Advanced Conversation with Jennifer on Health Care in the U.S. 🩺


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

  1. Hi Teacher. I love you ❤️

  2. thank's sister🌹
    شكرا أختاه😉

  3. Thank you for dates Vedder
    You are my teacher number one ❤

  4. Good job jenifer

  5. Best teacher I have ever seen 💝💝. Respect jennifer from Somalia 🇸🇴🇸🇴
    Who else proud Africa ?
    👇👇Hit 👇

  6. 😍😍😍

  7. Love mam . From India ❤❤❤🇮🇳🇮🇳🇮🇳👌👍

  8. i supported my teacher thank u i'm frm somalia i can't speak eng

  9. Hi

  10. Wow, I do like that. love you. A

  11. 💝Hi Jennifer. Thank you for explaining the American Health care system. Or at least have tried to explain in-depth as possible… Well, it's a very complicated issue not just in America, but all around the world.

    The physical and mental well-being of the nation versus a healthy economy and budget spending of the Government.

    There isn't a silver bullet that for sure!

    In this complicated variability of insurance (mess), paperwork, administration, etc, a fair amount of money is spent from the available money that can be used for real medical treatment.

    We have a Commonwealth system of Medicare. I can view this system as halfway from Socialist and Kapitalist system. Beside is private insurance too.

    All this is like a Bible in the hands of the faithful, but in reality, they are lost in understanding the true value of religion.

    I having the dental clean up twice a year and paying each time A$185 in total (110 private insurance the rest from my pocket). There are gruesome talks circulate around that doctors at the hospital recommend surgery to patients, because of their high earnings in the operating room. 💰🏅

  12. Health care is better in canada

  13. I want words about fight and hungry

  14. Stay in good shape with JenniferESL!

  15. Very good lesson there, Jennifer.
    I have supported Medicare For All ever since Bernie Sanders and Elizabeth Warren introduced me to the idea in 2016; however, I am now beginning to see some cracks appear as I look deeper into the concept. The cost of Medicare For All to the American tax payers has been estimated at thirty-trillion dollars over the next ten years. While I agree, it's still the best alternative, we must be fully aware that it has to be paid for and it is expensive. Most won't see great savings in their health costs, but it will certainly save more lives and mean that fewer go bankrupt when seriously ill. The plan, discussed at the recent Democratic debate, to have a choice, isn't really workable either as to make Medicare For All work, everyone has to pay into it..Giving Americans the option of keeping their employer-based health insurance and also paying for Medicare For All would help lessen the burden, but that one looks dead before it gets off the ground!

    Will Bernie and Elizabeth succeed in their ambitious plan for Single Payer? We'll find out soon.

  16. Thanks my dear teacher I'm from Somalia ❤

  17. You are the best one in my mind.😁😁😁

  18. Thank you Jennifer for this very interresting topic.

  19. This is a very informative video. Thanks for the lecture. Greetings from Korea 🇰🇷

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