WEBVTT - Health Care Systems Around the World 0:00:00.280 --> 0:00:02.840 Brought to you by the reinvented two thousand twelve camera. 0:00:03.160 --> 0:00:07.520 It's ready. Are you welcome to stuff you should know 0:00:08.160 --> 0:00:16.439 from house Stuff Works dot com? Hey, and welcome to 0:00:16.480 --> 0:00:19.320 the podcast. I'm Josh Clark. With me as always this 0:00:19.520 --> 0:00:23.320 Charles W. Chuck Bryant sliding into my seat and with 0:00:23.400 --> 0:00:29.120 us is Dr Molly Edmonds, m D esquire PhD LLC. Right, Yes, 0:00:29.320 --> 0:00:32.159 that get all of those. Molly. Uh. This is uh 0:00:32.440 --> 0:00:36.480 the final installment of our four part healthcare reform suite. 0:00:36.680 --> 0:00:39.000 We've reached the end of the final countdown. Can I 0:00:39.040 --> 0:00:42.040 just say, speaking for Molly and I thank god? Yeah, 0:00:42.040 --> 0:00:44.080 you're not speaking for me to Do you think I 0:00:44.240 --> 0:00:47.200 like this? Chuck? Are you ready to move on? Yeah? Okay, okay. 0:00:47.240 --> 0:00:50.120 So we've talked about healthcare reform. First of all, Molly, 0:00:50.240 --> 0:00:54.160 what was that statistic that that you mentioned, um a 0:00:54.240 --> 0:00:57.400 long time ago in a in a podcast far far away, 0:00:57.840 --> 0:01:00.920 where you said, like only one in a Americans think 0:01:01.000 --> 0:01:03.959 that the health care system in the US needs reforming. 0:01:05.080 --> 0:01:08.120 Are happy with their healthcare as it is. So. Um, 0:01:09.000 --> 0:01:12.840 what we've kind of deconstructed is why healthcare form is 0:01:12.880 --> 0:01:15.840 even on the table. We've talked about the uninsured. Right. 0:01:16.360 --> 0:01:20.240 We've talked about the fact that UM that America has 0:01:20.920 --> 0:01:27.960 UM really really terrible like mortality rates or UM disease rates, 0:01:28.280 --> 0:01:31.320 chronic disease rates, that kind of stuff. UM. So that 0:01:31.400 --> 0:01:34.760 in and of itself makes the health care system worth fixing. Right. 0:01:34.959 --> 0:01:36.920 But one thing that hasn't been brought up, and I 0:01:37.000 --> 0:01:39.280 haven't seen it brought up in coverage too much, is 0:01:39.319 --> 0:01:41.600 the fact that our health care system is actually keeping 0:01:41.760 --> 0:01:44.440 us from competing as well as we could on a 0:01:44.520 --> 0:01:48.920 global scale, right, which is why we would compare ourselves 0:01:49.000 --> 0:01:51.400 to other health care systems around the world. You know. 0:01:51.480 --> 0:01:53.960 The thing is that no one in this country wants 0:01:54.000 --> 0:01:56.160 to become like any other system in the world. But 0:01:56.240 --> 0:01:57.760 I don't know if you could find anyone who lives 0:01:57.760 --> 0:01:59.440 in another country who wants to trade place with an 0:01:59.440 --> 0:02:02.200 American that comes to their health care. We'll put We'll 0:02:02.240 --> 0:02:06.120 put let's talk about competitiveness and the health care reform 0:02:06.200 --> 0:02:10.480 system via Dr Michael Royson, who you guys might remember, right, Yes, 0:02:10.840 --> 0:02:14.240 what is he? Dr Roysen is the chief Wellness officer 0:02:14.360 --> 0:02:18.079 of the Cleveland Clinic and my hero and the co 0:02:18.360 --> 0:02:21.680 author of UM The You the Owner's Manual book series. 0:02:21.800 --> 0:02:24.160 Right with Dr Oz here is what he had to say, 0:02:25.240 --> 0:02:32.320 because healthcare is a expensive thing in America, and that 0:02:32.639 --> 0:02:37.760 we need reform for the economy to function, for jobs 0:02:37.919 --> 0:02:41.120 to be created, and for us to be competitive with 0:02:41.320 --> 0:02:44.239 Europe and Asia four jobs, and for us to not 0:02:44.480 --> 0:02:47.480 worry about a following standard of living, and for people 0:02:47.560 --> 0:02:50.519 to not worry, not have the stress of worrying about 0:02:50.960 --> 0:02:53.160 will there be health care for me when I need 0:02:53.240 --> 0:02:57.320 it that I can afford? Okay, So, if we're going 0:02:57.400 --> 0:03:00.840 to keep up with Europe and Asia, like Dr Reason suggested, 0:03:00.919 --> 0:03:04.080 we could by reforming our health care system. Um, maybe 0:03:04.120 --> 0:03:07.800 we should kind of peek in on what other countries 0:03:07.840 --> 0:03:11.120 around the world are doing, whether for better or for worse. Um, Malla, 0:03:11.160 --> 0:03:13.680 you wrote this article ten health care systems around the world, right, 0:03:13.720 --> 0:03:15.440 which is up on the site. Yeah, it's sort of 0:03:15.560 --> 0:03:17.519 I think, a virtual hot air balloon ride through the 0:03:17.560 --> 0:03:19.720 world of health care. It was. It was a delightful 0:03:19.760 --> 0:03:24.880 one too. It was beautiful, like so many bloody bandages. Um, so, 0:03:25.400 --> 0:03:28.440 where was there any particular health care system that struck 0:03:28.520 --> 0:03:34.760 you as arguably better than the US or better than 0:03:34.800 --> 0:03:37.240 all the other ones? Actually we wait, wait, let's talk 0:03:37.240 --> 0:03:44.280 about France. France transition. Oh gotcha get it? Yeah, I do. 0:03:44.440 --> 0:03:51.000 Now we mean yes, it's like, okay, France, Uh, they 0:03:51.040 --> 0:03:53.360 apparently have the best health care in the world, I 0:03:53.440 --> 0:03:56.080 mean World Health Organization. Right. Yeah, it's hard to argue 0:03:56.120 --> 0:04:00.720 with who. Moving on then, no, that's actually um, I 0:04:00.800 --> 0:04:04.160 think just because it's become a relic in the healthcare 0:04:04.160 --> 0:04:08.440 reform debate in the United States that who um two 0:04:08.520 --> 0:04:13.760 thousand report of a hundred countries healthcare system rankings is controversial. 0:04:13.840 --> 0:04:16.520 I think we should say that. Everybody's like, oh, well 0:04:16.600 --> 0:04:19.640 who said that? So okay, it must be true. Um. 0:04:19.760 --> 0:04:22.720 But again, you can pick apart anything. But so let's 0:04:22.760 --> 0:04:25.520 just stick to the fact that France was rated number 0:04:25.560 --> 0:04:27.880 one in the year two thousand by the World Health 0:04:28.000 --> 0:04:32.560 Organizations rankings of a countries. Right, right, So all French 0:04:32.640 --> 0:04:36.600 citizens will put in money based on their income, you 0:04:36.680 --> 0:04:39.240 can't opt out of it, and then in return they'll 0:04:39.279 --> 0:04:42.640 get about seventy of their healthcare paid for by the government. Um, 0:04:42.720 --> 0:04:45.120 you can get same day appointments, you can choose any 0:04:45.160 --> 0:04:48.120 healthcare provider you'd like. Um. But okay, so we said, 0:04:48.160 --> 0:04:50.520 s how do they pay for the other thirty percent? 0:04:51.000 --> 0:04:53.680 They all have supplemental insurance with either a public or 0:04:53.720 --> 0:04:56.800 a private plan, and that is more similar to how 0:04:56.839 --> 0:04:58.920 we have in the U S where that supplemental plan 0:04:59.520 --> 0:05:02.560 might come mere employer. So there there are a couple 0:05:02.600 --> 0:05:05.320 of problems with the French system, and it's not flawless. 0:05:06.160 --> 0:05:07.920 There is no flawless plan. We should go ahead and 0:05:07.960 --> 0:05:12.160 say that, you lie. Um. I saw one guy that said, 0:05:12.240 --> 0:05:13.640 I said it like this. He said, it's sort of 0:05:13.720 --> 0:05:17.560 like medicare for everybody with the French system. Yeah, I 0:05:17.640 --> 0:05:19.280 got it, and he was he was a pro. So 0:05:19.680 --> 0:05:23.120 they make up the other thirty with private plans, right, 0:05:23.240 --> 0:05:25.040 private or republic. And that's the problem is if you 0:05:25.160 --> 0:05:28.159 have money, then you would probably opt for a private plan. 0:05:28.320 --> 0:05:31.040 So some critics would say that the French plan is 0:05:31.120 --> 0:05:34.120 too divided by class. People who want really good care 0:05:34.160 --> 0:05:35.800 and can pay for it, get it. Those who can 0:05:36.080 --> 0:05:38.600 don't write. But they do that in England too. You 0:05:38.640 --> 0:05:41.360 can get also get your private insurance, right yeah, and 0:05:41.760 --> 0:05:44.400 we should say for a kind of a comprehensive rundown 0:05:44.480 --> 0:05:47.000 of England. Molly gave one in the third podcast. Right, 0:05:47.040 --> 0:05:51.240 so we're not gonna talk about this, We're okay. I 0:05:51.279 --> 0:05:52.920 mean it was a nice step on the balloon ride. 0:05:53.200 --> 0:05:57.040 But here's how France got it's awesome writing. Okay, it 0:05:57.160 --> 0:06:02.040 spends personal healthcare while that you spins over twice that, UM, 0:06:02.560 --> 0:06:05.680 so already they're using money pretty well. And if you 0:06:05.760 --> 0:06:07.880 get really sick, like you have just the worst form 0:06:07.920 --> 0:06:10.880 of cancer in the world, everything is paid for. Yeah, 0:06:10.960 --> 0:06:13.000 that's what I saw that your article. In some other 0:06:13.040 --> 0:06:14.920 stuff I read is that if the sicker you are 0:06:15.000 --> 0:06:16.880 in France, the better off you've got it, or the 0:06:16.920 --> 0:06:19.679 easier and quicker your claims will get paid as well. Exactly. 0:06:19.720 --> 0:06:22.400 But it's not just the really sick who benefit. Because UM, 0:06:22.480 --> 0:06:24.480 I think what's cool about Frances they have the lowest 0:06:24.560 --> 0:06:27.919 rate of deaths that could have been prevented. The US 0:06:27.960 --> 0:06:30.600 has the highest number of these preventable deaths that they say, 0:06:30.720 --> 0:06:32.919 or you know, if you had had an early diagnosis 0:06:33.080 --> 0:06:35.320 or if you'd had an early treatment in condition right, 0:06:35.440 --> 0:06:37.640 I did see also in another article I read that UM. 0:06:38.000 --> 0:06:41.400 One of the criticisms criticisms is that there's not great 0:06:41.440 --> 0:06:45.200 coordination between the GPS and the specialist in France. But 0:06:45.760 --> 0:06:48.120 if you're talking about problems, that's not the worst thing 0:06:48.120 --> 0:06:50.000 in the world. That's better than being denied for a 0:06:50.040 --> 0:06:55.480 pre existing condition. I think, wouldn't you say, I wouldn't say, yeah, Um, 0:06:56.200 --> 0:06:58.120 you guys done with France, because I'd like to get 0:06:58.160 --> 0:07:03.800 back in the balloon, okay, and just head on over 0:07:03.920 --> 0:07:07.839 a few kilometers a few clicks, if you will, to Germany, 0:07:11.800 --> 0:07:14.560 which is um out of the out of the healthcare 0:07:14.600 --> 0:07:16.800 systems in the in the article, this one's my favorite, 0:07:16.880 --> 0:07:19.400 and I'm not embarrassed to say that. One of the 0:07:19.440 --> 0:07:23.240 reasons why is because of the ample access to spa 0:07:23.440 --> 0:07:29.760 days and even the public health insurance plans, right and 0:07:29.840 --> 0:07:33.720 there's two hundred of them, correct, and their employer and 0:07:33.880 --> 0:07:37.080 employee funded, right. Yeah. And you know where that comes 0:07:37.160 --> 0:07:42.120 from is actually in three old Otto. Von Bismarck was 0:07:42.240 --> 0:07:46.480 like the spies. He was like, I want some healthcare 0:07:47.000 --> 0:07:49.680 like they had back in the days of guilds. And 0:07:49.880 --> 0:07:52.280 so he is basing all of this off the fact 0:07:52.320 --> 0:07:54.120 that when you were in your medieval guild for being, 0:07:54.200 --> 0:07:59.440 you know, the podcasters guild, the you know clothmaker's guild, 0:07:59.720 --> 0:08:03.000 you know with Germany, that was how they named them. Um, 0:08:03.960 --> 0:08:05.920 they all pay for each other sick time. They all 0:08:06.280 --> 0:08:09.560 got together, and it would be like us saying podcasters, 0:08:09.840 --> 0:08:12.840 let's have to pay for Josh's care when he has 0:08:12.920 --> 0:08:15.960 a stroke from smoking. I we can't even get podcasters 0:08:16.040 --> 0:08:17.720 to unite under this roof. I doubt if we can 0:08:17.760 --> 0:08:23.040 get it all around the world. So model, this is 0:08:23.040 --> 0:08:25.200 a pretty old system, and um, it's been around for 0:08:25.320 --> 0:08:27.440 hundreds of years. But if because they're always willing to 0:08:27.600 --> 0:08:31.320 keep reforming it. Yeah, I noticed that in another article 0:08:31.600 --> 0:08:37.559 UM from Berlin University. Actually, um, it was kind of 0:08:37.600 --> 0:08:41.640 a rundown of the German healthcare system. All these different 0:08:41.720 --> 0:08:43.839 years kept coming up, like they try new things like 0:08:43.960 --> 0:08:46.719 every year or two. Uh, and it seems like that's 0:08:46.760 --> 0:08:49.440 probably what you'd have to do. I think the impression 0:08:49.480 --> 0:08:52.439 that a lot of people in America have, whether supporters 0:08:52.559 --> 0:08:55.880 or opponents, is that this healthcare reform is going to 0:08:56.080 --> 0:08:58.920 happen and that's it. Yeah, And I think you're I 0:08:58.960 --> 0:09:01.000 think you make a very bad the point that it 0:09:01.160 --> 0:09:03.880 has to keep evolving and changing as problems come up 0:09:04.000 --> 0:09:06.839 or as things prove very effective, you know, you put 0:09:06.920 --> 0:09:10.200 more money into this or take funding away from that. Right. 0:09:10.240 --> 0:09:13.120 Some of their cool new initiatives are these disease management 0:09:13.160 --> 0:09:16.480 programs UM, where if the patient gets more counseling from 0:09:16.520 --> 0:09:18.280 a doctor, like if a nurse calls them up at 0:09:18.320 --> 0:09:20.480 home to make sure they're taking their meds, you know, 0:09:20.679 --> 0:09:24.280 sticking with their diet. These people have much um lower 0:09:24.360 --> 0:09:27.160 rates of hospital emissions and much lower rates of deaths 0:09:27.200 --> 0:09:29.720 from people than people who have the exact same conditions 0:09:29.760 --> 0:09:32.040 who aren't getting that counseling. So I think that's a 0:09:32.080 --> 0:09:34.400 pretty cool way to approach disease. I don't know, I 0:09:34.480 --> 0:09:36.400 could see like half the people in the United States 0:09:36.480 --> 0:09:37.959 thinking it's really nice thing to get a call, and 0:09:38.040 --> 0:09:40.400 half the people be like, stay out of my business, nurse, 0:09:40.960 --> 0:09:42.959 how did you get this number? Right? Well, and you 0:09:43.000 --> 0:09:44.880 know it's not like the nurses and the doctors love 0:09:44.960 --> 0:09:46.679 the system. I would say that you read a lot 0:09:46.720 --> 0:09:50.079 of articles about how the German doctors feel underpaid. To 0:09:50.240 --> 0:09:53.320 protests the most often right German doctors says they're paid 0:09:53.320 --> 0:09:57.520 about two thirds what American doctors um make, and but 0:09:57.760 --> 0:10:00.440 they pay less for malpractice insurance and some of them 0:10:00.480 --> 0:10:02.559 go to school for free med school. And you know 0:10:02.679 --> 0:10:05.040 one cool factor that I did not manage to squeeze 0:10:05.040 --> 0:10:08.040 into this article. But um, those plans, those two in 0:10:08.040 --> 0:10:11.280 our plans that we were talking about those plans get 0:10:11.320 --> 0:10:14.679 incentives if they get sicker people on their rosters. So 0:10:14.800 --> 0:10:17.120 instead of a system like in the US where people 0:10:17.280 --> 0:10:20.439 where we tend to deny people, they get benefits for 0:10:20.520 --> 0:10:23.040 doing that. In Germany it's pretty cool. Also, saw where 0:10:23.040 --> 0:10:25.400 you can in Germany you can go straight to a specialist, 0:10:25.800 --> 0:10:28.040 like you don't have to go through your gatekeeper GP, 0:10:28.200 --> 0:10:30.720 which's kind of cool. Also, there is a private insurance 0:10:30.800 --> 0:10:35.040 market for UM people who make over forty eight thousand 0:10:35.120 --> 0:10:39.080 euros a year. It's not compulsory for those people. Actually, 0:10:39.280 --> 0:10:43.400 long term health insurance is compulsory for everybody, but basic 0:10:43.480 --> 0:10:46.160 health care coverage isn't compulsory for people who make over 0:10:46.240 --> 0:10:49.680 forty eight thousand euros a year UM. So there's another 0:10:50.360 --> 0:10:54.560 uh I guess accompanying private insurance market, but that's still 0:10:54.640 --> 0:10:58.680 regulated by the government. UH. There's like you can't deny 0:10:58.840 --> 0:11:02.400 for pre existing condition and UM. And apparently your rates 0:11:02.480 --> 0:11:06.400 are assessed when you enter that private system UM based 0:11:06.440 --> 0:11:08.520 on your risk. But that's it. There's like a one 0:11:08.600 --> 0:11:10.439 time risk assessment and that sticks with you for the 0:11:10.520 --> 0:11:13.679 rest of your life. I missed the DEUT. I'm just 0:11:13.720 --> 0:11:16.080 gonna go ahead and say that you missed the Deutsche Mark. Yeah, 0:11:16.080 --> 0:11:18.600 I missed the deutsch Mark. Miss I missed the frank 0:11:18.679 --> 0:11:21.600 I miss this whole euro business. Yeah, but I hate 0:11:21.640 --> 0:11:24.160 to change money from country to country, so I thought 0:11:24.160 --> 0:11:26.079 it was kind of thrilling. But then you're left with 0:11:26.120 --> 0:11:28.880 your leftover coins. Yeah, but then you take them and 0:11:28.880 --> 0:11:30.800 you give them to your cousins and nephews and nieces. 0:11:32.840 --> 0:11:34.800 I actually haven't been to Europe since the introduce the Euros, 0:11:34.800 --> 0:11:38.559 I'd probably love it. Speaking of redistributing money. Oh, I 0:11:38.640 --> 0:11:40.599 know we're going next. This is gonna be kind of 0:11:40.679 --> 0:11:43.719 a long balloon ride. So it's just fly forward to 0:11:43.760 --> 0:11:53.440 when we when we land in Cuba. So Cuba, let's 0:11:53.440 --> 0:11:57.240 talk they have healthcare for well, you'd give the skinny 0:11:57.240 --> 0:11:59.360 because I have. I just read some articles where they 0:11:59.360 --> 0:12:02.000 say it wouldn't so for well, you know the famous example, 0:12:02.040 --> 0:12:04.640 I think Cuba. If you're a Michael Moore fans, when 0:12:04.640 --> 0:12:06.920 he took people to Cuba so they could get better 0:12:07.000 --> 0:12:09.520 care than they could in the United States, and you 0:12:09.559 --> 0:12:11.319 know it was meant to embarrass the U s health 0:12:11.360 --> 0:12:14.280 care system. There are obviously a lot of critics, as 0:12:14.320 --> 0:12:16.520 with anything Michael Moore does, of how it was portrayed 0:12:16.559 --> 0:12:18.679 in the movie. And some people say that there is 0:12:19.000 --> 0:12:21.640 um sort of one level for the people they're going 0:12:21.679 --> 0:12:25.000 to impress and then one level for everyone else, Right, 0:12:25.320 --> 0:12:27.760 But I do think that even those people who are 0:12:27.840 --> 0:12:31.680 in maybe that lower um echelon get an immense amount 0:12:31.679 --> 0:12:34.280 of preventative care. That's pretty pretty cool. Well that's it 0:12:34.360 --> 0:12:36.480 sounds like they do, uh do a pretty good job 0:12:36.520 --> 0:12:38.520 with preventative care because they kind of have to. Well, 0:12:38.559 --> 0:12:41.760 you guys were talking about Germany and doctors or nurses 0:12:41.840 --> 0:12:44.800 calling you up to going how you doing. Um, If 0:12:44.840 --> 0:12:46.319 you had a problem with that, you probably really have 0:12:46.440 --> 0:12:50.600 a problem with Cuba because any any person is subject 0:12:50.640 --> 0:12:53.800 to a surprise visit from their physician once a year. Yeah, 0:12:54.160 --> 0:12:56.760 they are going to stop at your door, see what 0:12:56.880 --> 0:12:59.480 you're doing, What are you eating? They're like, while we're here, 0:12:59.480 --> 0:13:02.400 what's under your mattress and what's in your closet? Well, see, 0:13:02.400 --> 0:13:04.480 that's sort of the problem is that, you know, because 0:13:04.840 --> 0:13:06.880 they have the preventative care, because they may not have 0:13:07.120 --> 0:13:09.840 let's say, a fridge or access to really fatty food 0:13:09.960 --> 0:13:12.800 or a really great car. Um. So it's almost like 0:13:13.000 --> 0:13:15.360 the you know what we would see as the deficiencies 0:13:15.400 --> 0:13:18.559 in Cuba have created a culture whereby they walk a lot, 0:13:19.760 --> 0:13:22.040 they don't have fast food. I mean it's coming. They 0:13:22.080 --> 0:13:23.760 say that that might be sort of the next wave 0:13:23.800 --> 0:13:27.560 of obesity, as Cuba is getting some fast food really well. 0:13:27.640 --> 0:13:31.520 As a result, Cuba they have I think they spend 0:13:31.520 --> 0:13:34.319 two hundred and sixty bucks of person on healthcare a 0:13:34.440 --> 0:13:37.439 year A year, Yeah, right, because they're they're really good 0:13:37.480 --> 0:13:40.000 with preventative wellness. But I do want to point out, 0:13:40.040 --> 0:13:41.920 you know, sometimes I believe you brought it up, Josh, 0:13:42.120 --> 0:13:43.920 there's the thought that if we spend a lot less 0:13:43.960 --> 0:13:48.000 on healthcare, will really skimp on our innovation. But Cuba 0:13:48.080 --> 0:13:52.600 surprisingly is known for its um innovation of medical break facs. 0:13:52.679 --> 0:13:56.880 I have heard that they the medical sector is their 0:13:57.200 --> 0:14:00.240 sixth largest in exports, obviously not to the US, but 0:14:01.120 --> 0:14:02.760 they really got to put themselves on the map with 0:14:02.840 --> 0:14:05.319 some vaccines they've come up with first meningitis B and 0:14:05.360 --> 0:14:08.160 then hepatitis B and UM. So they're really making a 0:14:08.240 --> 0:14:11.320 name for themselves in terms of their pharmaceutical and mechanical 0:14:11.480 --> 0:14:15.080 medical equipment exports. Chuck, you reference some articles that you've 0:14:15.120 --> 0:14:18.840 read that the Cuban um I think this is one 0:14:18.840 --> 0:14:21.280 of the systems where it all depends on who which 0:14:21.320 --> 0:14:23.720 side you're reading, because I read a bunch of articles 0:14:23.800 --> 0:14:26.120 that said and a lot of these people interviewed Cuban 0:14:26.360 --> 0:14:29.320 refugees that were now living in America, and they said 0:14:29.360 --> 0:14:33.320 things like there's two health care systems, one for health tourists, 0:14:33.760 --> 0:14:36.000 which apparently Michael Moore is a health tourist, and that's 0:14:36.000 --> 0:14:39.080 a big deal, kind of camera coup filling yourself around that, right, 0:14:39.080 --> 0:14:41.720 you're gonna get treated differently. But there's health tourism is 0:14:41.720 --> 0:14:43.520 a big deal there, and you can go and pay cash. 0:14:44.040 --> 0:14:46.720 And so there's one system for Communist Party officials and 0:14:46.800 --> 0:14:49.200 health tourists and then one for the rest of Cuba, 0:14:49.440 --> 0:14:52.360 and they maintain that, you know, if you're the rest 0:14:52.400 --> 0:14:54.880 of Cuba, you can't get things like aspirin, you can't 0:14:54.960 --> 0:14:57.080 get any biotics unless it's on the black market, and 0:14:57.160 --> 0:14:59.120 you don't have access to a lot of like basic 0:14:59.240 --> 0:15:01.920 medical care. Uh, you have to bring your own cheets 0:15:01.920 --> 0:15:04.000 to the hospital. Stuff like that. Well, I think there's 0:15:04.000 --> 0:15:06.320 also a concern that they get these really great statistics 0:15:06.360 --> 0:15:09.160 by fudging their numbers a little bit, Like Cuba has 0:15:09.200 --> 0:15:12.000 really good rates of mortality. I thought that was interesting. 0:15:12.040 --> 0:15:13.960 But in the United States, you know, if if a 0:15:14.000 --> 0:15:16.360 baby is born only lives a very short period of time, 0:15:16.720 --> 0:15:19.640 we count that, whereas if it was in the same 0:15:19.720 --> 0:15:21.160 if it was a lie for the same period of time, 0:15:21.200 --> 0:15:23.880 in Cuba, they may count that is dead on arrival. Right, 0:15:23.920 --> 0:15:26.800 And didn't you also say that some doctors allegedly will 0:15:27.480 --> 0:15:31.440 suggest abortions in the world the government UM suggests they 0:15:31.760 --> 0:15:35.800 abort a fetus that could be developmentally disabled or something. Right, Right, 0:15:35.960 --> 0:15:39.640 you know, there's just concerned that UM they have great numbers, 0:15:39.720 --> 0:15:41.800 but because you know, we don't really know much felt 0:15:41.840 --> 0:15:43.480 what goes on inside the country, we don't know exactly 0:15:43.520 --> 0:15:46.200 know how to get them right. It was really nice 0:15:46.240 --> 0:15:47.920 to visit it. Can it can be hard to separate 0:15:48.000 --> 0:15:50.120 your opinions on the Cuban health system from your opinions 0:15:50.160 --> 0:15:52.200 just on Cuba the country, right, So I don't want 0:15:52.200 --> 0:15:54.560 to oversell Cuba, Okay, but I'm glad I got to 0:15:54.640 --> 0:15:57.080 visit the balloon. I don't have any opinions on Cuba 0:15:57.080 --> 0:15:58.520 other than what I've heard from a couple of friends 0:15:58.560 --> 0:16:00.200 have traveled there and said it was really awesome, the men, 0:16:00.240 --> 0:16:02.560 that people were lovely, and the country is beautiful when 0:16:03.960 --> 0:16:07.880 politics aside the country itself. The love it's illegal, it's illegal, 0:16:08.160 --> 0:16:11.360 actually not true. Um, so you guys, let's head on 0:16:11.520 --> 0:16:18.160 over to China. Okay, Well, here we are in China, 0:16:18.480 --> 0:16:21.320 and this place is kind of screwed up all. I mean, 0:16:21.840 --> 0:16:23.240 I don't know if i'd want to get sick here. 0:16:23.680 --> 0:16:25.880 It used to be pretty good from what I understand 0:16:25.920 --> 0:16:29.280 in your article that there was cooperative healthcare system right right, 0:16:29.280 --> 0:16:31.240 and they dismantled it and that just didn't go very 0:16:31.280 --> 0:16:33.720 well because, uh, you know, no one knew were to 0:16:33.800 --> 0:16:35.560 send the bill, and the places they were sending the 0:16:35.640 --> 0:16:39.360 bill didn't pay up. And what the huge effect of 0:16:39.400 --> 0:16:42.680 this was that there's a giant divide between healthcare and 0:16:42.760 --> 0:16:45.600 cities and healthcare in the rural areas. Yeah. One of 0:16:45.680 --> 0:16:49.520 the I guess ideas for Chinese healthcare reform was that 0:16:49.720 --> 0:16:53.200 all farmers pay a dollar for healthcare, and they bought 0:16:53.280 --> 0:16:55.360 in a year, and they balked at that as being 0:16:55.440 --> 0:17:00.200 too expensive. Are the rural Chinese that poor really well 0:17:01.040 --> 0:17:03.240 just not really taken seriously over there. One Well, I 0:17:03.280 --> 0:17:05.240 think they're also saying that yes, a dollar was high, 0:17:05.359 --> 0:17:07.440 especially for the care they got. I was reading one 0:17:07.720 --> 0:17:09.639 article it was in the New York Times about how 0:17:09.680 --> 0:17:11.640 you got us in these world clinics and stray dogs 0:17:11.680 --> 0:17:14.320 are walking the halls of the clinics. But it's not 0:17:14.400 --> 0:17:17.600 worth a dollar a year. Straight dogs in your hospital. 0:17:17.960 --> 0:17:21.240 They bring dogs into American hospitals to perk up cancer 0:17:21.320 --> 0:17:23.760 patients and nice, healthy ones, not one that looks like 0:17:23.840 --> 0:17:26.600 they're going to die. You don't know whether they're straight 0:17:26.760 --> 0:17:29.840 or not. You're talking about the uh like they have 0:17:29.880 --> 0:17:32.280 different names at every hospital, I guess. But Love on 0:17:32.400 --> 0:17:38.680 four Paws, that kind of programs dogs love to not 0:17:39.680 --> 0:17:42.840 enough hospitals. Well, okay, so China is in addition to 0:17:43.040 --> 0:17:47.000 it's ridding the hospitals of stray dogs initiatives. Um, they're 0:17:47.240 --> 0:17:50.560 planning on building seven hundred thousand I guess probably pet 0:17:50.720 --> 0:17:54.080 unfriendly clinics in rural areas. I mean, maybe they'll bring 0:17:54.119 --> 0:17:56.080 the nice dogs into those clinics. But yes, they are 0:17:56.119 --> 0:17:57.960 in the middle of funneling just a ton of money 0:17:58.000 --> 0:18:02.400 into their healthcare system and hopes that they cannot eradicate 0:18:02.480 --> 0:18:06.000 this divide between ten years or so, ten or eleven years, 0:18:06.680 --> 0:18:13.480 but by the population will have health insurance. They're hoping 0:18:13.520 --> 0:18:21.600 the billion on it. Yes, e yen you want. I 0:18:21.600 --> 0:18:24.440 don't really know how to pronounce anything in China. Want. 0:18:24.680 --> 0:18:26.520 That doesn't sound like very much money to me. It 0:18:26.640 --> 0:18:29.720 does to build seven thousand clinics. Yeah, and well. The 0:18:29.760 --> 0:18:33.280 other problem is Molly points out that um of that 0:18:33.440 --> 0:18:36.040 money UH is supposed to come from the central government, 0:18:36.119 --> 0:18:38.359 which means provincial governments are gonna have to make up 0:18:38.359 --> 0:18:40.520 the rest. And right now, no one knows if they're 0:18:40.520 --> 0:18:42.600 going to pay up right, sort of the problem they 0:18:42.680 --> 0:18:45.040 had when they first dismantled them. No one wants to 0:18:45.080 --> 0:18:47.959 pay for healthcare. That's true everywhere, but you know one 0:18:48.000 --> 0:18:50.720 place where they do pay. There we going back to 0:18:50.760 --> 0:18:55.240 a bloom. Now, do we have enough game it's run 0:18:55.280 --> 0:18:58.600 on unicorn tiers? Excellent? Okay? Do we have enough unicorn 0:18:58.640 --> 0:19:00.920 tiers to make it to tai wall on? You think? Oh? 0:19:01.400 --> 0:19:04.480 I hope so, because Taiwan's got a pretty nifty system. 0:19:04.840 --> 0:19:08.480 I don't think it would work in this country. But dude, 0:19:08.520 --> 0:19:11.760 the smart card. The smart card sounds so convenient, although 0:19:11.840 --> 0:19:13.639 kind of mirror bracking for someone like me who has 0:19:13.680 --> 0:19:16.040 the tendency to lose things. Wait, wait, you guys can 0:19:16.680 --> 0:19:21.520 get to Taiwan. Okay, I wanted to do. I wanted 0:19:21.560 --> 0:19:24.320 to brief check before we got there. They're chatting along 0:19:24.400 --> 0:19:27.920 the way. Let's just all sit silently in a balloons. Alright. 0:19:27.920 --> 0:19:31.000 So we're in Taiwan. Now this is lovely. So back 0:19:31.040 --> 0:19:35.000 to the smart card before we were exactly Um, okay, 0:19:35.040 --> 0:19:36.720 So you get a smart card. It's got your entire 0:19:36.760 --> 0:19:39.560 medical history on it, right, and you can just show 0:19:39.640 --> 0:19:40.960 up to a doctor and give them your card and 0:19:40.960 --> 0:19:43.119 they can pull up your entire medical history. And that 0:19:43.280 --> 0:19:45.240 is how they will also build a government. So it's 0:19:45.320 --> 0:19:48.680 like your healthcare credit card that you never have to 0:19:48.720 --> 0:19:51.320 see the bill for and it's your entire medical history. Now, 0:19:51.760 --> 0:19:53.560 of course, I people who say that's a way too 0:19:53.640 --> 0:19:56.160 much information for any government to have about a person. 0:19:56.280 --> 0:19:58.080 I like the idea of the smart card. I wouldn't 0:19:58.080 --> 0:20:00.240 mind all my medical information being on one car because 0:20:00.240 --> 0:20:01.720 I'm a little distressed every time I go to the 0:20:01.800 --> 0:20:03.840 doctor and I see them pull out a paper file 0:20:04.600 --> 0:20:06.960 in the midst of thousands of paper files, it seems 0:20:07.119 --> 0:20:09.600 very archaic to me. Well, I've I've moved quite a 0:20:09.680 --> 0:20:11.600 bit and I just hate having to kind of start 0:20:11.680 --> 0:20:14.320 over every time with every doctor. And what do you do. 0:20:14.400 --> 0:20:16.239 I actually haven't changed doctor as much. You get them 0:20:16.280 --> 0:20:18.080 to send everything to your new doctor. I think you're 0:20:18.080 --> 0:20:21.240 supposed to. Really, maybe I shouldn't reveal how poorly I 0:20:21.280 --> 0:20:24.640 manage my health switchovers. So I am a health writer. 0:20:24.800 --> 0:20:27.960 The smart card sounds word well, yeah, medical medical billing, 0:20:28.080 --> 0:20:31.040 medical information. It's a huge, huge problem in the US, 0:20:31.119 --> 0:20:34.639 just an administrative costs and time. Yeah. And that's the 0:20:34.720 --> 0:20:36.639 thing that was cool about what Taiwan did is that 0:20:36.760 --> 0:20:39.720 in expanding coverage to cover so much more the population, 0:20:39.800 --> 0:20:41.960 that they cut all those costs because now they have 0:20:42.080 --> 0:20:45.280 no administrative costs essentially. But the fact matters is that 0:20:45.359 --> 0:20:48.840 now Taiwan doesn't spend enough on healthcare to cover their costs, 0:20:49.440 --> 0:20:51.480 and the Taiwanese have gotten used to these really low 0:20:51.560 --> 0:20:53.960