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

Translator: Clarence Bitegeko Reviewer: Doris Mangalu

So, a little while ago,

Kitambo kidogo hapo nyuma,

members of my family had three bits of minor surgery,

watu wa familia yangu walikuwa na upasuaji mdogo mara 3 hivi,

about a half hour each,

wa kama nusu saa kwa kila mmoja,

and we got three sets of bills.

na tulipata seti tatu za bili.

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

Kwa ule wa kwanza, madai ya nusukaputi pekee yalikuwa dola 2,000;

the second one, 2,000 dollars;

ule wa pili, dola 2,000;

the third one, 6,000 dollars.

ule wa tatu, dola 6,000.

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

Sasa mimi ni mwanahabari. Nikawa kama, sasa kuna nini kwani?

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

Nikagundua kuwa, nilipewa gharama za juu,

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

kulipishwa dola 1,419 kwa dawa ya nusukaputi ya kawaida

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

ambayo ningeweza kununua mtandaoni kwa dola mbili na senti arobaini.

I had a long and unsatisfactory argument with the hospital,

Nilikuwa na mabishano marefu na yasiyoridhisha na hospitali,

the insurer and my employer.

mtoa bima na mwajiri.

Everybody agreed that this was totally fine.

Kila mmoja alikubali kuwa hii ilikuwa sawa kabisa.

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

Lakini ilinifanya nifikirie, na kadri nilivyoongea na watu, niligundua zaidi:

nobody has any idea what stuff costs in health care.

hakuna anayefahamu gharama za vitu katika huduma za afya.

Not before, during or after that procedure or test

Siyo kabla, katikati, au baada ya huduma au vipimo

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

una wazo lolote nini itakuwa gharama.

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

Ni baada tu ya miezi kadhaa ndipo utapata "maelezo ya mafao"

that explains exactly nothing.

ambayo hayaelezei chochote.

So this came back to me a little while later.

Kwa hiyo hili lilikuja tena kwangu baadaye kidogo

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

Nilijitolea kuacha kazi kwa malipo kutoka New York Times

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

ambapo nilifanya kazi kwa zaidi ya miaka 20 kama mwanahabari.

I was looking for my next act.

Nilikuwa natafuta shughuli nyingine.

It turned out that next act was to build a company

Ikaotokea kuwa shughuli nyingine ni kuunda kampuni

telling people what stuff costs in health care.

kuwaambia watu gharama za vitu kwenye huduma za afya

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

Nilishinda shindano la simulizi kama "Shark Tank" ili kufanya hivyo.

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

Gharama za afya zimepanda hadi asilimia 18 ya pato la taifa kwa mwaka jana,

but nobody has any idea what stuff costs.

lakini hakuna anayefahamu gharama za vitu.

But what if we did know?

Lakinii ingekuwaje tungefahamu?

So we started out small.

Kwahiyo tulianza kidogo.

We called doctors and hospitals

Tuliita madaktari na mahospitali

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

na kuwauliza wangekubali kiasi gani pesa taslim kwa ajili ya matibabu madogo.

Some people were helpful.

Watu wengine walikuwa na msaada.

A lot of people hung up on us.

Wengi walitukatia mawasiliano.

Some people were just plain rude.

Wengine walikuwa jeuri tu.

They said, "We don't know,"

Walisema, "Hatujui,"

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

au, "Wanasheria wetu hawawezi kuturuhusu kuwaambia,"

though we did get a lot of information.

ingawa tulipata taarifa nyingi.

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

tuligundua, kwa mfano, kuwa hapa eneo la New York,

you could get an echocardiogram for 200 dollars in Brooklyn

unaweza kupata kipimo cha moyo kwa dola 200 Brooklyn

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

au kwa dola 2,150 Manhattan, maili chache tu pembeni.

New Orleans, the same simple blood test,

New Orleans, vipimo hivyo hivyo rahisi vya damu,

19 dollars over here,

dola 19 hapa,

522 dollars just a few blocks away.

dola 522 vitalu vichache tu pembeni.

San Francisco, the same MRI,

San Francisco, kipimo cha MRI,

475 dollars

dola 475

or 6,221 dollars just 25 miles away.

au dola 6,221 maili 25 tu pembeni.

These pricing variations existed for all the procedures

Tofauti hizi za bei zilikuwepo kwa matibabu ya aina zote

and all the cities that we surveyed.

na miji yote iliyofanyiwa utafiti.

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

Kisha tukaanza kuwauliza watu watuambie madai ya ya matibabu.

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

Kwa kushirikiana na redio stesheni ya kijamii WNYC hapa New York,

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

tuliuliza wanawake watuambie bei za kipimo cha saratani ya matiti.

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

Watu walituambia hakuna atakayesema, ilikuwa jambo binafsi sana.

But in the space of three weeks,

Lakini ndani ya wiki tatu,

400 women told us about their prices.

wanawake 400 walituambia juu ya bei zake,

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

Kisha tukaanza kufanya kuwa rahisi kwa watu kutoa taarifa zao

into our online searchable database.

katika kanzi data yetu ya mtandaoni inayopekulika.

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

Ni mfano wa Kayak.com na zana tumizi ya Waze pamoja kwa ajili ya huduma za afya.

(Laughter)

(Kicheko)

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

Tunaiita mwongozo wa jumuiya wa gharama za matibabu.

Our survey and crowdsourcing work grew into partnerships

Utafiti wetu na ukusanyaji taarifa kutoka uma ukapelekea ubia

with top newsrooms nationwide --

na vyombo vikubwa vya habari kitaifa

in New Orleans, Philadelphia,

ndani ya New Orleans, Philadelphia,

San Francisco, Los Angeles, Miami and other places.

San Francisco, Los Angeles, Miami na sehemu nyingine.

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

Tulitumia data kusimulia juu ya watu waliokuwa wakiteseka

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

na jinsi gani kuepuka mateso hayo, kuepuka madai ya "nimekudaka".

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

Mwanamke mmoja wa New Orleans aliokoa karibu dola 4,000 kwa kutumia data zetu.

A San Francisco contributor saved nearly 1,300 dollars

Mchangiaji wa San Francisco aliokoa karibu dola 1,300

by putting away his insurance card

kwa kuiweka mbali kadi yake ya bima

and paying cash.

na kulipa pesa taslimu.

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

Kuna watu wengi wanaokwenda kwenye hospitali zililizo mtandaoni

and getting out-of-network bills.

na kupata bili za nje ya mtandao.

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

Na pia kuna hospitali ambazo ziliendelea kudai mtu aliyekufa.

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

Tulijifunza kuwa maelfu ya watu walitaka kutuambia bei zao.

They want to learn what stuff costs,

Wanataka kujua gharama za vitu,

find out how to argue a bill,

kujua namna kuhoji juu ya bili,

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

kutusaidia kutatua hili tatizo linaloumiza wao, rafiki na familia zao.

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

Tuliongea na watu waliofikia kuuza gari ili kulipa bili ya afya,

go into bankruptcy,

na kufilisika

skip a treatment because of the cost.

kuacha matibabu kwa sababu ya gharama.

Imagine if you could afford the diagnosis

Fikiria ungeweza kumudu gharama za uchunguzi

but not the cure.

lakini siyo matibabu.

We set off a huge conversation about costs

Tulianzisha majadiliano makubwa juu ya gharama

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

tukihusisha madaktari, mahospitali, ndiyo, na wagonjwa wao,

or as we like to call them, people.

au tunavyopenda kuwaita, watu.

(Laughter)

(Kicheko)

We changed policy.

Tulibadili sera.

A consumer protection bill that had been stalled

Mswada wa kulinda walaji ambao ulikuwa umesimama

in the Louisiana legislature for 10 years

katika bunge la Louisiana kwa miaka 10

passed after we launched.

ulipita baada ya sisi kuzindua.

Let's face it:

Tukabiliane nayo:

this huge, slow-rolling public health crisis

janga hili kubwa na linalokuwa taratibu la afya ya jamii

is a national emergency.

ni dharura ya kitaifa.

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

Na sidhani kama serikali itatusaidia wakati wowote hivi karibuni.

But what if the answer was really simple:

Lakini vipi jibu lingekuwa rahisi sana:

make all the prices public all the time.

fanya bei zote wazi wakati wote.

Would our individual bills go down? Our health premiums?

Je bili zetu zitapungua? Ada ya bima ya afya?

Be really clear about this:

Kuwa wazi juu ya hili:

this is a United States problem.

hili ni tatizo la Marekani.

In most of the rest of the developed world,

Katika nchi nyingi nyingine zilizoendelea,

sick people don't have to worry about money.

wagonjwa hawahitaji kuwa na wasiwasi juu ya pesa.

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

Ni kweli pia kuwa uwazi wa bei hautatatua kila tatizo.

There will still be expensive treatments,

Bado kutakuwa na matibabu ya gharama,

huge friction from our insurance system.

msuguano mkubwa na mfumo wetu wa bima.

There will still be fraud

Bado kutakuwa na udanganyifu

and a massive problem with overtreatment and overdiagnosis.

na tatizo kubwa la matibabu yaliyozidi na uchunguzi uliopitiliza.

And not everything is shoppable.

Na si kila kitu kinanunulika.

Not everybody wants the cheapest appendectomy

Si kila mtu anataka upasuaji kidoletumbo wa bei rahisi

or the cheapest cancer care.

au matibabu saratani ya bei rahisi.

But when we talk about these clear effects,

Lakini tunapoongelea athari hizi za wazi,

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

tunaangalia jambo la halisi kabisa ambalo ni rahisi sana

When we first started calling for prices,

Tulipoanza kuulizia bei,

we actually felt like we were going to be arrested.

tulihisi kabisa kama tungekuja kukamatwa.

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

Ilionekana kama ni kwenda kinyume kuongelea dawa na huduma za afya

in the same breath,

kwa pamoja,

and yet it became liberating,

na bado ilileta ukombozi,

because we found not only data

sababu tulipata siyo taarifa tu

but also good and honest people out there in the system

bali pia watu wazuri na waaminifu katika mfumo uliopo

who want to help folks get the care they need

ambao wanataka kusaidia watu kupata huduma wanazohitaji

at a price they can afford.

katika bei wanazoweza kuzimudu.

And it got easier to ask.

Na ilizidi kuwa rahisi kuuliza.

So I'll leave you with some questions.

Hivyo, nitawaacha na maswali.

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

Ingekuwaje kama wote tungejua gharama za huduma za afya mapema?

What if, every time you Googled for an MRI,

Ingekuwaje, kila wakati ungetafuta MRI kwa google,

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

ungepata orodha ya wapi ununue na kwa kiasi gani,

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

namna unavyokua unatafuta kichapishi kupitia google?

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

Ingekuwaje kama muda wote na nguvu na pesa inayotumika kuficha bei

was squeezed out of the system?

vingeondolewa kwenye mfumo.

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

Ingekuwaje kama kila mmoja wetu angechagua uchunguzi wa $19 kila wakati

instead of the $522 one?

badala ya ule wa $522?

Would our individual bills go down?

Je bili zetu zingepungua?

Our premiums?

Ada za bima?

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

Sijui, lakini usipouliza, hutojua kamwe.

And you might save a ton of money.

Na unaweza kuokoa pesa nyingi.

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

Na nimekuwa nikifikiria kuwa wengi wetu na mfumo wenyewe

would be a lot healthier.

tungekuwa na afya zaidi.

Thank you.

Asanteni.

(Applause)

(Makofi)