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

399,815 views ・ 2019-03-11

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Tafadhali bofya mara mbili manukuu ya Kiingereza hapa chini ili kucheza video.

Translator: Clarence Bitegeko Reviewer: Doris Mangalu
00:12
So, a little while ago,
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Kitambo kidogo hapo nyuma,
00:14
members of my family had three bits of minor surgery,
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watu wa familia yangu walikuwa na upasuaji mdogo mara 3 hivi,
00:17
about a half hour each,
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wa kama nusu saa kwa kila mmoja,
00:19
and we got three sets of bills.
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na tulipata seti tatu za bili.
00:22
For the first one, the anesthesia bill alone was 2,000 dollars;
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Kwa ule wa kwanza, madai ya nusukaputi pekee yalikuwa dola 2,000;
00:26
the second one, 2,000 dollars;
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ule wa pili, dola 2,000;
00:28
the third one, 6,000 dollars.
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ule wa tatu, dola 6,000.
00:32
So I'm a journalist. I'm like, what's up with that?
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Sasa mimi ni mwanahabari. Nikawa kama, sasa kuna nini kwani?
00:37
I found out that I was actually, for the expensive one,
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Nikagundua kuwa, nilipewa gharama za juu,
00:40
being charged 1,419 dollars for a generic anti-nausea drug
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kulipishwa dola 1,419 kwa dawa ya nusukaputi ya kawaida
00:45
that I could buy online for two dollars and forty-nine cents.
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ambayo ningeweza kununua mtandaoni kwa dola mbili na senti arobaini.
00:50
I had a long and unsatisfactory argument with the hospital,
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Nilikuwa na mabishano marefu na yasiyoridhisha na hospitali,
00:53
the insurer and my employer.
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mtoa bima na mwajiri.
00:56
Everybody agreed that this was totally fine.
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Kila mmoja alikubali kuwa hii ilikuwa sawa kabisa.
00:59
But it got me thinking, and the more I talked to people, the more I realized:
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Lakini ilinifanya nifikirie, na kadri nilivyoongea na watu, niligundua zaidi:
01:03
nobody has any idea what stuff costs in health care.
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hakuna anayefahamu gharama za vitu katika huduma za afya.
01:06
Not before, during or after that procedure or test
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Siyo kabla, katikati, au baada ya huduma au vipimo
01:09
do you have any idea what it's going to cost.
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una wazo lolote nini itakuwa gharama.
01:11
It's only months later that you get an "explanation of benefits"
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Ni baada tu ya miezi kadhaa ndipo utapata "maelezo ya mafao"
01:15
that explains exactly nothing.
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ambayo hayaelezei chochote.
01:17
So this came back to me a little while later.
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Kwa hiyo hili lilikuja tena kwangu baadaye kidogo
01:20
I had volunteered for a buyout from the New York Times,
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Nilijitolea kuacha kazi kwa malipo kutoka New York Times
01:23
where I had worked for more than 20 years as a journalist.
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ambapo nilifanya kazi kwa zaidi ya miaka 20 kama mwanahabari.
01:26
I was looking for my next act.
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Nilikuwa natafuta shughuli nyingine.
01:28
It turned out that next act was to build a company
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Ikaotokea kuwa shughuli nyingine ni kuunda kampuni
01:31
telling people what stuff costs in health care.
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kuwaambia watu gharama za vitu kwenye huduma za afya
01:34
I won a "Shark Tank"-type pitch contest to do just that.
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Nilishinda shindano la simulizi kama "Shark Tank" ili kufanya hivyo.
01:37
Health costs ate up almost 18 percent of our gross domestic product last year,
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Gharama za afya zimepanda hadi asilimia 18 ya pato la taifa kwa mwaka jana,
01:42
but nobody has any idea what stuff costs.
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lakini hakuna anayefahamu gharama za vitu.
01:45
But what if we did know?
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Lakinii ingekuwaje tungefahamu?
01:48
So we started out small.
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Kwahiyo tulianza kidogo.
01:49
We called doctors and hospitals
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Tuliita madaktari na mahospitali
01:51
and asked them what they would accept as a cash payment for simple procedures.
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na kuwauliza wangekubali kiasi gani pesa taslim kwa ajili ya matibabu madogo.
01:57
Some people were helpful.
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Watu wengine walikuwa na msaada.
01:58
A lot of people hung up on us.
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Wengi walitukatia mawasiliano.
02:00
Some people were just plain rude.
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Wengine walikuwa jeuri tu.
02:02
They said, "We don't know,"
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Walisema, "Hatujui,"
02:04
or, "Our lawyers won't let us tell you that,"
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au, "Wanasheria wetu hawawezi kuturuhusu kuwaambia,"
02:07
though we did get a lot of information.
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ingawa tulipata taarifa nyingi.
02:10
We found, for example, that here in the New York area,
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tuligundua, kwa mfano, kuwa hapa eneo la New York,
02:12
you could get an echocardiogram for 200 dollars in Brooklyn
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unaweza kupata kipimo cha moyo kwa dola 200 Brooklyn
02:17
or for 2,150 dollars in Manhattan, just a few miles away.
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au kwa dola 2,150 Manhattan, maili chache tu pembeni.
02:22
New Orleans, the same simple blood test,
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New Orleans, vipimo hivyo hivyo rahisi vya damu,
02:25
19 dollars over here,
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dola 19 hapa,
02:27
522 dollars just a few blocks away.
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dola 522 vitalu vichache tu pembeni.
02:31
San Francisco, the same MRI,
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San Francisco, kipimo cha MRI,
02:34
475 dollars
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dola 475
02:36
or 6,221 dollars just 25 miles away.
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au dola 6,221 maili 25 tu pembeni.
02:42
These pricing variations existed for all the procedures
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Tofauti hizi za bei zilikuwepo kwa matibabu ya aina zote
02:46
and all the cities that we surveyed.
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na miji yote iliyofanyiwa utafiti.
02:49
Then we started to ask people to tell us their health bills.
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Kisha tukaanza kuwauliza watu watuambie madai ya ya matibabu.
02:52
In partnership with public radio station WNYC here in New York,
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Kwa kushirikiana na redio stesheni ya kijamii WNYC hapa New York,
02:56
we asked women to tell us the prices of their mammograms.
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tuliuliza wanawake watuambie bei za kipimo cha saratani ya matiti.
02:59
People told us nobody would do that, that it was too personal.
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Watu walituambia hakuna atakayesema, ilikuwa jambo binafsi sana.
03:03
But in the space of three weeks,
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Lakini ndani ya wiki tatu,
03:05
400 women told us about their prices.
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wanawake 400 walituambia juu ya bei zake,
03:09
Then we started to make it easier for people to share their data
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Kisha tukaanza kufanya kuwa rahisi kwa watu kutoa taarifa zao
03:12
into our online searchable database.
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katika kanzi data yetu ya mtandaoni inayopekulika.
03:15
It's sort of like a mash-up of Kayak.com and the Waze traffic app for health care.
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Ni mfano wa Kayak.com na zana tumizi ya Waze pamoja kwa ajili ya huduma za afya.
03:20
(Laughter)
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(Kicheko)
03:21
We call it a community-created guide to health costs.
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Tunaiita mwongozo wa jumuiya wa gharama za matibabu.
03:24
Our survey and crowdsourcing work grew into partnerships
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Utafiti wetu na ukusanyaji taarifa kutoka uma ukapelekea ubia
03:26
with top newsrooms nationwide --
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na vyombo vikubwa vya habari kitaifa
03:28
in New Orleans, Philadelphia,
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ndani ya New Orleans, Philadelphia,
03:30
San Francisco, Los Angeles, Miami and other places.
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San Francisco, Los Angeles, Miami na sehemu nyingine.
03:35
We used the data to tell stories about people who were suffering
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Tulitumia data kusimulia juu ya watu waliokuwa wakiteseka
03:39
and how to avoid that suffering, to avoid that "gotcha" bill.
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na jinsi gani kuepuka mateso hayo, kuepuka madai ya "nimekudaka".
03:44
A woman in New Orleans saved nearly 4,000 dollars using our data.
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Mwanamke mmoja wa New Orleans aliokoa karibu dola 4,000 kwa kutumia data zetu.
03:49
A San Francisco contributor saved nearly 1,300 dollars
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Mchangiaji wa San Francisco aliokoa karibu dola 1,300
03:52
by putting away his insurance card
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kwa kuiweka mbali kadi yake ya bima
03:54
and paying cash.
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na kulipa pesa taslimu.
03:56
There are a lot of people who are going to in-network hospitals
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Kuna watu wengi wanaokwenda kwenye hospitali zililizo mtandaoni
03:59
and getting out-of-network bills.
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na kupata bili za nje ya mtandao.
04:01
And then there was the hospital that continued to bill a dead man.
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Na pia kuna hospitali ambazo ziliendelea kudai mtu aliyekufa.
04:05
We learned that thousands of people wanted to tell us their prices.
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Tulijifunza kuwa maelfu ya watu walitaka kutuambia bei zao.
04:08
They want to learn what stuff costs,
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Wanataka kujua gharama za vitu,
04:10
find out how to argue a bill,
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kujua namna kuhoji juu ya bili,
04:11
help us solve this problem that's hurting them and their friends and families.
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kutusaidia kutatua hili tatizo linaloumiza wao, rafiki na familia zao.
04:15
We talked to people who had to sell a car to pay a health bill,
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Tuliongea na watu waliofikia kuuza gari ili kulipa bili ya afya,
04:18
go into bankruptcy,
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na kufilisika
04:20
skip a treatment because of the cost.
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kuacha matibabu kwa sababu ya gharama.
04:23
Imagine if you could afford the diagnosis
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Fikiria ungeweza kumudu gharama za uchunguzi
04:25
but not the cure.
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lakini siyo matibabu.
04:29
We set off a huge conversation about costs
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Tulianzisha majadiliano makubwa juu ya gharama
04:31
involving doctors and hospitals, yes, but also their patients,
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tukihusisha madaktari, mahospitali, ndiyo, na wagonjwa wao,
04:35
or as we like to call them, people.
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au tunavyopenda kuwaita, watu.
04:37
(Laughter)
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(Kicheko)
04:41
We changed policy.
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Tulibadili sera.
04:42
A consumer protection bill that had been stalled
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Mswada wa kulinda walaji ambao ulikuwa umesimama
04:45
in the Louisiana legislature for 10 years
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katika bunge la Louisiana kwa miaka 10
04:47
passed after we launched.
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ulipita baada ya sisi kuzindua.
04:50
Let's face it:
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Tukabiliane nayo:
04:51
this huge, slow-rolling public health crisis
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janga hili kubwa na linalokuwa taratibu la afya ya jamii
04:54
is a national emergency.
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ni dharura ya kitaifa.
04:56
And I don't think government's going to help us out anytime soon.
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Na sidhani kama serikali itatusaidia wakati wowote hivi karibuni.
05:00
But what if the answer was really simple:
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Lakini vipi jibu lingekuwa rahisi sana:
05:02
make all the prices public all the time.
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fanya bei zote wazi wakati wote.
05:06
Would our individual bills go down? Our health premiums?
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Je bili zetu zitapungua? Ada ya bima ya afya?
05:11
Be really clear about this:
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Kuwa wazi juu ya hili:
05:13
this is a United States problem.
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hili ni tatizo la Marekani.
05:15
In most of the rest of the developed world,
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Katika nchi nyingi nyingine zilizoendelea,
05:17
sick people don't have to worry about money.
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wagonjwa hawahitaji kuwa na wasiwasi juu ya pesa.
05:20
It's also true that price transparency will not solve every problem.
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Ni kweli pia kuwa uwazi wa bei hautatatua kila tatizo.
05:24
There will still be expensive treatments,
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Bado kutakuwa na matibabu ya gharama,
05:27
huge friction from our insurance system.
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msuguano mkubwa na mfumo wetu wa bima.
05:29
There will still be fraud
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Bado kutakuwa na udanganyifu
05:31
and a massive problem with overtreatment and overdiagnosis.
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na tatizo kubwa la matibabu yaliyozidi na uchunguzi uliopitiliza.
05:35
And not everything is shoppable.
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Na si kila kitu kinanunulika.
05:38
Not everybody wants the cheapest appendectomy
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Si kila mtu anataka upasuaji kidoletumbo wa bei rahisi
05:40
or the cheapest cancer care.
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au matibabu saratani ya bei rahisi.
05:43
But when we talk about these clear effects,
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Lakini tunapoongelea athari hizi za wazi,
05:45
we're looking at a real issue that's actually very simple.
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tunaangalia jambo la halisi kabisa ambalo ni rahisi sana
05:50
When we first started calling for prices,
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Tulipoanza kuulizia bei,
05:52
we actually felt like we were going to be arrested.
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tulihisi kabisa kama tungekuja kukamatwa.
05:55
It seemed kind of transgressive to talk about medicine and health care
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Ilionekana kama ni kwenda kinyume kuongelea dawa na huduma za afya
05:58
in the same breath,
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kwa pamoja,
06:00
and yet it became liberating,
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na bado ilileta ukombozi,
06:01
because we found not only data
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sababu tulipata siyo taarifa tu
06:04
but also good and honest people out there in the system
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bali pia watu wazuri na waaminifu katika mfumo uliopo
06:06
who want to help folks get the care they need
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ambao wanataka kusaidia watu kupata huduma wanazohitaji
06:08
at a price they can afford.
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katika bei wanazoweza kuzimudu.
06:11
And it got easier to ask.
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Na ilizidi kuwa rahisi kuuliza.
06:13
So I'll leave you with some questions.
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Hivyo, nitawaacha na maswali.
06:15
What if we all knew what stuff cost in health care in advance?
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Ingekuwaje kama wote tungejua gharama za huduma za afya mapema?
06:19
What if, every time you Googled for an MRI,
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Ingekuwaje, kila wakati ungetafuta MRI kwa google,
06:23
you got drop-downs telling you where to buy and for how much,
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ungepata orodha ya wapi ununue na kwa kiasi gani,
06:26
the way you do when you Google for a laser printer?
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namna unavyokua unatafuta kichapishi kupitia google?
06:30
What if all of the time and energy and money that's spent hiding prices
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Ingekuwaje kama muda wote na nguvu na pesa inayotumika kuficha bei
06:34
was squeezed out of the system?
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vingeondolewa kwenye mfumo.
06:37
What if each one of us could pick the $19 test every time
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Ingekuwaje kama kila mmoja wetu angechagua uchunguzi wa $19 kila wakati
06:40
instead of the $522 one?
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badala ya ule wa $522?
06:43
Would our individual bills go down?
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Je bili zetu zingepungua?
06:45
Our premiums?
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Ada za bima?
06:46
I don't know, but if you don't ask, you'll never know.
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Sijui, lakini usipouliza, hutojua kamwe.
06:49
And you might save a ton of money.
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Na unaweza kuokoa pesa nyingi.
06:51
And I've got to think that a lot of us and the system itself
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Na nimekuwa nikifikiria kuwa wengi wetu na mfumo wenyewe
06:55
would be a lot healthier.
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tungekuwa na afya zaidi.
06:57
Thank you.
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Asanteni.
06:58
(Applause)
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(Makofi)
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