ABOUT THE SPEAKER
Jeanne Pinder - Journalist
Jeanne Pinder asks why it's so hard to make sense of US healthcare bills -- and suggests what we might do about it.

Why you should listen

Lifelong journalist Jeanne Pinder is founder and CEO of ClearHealthCosts, a digital media startup that demands price transparency from the US healthcare system. After taking a buyout from the New York Times, where she worked for more than 20 years, she won a Shark Tank-style competition with her ClearHealthCosts pitch and hasn't looked back.

Since its founding in 2011, ClearHealthCosts has won a slew of journalism grants and prizes and has reported on and crowdsourced health price data in partnership with prestigious newsrooms in New Orleans, Philadelphia, Miami, San Francisco, Los Angeles, New York and elsewhere. This work has won numerous journalism prizes -- a national Edward R. Murrow award, a Society for Professional Journalists public service gold medal and a spot as a finalist for a Peabody Award, among others. 

Pinder and the company have won grants from the John S. and James L. Knight Foundation, the International Women's Media Foundation, the Tow Center for Digital Journalism at Columbia University, the Tow-Knight Center for Entrepreneurial Journalism at the CUNY Graduate School of Journalism and others.   

Previously, in her native Iowa, Pinder worked at The Des Moines Register and the Grinnell Herald-Register, a twice-weekly newspaper that her grandfather bought in 1944.
 
Pinder speaks fluent but rusty Russian. In a previous lifetime, she lived in what was then the Soviet Union, a place almost as mysterious as the US healthcare marketplace.

More profile about the speaker
Jeanne Pinder | Speaker | TED.com
TED Residency

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

Jeanne Pinder: Que pasaría se os custos sanitarios nos EUA fosen transparentes?

Filmed:
1,875,298 views

Nos EUA a mesma análise de sangue pode custar 19 dólares nunha clínica e 522 noutra clínica próxima, e ninguén sabe desta diferenza até que semanas máis tarde recibe a factura. A xornalista Jeanne Pinder di que isto non debería ser así. Construíu unha plataforma que compara os verdadeiros custos dos procedementos médicos e fai pública esta información, amosando os segredos dos prezos dos servizos sanitarios. Saber canto custan con antelación as cousas pode facernos estar máis sans, aforrar diñeiro e, á vez, axudar a reconstruír un sistema roto.
- Journalist
Jeanne Pinder asks why it's so hard to make sense of US healthcare bills -- and suggests what we might do about it. Full bio

Double-click the English transcript below to play the video.

00:12
So, a little while ago,
0
815
2052
Hai algún tempo,
00:14
members of my family
had three bits of minor surgery,
1
2891
3043
familiares meus necesitaron
tres pequenas cirurxías
00:17
about a half hour each,
2
5958
1565
de preto de media hora cada unha.
00:19
and we got three sets of bills.
3
7547
2077
E recibimos tres facturas.
00:22
For the first one, the anesthesia bill
alone was 2,000 dollars;
4
10011
4226
Na primeira, só a anestesia
xa eran 2000 dólares;
00:26
the second one, 2,000 dollars;
5
14261
2380
na segunda outros 2000 dólares;
00:28
the third one, 6,000 dollars.
6
16665
2769
pero na terceira foron 6000 dólares.
00:32
So I'm a journalist.
I'm like, what's up with that?
7
20311
3878
Son xornalista e pensei,
como é posible?
00:37
I found out that I was actually,
for the expensive one,
8
25022
3074
Descubrín que na máis cara
00:40
being charged 1,419 dollars
for a generic anti-nausea drug
9
28120
5819
cobraran 1419 dólares
por un xenérico antináuseas
00:45
that I could buy online
for two dollars and forty-nine cents.
10
33963
3553
que eu mesma podía comprar
por 2,49 dólares.
00:50
I had a long and unsatisfactory
argument with the hospital,
11
38782
3115
Tiven unha discusión longa
e insatisfactoria co hospital,
00:53
the insurer and my employer.
12
41921
2600
o seguro e o meu xefe.
00:56
Everybody agreed
that this was totally fine.
13
44545
2789
Todos estaban de acordo coa factura.
00:59
But it got me thinking, and the more
I talked to people, the more I realized:
14
47855
3663
Canto máis falaba coa xente,
máis conta me daba dunha cousa:
01:03
nobody has any idea
what stuff costs in health care.
15
51542
2707
ninguén sabe de verdade o prezo
que ten a sanidade.
01:06
Not before, during or after
that procedure or test
16
54273
3086
Nin antes, nin durante, nin despois
de calquera proceso médico
01:09
do you have any idea
what it's going to cost.
17
57383
2276
sabemos cal vai ser o seu custo.
01:11
It's only months later that you get
an "explanation of benefits"
18
59683
3435
Só uns meses despois recibes
a "explicación de prestacións"
que non dá demasiadas explicacións.
01:15
that explains exactly nothing.
19
63142
2157
Este pensamento volveu a min
un pouco despois.
01:17
So this came back to me
a little while later.
20
65801
2604
01:20
I had volunteered for a buyout
from the New York Times,
21
68429
2606
Ofrecinme para unha saída voluntaria
do New York Times
01:23
where I had worked for more than
20 years as a journalist.
22
71059
2833
no que traballara como xornalista
máis de 20 anos.
Estaba xa pensando no meu seguinte paso.
01:26
I was looking for my next act.
23
74254
2093
01:28
It turned out that next act
was to build a company
24
76705
2645
E este novo paso foi crear unha empresa
01:31
telling people what stuff costs
in health care.
25
79374
2376
que dixera cal é o custo
dos coidados sanitarios.
01:34
I won a "Shark Tank"-type
pitch contest to do just that.
26
82128
3306
E gañei un concurso, tipo Shark Tank,
para facer xusto iso.
Os custos da sanidade eran case o 18%
do PIB o ano pasado
01:37
Health costs ate up almost 18 percent
of our gross domestic product last year,
27
85826
4272
01:42
but nobody has any idea what stuff costs.
28
90122
2713
pero ninguén sabe canto
custan as cousas.
Pero, e se o soubésemos?
01:45
But what if we did know?
29
93225
1682
01:48
So we started out small.
30
96145
1659
E comezamos por un pequeno proxecto.
01:49
We called doctors and hospitals
31
97828
1745
Chamamos a médicos e a hospitais
01:51
and asked them what they would accept
as a cash payment for simple procedures.
32
99597
4493
e preguntamos se en procedementos
simples aceptarían pago en efectivo.
01:57
Some people were helpful.
33
105075
1790
Algunhas persoas quixeron axudar.
01:58
A lot of people hung up on us.
34
106889
1853
Outras colgaban.
02:00
Some people were just plain rude.
35
108766
2111
E algunhas outras enfadáronse.
02:02
They said, "We don't know,"
36
110901
1922
Dicían: "Non sabemos"
02:04
or, "Our lawyers won't
let us tell you that,"
37
112847
2542
ou "os nosos avogados non nos deixan
falar diso".
02:07
though we did get a lot of information.
38
115899
1874
E inda así conseguimos moita información.
02:10
We found, for example,
that here in the New York area,
39
118207
2674
Descubrimos, por exemplo,
que aquí en Nova York
02:12
you could get an echocardiogram
for 200 dollars in Brooklyn
40
120905
4090
podes facer un ecocardiograma
por preto de 200 $ en Brooklyn
ou por 2150 $ en Manhattan,
estando a moi poucos quilómetros.
02:17
or for 2,150 dollars in Manhattan,
just a few miles away.
41
125019
4970
02:22
New Orleans, the same simple blood test,
42
130961
2519
En Nova Orleáns a mesma
análise de sangue sinxela
02:25
19 dollars over here,
43
133504
2272
19 $ nun lugar e 522 $
noutro moi preto.
02:27
522 dollars just a few blocks away.
44
135800
3205
02:31
San Francisco, the same MRI,
45
139755
2715
En San Francisco, 475 $
por unha resonancia magnética
02:34
475 dollars
46
142494
2317
02:36
or 6,221 dollars just 25 miles away.
47
144835
4860
ou 6221 $ noutro lugar a só 40 km.
02:42
These pricing variations existed
for all the procedures
48
150822
3268
Estas diferenzas de prezo existen
en todos os procedementos
e en todas as cidades que enquisamos.
02:46
and all the cities that we surveyed.
49
154114
2045
Entón empezamos a preguntarlle á xente
polas súas facturas médicas.
02:49
Then we started to ask people
to tell us their health bills.
50
157165
2853
02:52
In partnership with public radio station
WNYC here in New York,
51
160512
3753
En colaboración coa radio pública
de aquí, de Nova York,
02:56
we asked women to tell us
the prices of their mammograms.
52
164289
2932
pedímoslles ás mulleres que nos deran
os prezos das súas mamografías.
02:59
People told us nobody would do that,
that it was too personal.
53
167624
3279
Dicíannos que ningunha o faría,
que era demasiado persoal.
Pero en tres semanas,
03:03
But in the space of three weeks,
54
171490
1779
400 mulleres falaran con nós
dos seus prezos.
03:05
400 women told us about their prices.
55
173293
3171
Nese momento, comezamos a promover
03:09
Then we started to make it easier
for people to share their data
56
177272
3084
que a xente compartise os seus datos
na nosa plataforma en Internet.
03:12
into our online searchable database.
57
180380
2702
É unha mestura entre kayak.com e
a aplicación Waze pero para a saúde.
03:15
It's sort of like a mash-up of Kayak.com
and the Waze traffic app for health care.
58
183106
5138
03:20
(Laughter)
59
188268
1049
(Risas)
03:21
We call it a community-created
guide to health costs.
60
189341
2907
Chamámoslle guía comunitaria
dos custos da saúde.
03:24
Our survey and crowdsourcing work
grew into partnerships
61
192272
2635
O noso traballo de enquisa
e colaboración aberta
medrou ao asociarnos
con redaccións de todo o país:
03:26
with top newsrooms nationwide --
62
194931
1866
03:28
in New Orleans, Philadelphia,
63
196821
2072
Nova Orleáns, Filadelfia,
03:30
San Francisco, Los Angeles,
Miami and other places.
64
198917
3711
San Francisco, Os Ánxeles,
ou Miami, entre outros.
03:35
We used the data to tell stories
about people who were suffering
65
203212
3923
Usamos os datos para contar as historias
das persoas que sofren,
03:39
and how to avoid that suffering,
to avoid that "gotcha" bill.
66
207159
3820
como evitar isto e tamén evitar
estas facturas.
03:44
A woman in New Orleans saved
nearly 4,000 dollars using our data.
67
212579
3842
Unha muller en Nova Orleáns aforrou
uns 4000 $ grazas aos nosos datos.
03:49
A San Francisco contributor
saved nearly 1,300 dollars
68
217147
3311
Un colaborador de San Francisco,
case 1300 $
03:52
by putting away his insurance card
69
220482
1801
renunciando á súa póliza de seguros
03:54
and paying cash.
70
222307
1450
e facendo o pago en metálico.
03:56
There are a lot of people
who are going to in-network hospitals
71
224513
3028
Hai moitas persoas que van
á súa rede de hospitais
pero que reciben facturas de fóra dela.
03:59
and getting out-of-network bills.
72
227565
1629
04:01
And then there was the hospital
that continued to bill a dead man.
73
229838
3209
E mesmo había un hospital que facturaba
a un home xa finado.
04:05
We learned that thousands of people
wanted to tell us their prices.
74
233071
3152
Soubemos que milleiros de persoas
nos querían dicir os seus prezos.
04:08
They want to learn what stuff costs,
75
236247
1729
Querían saber o que custan as cousas,
04:10
find out how to argue a bill,
76
238000
1634
saber como discutir unha factura,
04:11
help us solve this problem that's hurting
them and their friends and families.
77
239658
4270
axudar a solucionar un problema
que lles afecta a eles,
aos seus amigos e familias.
Falabamos con persoas que tiveran que
vender o coche
04:15
We talked to people who had
to sell a car to pay a health bill,
78
243952
2976
para pagar as facturas,
que entraran en quebra,
04:18
go into bankruptcy,
79
246952
1387
04:20
skip a treatment because of the cost.
80
248363
2273
ou que deixaran o tratamento
polo alto prezo.
Imaxinen que poidan pagar o diagnóstico
04:23
Imagine if you could afford the diagnosis
81
251230
2660
pero non a cura.
04:25
but not the cure.
82
253914
1516
Comezamos unha enorme conversa
sobre os custos
04:29
We set off a huge conversation about costs
83
257589
2162
04:31
involving doctors and hospitals, yes,
but also their patients,
84
259775
3751
con médicos e hospitais, si,
pero tamén cos doentes.
04:35
or as we like to call them, people.
85
263550
2191
Ou como nos gusta chamalos, xente.
04:37
(Laughter)
86
265765
1904
(Risas)
Cambiamos a política.
04:41
We changed policy.
87
269519
1151
04:42
A consumer protection bill
that had been stalled
88
270694
2326
Un proxecto de lei de protección
ao consumidor,
parado 10 anos no lexislativo de Luisiana
04:45
in the Louisiana legislature for 10 years
89
273044
2123
04:47
passed after we launched.
90
275191
1842
foi aprobado tras o noso lanzamento.
Sexamos sinceros,
04:50
Let's face it:
91
278797
1151
04:51
this huge, slow-rolling
public health crisis
92
279972
2395
esta gran e lenta crise
da sanidade pública
é unha emerxencia nacional.
04:54
is a national emergency.
93
282391
1867
E non creo que o goberno
nos vaia axudarnos no curto prazo.
04:56
And I don't think government's
going to help us out anytime soon.
94
284649
3146
05:00
But what if the answer was really simple:
95
288652
2148
Mais, e se a resposta fose sinxela
05:02
make all the prices public all the time.
96
290824
3020
como facer que todos os prezos
fosen públicos?
05:06
Would our individual bills go down?
Our health premiums?
97
294605
3666
Baixarían as facturas? As primas?
Teñan isto claro.
05:11
Be really clear about this:
98
299749
1722
05:13
this is a United States problem.
99
301495
1910
É un problema dos EUA.
En boa parte do mundo desenvolvido
05:15
In most of the rest
of the developed world,
100
303429
2055
05:17
sick people don't have
to worry about money.
101
305508
2759
as persoas non se teñen
que preocupar polo diñeiro.
05:20
It's also true that price transparency
will not solve every problem.
102
308291
4018
Tamén é certo que a transparencia
nos prezos non o resolve todo.
Aínda haberá tratamentos caros
05:24
There will still be expensive treatments,
103
312333
2806
e unha gran fricción
no noso sistema de seguros.
05:27
huge friction from our insurance system.
104
315163
2692
Haberá fraude aínda
05:29
There will still be fraud
105
317879
1680
e un problema masivo
de sobretratamento e sobrediagnóstico.
05:31
and a massive problem
with overtreatment and overdiagnosis.
106
319583
3371
05:35
And not everything is shoppable.
107
323537
2615
E non todo se compra con diñeiro.
Non todo o mundo quere a apendicectomía
05:38
Not everybody wants
the cheapest appendectomy
108
326176
2454
ou o tratamento para o cancro
máis baratos.
05:40
or the cheapest cancer care.
109
328654
1851
05:43
But when we talk
about these clear effects,
110
331513
2155
Mais cando falamos destes efectos claros,
05:45
we're looking at a real issue
that's actually very simple.
111
333692
3527
vemos un problema que é
realmente moi sinxelo.
05:50
When we first started calling for prices,
112
338394
1954
Cando comezabamos a chamar
para pedir prezos,
05:52
we actually felt like
we were going to be arrested.
113
340372
2479
sentíamos que nos ían arrestar.
05:55
It seemed kind of transgressive
to talk about medicine and health care
114
343162
3592
Parecía infrinxir algunha norma falar
de medicina e de asistencia sanitaria
na mesma frase,
05:58
in the same breath,
115
346778
1345
mais resultou liberador.
06:00
and yet it became liberating,
116
348147
1552
06:01
because we found not only data
117
349723
2312
Non só atopamos datos
senón tamén boas persoas no sistema
06:04
but also good and honest people
out there in the system
118
352059
2641
que queren axudar á xente
a ter os coidados que precisan
06:06
who want to help folks
get the care they need
119
354724
2144
06:08
at a price they can afford.
120
356892
1418
e a un prezo que poidan pagar.
06:11
And it got easier to ask.
121
359631
1875
Fíxose máis fácil preguntar.
06:13
So I'll leave you with some questions.
122
361530
2081
Así que acabo con algunhas cuestións.
06:15
What if we all knew what stuff cost
in health care in advance?
123
363635
3329
E se soubésemos todos o que custan
os coidados médicos por adiantado?
06:19
What if, every time
you Googled for an MRI,
124
367983
3187
Que pasaría se cando buscase en Internet
"resonancia magnética"
06:23
you got drop-downs telling you
where to buy and for how much,
125
371194
3400
se despregase un menú coa información
sobre onde comprala e os prezos,
06:26
the way you do when
you Google for a laser printer?
126
374618
2457
igual que pasa cando buscas
unha impresora láser?
06:30
What if all of the time and energy
and money that's spent hiding prices
127
378094
4244
Que pasaría se todo o tempo, enerxía e
diñeiro que se gasta ocultando os prezos
06:34
was squeezed out of the system?
128
382362
1984
se eliminase do sistema?
06:37
What if each one of us could pick
the $19 test every time
129
385188
3199
Que pasaría se cada un puidese
escoller a proba de 19 $
06:40
instead of the $522 one?
130
388411
2337
en lugar da de 522 $?
06:43
Would our individual bills go down?
131
391384
1738
Baixarían as nosas facturas?
06:45
Our premiums?
132
393146
1403
As nosas primas do seguro?
06:46
I don't know, but if you don't ask,
you'll never know.
133
394573
2848
Non o sei, mais se non se pregunta
nunca o saberemos.
06:49
And you might save a ton of money.
134
397445
1870
E cada un poderíamos aforrar
moitos cartos.
06:51
And I've got to think that a lot of us
and the system itself
135
399767
3539
E teño que pensar que moitos de nós,
e o propio sistema, seriamos máis sans.
06:55
would be a lot healthier.
136
403330
1582
06:57
Thank you.
137
405676
1188
Grazas.
(Aplausos)
06:58
(Applause)
138
406888
3828
Translated by Miguel Guisantes
Reviewed by Xusto Rodriguez

▲Back to top

ABOUT THE SPEAKER
Jeanne Pinder - Journalist
Jeanne Pinder asks why it's so hard to make sense of US healthcare bills -- and suggests what we might do about it.

Why you should listen

Lifelong journalist Jeanne Pinder is founder and CEO of ClearHealthCosts, a digital media startup that demands price transparency from the US healthcare system. After taking a buyout from the New York Times, where she worked for more than 20 years, she won a Shark Tank-style competition with her ClearHealthCosts pitch and hasn't looked back.

Since its founding in 2011, ClearHealthCosts has won a slew of journalism grants and prizes and has reported on and crowdsourced health price data in partnership with prestigious newsrooms in New Orleans, Philadelphia, Miami, San Francisco, Los Angeles, New York and elsewhere. This work has won numerous journalism prizes -- a national Edward R. Murrow award, a Society for Professional Journalists public service gold medal and a spot as a finalist for a Peabody Award, among others. 

Pinder and the company have won grants from the John S. and James L. Knight Foundation, the International Women's Media Foundation, the Tow Center for Digital Journalism at Columbia University, the Tow-Knight Center for Entrepreneurial Journalism at the CUNY Graduate School of Journalism and others.   

Previously, in her native Iowa, Pinder worked at The Des Moines Register and the Grinnell Herald-Register, a twice-weekly newspaper that her grandfather bought in 1944.
 
Pinder speaks fluent but rusty Russian. In a previous lifetime, she lived in what was then the Soviet Union, a place almost as mysterious as the US healthcare marketplace.

More profile about the speaker
Jeanne Pinder | Speaker | TED.com