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

翻译人员: Shu Fei Chow 校对人员: Yolanda Zhang

Every day in this country,

在这个国家的每一天，

families are forced to make impossible choices

很多家庭在医疗上都要

被迫做出艰难的抉择。

when it comes to their health care.

Like Kimberly, who said,

就像金伯利所说，

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

“有时候我得在 食物与药物之间做出抉择。

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

这些都不是奢侈品， 因为我的收入没那么多。

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

这问题的性质就像： ‘我该买洗发剂还是护发素？’

Things you take for granted."

——本该是理所当然的事情。”

And Debbie, who said,

黛比也说：

"You put your medicine in one hand,

“一边是不得不吃的药，

your living costs in the other.

另一边是不得不花费的生活开销。

OK. Well, what am I going to do?

好吧，那我该怎么做才对？

Am I going to get my medicine

我是该按时吃药，

or am I going to pay my bills?

还是先支付生活开销？

Well, I can't live without my medicine,

的确，我无法在 没有药物的情况下生存，

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

但我也无法在不支付 生活开销的前提下生存。”

Ten thousand people die every month in this country,

在这个国家， 每个月都有多达一万人

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

死于没有及时服用必需的药物。

More people die from not taking medications

因缺乏药物治疗的死亡人数

than opioid overdoses and car accidents combined.

远远超过服用过量阿片类药物， 以及死于车祸意外的人数总和。

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

但你确实无法获得 你负担不起的药物。

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

如今，每个家庭每年在医药方面

on medications.

平均要花费 3000 美元。

About a third of folks who are uninsured

大约三分之一的人 没有医疗保险，

said that they stopped taking medicine as prescribed

并因无法负担昂贵的药费

because of cost.

而不得不停止服药。

Even folks with insurance,

即使是有医疗保险的人们，

if they make under 35,000 dollars a year,

如果他们的年收入 低于 3.5 万美元，

half of them report skipping the medications

且医疗保险没有 覆盖长期的药物费用，

if their insurance doesn't cover it.

一半的人也会选择不吃药物。

So there are 10 million adults like Kimberly and like Debbie

有一千万成年人 正像金伯利、黛比一样，

who are forced to make impossible choices every day.

被迫每天做出这样的艰难取舍。

We all know that prescription drug prices are too high.

众所周知，当今的药物价格过于高昂。

And our health care system,

而我们的医疗体系

that makes some folks uninsured and other folks underinsured,

并没有给予那些没有医疗保险 或是投保不足的人们

doesn't prioritize people who need access now

优先接受治疗

and need medications now.

或是优先服用药物的便利。

Ten million -- it's a big number,

一千万是个天文数字，

but it's also a solvable number,

但也是个可解的数字，

because there's also 10 billion dollars

因为与此同时， 有价值一百亿美元

of perfectly good, unused medication

完好无损且未使用过的药物

that goes to waste.

被白白浪费了。

So this is an injustice on two sides:

这造成了两个方面的不公：

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

一方面，人们无法得到他们 赖以生存的药物；

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

另一方面，同样的药物 将会被送去医疗废料焚化炉，

to be destroyed.

进行销毁。

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

这样的药物浪费是不合情理的， 但同时也为我们提供了一个契机。

I started SIRUM,

我与另外两位合伙人，亚当和乔治

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

共同成立了 SIRUM 这家非盈利科技公司，

to turn discarded medications into a lifeline,

目标是将废弃的药物 转化为救人的生命线，

just like the medications in this warehouse.

就像这个仓库中的药物。

We may not be able to fix

我们也许没办法解决

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

医疗系统里的所有问题，

but we can fix this one.

但至少我们可以解决这个问题。

Medications come from manufacturers and wholesalers who have safety stock,

一部分药物来自制造商 和批发商的安全仓库，

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

一旦有效期将至， 它们就会被销毁。

It also comes from health care facilities

还有一部分药物来自医疗机构，

like hospitals, pharmacies and nursing homes,

如医院、药局和疗养院，

who end up with surplus when a patient stops taking medication

尤其是病人 因停止服用或是去世后

or when they pass away.

所剩下的那部分。

We can use this untapped source of medications

我们可以利用这些 未开发的药物来源，

to supply all 10 million people who need medications.

满足那一千万人的药物需求。

And we can do this today.

而今天我们做到了。

SIRUM gets surplus medications

SIRUM 将在上百间医疗机构

by putting recycling bins into these hundreds of facilities

放置回收箱，

that have surplus.

来收集这些剩余药物。

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

当回收箱装满剩余药物后，

SIRUM initiates a courier pickup to pick up that medication,

SIRUM 便派快递公司 前去领取这些药物，

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

而运送、追踪货单及税务事宜 都由我们自己处理。

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

药物捐赠者之所以愿意捐赠，

是因为这相较于管控严格的 药物销毁过程来得更加便宜、方便。

than the highly regulated medicine destruction process.

And there are strong tax incentives to actually donate.

再加之，药品捐赠者 能享有更多的税务津贴。

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

然后，我们将这些捐赠药物 送给那些有需要的人们。

A new prescription comes in,

每收到一份新的药方，

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

我们都会对病患的需求 和平台现有的药物存量进行匹配，

Our platform then generates a warehouse pick list,

提供仓库药物提取清单，

the medications are picked and the prescriptions filled.

并依照药方来配药给病患。

We are building the 21st-century pharmacy experience

我们正在打造 一个为低收入家庭服务的

that low-income families deserve.

21 世纪药局。

Patients can register in under five minutes

患者只需不到 5 分钟的时间 便能完成注册，

and have access to over 500 different medications,

搜索超过 500 多种药物，

a stable list of medications for everything from heart disease

包括了从心脏病到

to mental health conditions,

身心健康的一系列药物清单，

actually representing over 75 percent of all prescriptions prescribed

其中囊括了

全美国超过 75% 的药方。

in the United States today.

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

我们还与社区卫生中心和免费诊所的 医生、护士和病例管理人员

at community health centers and free clinics

组成的网络合作，

that refer patients to the service.

向患者推广我们的服务。

We make it as easy for these health care providers

我们也为医护人员提供便利，

to have a prescription filled with donated medications

让他们用这些捐赠药物 为病患开药方，

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

几乎与将药方发送给 当地的药房无异。

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

患者可直接通过我们 其中一方合作伙伴领取药物，

or have medications delivered directly to their home.

或者要求把药物递送到家。

By circumventing the traditional supply chain,

通过规避传统的药物供应链，

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

我们的收费平价又透明——

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

大部分药物的一个月收费 大约只有两美金。

And that allows a predictable, affordable price

如此一来，就能提供一个 可预测且相当实惠的价格，

that folks can actually budget for.

让人们能将医药费用 列入日常花销。

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

我们已经满足了 15 万人的药物需求。

But we can do more.

但我们能做的还有很多。

Our goal is to reach one million people

我们的目标是在接下来的五年，

with approaching a billion dollars of unused medicine

将价值十亿美元的未使用药物

in the next five years,

提供给一百万人，

scaling our program to 12 states.

并将这个计划 扩大至十二个州。

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

这一规模让我们得以覆盖

to 40 percent of the 10 million people

那些缺乏持续且可负担药物供应的

who lack consistent, affordable access.

一千万人口社区中 40% 的患者。

Our direct service to one million people

我们为这一千万人所提供的服务

will drive price competition for so many more.

会引发更多的药物价格竞争。

Walmart launched one of the only price innovations in pharmacy

沃尔玛曾于 2006 年 推出了极其罕见的

in 2006,

药物创新价格活动，

by offering a limited list of medications

只需支付四美元的固定费用，

for a flat fee of four dollars.

就可以购买有限种类的药物。

This sparked incredible change.

这引发了令人难以置信的变革，

It sparked competitors to offer other lists

也激起了同行竞争者相继推出

and price match guarantees.

平价且具有品质保证的药物，

By targeting transparent, affordable medications

除了将这些价格实惠、透明的药物

into these new states,

引进这些新的州，

we can actually drive regional price competition

实际上就推动了 地区性的价格竞争，

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

从而降低了药物价格， 让整个低收入群体获益。

Our health care system is complex.

我们的医疗体系非常复杂，

It is daunting.

令人望而却步，

It feels impossible to make headway.

任何改变似乎都遥不可及。

But we can completely reimagine medicine access.

但我们完全可以重塑供药环节。

By using surplus medications as a beachhead to force change

除了通过使用剩余药物作为立足点，

into this multibillion dollar industry,

迫使这个价值数十亿美元的产业 进行改革，

we can create radical access to medications

我们也可以凭借一个基本信念，

based on a fundamental belief

即一个最富裕国家的人民

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

有能力、也有资格获取 他们所需的药物

can and should have access to medicine that they need

来维系生命和健康——

to survive and to thrive.

来创造一个激进的药物供给体系。

I do not pretend to have all of the answers

我并不是说，我们有办法解决

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

我们医疗保健系统中所有的问题。

But getting medications to the millions of people

但为数百万人提供药物，

who need it to live a healthy life,

让他们能够活得健康，

saving medicine to save lives --

避免药物被销毁的同时 又能拯救生命——

that is something we can do today.

这就是我们今天能做到的事情。

Thank you.

谢谢。