Advanced Conversation with Jennifer on Health Care in the U.S. - By JenniferESL
Transcript
00:00 | Hi I'm jennifer from english with jennifer and I'm ready | |
00:04 | to share another current issue . If you'd like to | |
00:07 | communicate more confidently and effectively in english , be sure | |
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00:21 | of my channel . There are three different levels . | |
00:24 | Click to view all the perks in this video . | |
00:29 | I'm going to share vocabulary and information related to health | |
00:32 | care in the US . I'll do my best to | |
00:35 | give a balanced presentation . It's not my goal to | |
00:38 | promote a political agenda . As an english language teacher | |
00:43 | , I'm here to offer the language support that learners | |
00:46 | will need to follow and participate in discussions about health | |
00:50 | care . So are you ready ? Let's get started | |
01:00 | . Mhm . Health care refers to the services you | |
01:06 | get to prevent and treat medical problems . When we | |
01:10 | talk about our health were referring to our physical and | |
01:13 | mental well being in the U . S . We | |
01:18 | have many medical professionals and in general health care professionals | |
01:22 | who provide services for our physical and mental health . | |
01:28 | A health care provider isn't necessarily a doctor or a | |
01:32 | nurse . Healthcare providers include therapists , counselors and various | |
01:37 | technicians . Note that health care can be written as | |
01:43 | one word or two , just be consistent in your | |
01:46 | own writing . The health care system in the U | |
01:51 | . S . Can be confusing . There are different | |
01:54 | ways you can get medical treatment and basically any visit | |
01:58 | to any medical center involves paperwork and some form of | |
02:02 | payment by someone . Hospitals , clinics and private practices | |
02:08 | need to get paid . Even after you get treatment | |
02:12 | , you may have to worry about completing more paperwork | |
02:15 | and making additional payments . Let's start with a fundamental | |
02:21 | question is healthcare a basic human right or a privilege | |
02:26 | ? A human right is something everyone should have . | |
02:29 | A privilege is a benefit , something good and useful | |
02:34 | , but not everyone receives it . If we talk | |
02:38 | about getting a basic education , for example , every | |
02:42 | child in the us has access to public schools , | |
02:45 | it's their right to get an education from Kindergarten through | |
02:48 | 12th grade . Our public schools are paid for with | |
02:53 | tax dollars . If you are a U . S | |
02:55 | . Citizen or resident you pay local state and federal | |
03:00 | taxes . Whether you have school aged Children or not | |
03:04 | , tax money funds , the public school system , | |
03:07 | families don't pay tuition at public schools . Now , | |
03:13 | with healthcare , we don't really have a free healthcare | |
03:15 | system for everyone . You'll hear terms like national health | |
03:20 | care system or universal healthcare . We don't have that | |
03:24 | kind of program where services are free for everyone . | |
03:30 | However , tax dollars are used to pay for federal | |
03:34 | and state medical programs that some people participate in . | |
03:38 | I'll explain more a bit later . Yeah . Yeah | |
03:55 | . Mhm . I'd say the majority of americans have | |
04:01 | health insurance and most often it's employer based insurance . | |
04:06 | That means that people have health insurance policies through their | |
04:10 | employers . The policy is the agreement in terms health | |
04:16 | insurance is a benefit , employers can give employers pay | |
04:21 | most of the cost of the policy and then the | |
04:24 | remaining money is deducted or taken out of your paycheck | |
04:30 | . A health insurance policy for one employee can cover | |
04:34 | that individual or an entire family . For example , | |
04:38 | my husband has a full time job with a company | |
04:42 | . Health insurance is one of his benefits . He's | |
04:45 | the policy holder as his spouse . I'm insured and | |
04:50 | our Children are eligible , dependants eligible means they meet | |
04:55 | all the requirements to be considered dependence , so they're | |
04:59 | insured too . We can talk about being insured or | |
05:04 | covered . It's the same thing . Our family has | |
05:08 | insurance , we have coverage . Those are the new | |
05:12 | ones , Even as a benefit . Health insurance is | |
05:18 | expensive . I read that the average company contributes 70-80 | |
05:23 | towards health insurance . The employee pays the rest if | |
05:29 | you have a family plan more is deducted from your | |
05:33 | paycheck . Even after those deductions , you still have | |
05:37 | copays and deductibles . Getting confused by all the terminology | |
05:44 | . We can get confused too . Sometimes the premium | |
05:48 | is the total cost . It's the amount you pay | |
05:51 | in order to have a health insurance policy . When | |
05:55 | you hear people talk about high premiums or premiums going | |
05:59 | up there , talking about high costs or costs going | |
06:03 | up . As I said , the employer usually covers | |
06:07 | most of the premium . The rest you have to | |
06:10 | contribute as the employee . It's taken out of your | |
06:13 | paycheck copay is short for co payment . This is | |
06:20 | the amount of money that you have to pay when | |
06:22 | you visit a health care provider and receive some kind | |
06:26 | of service . A copay is in addition to your | |
06:31 | premium , for example , it maybe 10 to $25 | |
06:36 | when you visit your regular doctor , who we call | |
06:39 | your primary care physician or your primary care provider . | |
06:47 | But your copay to see a specialist will be even | |
06:50 | higher , maybe $30 or $50 . And if you | |
06:55 | have to go to the emergency room , your copay | |
06:58 | maybe as much as 12 or even $300 . Some | |
07:05 | argue that copay served at least one purpose and that's | |
07:08 | to reduce the use of services . If you know | |
07:11 | you have a copay then you're not so quick to | |
07:14 | seek medical attention for every little problem . We also | |
07:21 | have copays for medicine at the pharmacy . Your health | |
07:24 | insurance policy will usually cover a larger percentage of the | |
07:28 | cost . Some of my co pays are as low | |
07:31 | as $7 . Others $70 . Then there are things | |
07:38 | that you need but they're not covered by insurance like | |
07:41 | a back brace or vitamins you have to pay out | |
07:46 | of pocket . These things are an out of pocket | |
07:49 | expense . For example there's a little bottle of vitamins | |
07:53 | that I need . It lasts for about three months | |
07:56 | . Each bottle is over $100 that's not covered by | |
08:00 | my insurance deductibles are not to be confused with premiums | |
08:08 | . The premium is the total cost of your plan | |
08:11 | . A deductible is the amount you have to pay | |
08:14 | before your insurance will start covering your medical expenses . | |
08:21 | Maybe you have a $500 deductible . That means you | |
08:24 | have to spend $500 before the insurance company starts covering | |
08:29 | expenses . You might have a high premium with a | |
08:35 | low deductible or a low premium with a high deductible | |
08:39 | . In short health insurance companies are running a business | |
08:43 | and they have to make money . Yeah . Yeah | |
08:50 | . Mhm . Yeah . Yeah . Yeah . With | |
09:03 | premiums deductibles co pays and out of pocket expenses . | |
09:07 | You don't want to get sick . It's expensive . | |
09:11 | Well the good news is that many preventive health care | |
09:14 | services are covered under a plan . For example , | |
09:18 | we don't have copays when we get our flu shot | |
09:20 | and we don't pay extra when we go for our | |
09:24 | yearly eye exam or when we go for dental cleanings | |
09:28 | twice a year . Keeping people healthy , avoids bigger | |
09:32 | costs right ? But everyone gets sick now and then | |
09:37 | injuries happen . Health problems arise especially as you get | |
09:41 | older . What do you do if you don't have | |
09:45 | private health insurance ? We have one federal program called | |
09:51 | Medicare . It's mainly for the elderly . So if | |
09:54 | you're over 65 you're entitled to Medicare . And if | |
09:59 | you have some kind of disability you can get coverage | |
10:02 | from Medicare . Those over 65 likely contributed earlier when | |
10:09 | they were younger and paid taxes . So coverage and | |
10:14 | retirement makes sense . Most everyone agrees . Even on | |
10:19 | Medicare you'll have premiums deductibles and co pays at least | |
10:24 | that's what I understand . If you can't afford there's | |
10:28 | additional expenses . Then there's Medicaid . Medicaid is another | |
10:33 | government program . It's a federal and state program that | |
10:37 | offers financial assistance to low income patients . Yeah . | |
10:49 | Yeah mm . Mhm . In the U . S | |
10:59 | . We have a law that allows everyone to get | |
11:02 | medical treatment in an emergency situation regardless of their ability | |
11:07 | to pay mm . Tala stands for Emergency Medical Treatment | |
11:13 | and Labour Act . It's a law that says you | |
11:16 | have to give a patient any patient access to emergency | |
11:21 | services . So here's how I understand the law . | |
11:26 | Under um tele Medicare participating hospitals with emergency services must | |
11:31 | screen all patients coming to the emergency room . The | |
11:35 | er then if there is an emergency condition , the | |
11:40 | hospital must treat and stabilize the patient . So there | |
11:44 | should be no patient dumping . But um Tala does | |
11:47 | not necessarily require ongoing care . Once a hospital has | |
11:52 | met its um Talal obligations , it's no longer obligated | |
11:56 | to provide services to that patient . The challenge with | |
12:02 | this kind of law is funding Costs and charges are | |
12:07 | two different things . Hospital may not charge a patient | |
12:12 | for a service , but there's still a cost to | |
12:15 | the hospital . How much can be given for free | |
12:19 | before hospital doesn't have enough money to cover its expenses | |
12:24 | and pay its employees . The government has a set | |
12:29 | amount of money for health care . How should that | |
12:32 | money be managed ? The um tele law ties into | |
12:37 | the issue of ethics , ethics has to do with | |
12:40 | what is morally right and wrong . Health care is | |
12:45 | a business in any business faces the challenge of managing | |
12:49 | finances while still being ethical . But can a healthcare | |
12:54 | facilities stay in business if too many services are given | |
12:57 | for free ? Yeah . Mm . Yeah . Health | |
13:17 | care almost always makes the news headlines . There are | |
13:20 | often new policies , new proposals and new controversial cases | |
13:25 | that make us question how we can improve our current | |
13:28 | health care system . Some believe the current system has | |
13:33 | some good aspects and it simply needs to be improved | |
13:36 | and fixed in certain areas . Others say the current | |
13:41 | system doesn't work . It needs to be replaced with | |
13:44 | universal healthcare for all residents in the US . You'll | |
13:48 | hear these people talk about the need for a complete | |
13:51 | overhaul . That's a complete change . Many of the | |
13:58 | 2020 . US . Democratic presidential candidates have very progressive | |
14:02 | proposals . A number of them want Medicare for all | |
14:06 | , a government run program . This would mean no | |
14:11 | more private insurance companies . Americans would pay taxes and | |
14:15 | taxes would cover medical services for everyone under Medicare for | |
14:21 | all hospitals , clinics and pharmacies would receive payment from | |
14:25 | one pair the government . So you'll hear the term | |
14:29 | single payer healthcare . Some candidates are proposing more moderate | |
14:36 | versions of this reform so that americans could keep their | |
14:39 | health insurance coverage through their employers and still work with | |
14:44 | private insurance companies . So some are proposing Medicare for | |
14:50 | all who want it . You'd still have the option | |
14:53 | to work with a private insurer , you'd still have | |
14:55 | the option to keep insurance through your employer . The | |
15:01 | public option allows people to buy in if they want | |
15:04 | to . At least . That's how I understand it | |
15:08 | again . Health care is confusing so I apologize for | |
15:11 | any inaccuracies . I'm explaining the concepts as I understand | |
15:16 | them . We had a degree of reform under President | |
15:20 | Obama when the Affordable Care Act was created , that | |
15:24 | was back in 2010 and it was created to expand | |
15:28 | coverage to those who were without any . One of | |
15:33 | the controversial ideas has been to require or mandate that | |
15:37 | everyone has to have insurance . If you don't buy | |
15:40 | in , you have to pay a penalty . The | |
15:44 | logic is that everyone has to buy in or pay | |
15:47 | the penalty . So there should be enough money to | |
15:50 | cover the treatment of those who need it . But | |
15:55 | this is one point that causes arguments . The young | |
15:58 | and healthy have less need for health insurance and medical | |
16:01 | services in general . So they may wish to live | |
16:04 | without insurance and avoid unnecessary costs . Is it right | |
16:09 | to create a universal health care system and require everyone | |
16:13 | to participate ? Mm mm . Yeah . So I've | |
16:33 | mentioned the Medicare for All plan . It's a universal | |
16:36 | health care system and there are at least two ways | |
16:39 | of looking at it . On the one hand , | |
16:42 | everyone gets coverage , those who need medical services received | |
16:46 | those services . On the other hand , everyone is | |
16:49 | required to buy in to contribute tax dollars . So | |
16:54 | essentially it also means that healthy people are paying for | |
16:57 | others medical expenses , arguments arise over how much each | |
17:04 | person should contribute . Should people with higher incomes pay | |
17:08 | more ? How much more ? What's fair ? Low | |
17:13 | income households are unable to contribute as much . Yet | |
17:16 | households with a higher income might argue that they are | |
17:20 | being asked to shoulder too much of the burden . | |
17:23 | This is especially true of the middle or upper middle | |
17:26 | class . Some politicians argue that although people would be | |
17:31 | paying higher taxes , their health care costs would be | |
17:34 | lower . With things balance out . In the end | |
17:38 | , would they be better ? Would they be worse | |
17:43 | ? Plenty of residents and citizens have come from other | |
17:46 | countries . Countries with state run healthcare systems and there | |
17:50 | are mixed opinions . On the one hand , countries | |
17:54 | with universal healthcare systems don't have to deal with all | |
17:58 | the paperwork and billing issues that we americans do because | |
18:02 | of our private insurance companies . On the other hand | |
18:05 | , there are stories of longer wait times at the | |
18:08 | doctor's office or just to schedule appointments and services . | |
18:14 | There's a question of quality care . Would a government | |
18:18 | run healthcare system be able to pay medical professionals well | |
18:23 | if doctors and nurses and other health care professionals aren't | |
18:27 | paid well , will they have enough incentive to perform | |
18:31 | well every day and with every patient I'll end here | |
18:38 | . There's a lot to think about . I welcome | |
18:40 | you to post opinions and the comments but I ask | |
18:43 | that everyone expressed ideas respectfully . Let's be open to | |
18:47 | hearing different points of view as we continue this discussion | |
18:53 | . If you found this lesson useful then please like | |
18:56 | this video and don't forget to subscribe . If you'd | |
18:59 | like to talk about health care or any other topic | |
19:02 | with me one on one , you can book a | |
19:04 | 30 minute lesson . The link is in the video | |
19:07 | description as always . Thanks for watching and happy studies | |
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19:33 | Mm |
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