:26
In the private sector,
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๋ฏผ๊ฐ„ ๋ถ€๋ฌธ์—์„œ๋Š”,
09:27
when you squeeze that kind of additional value
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๊ณ ์ •๋น„์šฉ ํˆฌ์ž์—์„œ
09:30
out of a fixed-cost investment,
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์ถ”๊ฐ€์  ๊ฐ€์น˜๋ฅผ ๋ฝ‘์•„๋‚ธ๋‹ค๋ฉด,
09:32
it's called a billion-dollar company.
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10์–ต๋‹ฌ๋Ÿฌ ๊ธฐ์—…์ด๋ผ ๋ถˆ๋ฆฝ๋‹ˆ๋‹ค.
09:34
But in my world,
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ํ•˜์ง€๋งŒ ์ œ ๊ด€์ ์—์„œ๋Š”,
09:36
it's called reduced obesity and diabetes.
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๊ทธ๊ฑด ๋น„๋งŒ๊ณผ ๋‹น๋‡จ์˜ ๊ฐ์†Œ์ž…๋‹ˆ๋‹ค.
09:39
It's called healthcare --
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์ด๋Š” ๊ณง ๊ฑด๊ฐ• ๊ด€๋ฆฌ ์‹œ์Šคํ…œ์ž…๋‹ˆ๋‹ค--
09:41
a system where doctors can prescribe solutions
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์˜์‚ฌ๋“ค์ด ๊ฑด๊ฐ•์„ ๊ฐœ์„ ํ•˜๊ธฐ ์œ„ํ•ด
09:44
to improve health,
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ํ•ด๊ฒฐ์ฑ…์„ ์ฒ˜๋ฐฉํ•˜๊ณ ,
09:46
not just manage disease.
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๋‹จ์ˆœํžˆ ์งˆ๋ณ‘์„ ๊ด€๋ฆฌํ•˜๋Š” ๊ฒƒ์ด ์•„๋‹™๋‹ˆ๋‹ค.
09:48
Same thing in the clinic waiting room.
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์ง„์ฐฐ ๋Œ€๊ธฐ์‹ค๋„ ๋งˆ์ฐฌ๊ฐ€์ง€ ์ž…๋‹ˆ๋‹ค.
09:49
So every day in this country
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์ด ๋‚˜๋ผ์—์„œ ๋งค์ผ
09:51
three million patients
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300๋งŒ๋ช…์˜ ํ™˜์ž๊ฐ€
09:52
pass through about 150,000 clinic waiting rooms in this country.
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์•ฝ 15๋งŒ๊ฐœ์˜ ๋Œ€๊ธฐ์‹ค์„ ๋“œ๋‚˜๋“ญ๋‹ˆ๋‹ค.
09:57
And what do they do when they're there?
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๊ทธ๋“ค์€ ๊ฑฐ๊ธฐ์„œ ๋ฌด์—‡์„ ํ• ๊นŒ์š”?
09:59
They sit, they watch the goldfish in the fish tank,
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์•‰์•„ ์žˆ๊ฑฐ๋‚˜, ์–ดํ•ญ์— ์žˆ๋Š” ๊ธˆ๋ถ•์–ด๋ฅผ ์ง€์ผœ๋ณด๊ณ ,
10:02
they read extremely old copies
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์ •๋ง ์˜ค๋ž˜๋œ ์ง‘์•ˆ ๊ด€๋ฆฌ ์žก์ง€๋ฅผ
10:05
of Good Housekeeping magazine.
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์ฝ๊ณ  ์žˆ์Šต๋‹ˆ๋‹ค.
10:07
But mostly we all just sit there forever, waiting.
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ํ•˜์ง€๋งŒ ๋Œ€๋ถ€๋ถ„์€ ๊ณ„์† ์•‰์•„์„œ ๊ธฐ๋‹ค๋ฆฝ๋‹ˆ๋‹ค.
10:10
How did we get here
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์–ด์ฉŒ๋‹ค๊ฐ€ ์šฐ๋ฆฌ๋Š”
10:12
where we devote hundreds of acres and thousands of hours
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์ˆ˜๋ฐฑ ํ‰๊ณผ ์ˆ˜์ฒœ ์‹œ๊ฐ„์„
10:15
to waiting?
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๊ธฐ๋‹ค๋ฆฌ๋Š”๋ฐ ํˆฌ์žํ•˜๊ฒŒ ๋˜์—ˆ์„๊นŒ์š”?
10:17
What if we had a waiting room
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๋งŒ์•ฝ ์šฐ๋ฆฌ์—๊ฒŒ ์•„ํ”„๋”๋ผ๋„
10:18
where you don't just sit when you're sick,
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๊ธฐ๋‹ค๋ฆฌ๊ณ  ์žˆ์ง€๋งŒ์€ ์•Š์€
10:20
but where you go to get healthy.
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๊ฑด๊ฐ•ํ•ด์ง€๋Ÿฌ ๊ฐ€๋Š” ๋Œ€๊ธฐ์‹ค์ด ์žˆ์—ˆ๋”๋ผ๋ฉด.
10:22
If airports can become shopping malls
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๋งŒ์•ฝ ๊ณตํ•ญ์ด ์‡ผํ•‘๋ชฐ์ด ๋˜๊ณ ,
10:25
and McDonald's can become playgrounds,
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๋งฅ๋„๋‚ ๋“œ๊ฐ€ ๋†€์ดํ„ฐ๊ฐ€ ๋  ์ˆ˜ ์žˆ๋‹ค๋ฉด,
10:27
surely we can reinvent the clinic waiting room.
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๋‹น์—ฐํžˆ ์ง„๋ฃŒ ๋Œ€๊ธฐ์‹ค๋„ ๋ฐ”๊ฟ€ ์ˆ˜ ์žˆ๊ฒ ์ฃ .
10:31
And that's what Health Leads has tried to do,
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๊ทธ๊ฒƒ์ด ๋ฐ”๋กœ <ํ—ฌ์Šค๋ฆฌ๋“œ>๊ฐ€ ํ•˜๋ ค๊ณ  ํ•˜๋Š” ์ผ์ž…๋‹ˆ๋‹ค.
10:33
to reclaim that real estate and that time
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๊ทธ ๊ณต๊ฐ„๊ณผ ์‹œ๊ฐ„์„ ๋˜์ฐพ์•„์„œ
10:35
and to use it as a gateway
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ํ™˜์ž๋“ค์„ ๊ทธ๋“ค์ด ๊ฑด๊ฐ•ํ•ด์ง€๊ธฐ ์œ„ํ•œ ์ž์›๋“ค๋กœ ์—ฐ๊ฒฐํ•ด์ฃผ๋Š”
10:37
to connect patients
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ํ™˜์ž๋“ค์„ ๊ทธ๋“ค์ด ๊ฑด๊ฐ•ํ•ด์ง€๊ธฐ ์œ„ํ•œ ์ž์›๋“ค๋กœ ์—ฐ๊ฒฐํ•ด์ฃผ๋Š”
10:38
to the resources they need to be healthy.
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๊ด€๋ฌธ์œผ๋กœ ๋ฐ”๊พธ๋Š” ์ผ์„ ๋ง์ด์ฃ .
10:40
So it's a brutal winter in the Northeast,
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๋ถ๋™์ชฝ์— ์ž”ํ˜นํ•œ ๊ฒจ์šธ์—
10:42
your kid has asthma, your heat just got turned off,
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์•„์ด๊ฐ€ ์ฒœ์‹์ด ์žˆ๊ณ , ๋‚œ๋ฐฉ์ด ๋‚˜๊ฐ„๋ฐ๋‹ค๊ฐ€,
10:44
and of course you're in the waiting room of the ER,
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์ถ”์šด ๊ณต๊ธฐ๊ฐ€ ์•„์ด์— ์ฒœ์‹์„ ์•…ํ™”์‹œ์ผœ
10:47
because the cold air triggered your child's asthma.
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์‘๊ธ‰์‹ค ๋Œ€๊ธฐ์‹ค์— ๊ธฐ๋‹ค๋ฆฌ๊ณ  ์žˆ๋‹ค๊ณ  ์ƒ๊ฐํ•ด๋ด…์‹œ๋‹ค.
10:49
But what if instead of waiting for hours anxiously,
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ํ•˜์ง€๋งŒ ๋งŒ์•ฝ ๋ช‡์‹œ๊ฐ„๋™์•ˆ ๋ถˆ์•ˆํ•ดํ•˜๋Š” ๊ฒƒ์ด ์•„๋‹ˆ๋ผ,
10:52
the waiting room became the place
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๋Œ€๊ธฐ์‹ค์ด <ํ—ฌ์Šค๋ฆฌ๋“œ>๊ฐ€ ์ง‘์—
10:54
where Health Leads turned your heat back on?
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๋‚œ๋ฐฉ์„ ๋‹ค์‹œ ํ‹€์–ด ์ค„ ์ˆ˜ ์žˆ๋Š” ๊ณต๊ฐ„์ด ๋œ๋‹ค๋ฉด?
10:57
And of course all of this requires
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๋ฌผ๋ก  ์ด ๋ชจ๋‘๋Š” ๋” ๋งŽ์€ ์ธ๋ ฅ์„
10:58
a broader workforce.
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์š”๊ตฌํ•ฉ๋‹ˆ๋‹ค.
11:00
But if we're creative, we already have that too.
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ํ•˜์ง€๋งŒ ์ฐฝ์˜์ ์œผ๋กœ ์ƒ๊ฐํ•ด๋ณด๋ฉด, ์ด๋ฏธ ๊ทธ ์ธ๋ ฅ์€ ์žˆ์Šต๋‹ˆ๋‹ค.
11:03
We know that our doctors and nurses
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์šฐ๋ฆฌ์—๊ฒŒ ์˜์‚ฌ์™€ ๊ฐ„ํ˜ธ์‚ฌ,
11:06
and even social workers
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๊ทธ๋ฆฌ๊ณ  ์‚ฌํšŒ ๋ณต์ง€์‚ฌ๊ฐ€
11:07
aren't enough,
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์ถฉ๋ถ„ํ•˜์ง€ ์•Š์Šต๋‹ˆ๋‹ค.
11:09
that the ticking minutes of health care
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๊ฑด๊ฐ•๊ด€๋ฆฌ ์‹œ์Šคํ…œ์˜ ํ˜๋Ÿฌ๊ฐ€๋Š” ์‹œ๊ฐ„์ด
11:10
are too constraining.
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๋„ˆ๋ฌด ์–ต์••์ ์ž…๋‹ˆ๋‹ค.
11:12
Health just takes more time.
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๊ฑด๊ฐ•์€ ๊ทธ์ € ์‹œ๊ฐ„์„ ๋” ํ•„์š”๋กœํ•ฉ๋‹ˆ๋‹ค.
11:14
It requires a non-clinical army
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์‚ฌํšŒ๋ณต์ง€์‚ฌ์™€ ์‚ฌ๋ก€๊ด€๋ฆฌ์‚ฌ ๋“ฑ์œผ๋กœ ๊ตฌ์„ฑ๋œ
11:17
of community health workers and case managers
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๋น„์ž„์ƒ์˜๋ฃŒ ๊ตฐ๋Œ€๊ฐ€ ํ•„์š”ํ•˜์ง€์š”.
11:19
and many others.
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๋น„์ž„์ƒ์˜๋ฃŒ ๊ตฐ๋Œ€๊ฐ€ ํ•„์š”ํ•˜์ง€์š”.
11:21
What if a small part of that next healthcare workforce
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๋ฏธ๋ž˜ ๊ฑด๊ฐ•๊ด€๋ฆฌ ์ธ๋ ฅ์˜ ์ผ๋ถ€๋ถ„์ด
11:24
were the 11 million college students in this country?
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์ด ๋‚˜๋ผ์˜ 1,100๋งŒ ๋Œ€ํ•™์ƒ๋“ค์ด๋ผ๋ฉด ์–ด๋–จ๊นŒ์š”?
11:28
Unencumbered by clinical responsibilities,
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์˜๋ฃŒ์  ์ฑ…์ž„์œผ๋กœ ์ง€์žฅ๋ฐ›์ง€ ์•Š๊ณ ,
11:31
unwilling to take no for an answer
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ํ™˜์ž๋ฅผ ์ง“๋ฐŸ๋Š” ๊ด€๋ฃŒ๋“ค์—๊ฒŒ์„œ
11:33
from those bureaucracies
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์•ˆ๋œ๋‹ค๋Š” ๋Œ€๋‹ต์„ ์šฉ๋‚ฉํ•˜์ง€ ์•Š๊ณ ,
11:35
that tend to crush patients,
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์•ˆ๋œ๋‹ค๋Š” ๋Œ€๋‹ต์„ ์šฉ๋‚ฉํ•˜์ง€ ์•Š๊ณ ,
11:37
and with an unparalleled ability
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์ˆ˜๋…„๋™์•ˆ ๊ตฌ๊ธ€์„ ์‚ฌ์šฉํ•˜๋ฉฐ
11:39
for information retrieval
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์ •๋ณด๋ฅผ ์ฐพ๋Š” ๋Šฅ๋ ฅ์ด ํƒ์›”ํ•œ
11:40
honed through years of using Google.
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๋Œ€ํ•™์ƒ๋“ค์„ ๋ง์ด์ฃ .
11:43
Now lest you think it improbable
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๋งŒ์•ฝ ์ด๋Ÿฐ ์ผ์—
11:46
that a college volunteer
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๋Œ€ํ•™์ƒ ๋ด‰์‚ฌ์ž๊ฐ€
11:47
can make this kind of commitment,
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์ „๋…ํ•˜๋Š” ๊ฒƒ์ด ๋ถˆ๊ฐ€๋Šฅํ•˜๋‹ค ์ƒ๊ฐํ•œ๋‹ค๋ฉด,
11:49
I have two words for you:
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๋‘ ๋‹จ์–ด๋งŒ ๋ง์”€๋“œ๋ฆฌ๊ฒ ์Šต๋‹ˆ๋‹ค:
11:51
March Madness.
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3์›”์˜ ๊ด‘๋ž€.
11:53
The average NCAA Division I men's basketball player
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NCAA ๋‚จ์ž 1๋ถ€ ๋†๊ตฌ์„ ์ˆ˜๋Š”
11:57
dedicates 39 hours a week to his sport.
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ํ‰๊ท  ๋งค์ฃผ 39์‹œ๊ฐ„์˜ ์‹œ๊ฐ„์„ ์šด๋™์— ํˆฌ์žํ•ฉ๋‹ˆ๋‹ค.
12:00
Now we may think that's good or bad,
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๊ทธ๊ฒŒ ์ข‹๊ฑฐ๋‚˜ ๋‚˜์  ์ˆ˜๋„ ์žˆ์ง€๋งŒ,
12:02
but in either case it's real.
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์–ด์จ‹๋“  ์‚ฌ์‹ค์ž…๋‹ˆ๋‹ค.
12:05
And Health Leads is based on the presumption
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<ํ—ฌ์Šค๋ฆฌ๋“œ>๋Š” ๊ทธ๋™์•ˆ ์šฐ๋ฆฌ๊ฐ€
12:07
that for too long
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๋„ˆ๋ฌด ์˜ค๋žœ ์‹œ๊ฐ„๋™์•ˆ
12:09
we have asked too little of our college students
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๋Œ€ํ•™์ƒ๋“ค์ด ์ทจ์•ฝํ•œ ์ง€์—ญ ์‚ฌํšŒ๋“ค์—๊ฒŒ ์ฃผ๋Š” ์‹ค์งˆ์ ์ธ ์˜ํ–ฅ์„
12:11
when it comes to real impact in vulnerable communities.
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๋„ˆ๋ฌด ์ ๊ฒŒ ์š”๊ตฌํ–ˆ๋‹ค๊ณ  ๊ฐ€์ •ํ•ฉ๋‹ˆ๋‹ค.
12:15
College sports teams say,
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๋Œ€ํ•™ ์šด๋™ ํŒ€๋“ค์€ ๋งํ•˜์ฃ .
12:16
"We're going to take dozens of hours
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"์šฐ๋ฆฐ ์ˆ˜์‹ญ ์‹œ๊ฐ„๋™์•ˆ
12:18
at some field across campus at some ungodly hour of the morning
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๋ง๋„ ์•ˆ๋˜๋Š” ์•„์นจ ์Šค์ผ€์ฅด์— ์บ ํผ์Šค๋ฅผ ๋›ฐ๋ฉด์„œ
12:22
and we're going to measure your performance, and your team's performance,
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๋„ˆ์˜ ์ˆ˜์ค€, ๊ทธ๋ฆฌ๊ณ  ํŒ€์˜ ์ˆ˜์ค€์„ ์ธก์ •ํ•  ๊ฒƒ์ด๊ณ ,
12:25
and if you don't measure up or you don't show up,
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๋งŒ์•ฝ ๋’ค์ณ์ง€๊ฑฐ๋‚˜ ์ถœ์„์„ ํ•˜์ง€ ์•Š๋Š”๋‹ค๋ฉด,
12:27
we're going to cut you off the team.
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ํŒ€์—์„œ ์ž๋ฅผ๊ฒƒ์ด๋‹ค.
12:29
But we'll make huge investments
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ํ•˜์ง€๋งŒ ์šฐ๋ฆฐ ๋„ˆ์˜ ํ›ˆ๋ จ๊ณผ ๋ฐœ์ „์—
12:30
in your training and development,
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๊ฑฐ๋Œ€ํ•œ ๊ธˆ์•ก์„ ํˆฌ์žํ•  ๊ฒƒ์ด๋ฉฐ,
12:32
and we'll give you an extraordinary community of peers."
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์ฃผ์œ„์— ๋›ฐ์–ด๋‚œ ๋™๋ฃŒ๋ฅผ ์„ ์‚ฌํ•  ๊ฒƒ์ด๋‹ค."
12:35
And people line up out the door
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๊ทธ๋Ÿฌ๋ฉด ์‚ฌ๋žŒ๋“ค์€ ์ค„์„ ์„œ์„œ
12:37
just for the chance to be part of it.
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๊ทธ ๋‹จ์ฒด์˜ ์ผ๋ถ€๋ถ„์ด ๋˜๋ ค๊ณ  ํ•ฉ๋‹ˆ๋‹ค.
12:40
So our feeling is,
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๊ทธ๋Ÿฌ๋‹ˆ ์šฐ๋ฆฌ๊ฐ€ ๋Š๋ผ๊ธฐ์—”,
12:41
if it's good enough for the rugby team,
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๋Ÿญ๋น„ ํŒ€์—๋„ ํšจ๊ณผ๊ฐ€ ์žˆ๋‹ค๋ฉด,
12:42
it's good enough for health and poverty.
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๊ฑด๊ฐ•๊ณผ ๊ฐ€๋‚œ์—๋„ ํšจ๊ณผ๊ฐ€ ์žˆ๊ฒ ์ฃ .
12:44
Health Leads too recruits competitively,
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<ํ—ฌ์Šค๋ฆฌ๋“œ> ์—ญ์‹œ ๊ฒฝ์Ÿ์ ์œผ๋กœ ๊ณ ์šฉ์„ํ•˜๋ฉฐ,
12:48
trains intensively,
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์น˜์—ดํ•˜๊ฒŒ ํ›ˆ๋ จ์‹œํ‚ค๊ณ ,
12:49
coaches professionally,
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์ „๋ฌธ์ ์œผ๋กœ ์ง€๋„ํ•˜๋ฉฐ,
12:51
demands significant time,
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๋งŽ์€ ์‹œ๊ฐ„์„ ์š”๊ตฌํ•˜๊ณ ,
12:53
builds a cohesive team
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์‘์ง‘๋ ฅ์ด ๊ฐ•ํ•œ ํŒ€์„ ํ˜•์„ฑํ•ด,
12:55
and measures results --
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๊ฒฐ๊ณผ๋ฅผ ์ธก์ •ํ•ฉ๋‹ˆ๋‹ค--
12:56
a kind of Teach for America for healthcare.
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๊ฑด๊ฐ•๋ณต์ง€์˜ <Teach for America>์ธ ์…ˆ์ด์ฃ .
12:59
Now in the top 10 cities in the U.S.
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๊ฐ€์žฅ ๋งŽ์€ ์ €์†Œ๋“์ธต ์˜๋ฃŒ ๋ณด์žฅ ํ™˜์ž๋“ค์ด ์žˆ๋Š”
13:01
with the largest number of Medicaid patients,
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๋ฏธ๊ตญ 10๋Œ€ ๋„์‹œ๋“ค์—์„œ๋Š”
13:03
each of those has at least 20,000 college students.
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์ด์ œ ๊ฐ ๋„์‹œ๋งˆ๋‹ค ์ตœ์†Œ 2๋งŒ๋ช…์˜ ๋Œ€ํ•™์ƒ๋“ค์ด ์žˆ์Šต๋‹ˆ๋‹ค.
13:06
New York alone has half a million college students.
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๋‰ด์š•๋งŒํ•ด๋„ 50๋งŒ ๋Œ€ํ•™์ƒ๋“ค์ด ์žˆ์ฃ .
13:10
And this isn't just a sort of short-term workforce
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์ด๊ฑด ๋‹จ์ˆœํžˆ ํ™˜์ž๋“ค์„ ๊ธฐ๋ณธ ์ž์›๊ณผ ์—ฐ๊ฒฐํ•ด์ฃผ๋Š”
13:13
to connect patients to basic resources,
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๋น„์ •๊ทœ์ง๋“ค์ด ์•„๋‹ˆ๋ผ,
13:15
it's a next generation healthcare leadership pipeline
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์ฐจ์„ธ๋Œ€ ๊ฑด๊ฐ•๋ณต์ง€๋ฅผ ์ž‡๋Š” ์ง€๋„์ž ์œก์„ฑ์œผ๋กœ
13:18
who've spent two, three, four years
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2, 3, 4๋…„๋™์•ˆ
13:21
in the clinic waiting room
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์ง„๋ฃŒ ๋Œ€๊ธฐ์‹ค์—์„œ
13:22
talking to patients about their most basic health needs.
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ํ™˜์ž๋“ค์— ๊ธฐ๋ณธ์ ์œผ๋กœ ๊ฑด๊ฐ•์— ํ•„์š”ํ•œ ๊ฒƒ์— ๋Œ€ํ•ด์„œ ์ด์•ผ๊ธฐ ํ•ด์ฃผ๊ฒŒ๋ฉ๋‹ˆ๋‹ค.
13:26
And they leave with the conviction,
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๊ทธ๋“ค์ด ๋– ๋‚ ๋•Œ ์ฏค์—” ํ™•์‹ ๊ณผ,
13:28
the ability and the efficacy
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๋Šฅ๋ ฅ, ๊ทธ๋ฆฌ๊ณ  ๋Šฅ๋ฅ ๋กœ
13:30
to realize our most basic aspirations for health care.
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๊ฑด๊ฐ•๋ณต์ง€๋ฅผ ์œ„ํ•œ ๊ฐ€์žฅ ๊ธฐ๋ณธ์ ์ธ ์—ผ์›์„ ๊นจ๋‹ซ๊ฒŒ ๋˜์ฃ .
13:34
And the thing is, there's thousands of these folks already out there.
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์ด๋ฏธ ์ˆ˜์ฒœ๋ช…์˜ ์ธ๋ ฅ์ด ๋ฐ–์— ์กด์žฌํ•ฉ๋‹ˆ๋‹ค.
13:37
So Mia Lozada is Chief Resident of Internal Medicine
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๋ฏธ์•„ ๋กœ์ž๋‹ค์”จ๋Š” UCSF์˜๋ฃŒ์„ผํ„ฐ์—์„œ
13:41
at UCSF Medical Center,
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๋‚ด๊ณผ ์ˆ˜์„ ๋ ˆ์ง€๋˜ํŠธ๋กœ ์žˆ์Šต๋‹ˆ๋‹ค.
13:42
but for three years as an undergraduate
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๊ทธ๋…€๋Š” ํ•™๋ถ€ 3๋…„๋™์•ˆ
13:44
she was a Health Leads volunteer
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<ํ—ฌ์Šค๋ฆฌ๋“œ> ์ž์›๋ด‰์‚ฌ์ž๋กœ
13:46
in the clinic waiting room at Boston Medical Center.
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๋ณด์Šคํ†ค ์˜๋ฃŒ์„ผํ„ฐ ๋Œ€๊ธฐ์‹ค์—์„œ ์ผํ–ˆ์ฃ .
13:49
Mia says, "When my classmates write a prescription,
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๋ฏธ์•„๊ฐ€ ๋งํ•˜๊ธด, "์ œ ๋ฐ˜ ์นœ๊ตฌ๋“ค์ด ์ฒ˜๋ฐฉ์ „์„ ์“ธ๋•Œ,
13:53
they think their work is done.
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์ž๊ธฐ ์ผ์ด ๋๋‚œ์ค„ ์••๋‹ˆ๋‹ค.
13:55
When I write a prescription,
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์ œ๊ฐ€ ์ฒ˜๋ฐฉ์ „์„ ์“ธ๋•Œ ์ƒ๊ฐํ•ฉ๋‹ˆ๋‹ค.
13:56
I think, can the family read the prescription?
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์ด ๊ฐ€์กฑ์ด ์ฒ˜๋ฐฉ์ „์„ ์ฝ์„ ์ˆ˜ ์žˆ์„๊นŒ?
13:59
Do they have transportation to the pharmacy?
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์•ฝ๊ตญ์— ๊ฐˆ ์ˆ˜ ์žˆ๋Š” ์ด๋™์ˆ˜๋‹จ์ด ์žˆ์„๊นŒ?
14:01
Do they have food to take with the prescription?
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์ฒ˜๋ฐฉ์ „๊ณผ ๊ฐ™์ด ๋จน์„ ์ˆ˜ ์žˆ๋Š” ์Œ์‹์ด ์žˆ์„๊นŒ?
14:03
Do they have insurance to fill the prescription?
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์ฒ˜๋ฐฉ์ „์„ ๋ฐ›์„ ์ˆ˜ ์žˆ๋Š” ๋ณดํ—˜์ด ์žˆ์„๊นŒ?
14:06
Those are the questions I learned at Health Leads,
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์ด๋Ÿฐ ์งˆ๋ฌธ๋“ค์„ ์ €๋Š” <ํ—ฌ์Šค๋ฆฌ๋“œ>์—์„œ ๋ฐฐ์› ๊ณ ,
14:08
not in medical school."
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์˜๋Œ€์—์„œ ๋ฐฐ์šฐ์ง€ ๋ชปํ–ˆ์Šต๋‹ˆ๋‹ค."
14:10
Now none of these solutions --
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์ด ํ•ด๊ฒฐ์ฑ… ์ค‘์—์„œ๋Š” ์•„๋ฌด๊ฒƒ๋„--
14:12
the prescription pad, the electronic medical record,
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์ฒ˜๋ฐฉ ๋ฉ”๋ชจ์ง€, ์ „์‚ฐ ์˜๋ฃŒ ๊ธฐ๋ก,
14:15
the waiting room,
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๋Œ€๊ธฐ์‹ค,
14:16
the army of college students --
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๋Œ€ํ•™์ƒ ์ง‘๋‹จ ์–ด๋–ค๊ฒƒ๋„ --
14:17
are perfect.
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์™„๋ฒฝํ•˜์ง€ ์•Š์Šต๋‹ˆ๋‹ค.
14:18
But they are ours for the taking --
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ํ•˜์ง€๋งŒ ์šฐ๋ฆฌ๊ฐ€ ๊ฐ€์งˆ ์ˆ˜ ์žˆ๋Š” ๊ฒƒ์ด์ฃ --
14:21
simple examples
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๊ฐ„๋‹จํ•œ ์˜ˆ๋“ค๋กœ,
14:22
of the vast under-utilized healthcare resources
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์ถฉ๋ถ„ํžˆ ํ™œ์šฉ๋˜์ง€ ์•Š์€ ๊ฑด๊ฐ•๋ณต์ง€์ž์›์œผ๋กœ
14:26
that, if we reclaimed and redeployed,
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๋งŒ์•ฝ ์šฐ๋ฆฌ๊ฐ€ ๋˜์ฐพ์•„ ์žฌ๋ฐฐ์น˜ํ•œ๋‹ค๋ฉด,
14:29
could realize our most basic aspiration
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๊ฑด๊ฐ•๋ณต์ง€์˜ ๊ฐ€์žฅ ๊ธฐ๋ณธ์ ์ธ ์—ผ์›์„
14:32
of healthcare.
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์ด๋ฃฐ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
14:34
So I had been at Legal Services for about nine months
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์ €๋Š” ๋ฒ•๋ฅ ์ƒ๋‹ด์†Œ์—์„œ 9๊ฐœ์›” ์žˆ์œผ๋ฉด์„œ
14:37
when this idea of Health Leads started percolating in my mind.
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์ œ ๋จธ๋ฆฌ ์†์— <ํ—ฌ์Šค๋ฆฌ๋“œ>์— ๋Œ€ํ•œ ์•„์ด๋””์–ด๊ฐ€ ์‹นํ…„์Šต๋‹ˆ๋‹ค.
14:40
And I knew I had to tell Jeff Purcell, my attorney,
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์ œ ๋ณ€ํ˜ธ์‚ฌ ์ œํ”„ ํŽ„์…€์—๊ฒŒ ๋– ๋‚˜์•ผํ•œ๋‹ค๊ณ 
14:43
that I needed to leave.
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์•Œ๋ ค์•ผ๋งŒ ํ–ˆ์ฃ .
14:44
And I was so nervous,
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์ „ ๋„ˆ๋ฌด๋‚˜ ๊ธด์žฅ์ด ๋ฌ์–ด์š”.
14:45
because I thought he was going to be disappointed in me
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๊ทธ๊ฐ€ ์ œ๊ฐ€ ์–ด๋–ค ๋ฏธ์นœ ์•„์ด๋””์–ด์— ์‚ฌ๋กœ ์žกํ˜€
14:48
for abandoning our clients for some crazy idea.
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์šฐ๋ฆฌ ๊ณ ๊ฐ๋“ค์„ ๋ฒ„๋ฆฐ๋‹ค๊ณ  ์ƒ๊ฐํ• ๊นŒ๋ด์š”.
14:51
And I sat down with him and I said,
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๊ทธ๋ž˜์„œ ์ „ ๊ทธ์™€ ๋‹จ๋‘˜์ด ์•‰์•„ ๋งํ–ˆ์Šต๋‹ˆ๋‹ค.
14:53
"Jeff, I have this idea
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"์ œํ”„, ์ „ ์•„์ด๋””์–ด๊ฐ€ ์žˆ๋Š”๋ฐ,
14:55
that we could mobilize college students
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๋Œ€ํ•™์ƒ๋“ค์„ ๋™์›ํ•˜๋ฉด ํ™˜์ž๋“ค์˜
14:57
to address patients' most basic health needs."
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๊ฐ€์žฅ ๊ธฐ๋ณธ์ ์ธ ๊ฑด๊ฐ• ๋ฌธ์ œ๋ฅผ ํ•ด๊ฒฐํ•  ์ˆ˜ ์žˆ์„๊ฒƒ ๊ฐ™์•„์š”.
15:00
And I'll be honest,
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์†”์งํžˆ ๋งํ•˜์ž๋ฉด,
15:02
all I wanted was for him to not be angry at me.
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์ „ ๊ทธ๊ฐ€ ์ €ํ•œํ…Œ ํ™”๋ฅผ ์•ˆ๋‚ด๊ธฐ๋งŒ์„ ๋ฐ”๋žฌ์–ด์š”.
15:05
But he said this,
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๊ทผ๋ฐ ๊ทธ๊ฐ€ ๋งํ•˜๊ธธ,
15:06
"Rebecca, when you have a vision,
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"๋ฆฌ๋ฒ ์นด, ๋งŒ์•ฝ ๋„ˆ์—๊ฒŒ ๋ชฉํ‘œ๊ฐ€ ์žˆ๋‹ค๋ฉด,
15:10
you have an obligation to realize that vision.
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๊ทธ ๋ชฉํ‘œ๋ฅผ ์ด๋ฃฐ ์˜๋ฌด๊ฐ€ ์žˆ์–ด์š”.
15:13
You must pursue that vision."
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๊ทธ ๋ชฉํ‘œ๋ฅผ ์ซ“์œผ์„ธ์š”."
15:17
And I have to say, I was like "Whoa.
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์†”์งํžˆ ๋งํ•˜๋ฉด, ์ „ "์™€,
15:20
That's a lot of pressure."
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์ข€ ๋ถ€๋‹ด์Šค๋Ÿฌ์šด๋ฐ"๋ผ๊ณ  ์ƒ๊ฐํ–ˆ์Šต๋‹ˆ๋‹ค.
15:22
I just wanted a blessing,
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์ „ ๊ทธ์ € ์‘์›์„ ์›ํ–ˆ์„๋ฟ,
15:23
I didn't want some kind of mandate.
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๋ฌด์Šจ ์ž„๋ช…์„ ์›ํ•˜์ง€ ์•Š์•˜๊ฑฐ๋“ ์š”.
15:25
But the truth is
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ํ•˜์ง€๋งŒ ์‚ฌ์‹ค
15:26
I've spent every waking minute nearly since then
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์ „ ๊ทธ ์ˆœ๊ฐ„๋ถ€ํ„ฐ ๋งค ์ˆœ๊ฐ„
15:29
chasing that vision.
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๊ทธ ๋ชฉํ‘œ๋ฅผ ์ซ“๊ณ  ์žˆ์Šต๋‹ˆ๋‹ค.
15:31
I believe that we all have a vision
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์ „ ์šฐ๋ฆฌ ๋ชจ๋‘๊ฐ€ ์ด ๊ตญ๊ฐ€์˜ ๊ฑด๊ฐ• ๋ณต์ง€๋ฅผ ์œ„ํ•œ
15:34
for healthcare in this country.
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๋ชฉํ‘œ๊ฐ€ ์žˆ๋‹ค๊ณ  ๋ฏฟ์Šต๋‹ˆ๋‹ค.
15:36
I believe that at the end of the day
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๊ทธ๋ฆฌ๊ณ  ๋งˆ์ง€๋ง‰์—
15:38
when we measure our healthcare,
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๊ฑด๊ฐ•๋ณต์ง€๋ฅผ ํ‰๊ฐ€ํ• ๋•Œ์ฏค
15:40
it will not be by the diseases cured,
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์–ผ๋งˆ๋‚˜ ์งˆ๋ณ‘์„ ์น˜๋ฃŒํ–ˆ๋ƒ๊ฐ€ ์•„๋‹ˆ๋ผ,
15:43
but by the diseases prevented.
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์–ผ๋งˆ๋‚˜ ์˜ˆ๋ฐฉํ–ˆ๋Š”๊ฐ€๋ฅผ ๋ณผ๊ฒƒ์ž…๋‹ˆ๋‹ค.
15:45
It will not be by the excellence of our technologies
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๊ธฐ์ˆ ์ด ์–ผ๋งˆ๋‚˜ ๋›ฐ์–ด๋‚œ์ง€,
15:48
or the sophistication of our specialists,
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ํ˜น์€ ์ „๋ฌธ์˜๋“ค์ด ์–ผ๋งˆ๋‚˜ ์ˆ˜์ค€ ๋†’์€์ง€๊ฐ€ ์•„๋‹ˆ๋ผ,
15:51
but by how rarely we needed them.
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์–ผ๋งˆ๋‚˜ ์ ๊ฒŒ ๊ทธ๋“ค์ด ํ•„์š”๋กœ ํ•œ์ง€๋กœ ๋ง์ด์ฃ .
15:54
And most of all,
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๊ทธ ์ค‘์—์„œ๋„,
15:55
I believe that when we measure healthcare,
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์ „ ๊ฑด๊ฐ•๋ณต์ง€๋ฅผ ์ธก์ •ํ• ๋•Œ,
15:58
it will be, not by what the system was,
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์‹œ์Šคํ…œ์ด ํ˜„์žฌ ์–ด๋–ค์ง€๊ฐ€ ์•„๋‹ˆ๋ผ,
16:00
but by what we chose it to be.
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์–ด๋–ป๊ฒŒ ๋ฐ”๋€Œ๋ ค๊ณ  ํ•˜๋Š”์ง€๋ฅผ ๋ด์•ผํ•œ๋‹ค๊ณ  ์ƒ๊ฐํ•ฉ๋‹ˆ๋‹ค.
16:03
Thank you.
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๊ฐ์‚ฌํ•ฉ๋‹ˆ๋‹ค.
16:04
(Applause)
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(๋ฐ•์ˆ˜)
16:14
Thank you.
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๊ฐ์‚ฌํ•ฉ๋‹ˆ๋‹ค.
16:16
(Applause)
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(๋ฐ•์ˆ˜)
์ด ์›น์‚ฌ์ดํŠธ ์ •๋ณด

์ด ์‚ฌ์ดํŠธ๋Š” ์˜์–ด ํ•™์Šต์— ์œ ์šฉํ•œ YouTube ๋™์˜์ƒ์„ ์†Œ๊ฐœํ•ฉ๋‹ˆ๋‹ค. ์ „ ์„ธ๊ณ„ ์ตœ๊ณ ์˜ ์„ ์ƒ๋‹˜๋“ค์ด ๊ฐ€๋ฅด์น˜๋Š” ์˜์–ด ์ˆ˜์—…์„ ๋ณด๊ฒŒ ๋  ๊ฒƒ์ž…๋‹ˆ๋‹ค. ๊ฐ ๋™์˜์ƒ ํŽ˜์ด์ง€์— ํ‘œ์‹œ๋˜๋Š” ์˜์–ด ์ž๋ง‰์„ ๋”๋ธ” ํด๋ฆญํ•˜๋ฉด ๊ทธ๊ณณ์—์„œ ๋™์˜์ƒ์ด ์žฌ์ƒ๋ฉ๋‹ˆ๋‹ค. ๋น„๋””์˜ค ์žฌ์ƒ์— ๋งž์ถฐ ์ž๋ง‰์ด ์Šคํฌ๋กค๋ฉ๋‹ˆ๋‹ค. ์˜๊ฒฌ์ด๋‚˜ ์š”์ฒญ์ด ์žˆ๋Š” ๊ฒฝ์šฐ ์ด ๋ฌธ์˜ ์–‘์‹์„ ์‚ฌ์šฉํ•˜์—ฌ ๋ฌธ์˜ํ•˜์‹ญ์‹œ์˜ค.

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