美国温斯坦影业公司
乔治·沃克·布什 George Walker Bush
美国遇到了个问题 We got issue in America
美国遇到了个问题
太多良医没有患者可以医治
Too many good docs are getting out of business.
许多的妇产科医生 Too many ob-gyns aren't able to
无法为国内的妇女们提供帮助 practice their love with women across this country
翻校后期：Libsu苏苏 和 吃小货
我失业了 我不想再为此负债累累了
I don't have a job. I don't want to have any more debt out to anybody else.
我在冲洗伤口
I'm flushing the wound.
这是Adam This is Adam
美国温斯坦影业公司
他遭遇了意外事故 He had an accident
美国狗咬狗影业公司
他是美国将近五千万没有医保的人中的一员
He's one of nearly 50 million Americans with no health insurance.
医疗内幕
（sicko： 道德败坏的人；神经有问题的人）
但这部影片 并不是关于Adam But this film isn't about Adam
就是这台锯 那个时候它正这样转着
So this is the table saw. It was spinning that way...
这是Rick This is Rick
联合制片人
那时我抓着一块木头 我抓在这里 它碰到了一个节点
I was gripping a piece of wood and I grabbed it here and it hit a knot...
他锯掉了他的两个手指尖 He sawed off the tops of to of his fingers
就是那么快 and it was that quick
执行制片人
他首先想到的是 His first thought?
我没买医疗保险 I don't have insurance
这得花多少钱 两三千美金甚至更多 Am I gonna have to pay cash for this? $ 2,000, $3,000 or more?
并且这是否意味着我不能(免费)叫救护车 Does that mean we're not gonna get a car?
美国电影电视剪接师协会最佳纪录片剪辑奖 2007芝加哥电影评论协会奖最佳纪录片奖 2007拉斯韦加斯电影评论组织奖最佳纪录片奖 2008纽约电影评论圈奖最佳纪录片奖 2008北美广播影评人协会奖最佳纪录片奖
■
本片荣获
第80届奥斯卡金像奖 最佳纪录长片提名
同时Rick也不能享受医疗保健制度 Rick also doesn't have health coverage
于是医院给了他几个选择 So the hospital gave him a choice
6万美元接上他的中指
Reattach the middle finger for $60.000.
或者1.2万美元接上无名指
Or do the ring finger for 12.000.
给自己的身体标价的感觉太难受了
It's an awful feeling to just try to put a value on your body.
DAN SWIETLIK GEOFFREY RIGHMAN GHRISTOPHER SEWARD
Editors
Rick做为一个绝望的浪漫主义者选择了无名指 Being a hopeless romantic Rick chose the ring finger
支付了相对廉价的1.2万美元 For the bargain price of 12 grand
他的中指尖 The top of his middle finger
现在在俄勒冈州的填埋场中享受它的新家 now enjoys its new home in an Oregon landfill
我可以做那种把戏 I can do that thing where, you know,
一个老头曾经把手指给拔了下来 the old man used to pull the finger off
制片人
我们的主角不是Rick This movie isn't about Rick either
没错 将近五千万 Yes There are nearly 50
美国人没有医疗保险 million Americans with no health insurance
他们每天都祈祷着不要生病 They pray every day they don't get sick
因为他们中的1.8万人将在今年死去
Because 18.000 of them will die this year.
仅仅因为没有医保
Simply because they're uninsured.
我们的主角也不是这些没有医保的人 But this movie isn't about them
而是它是关于这2.5亿有医疗保险的人的 It's about the 250 million of you who have health insurance
关于这些活在美国梦中的 Those of you who are living the American Dream
总导演 迈克尔·摩尔
Larry和Donna Smith今天搬家
It's moving day for Larry and Donna Smith.
家当都装到了这两辆车里
They've packed everything they own in these two cars.
驶向科罗拉多州的丹弗市 And are driving to Denver Colorado
驶向他们那位于 To their new home
-你好 -你好 -Hi -Hello
女儿家的储藏间中的“家” in their daughter's storage room
这是个温馨的家 This is home, sweet home
-看看这些东西 -我们会把他们都收拾好的 -Look at all that stuff -We'll get everything organized
-我们会的 -我们拿这电脑怎么办 -We will -What do we do with the computer?
-就放那儿 -就放那儿 -It stays -It stays there
这儿就是Heather So this is where Heather
跟我们说的放架子床的地方 talked about we might have to put bunk beds
我明白她的意思了 I see what she's talking about
对于Larry和Donna来说他们并不该有这样一个结局 It wasn't supposed to end up like this for Larry and Donna
他们本来都有一份好工作 They both had good jobs
她是一份报纸的编辑 She was a newspaper editor
而他是一名机械师 And he was a union machinist
他们有六个孩子 They raised six kids who all
全都进了像芝加哥大学之类的好学校 went to fine schools like the University of Chicago
Larry发作了一次心脏病
But Larry had a heart attack.
又遭遇了一次 And then another one
同时Donna患上了癌症 And then Donna got cancer
尽管他们有医疗保险 And even though they had health insurance
理赔很快就花光了 The copays and deductibles soon added up
他们已经无力维持现有房子的费用
to the point where they could no longer afford to keep their home.
如果有人10年前告诉我 If somebody told me ten years ago
这种事情会因为医疗保健而发生在我们身上 this was gonna happen to us because of healthcare,
我肯定会说这不可能 I would have said, "It's not possible "
这不会发生在美国 Not in the United States
我们不会让它发生 We wouldn't let that happen to people
-要不要休息会 -不用了
- Are we gonna quit? - No.
他们破产了
They were bankrupt.
所以他们搬去和女儿住
So they moved in with their daughter.
我们会解决这一切的
We'll get it all figured out.
等梳妆台清理了 这样就有地儿了
We emptied the dresser so you have a spot.
噢 好 很好
Nice, very nice.
他们的儿子Danny也从临镇赶来
Even their son Danny popped in from across town
欢迎他们迁居到丹佛
to welcome them to Denver.
-我们该怎么帮你们 -我不知道 这是个问题
- What do we do about people like you? - I don't know, that's a good question.
你们付的那9,000应该是可扣免的 那该医保付
You're supposed to pay a deductible for $9,000, I understand. That's healthcare.
到底要我和凯蒂该怎么办
What about people like Kathy and I that have to come up there
每5年就帮你们你们搬家 2年甚至1年
and move you every five years, every two years, every year,
-房子越换越小 钱越来越少 -Russe也一直在说的
- cause you don't have enough money? - That's what Russell says too.
我很抱歉这本来也不是我们所希望的
I'm sorry. It's not what we wanted to have happen in life.
我们已经竭尽全力在改变了
And we're doing what we can to make the change.
你不明白对于一个50多岁的人的感受
You don't know what that feels like inside at 50-some years old,
不得不向自己20多岁的孩子请求帮助
to have to reach out to my 20-something-year-old for help.
接下来的几个月会很辛苦
It's gonna be hard for four, five, six, seven months, it's gonna be hard.
无论现在我们搬去哪里 麻烦依然紧追不舍
I have a feeling of you bring your problems with you no matter where you go.
是啊
Yeah.
现在我都还没找到出路
But I don't know what to do about that.
祸不单行 他们的女婿保罗
By sheer coincidence. Their daughter's husband. Paul.
在那一天 失业了
Was leaving on a job the very same day they arrived.
保罗是个工程承包商 但最近接不到什么活
Paul was a contractor. But there weren't many jobs lately.
所以他在城外找了一份工作
So he found work out of town.
有事打电话
I'm sure you'll keep a telephone conversation.
还是Eail吧
Email you.
宝贝们 别哭了
You're gonna be just fine, lovies.
生活不易 对吧
Weird situation, isn't it?
-告诉我爸爸到哪儿去了 -伊拉克
- Tell me where Daddy's going. - Iraq.
爸爸为什么去伊拉克
Why is Daddy going to Iraq?
去做水管工
To do some plumbing.
哦 孩子
Oh, boy.
这是我早晨的工作 第一件事情就是打扫这里
This I do early in the morning. The first thing I do is I clean here.
今年79岁的Frank Cardile 本该躺在海滩晒太阳
我告诉他们 首席执行官是Bruce van cleve
At age 79. Frank Cardile should be kicking back on a beach somewhere.
尽管他有医疗保险
But even though he's insured by Medicare.
也无法支付他和妻子所有的医药费用
It doesn't cover all the cost of the drugs that he and his wife need.
只要我还在这工作 我的医药就可以免单
Being that I'm an employee here, my medicine is for free.
所以我要一直工作下去 直到我死
So that's why I gotta keep working. Until I die.
这没什么不对的
There is nothing wrong with that.
我必须要时刻注意哪些地方会撒出东西来
I always gotta keep my ears open because there's always spillages.
有时候是一加仑的牛奶
Sometimes you get a gallon of milk.
番茄酱之类的很麻烦 要花费半个小时来清理干净
Tomato sauce oh, you're in trouble. It'll take a half-hour to clean that up.
我得检查每条过道保证一切都干干净净
And I look up on every aisle so as everything is clean.
地上有东西就得马上捡起来 不管是垃圾还是纸屑
If I see something I pick it up, whether it's paper or garbage.
有一次我把钥匙和垃圾一起扔进去了
One day I had the keys in my hand and they went in there.
我只好爬进去把钥匙拿出来
And I had to climb in there to get the keys out.
真是倒霉事啊
It's a sad situation.
我可以负责任的说 这里没什么美好生活
If there are golden years, I can't find 'em, I'll tell you that.
她原来有治屁股的止痛药
She had a painkiller for her hip.
卖药的女孩说这要213美元 我说 一个止痛药这么贵?
The girl said, "Frank, this is $ 213." "What, for a painkiller?"
-我就不要了 -我走了 我说 我得回去
- I didn't take it. - I backed off. I said, "I gotta come back."
那些医生开的药
What's in them? What's in these new drugs that they distribute?
我觉得有一半是没用的
I don't believe you need half of the things they tell you.
年岁渐长 我越来越少吃药
I have never taken medication now, as I'm getting older.
我甚至连阿司匹林都不吃了
I don't even like to take an aspirin.
我更愿意来点儿白兰地
I do like a little brandy.
现在我都还没明白是怎么发生的 卡车头突然撞进后车座
I don't really know how this happened, but the trunk came forward into the back seat.
Laura Burnham曾遭遇一次正面的车祸 把她撞昏了
Laura Burnham was in a head-on collision that knocked her out cold.
医护人员把她从车里救出来 用救护车送进了医院
Paramedics got her out of the car and into an ambulance for a trip to the hospital.
我从保险公司收到了一张账单
I get a bill from my insurance company
告诉我他们不会支付救护车的费用
telling me that the ambulance ride was not going to be paid for,
因为这不在预批的项目当中
because it wasn't preapproved.
可是什么时候我该预先申请它呢
I don't know exactly when I was supposed to preapprove it, you know?
比如在我在车里恢复意识之后 在我进救护车之前
Like after I gain consciousness in the car, before I got in the ambulance?
是不是在被抬进救护车之前 我该排除万难的拿起手机预申
I should have grabbed my cellphone off the street and called in the ambulance?
这也太离谱了
I mean, it's just crazy.
我给Jason申请了一份健康网公司的保险
I applied for HealthNet insurance for Jason.
他们因为他的身高和体重而拒绝了
They rejected him because of his height and weight.
杰森身高183厘米 体重118斤
Jason is six feet tall and 130 pounds.
太瘦
我申请了蓝带和蓝盾的健康保险
I applied for healthcare through BlueCross BlueShield
他们告诉我 我的体重指数超标 不允许申请
and they told me that my body mass index was too high.
我身高155厘米 体重160斤
I'm 5' 1 ", I weigh 175 pounds."
太胖
我一直天真的以为 医保公司是为我们着想的
I always thought health insurance companies were there to help us.
所以我在互联网上发了一个帖子
So I posted a note on the internet.
告诉我你和保险公司之间的故事 迈克尔 摩尔
问大家有没有类似的经历
Asking people if they had had any similar stories
关于他们医保公司的问题的
about problems with their insurance company.
来信
24小时内 我接到了3700多封回信
Within 24 hours. I had over 3700 responses.
到这周末超过25000人
And by the end of the week. Over 25.000 people
给我发来了他们的医保恐怖经历
had sent me their healthcare horror stories.
小心点 胖子摩尔要来了
他们中的一些人等不及我回复他们
Some of them decided not to wait for me to get back to them.
像Doug Noe 未经我同意下 借用我的名声 开始与医保公司斗智斗勇了
Like Doug Noe. Who took matters into his own hands. Without my permission.
他的女儿在九个月大时 被诊断出将逐渐失聪
His daughter was nine months old when they discovered she was going deaf.
GIGNA 医保公司
他的健康保险公司 CIGNA
His health insurance company. CIGNA.
尊敬的ANNETTENOE:
我们在2006年1月19日收到您的请求
获得批准:左耳的人工耳蜗
说他们只能给她支付一只耳朵植入助听器的钱
Said they'd pay for an implant in only one of her ears.
▅
根据他们发来的信件
According to the letter they sent.
由于双耳都植入助听器是实验性的 所以拒绝
It's experimental for her to hear in two ears.
如果耳蜗助听器能够在一边耳朵好用
If a cochlear implant is good for one ear,
无疑在另一边耳朵里也好用
it doesn't even make any sense that it wouldn't be good for the second ear.
特别对于一个刚刚准备开始学说话的孩子来说
Especially when a child is just starting to learn how to talk,
她必须通过她的两只耳朵来学习
she has to learn from both sides of her head.
于是他坐下来给CIGNA写了一封信
That's when he sat down to write CIGNA a letter.
这是写给CIGNA的信: 著名纪录片制片人迈克尔·摩尔
This is to CIGNA. "Noted filmmaker Michael Moore
正在为他的下一部电影收集信息
is in the process of gathering information for his next film."
我将关于CIGNA对我的医疗费用不允支付的信息发了过去
"I've sent information concerning CIGNA's lack of caring for its policy holders."
你们的首席执行官之前有上过电影吗？？
你们的首席执行官上过电影吗
"Has your CEO ever been in a film before?"
在知道答案之前 他就收到了来自CIGNA总部的语音邮件
Before he knew it. He received a call on his voice mail from CIGNA.
星期二 上午8:54
Tuesday. 8.:54 am.
GIGNA总部
你好 Noe先生 我是GIGNA医保公司的Edward
我来电向Annette致以问候
告诉你个好消息
专家的复诊结果出来了
公司决定撤销之前的否定赔付
安装第二个助听器是非常重要的
一定是耳蜗助听器
感谢你
威胁明显起了作用 Annette将在7月植入她的第二只助听器
Obviously all this worked because Annette is going to get her second implant in July.
你好 迈胖子 我在这个医保行业供职
"Dear Mike. I work in the industry."
我为卫生维护组织(HMO)工作
"I work for an HMO."
我开始收到上千封各样的信
I started to get hundreds of letters of a different sort
我在明尼苏达州蓝盾医保公司工作
在佛罗里达州棕榈滩县一个医院
都是在医保行业工作的人写的
from people who work inside the healthcare industry.
我目前在 A&W医保公司工作
主题：关于美国健康维护组织
他们什么看到了 他们对这感到厌烦
They'd seen everything and they were fed up with it.
我恨美国健康维护组织
一个腐败的体系
健康保险公司真烂 稀巴烂
"Health insurance companies suck. Flat suck."
稀烂
稀巴烂
就像主要负责拒绝病人
Like Becky Malke. Who was in charge of keeping sick people away
来自美国顶级保险公司之一的Becky Malke
from one of America's top insurance companies.
我在一个电话中心工作 人们打电话过来要求支取保险金
I work in a call center, so people call in and ask for insurance quotes.
有一些预先规定的症状 基本上整个行业
There are certain preexisting conditions, basically industry-wide,
医保公司业务员
都不会包含的
that will not be covered -
糖尿病 心脏病 某些癌症
diabetes, heart disease, certain forms of cancer.
如果你有这些症状 你几乎不可能拿到你的保险金
If you have these conditions, you are likely not going to get your health insurance.
我 们 将 拒 绝 偿 付 您 的
▅
那份让你拿不成保险金的列表有多长
How long is this list of conditions that make you ineligible?
那是个非常长的列表 非常长
It would be a really long list. It would be a long list.
表 格 目 录
投保前已有病症
第1-37页
长到你可以把这房子绕一圈
It could wrap around this house.
如果你要是患上了这些病
background music星球大战主题曲
就别想得到保险赔偿金
阿狄森氏病 肾上腺功能不全 艾滋病 酒精施虐者 酒精性肝硬化 阿尔茨海默氏病的 淀粉样变性 肌萎缩性脊髓侧索硬化症（ALS） 动脉瘤 心绞痛 介入治疗 强直性脊柱炎 强直 抗凝药物治疗 主动脉瓣关闭不全 主动脉瓣或二尖瓣置换 主动脉狭窄的 再生障碍性贫血 心律失常 动脉栓塞 血栓（血凝块） 动脉闭塞 动脉硬化闭塞症 动静脉畸形 关节炎 关节炎 类风湿 人工关节 人工瓣膜 接触石棉（石棉） 哮喘 动脉硬化闭塞症 动脉粥样硬化血栓性疾病 房颤 自闭症
肝脏疾病 胆汁性肝硬化 双相性精神障碍 芽生菌 性脑损伤 肾小球肾炎 支气管扩张 伯格氏病（血栓） 暴食 伯基特肿瘤
癌症（乳腺癌或前列腺） 类癌综合征 心脏搭桥 心肌病 食管 贲门失弛缓症 脑性麻痹 腓骨肌萎缩症 克罗恩病 慢性肾小球肾炎 慢性肝炎 慢性阻塞性肺疾病 慢性肺源性心脏病 肝硬化 缩窄主动脉 结肠造口 充血性心力衰竭 库利贫血 肺心病 冠状动脉疾病 ​​冠心病 克罗恩病（溃疡性结肠炎） 脊柱弯曲 库欣综合征 囊性纤维化 囊性肾病 囊性肺疾病
痴呆 颌面功能异常 皮肌炎 糖尿病（所有类型） 唐氏综合症的 自主神经系统疾病的家庭暴力 药物滥用非法 药物滥用处方 药精神病
电休克治疗 肺气肿 脑病 肝脏肿大 食管静脉曲张 页面顶部 法布里病 因子VIII或IX缺乏 性脂肪肝 生育治疗 页面顶部 胃旁路/装订 抽动秽语综合征 肾小球肾炎，慢性 肺出血肾炎综合征 格林-巴利综合征 心脏或肺移植的心脏病发作 偏瘫 血色素沉着症 溶血性贫血 血友病A或B 过敏的紫癜 丙型肝炎，G，非A非B 肝肿大 椎间盘突出椎间盘 HIV 霍奇金病 亨廷顿舞蹈病 脑积水 肾积水 脾功能亢进的 甲状腺功能亢进症
投保前预先存在的条件A-Z由于确实太长影片只放到H 完整可以搜索: List of Pre-Existing Medical Conditions
有时你预先就能知道 在最后他们的申请会被拒绝
Sometimes you know they're gonna be declined at the end of the application,
他们就像 有一次我接待了一对夫妇
and they're like... God, like one time I had a couple,
他们对于能拿到(保险)是如此的高兴 我要哭了
and they were so happy to get... I'm gonna cry.
他们是那么高兴 我帮他们进行了申请
They were so happy that they were... l took them through this application.
丈夫因为工作迟到了
And the husband was late for work.
然后妻子说 宝贝别担心 一切都会好的
And the wife said to him, "Don't worry, baby, it's gonna be OK."
我们现在有健康保险了
"We have health insurance now."
当我看到他们的申请表的时 我就知道他们会被拒绝
And when I looked, I could tell they were gonna get declined
因为他们之前的一些病症 可是当时他们还很开心
because of their health conditions. And they were so happy.
我想 他们过两个星期就会接到那个电话
I thought, "God, they're gonna get that call in a couple of weeks"
告诉他们不符合保险的条件
telling them that they're not eligible for insurance."
I just felt so bad 'cause I just really thought
我难受极了因为我真的想
也知道 我不能对他们说任何事情
and I knew and I couldn't say anything to them.
我觉得自己就是废物
I just felt like crap.
所以我每次接电话的时候都感觉自己是个婊子
That's why I'm such a bitch on the phone to people,
我不想伤害他们
because I don't wanna get to know them,
我不想再了解他们的痛楚 我仅仅想上班 下班
I don't wanna know about their lives, I just wanna get in and out,
做完工作 我再也无法承受这种负罪感
and get done with it 'cause I can't take the stress of it.
虽然becky对接听申请医保赔付的电话感到痛苦
In spite of Becky being a bit of a pain on the phone.
Kaiser Permanente医疗集团
在美国 任然有2亿5千万人购买健康保险
A quarter billion Americans are still able to get health insurance.
只为创造可能
联合健康集团
HUMANA健康保险公司引导最大需求
BCBSLA蓝十字蓝盾
安泰保险金融集团
安信龙健康保险公司
每一个美国人应得的医疗保健
让我们来看看这些快乐的有保险的客户
Let's meet some of these happy insured customers.
Maria有蓝盾保险
Maria has BlueShield.
Diane Horizon有蓝带保险
And Diane. Horizon BlueCross.
BCS对Laurel承保
BCS insures Laurel.
Caroline有CIGNA
And Caroline has CIGNA.
很好 他们都投了保险
And it's a good thing that they're all fully covered.
描述你享受的保险和福利
我被诊断出患有脊椎肿瘤
I ended up being diagnosed with retroperitoneal cancer.
-脑肿瘤 -乳腺癌
- Brain tumor. - Breast cancer.
右颞叶脑肿瘤
Brain tumor on the right temporal lobe.
因为他们有医保 他们在医务室得到了贵宾的接待
As they were insured. They got the red-carpet treatment at the doctor's office.
她要求我去看一个神经科医生
She requested for me to see a neurologist.
他们治疗的方法就是切除它
The way they would treat it was to remove it.
手术要等到了11月9日
Surgery was scheduled for December 9.
有一个检查需要做
There is a test that you can take
会指出化疗是否会对你有利
that will show whether or not you would benefit from chemo.
他们得到了治疗 但都是在和医保公司争斗之后
They got their treatment. But not before battling their insurance companies.
(医保公司)详细调查是否有预先存在的病情
Investigated whether or not this was a preexisting condition.
(医保公司回复)这并不需要治疗
"It's not medically necessary."
他们说是实验性质的(所以不允以赔付)
They claim that it's experimental.
我们不认为这肿瘤会威胁生命
"We don't consider that life-threatening."
然而Diane死于没有生命威胁的肿瘤
Diane died from her non life-threatening tumor.
Laurel的癌细胞现在扩散到了她的全身
Laurel's cancer is now spread throughout her body.
她的“实验性检查”表明Caroline需要化疗
Her "experimental test" proved that Caroline needed chemo.
在日本旅行的时候Maria病了
While vacationing in Japan. Maria became ill
做了核磁共振 而蓝盾拒绝赔付
and got the MRI that BlueShield of California had refused to approve.
在日本医生告诉她 她患有脑肿瘤
The doctors in Japan told her she had a brain tumor.
而蓝盾反复告诉她 她没有肿瘤
BlueShield had said repeatedly she didn't have a tumor.
她当时说: 好啊 我可以确定的是我有个律师
That's when she said.: "Well. I'm pretty sure I have a lawyer."
Maria Watanabe质问蓝盾保险,加利福尼亚州,引用资料.
3月13 2003
March 13, 2003.
请看项目一
I'm gonna direct your attention to exhibit one.
蓝盾保险药物主管 负责拒绝医疗团队请求
请告诉我这是什么
Please describe for me what it is.
这是对推荐眼科医师的拒绝书
It is a denial for referral to an ophthalmologist.
-上面是你的签名吗 -是的
- Is it your signature on this? - Yes.
请看到项目二
I'd like to direct your attention to exhibit two.
这是一个拒绝推荐
This is a denial of a request for referral
脑部进行磁核共振成相的
for a magnetic resonance imaging test of the brain.
-这有你的签名吗 -是的
- It has your signature? - Yes.
请你看到项目三 请读这份文档
Directing your attention to exhibit three. Please read this document.
这是对一个推荐神经外科医生的拒绝
This is a denial of a referral to a neurosurgeon.
你能跟我解释一下你是如何签署这些拒绝信的吗
Can you explain for me how you came to sign the denial letter?
这是在所有的拒绝信上一个标准签名
This is a standard signature put on all denial letters.
-那是你的签名还是印章 -是印章
- Is it your signature or a stamp? - That is a stamp.
在你的图章盖上之前 你有没有看过这些信件
Did you ever see a denial letter before your signature was stamped on it?
没有 但否定信件基本上都一样
No, but the denial letters are fundamentally the same.
发出的拒绝信
The denial letters that are sent out...
-你的回答是否定的 -是的 否定的
- The answer is no. - No. All right.
对于一个好的主管的定义是能为公司省钱的人
The definition of a good director was somebody who saves the company money.
Linda Peeno是Humana的一名医学观测员
Dr. Linda Peeno was a medical reviewer for Humana.
她辞掉了工作因为她不喜欢他们做事的方法
She left her job because she didn't like their way of doing business.
他们告诉我必须有10%的拒绝率
I was told when I started that I had to keep a 10% denial.
然后每周他们报告所有通过审查的案例
Then they were giving us reports weekly that would have all the cases we reviewed,
通过比例和拒绝比例
the percent approved and the percent denied.
和我们实际拒绝的比例
And our actual percentage denial rate.
然后会有另一个报告 来比较我们和其他审查人员
Then there would be another report that compared me to all the other reviewers.
否 决
医生
拒绝比例最高的医生会有奖金
The doctor with the highest percent of denials was gonna get a bonus.
真的 那么你作为一个为HMO工作的医生
Really? So you, as a doctor, working for the HMO,
你的拒绝率越高 奖金越高
if you denied more people healthcare, you got a bonus?
奖金
行业潜规则就是这样的
That was how they set it up.
任何对保险的支付都看成是医疗经费的损失
Any payment for a claim is referred to as a medical loss.
这是行业里使用的术语
That's the terminology the industry uses.
当你不把钱花在谁身上 拒绝他们
I mean, when you don't spend money on somebody, you deny their care,
或者决定把钱捞回来 不必花了它
or you make a decision that brings money in and you don't have to spend it,
这就能为公司省钱
it's a savings to the company.
这是Tarsha Harris
This is tarsha Harris.
蓝带一开始没有拒绝她的治疗
BlueCross didn't deny her her treatment.
甚至还批准了她的手术
And actually approved her operation.
总账单
然而之后 他们发现在遥远的过去
But then they discovered that in the distant past.
她曾经患有真菌感染
She had had a yeast infection.
实际上这很正常 人们都很容易感染
Apparently it's common. Men, women can get a yeast infection.
我开了真菌感染的药膏 很普通的药膏 就完了
So I was prescribed the yeast infection cream, general cream, and it went away.
后来她写信申请保险金
She later applied for health insurance
这就是你想要发掘的严重的病
and that's what you're supposed to be disclosing - serious ailments.
Tarsha Harris的律师
真菌感染是一种不严重的病 保险公司实在是没事找事
The yeast infection is not a serious ailment. There was nothing she could have done.
直到他们必须花钱的时候他们才看到
It wasn't until they were gonna have to spend money that they looked.
如果他们以前花5分钟去弄清楚真菌感染
If they'd taken five minutes and wanted to clear up the yeast infection,
他们本应该看看她的病历或者和她的医生谈谈
they could've looked at her records or talked to her doctor.
因为这个没有透露过的真菌感染
Because of the undisclosed yeast infection.
有 必 要 追 溯 取 消 本 协 议
蓝带公司拒绝了他的赔付
BlueCross dropped tarsha Harris.
她觉得真菌感染没什么大不了的 可是蓝带变卦了
She thinks she's put this behind her. And then BlueCross changes their mind,
告诉医生 我们把钱要回来 去向Tarsha要钱吧
tells the doctors, "We're taking the money back, go get the money from Tarsha."
事实上就只是个真菌感染 仅仅如此而已
The fact of the matter is it was a yeast infection, that's all it was.
我现在都还有点怨恨 我再也不相信保险公司了
I'm still a little bitter because I don't trust insurance companies now.
对我来说 似乎他们总在为自己找托词
To me, it seems they're always gonna be looking for a way out.
这样又怎么可能对病人有帮助呢
What happened to helping the person that's sick?
只会让我们的病情更糟糕
Don't make their problems worse.
这是Lee Einer
This is Lee Einer.
如果他们没能在申请阶段拒绝你
If they weren't able to weed you out in the application process.
或者支付了你所需的治疗费用
Or deny you the care your doctor said you needed.
或者稀里糊涂帮你付了手术费
And somehow ended up paying for the operation.
他们会派出Lee 他们的保险“葛朗台”
They send in Lee. Their hitman.
他的工作是用一切可能的办法把公司的钱要回来
His job is to get the company's money back any way he can.
他所要做的就是从你的申请表中找出错误
All he has to do is find one slip-up on your application.
或某个先前存在 连你自己不知道的不利条件
Or a preexisting condition you didn't know you had.
我们会像对待谋杀案一样追踪它
We're gonna go after this like it's a murder case.
我的意思是整个小组专门用来
And I mean the whole unit dedicated to
既往医疗/手术史
敏感症:环丁羟吗喃 复方咖麦胺 安定 酮咯酸注射剂
研究你过去五年的病历 以及一切和健康有关的资料
going through your health history for the last five years,
高胆固醇
他曾在加拿大滑雪
寻找任何蛛丝马迹
looking for anything that would indicate
医疗情况 背痛
证明你有隐瞒 或者没有如实说明
that you concealed something, you misrepresented something,
医疗情况 肿胀以及腹部发热
遗漏事实材料
▅
他们就可以撤销保险单
so that they can cancel the policy
或者把大幅增加保险费 让你无法支付
or jack the rates so high that you can't pay them.
如果我们找不到你在申请中没有透露的任何事情
And if we couldn't find anything you didn't disclose on the application,
你依旧会收到一个准备好的拒绝
you can still get hit with a preexisting denial,
因为你甚至连一次治疗也没有进行
because you don't even have to have sought medical treatment for it.
一些州对(保险公司要求)拥有一份详细身体既往状况是合法的
In some states, it's legal to have a prudent person preexisting condition.
这个解释起来的确很费劲
And that's a mouthful, I know,
但是他们说的是如果在你的保险生效之前
but what that says is if prior to your insurance kicking in,
你有了某些病症 而这些病症会促使一个正常人
you had any symptom which would incline a normally prudent person
去寻求治疗
to have sought medical care,
那么该症状就成为了除外条件
then the condition of which that symptom was a symptom is excluded.
我知道
I know!
很难懂是吧 但就是这么操作的
It's labyrinthine, isn't it? But that's how it works.
由于遗漏既往医疗历史记录
他们应该是公正的
They're supposed to be even-handed,
但是对一个保险公司来说 那是该死的钱
but with an insurance company, it's their frigging money!
所有暂定索赔将被否决
所以这是特意的 并不是错误
So it's not unintentional, it's not a mistake,
也不是疏忽 你没有滑进坑里
it's not an oversight, you're not slipping through the cracks.
是有人故意挖个坑让你掉进去
Somebody made that crack and swept you towards it.
目的只是为了更多的利润
And the intent is to maximize profits.
回想一下 我不知道我那么做是不是害过别人
Looking back, I don't know that I killed anybody.
我有做过什么伤天害理的事吗
Did I do harm in people's lives?
嗯 事实如此
Yeah. Hell, yeah.
我从保险公司辞职已经很久了
I haven't worked for insurance companies for a long time,
我觉得离开都不能弥补
and I don't think that really serves to atone
我犯下的过错
for my participation in that mess.
感谢上帝 至少我离开了
I am glad I'm out of it, though.
Julie Pierce曾经努力为她的丈夫Tracy争取治疗
Julie Pierce was struggling to get care for her husband tracy.
因为Tracy患了肾癌
Who was suffering from kidney cancer.
圣约瑟夫医疗中心
Julie在在密苏苏里堪萨斯城St Joseph's医疗中心的
Julie works in the intensive care unit at St. Joseph's Medical Center
特别护理病房工作
in Kansas City. Missouri.
该中心为她的家庭提供医疗保险
Which provided her family with health insurance.
医生每个月都要尝试一种新药
Every month, there was a new drug that the doctor wanted to try.
▅
内含一个5毫米的注射器
我的保险公司拒绝了 某封信上写着 不是必要的治疗
My insurance denied it. One letter might say, "not a medical necessity,"
▅
阿瓦斯丁400毫克/ 16 mL容量瓶
审查结果通知
另一封信则写着 那不是用来治疗这种癌症的
one letter might say, "it's not for this particular type of cancer,"
他们拒绝了
and they denied it.
之后我们想到了骨髓移植 那方法确实有效
Then we came up with the bone marrow. It has showed to stop it,
有时候几乎可以完全摆脱痛苦
sometimes to completely get rid of it.
Tracy的医生说这种方法已有成功的先例
Tracy's doctors said this treatment had been successfully tried
治好了很多病人
on many other patients.
如果Tracy的兄弟中 有一个匹配成功的话
If one of tracy's brothers turned out to be a suitable donor.
他们承诺骨髓移植可以彻底治好Tracy的病
There were promising bone marrow treatments for beating tracy's cancer.
两周以后 在堪萨斯大学的护士打电话告诉我
Two weeks later, the bone marrow nurse at KU called me and she goes:
结果已经出来了 他最小的弟弟骨髓匹配十分完美
"We've got the results back. His youngest brother is a perfect donor match."
我们欣喜若狂
We were ecstatic.
我想那是他一生中最幸福的时候
You know, I think that's the happiest I had seen him...
在那一刻
in a while.
我们提交了申请 然后他们拒绝了
So we submitted it and they denied it.
理由是那只是 实验性的
Said it was "experimental."
我找到受保险公司委托专门管理我们医疗申请的理事会
So I found out that there is a board of trustees over our medical plan
我所在的医院也有
that actually work at my hospital.
哪些申请可以被批准 是由他们来决定的
And they are the final decision-makers on what gets approved and what doesn't.
Julie和她的丈夫和儿子
Julie and her husband and their son. Tracy Junior.
和理事会的人进行了一次面谈
Demanded a meeting with the health plan's board of trustees.
那些掌有通过他丈夫医疗诉求的人
The very people who had the power to approve their claim.
他们对Julie的遭遇表示同情
They told Julie that they were sympathetic to her situation.
我说 此刻我丈夫挣扎在生死边缘 你们的同情只是虚情假意
I said, "Your sympathy does me no good when I'm burying him next year."
我告诉他们 首席执行官司Bruce van cleve
And I told them, I said if I was... Bruce van Cleve was our CEO.
我敢打赌说 如果我是首席执行官的妻子 申请一定会被批准
I said, "I bet if it was Bruce van Cleve's wife, it would get approved."
不 根本跟地位高低没关
"No, it's nothing like that."
我说 只是因为我丈夫他是个黑人
I said, "Or maybe if my husband was white."
然后我起身 走了出去
And I got up and walked out of the room.
当我们回到家 发现他（丈夫）把自己锁在浴室里
When we got home, I found him up in the bathroom.
-我敲了敲门 说 你在干嘛 -没什么
And I knocked on the door and said, "What are you doing in there?" "Nothing."
我打开门 通常他会说: 你觉得我在这里还能干嘛
I opened the door 'cause usually he'll say: "What do you think I'm doing in here?"
他只是坐在那里 哭
And he was sitting in there and he was crying.
他说 为什么不可以 我是个好人啊
And he said, "Why me? I'm a good person."
我会说 我们还没有放弃
And I said, "But we're not done fighting this."
我们要坚强 他接着说
"We're strong, yeah." And then he said...
他说 我知道我就要死了
You know, he goes, "I can see now that I'm gonna die."
他说 这世上只有你和孩子是我放不下的
He said, "I can leave everything, but I don't want to leave you and Tracy."
医生说他只能活三个星期了
The doctor told me he would die in three weeks.
而且
And...
1月13号是我的生日
On January 13th, which was my birthday,
他病的只能躺在床上了
he went to sleep.
五天后他在家里死去
And he died five days later, here at home.
他是我此生的挚友
He was my best friend.
是我的灵魂伴侣 是我孩子的父亲
He was my soul mate. He was my son's father.
我们本可以相伴到老的
I mean, we were to grow old together.
他们（医保公司）夺走了我生命中最重要的东西
They took away everything that matters.
我只想知道 为什么是我的丈夫
I wanna know why, why my husband?
为什么不给他活下去的机会
Why wasn't he given the chance to live?
他们总是对大众宣扬 说一定会关心病人 濒死之人 穷人
You preach these vision and values that we care for the sick, the dying, the poor.
医疗保险不会丢下任何一个人不管
That we're a healthcare that leaves no one behind.
可是他们却抛下了他 甚至连希望的机会都不给
You left him behind. You didn't even give him a start.
就好像他什么都不是
It was as if he was nothing.
我想要他们（医保公司）能够稍微觉醒
And I want them to have a conscience about it.
可是我丈夫的死 好像对他们一点触动都没有
And I don't think they do. I don't think it has fazed them one bit.
若无其事
At all.
然而 这样的悲惨
There was one person in the healthcare industry
确确实实触动了一个人的神经
who did have a conscience.
Linda Peeno医生 曾经是Humana的一名医疗检查者
Dr. Linda Peeno. A former medical reviewer at Humana.
我叫Linda Peeno
My name is Linda Peeno.
今天我在这里向大家坦白
I am here today to make a public confession.
在1987年的春天 我还是一名内科医生
In the spring of 1987, as a physician,
我拒绝了一个病人必需的手术申请
I denied a man a necessary operation
手术本可以救他一命 结果他死了
that would have saved his life, and thus caused his death.
没有任何人或者组织 因为这件事对我进行追究
No person and no group has held me accountable for this,
只是因为我所做的 为公司节省了50万美元
because, in fact, what I did was I saved the company a half a million dollars for this.
此外 这个案子维护了我的名誉
And, furthermore, this particular act secured my reputation
作为一个好的医疗主任的名誉
as a good medical director,
它还成为了我在保险行业晋升的跳板
and it insured my continued advancement in the healthcare field.
我从一个周薪几百美元的医疗检查员
I went from making a few hundred dollars a week as a medical reviewer
迅速提拔为内科医生主管 薪水也涨了六倍
to an escalating six-figure income as a physician executive.
我的主要的职责就是利用我的医学专业知识
In all my work, I had one primary duty, and that was to use my medical expertise
为我曾服务过的组织获得经济利益
for the financial benefit of the organization for which I worked.
我反复麻醉自己 我不是在拒绝医疗申请
And I was told repeatedly that I was not denying care,
我只是在拒绝付款
I was simply denying payment.
我深知被操纵的医疗会使病人致残或者死亡
I know how managed care maims and kills patients.
因而我在此告知天下 肮脏源于操控
So I'm here to tell you about the dirty work of managed care.
至今 我愧疚于那百千份的医疗申请
And I'm haunted by the thousands of pieces of paper
因为我把那个该死的 拒绝 写在了上面
on which I have written that deadly word - "denied."
谢谢
Thank you.
反思历史 我们为什么把这次医疗内幕的矛盾点
How did we get to the point of doctors at health insurance companies
聚焦在医疗保险公司的医生上
actually being responsible for the deaths of patients?
是谁发明了这个系统
Who invented this system?
这场医患纷争系统是怎么开始的
How did this all begin?
HMO(美国健康管理模式)是从哪儿开始启动的
Where did the HMO start?
得感谢那些令人惊奇的磁带 还原历史的一瞬
Thanks to the wonders of magnetic tape. We know.
1971年2月17号 下午5:23
理查德·尼克松 Richard Milhous Nixon
Ehrlichman政治顾问: 我们现在来仔细研究下副总统在这件事上的问题
第一个问题 我们是否应该包括
美国健康保险计划就像Edgar Kaiser(美国凯撒铝业及医药公司创始人)的永久计划那样
Nixon总统:现在我问你
你知道我对这些医疗项目不是太苛刻
这是一个私人企业项目
恩 这倒挺诱人的
Edgar Kaiser正在做这个有利可图的项目
他能一直做下去的原因是
我曾让Edgar Kaiser过来跟我谈过这件事
我们把这个项目深入的谈了下
所有的激励措施反而使 人们得到的医疗保健更少了
不过正因为如此 提供的医疗保健越少 他们越能从中获利
很好。
激励措施很不错
不错
第二天 1971年2月18日
今天我将提出一项新的国民医疗服务制度
I am proposing today a new national health strategy.
这个规划的目的是
The purpose of this program is simply this -
让美国公民得到 世界上最好的卫生保险
I want America to have the finest healthcare in the world,
让每个美国公民 可以得到及时的治疗
and I want every American to be able to have that care when he needs it.
计划由Nixon和Edgar Kaiser策划
The plan hatched between Nixon and Edgar Kaiser worked.
接下来的年代里 病人获得的治疗越来越少
In the ensuing years. Patients were given less and less care...
附近的医院发生了严重的堵塞 情况并没有好转的迹象
Bigger logjams at the nearby hospital and less quality medical care.
从早上七点以来已经持续了18个小时
Been here about 18 hours, since 7:00 this morning.
那些看上去在抽筋的和脸色难看人的也许有生命危险
What looks cramped and unsightly can also be dangerous.
当保险公司开始变得富有
While health insurance companies became wealthy.
系统就不起作用了
The system was broken.
3700万美国公民没有得到足够的保护来应对灾难性的疾病
37 million Americans are without protection against catastrophic illness.
受损失的人是那些穷人 他们需要的紧急治疗被推迟了
The losers are the poor. Who may now postpone urgent healthcare
当他们得到治疗时一切已经太迟了
until it's too late.
这种状况持续了很多年
This went on for years.
直到这个人开始执政（克林顿总统）
Until this man rode into town.
和这个美丽的姑娘的出现(希拉里·克林顿)
Bringing with him his little lady.
( I'll take you there by Staple Singers )
希拉里·克林顿 Hillary Diane Rodham Clinton
时髦
Sassy.
聪慧
Smart.
性感
Sexy.
让男人闻风丧胆
Some men couldn't handle it.
今天我将宣布
Today I am announcing the formation
关于国民医疗制度的总统特遣小分队
of the President's Task Force on National Health Reform,
由第一夫人Hillary Rodham Clinton领导
chaired by the First Lady, Hillary Rodham Clinton.
Hillary Clinton 决定优先为大家争取医疗保险
Hillary Clinton decided to make healthcare for everyone her top priority.
现在全民覆盖
Universal coverage now.
不管你在哪儿作 是否工作
It will not depend upon where you work, whether you work,
或者你是否有预先存在的条件
or if you have a preexisting condition.
获得医疗保障的权利不可侵犯
Healthcare that can never be taken away.
有些共和党人抱怨 Clinton夫人之所以能这么做
Some Republicans complain Mrs. Clinton is getting a free ride.
是因为她是总统的夫人 Because she is the President's wife
Clinton总统冒了相当大的风险去
It's fairly risky business what President Clinton did,
让他的妻子主持 这样一个重大的政策方针
to put his wife in charge of some big policy program.
在本次众议院会议上 我一点都不支持这项改革
And while I don't share the chairman's joy at our holding hearings
(德克萨斯州议员代表)
这项提议由政府控制的医疗保险系统
on a government-run healthcare system,
我尽可能会分享他意见 使得我们的辩论和立法过程
I do share his intention to make the debate and the legislative process
-更加地令人激动 -我确信你会的 Armey先生
- as exciting as possible. - I'm sure you will do that, Mr. Armey.
-我们会尽我们所能的 -你和Kevorkian医生
- We'll do the best we can. - You and Dr. Kevorkian, I think.
(Jack Kevorkian 美国安乐死活动家 倡导死亡权利 )
我想我已经了解你们的魅力和智慧 在我看来
I have been told about your charm and wit, and let me say...
关于你们魅力的报道是夸大其词的
Reports on your charm are overstated
-而关于你们智慧的报道是不充分的 -非常感谢
- and reports on your wit are understated. - Thank you. Thank you very much.
她让政府变得愚蠢
She drove Washington insane.
你想让政府控制你的医疗保险
Do you want the government to control your healthcare?
你将失去选择医生的权利
You won't have the choice of your own doctors.
-抵制政府干预 - 呼吁市场化控制
- Less government. - More control.
-抵制政府干预 -让公众自己掌握家庭的控制权
- More government. - Less control for you and your family.
当你妈妈病了 她可能向一个官僚主义者而不是医生诉说
When your mama gets sick, she might talk to a bureaucrat instead of a doctor.
这简直不可理喻 而且会变得更加混乱
This is a total mess, and it's about to get messier.
他们这是大搞专治 官僚 是在实行社会主义
Not this bureaucratic, socialistic plan that they have.
-这就是社会主义 -社会主义公费医疗制度
- Socialist takeover... - Socialized medicine.
什么才能和 一个巨大的社会试验相比
What really amounts to a giant social experiment.
红 色 梦 魇
哦 社会主义公费医疗制度
Ooh! Socialized medicine.
公费医疗
没有什么恐惧 比自己吓自己更恐怖
Nothing put more fear in us than the thought of that.
反对社会主义公费医疗制度的主要的恐惧散播者
And the chief fearmongers against socialized medicine
政治犯33营
一直是那些好医生
have always been the good doctors
他们为美国医疗协会工作
of the American Medical Association.
美 国 医 疗 协 会 出 品
这会把政府塞进你的医院
This would put the government smack into your hospital,
你 家 医 生 专 题
他们会制定服务标准
defining services, setting standards,
设立委员会发布报告
establishing committees, calling for reports,
决定谁留下谁退出
deciding who gets in and who gets out.
毕竟政府对每一个人都是公平的 你难道不知道吗
After all, the government has to treat everyone fair and equal, don't you know?
带领我们走上新医疗人人皆有医保的大路
Take us all the way down the road to a new system of medicine for everybody.
共产党情报局
是的 人人都能得到服务
Yes. Medicine for everyone.
美国医疗协会可不想这样
The AMA didn't want that.
为了在国内把这个论点传播的更远
And to drive the point home further.
他们进行的宣传 遍布了整个国家
They held thousands of coffeeklatsches all over the country.
他们邀请所有的人来喝咖啡 听录音
Where they invited their neighbors to come and listen to a record
由著名的演员录制录音 来散播公费医疗制邪恶论
made by a well-known actor on the evils of socialized medicine.
我叫Ronald Reagan
My name is Ronald Reagan.
一个传统的强迫人们接受社会主义的方法
One of the traditional methods of imposing statism or socialism on a people.
是通过医疗服务
Has been by way of medicine.
医生开始失去自由 就像一个谎言导致一个接一个谎言
The doctor begins to lose freedoms. It's like telling a lie. And one leads to another.
一个医生决定去一个城镇工作
A doctor decides he wants to practice in one town.
政府对他说 你不能去这个城镇
The government says to him. "You can't live in that town.
他们已经有了足够的医生 你得去其它的地方
They already have enough doctors. You have to go someplace else."
一旦有了先例 我们都可以预见会发生什么
All of us can see what happens once you establish the precedent
政府可以决定一个人工作的地方和工作的方式
that the government can determine a man's working place and his methods.
之后就会扩展到其他的领域
And behind it will come other federal programs
这个曾经自由的国度 将成为专治的地狱
that will invade every area of freedom as we have known it in this country.
直到有天我们觉悟到 我们实行的是社会主义
Until one day. We will awake to find that we have socialism.
白宫低声下气的
The White House said to tone down the rhetoric.
安抚烧毁 Hillary Clinton 的画像 的人们的情绪
Reacting to burning an effigy of Hillary Clinton.
时代在变 但是恐吓战术没有变
The times may have changed. But the scare tactics hadn't.
美国健康保险协会
医疗保险产业花费了大约一百万美元
The healthcare industries spent over a hundred million dollars
美国医学协会
美国全民健全经济组织
美国基督教联盟
去打击 Hillary 的医疗保险计划 他们取得了胜利
to defeat Hillary's healthcare plan. And they succeeded.
美国餐馆协会
美国共和党全国委员会
我现在想提及一下总统
And I want now to introduce to you the president,
因为他喜爱Easter egg roll
because he loves the Easter egg roll.
在白宫接下来的七年里
For the next seven years in the White House.
Hillary不被允许再次提出那个计划
She wasn't allowed to bring it up again.
这儿有谁有两岁了吗
Is anybody here older than two?
十五年过去了
A decade and a half went by.
美国依旧没有全国性的健康计划
And still America had no universal health plan.
美国的健康状况滑到了第37名
The United States slipped to number 37 in healthcare around the world.
只比斯洛文尼亚稍微领先一点
Just slightly ahead of Slovenia.
不过这情有可原 你懂得 国会议员情总是很“忙”
But that's understandable. Because Congress was busy with other matters.
Speaker先生 今天我来表示祝贺
Mr. Speaker, today I rise to offer congratulations
向Just Born lncorporated的糖果制造商
to the confectioners at Just Born lncorporated,
为他们的五十周年纪念日
as they celebrate the 50th anniversary
他们最具传奇性的产品
of one of their most recognized and celebrated products,
同时也是我女儿最喜爱的Marshmallow Peeps(一种糖果)
not to mention my daughter's favorite, Marshmallow Peeps.
就这样 医疗保险公司安稳的步入了21世纪
And thus. The healthcare industry went unchecked into the 21 st century.
Humana的利润这一年上涨了两倍
Humana more than doubles its fourth quarter profit, lifts its earning for the year...
美国健康公司的股价翻了三番
United Health has tripled its share prices.
赚取不道德的利润
Making obscene profits...
比期望获得收入要容易得多
better-than-expected earnings.
他们有很多富有的股东
There's a lot of wealthy shareholders out there.
他们愿意分享他们的财富给贫困的人医治吗
Are they willing to share some of that wealth?
使他们的首席执行官 变成亿万富翁
Turning their CEOs into billionaires.
只要他们想 任何时候都可以巧妙的避开法律
And skirting the law whenever they wanted.
但是他们最大的成就 是收买美利坚合众国的众议院议员
But their biggest accomplishment was buying our United States Congress.
这里是华盛顿 游说议员竟然变得如此厚颜无耻
This is Washington at work. Lobbying has become so brazen...
有4倍于医疗保险行业的游说议员
With four times as many healthcare lobbyists
在众议院里为他们游说
than there are members of Congress.
他们甚至试图收买那些年老的反对者
They even managed to buy off old foes.
Hillary因为她的沉默获得了奖励
For her silence. Hillary was rewarded.
医疗保险产业给她的回报
And she became the second largest recipient in the Senate
是排在第二的
of healthcare industry contributions.
我们把整个医疗保险系统给了保险产业
We've given the entire healthcare system over to the insurance industry.
-他们完全控制了 -好吧 不是完全控制
- And they have total control. - Well. Not total control.
医药公司也喜欢 收买美国众议院议员
Drug companies like to buy their members of Congress too.
这是收买这些人的价码
Here's what it costs to buy these men.
这个女人
And this woman.
这个家伙
This guy.
这个家伙 还有他
And this guy. And him too.
女士们先生们 美国总统
Ladies and gentlemen, the President of the United States.
最大的支票为最后出场的保留着
And the biggest check was saved for last.
他们为什么把这些现金都上交了
Why did they hand out all this cash?
他们想要一份法案通过 一份帮助老年人获得更好的医疗的法案
They wanted a bill passed - a bill to help seniors with their prescriptions.
让人们对它没有误解
Let there be no mistake about it.
共和党人爱他们的妈妈 爸爸 和他们的祖父母
Republicans love their mothers, their fathers and their grandparents
就像这个国家里所有的人一样 我们也会照顾好他们
as much as anybody else on this hill, and we're gonna take care of them.
当然 那的确是一个重要的法案 从纳税人的钱中分8000亿
Of course. It was really a bill to hand over 800 billion of our tax dollars
医药与健康保险产业
to the drug and health insurance industry.
医药公司可以要求任何东西
By letting the drug companies charge whatever they wanted.
还可以让他们的私人医疗保险公司 成为中产阶级
And making the private health insurance companies the middleman.
公司里的每个人都必须缩减经费
Everybody was going to get their cut.
他们指定把工作做完的那个人
The man they appointed to get the job done
是国会议员Billy tauzin
was congressman Billy tauzin.
显然他适合那份工作 他可是有大招的
He was the right man for the job because he had a secret weapon.
这个房间里没有人 能在对母亲的爱上胜过我
There's no one in this house loves their mother more than I love my mother.
这一点上我恐怕无法认同 先生
I challenge you on that, sir.
我们对妈妈的爱都是一样的
Nobody in this body that loves their mother any more or any less than any one of us.
我爱那个女人
I love that woman.
你有哪怕那么一秒钟
Do you think for a second you love your moms and dads
爱你的父母胜过我们对我们父母的爱
any more than we love ours?
你觉得参与投票的共和党与民主党
Do you think Republicans and Democrats who will vote...
你真的相信那个吗Stoddard先生 上帝保佑你
Do you really believe that, Mr. Stoddard? God bless you.
哦 他们都爱他们的妈妈
Oh. They all loved their mothers.
只是他们并不爱我们的妈妈
It's just that they didn't love our mothers as much.
我很荣幸签署这份 具有历史意义的法律文件
Now I'm honored and pleased to sign this historic piece of legislation -
乔治·沃克·布什 George Walker Bush
《现代医疗处方药改进法案2003》
the Medicare Prescription Drug, lmprovement, and Modernization Act of 2003.
他们没有告诉我们的是 老人可以不用
What they didn't tell us was that the elderly could end up paying more
为了他们的处方支付以前那么多的钱
for their prescriptions than they did before.
大约三分之二的老人 每年还依旧要支付大约2000美元
Over two thirds of senior citizens could still pay over $ 2.000 a year.
当这个结束之后 参与其中的14位国会议员
And when it was over. 14 congressional aids who worked on the bill
辞去议员身份 投入到有关民众健康的事业中去
quit their jobs on the Hill and went to work for the healthcare industry.
正如这位成功“转型”的议员
As did one congressman.
我得到了一张价值千金的票
'Cause I've got a golden ticket...
Billy tauzin辞去了议员身份 成为了PhRMA的CEO
Billy tauzin left Congress to become the CEO of PhRMA.
成为了医药产业游说议员的一员
The drug industry lobby.
他的工资是一年二百万美元
For a salary of $ 2 million a year.
噢 在华盛顿的那一天是幸福的
Oh. It was a happy day in Washington.
许多美国民众都知道 他们再也见不到美国的全民医疗保健了
Many Americans knew they were never going to see universal healthcare.
那也是一些人决定去其他国家碰运气的原因
And that's why some of them decided to look elsewhere for help.
我们正在跨越底特律河
We're driving across the Detroit river.
它的后面是康复中心 你可以看到那个建筑
Back there is the Renaissance Center, you can see it.
大部分的康复设施都在Detrot镇 就在地平线上
General Motors' headquarters, downtown Detroit, the skyline.
在这座桥上开车 风景太好了
You get a really nice view from driving over the bridge.
她是Adrian Campbell 一个单身妈妈
This is Adrian Campbell. A single mother.
她在22岁的时候查出患上了癌症
Who at the age of 22 came down with cancer.
我患的宫颈癌 而且由于保险公司的缘故 我都放弃了
I got cervical cancer and I was denied through the insurance company.
他们说 我们不会偿付保险金因为你才22岁...
They said, "We're not paying for it because you're 22 and you don't have..."
你不可能会得宫颈癌的 你太年轻了
"You shouldn't be having cervical cancer. You're too young."
癌症不因年龄而临幸患者 账单也是
Forced into debt. But now cancer free.
Adrian已经受够了美国医疗保健系统
Adrian was fed up with the American healthcare system.
她想出个法子
She had a new plan.
穿越国境前我已经做好了准备
I have everything ready before I even hit the border.
我准备好了护照 需要的费用
I got my passports ready, I got my money out.
来这里 路上的费用是3美元25美分
It's three dollars and 25 cents to get across one way.
一切就绪 我已经迫不及待了
And I got everything just sitting up here on my visor just ready to go.
Aurora 安静
Aurora, be very quiet.
-身份 -美国人
- Citizenships? - US.
-住哪儿 -密歇根州
- Where do you live? - Michigan.
-没在摄像吧 -没有
- That's not on, right? - No.
她可能住在密歇根
She may live in Michigan.
但是离边境线上10个街区 Adrian成了一个加拿大人
But ten blocks across the border. Adrian becomes a Canadian.
你在这里住了多长时间了 三个月
How long have you been living here? Three months?
两个月 我还没有申请安大略省医保卡
A couple. I haven't applied for the OHIP card yet.
-我只有原来的 -这要花10分钟
- I still have mine. - It takes ten minutes.
没问题 好的 谢谢
That's fine, I don't mind. OK, thank you.
我在诊所留下了Kyle的地址
I put down Kyle's address at the clinic,
你知道 当别人问我俩的关系的时候
and when they ask, you know, what my relationship is,
我就说他是我太太
I put down that I was his common-law partner.
我不喜欢撒谎 但是我更不想债务缠身
I don't like to lie and I don't like liars.
这只是一个善意的谎言 他帮我省下一大笔开销
It's little white lies, but it's... You know, I'm saving the money.
在这里 你上医院看病不需要带着支票 它提供给我们
You don't bring a checkbook when you go to the hospital here. It's provided to us.
在这里 你不用担心病无医治
It's something you don't have to worry about or go out of your way to get.
没有费用压力
Stress free.
-他们叫警察了 -因为发现了摄像机
- They called the cops. - The presence of our camera
提醒诊所察觉到有事情发生
alerted the clinic that something was up.
觉得不能继续在这里就诊了
And I don't think I'm gonna get seen now.
我有个新想法
So I have another idea.
我会去其它的医疗机构
I'm gonna go down to the other clinic.
我们刚刚经过了一个医疗中心
There is a clinic down... one that we passed.
看 警察局在那里
The police showed up over there. Look.
是的Adrian的做法是违法的 但是我们是美国人
Yes. What Adrian was doing was illegal. But we're Americans.
当我们需要的时候 我们就会去其它国家
We go into other countries when we need to.
这很狡猾 但这也是允许的
It's tricky. But it's allowed.
如果稍微改变一下 我的意思是
It's kind of frustrating having... l mean...
-成个家或许会能解决这一切 -她就有医疗保障了
Just get married and that'd solve everything - she'd be covered.
美国人为了医保嫁给加拿大人
Americans marry Canadians just for the healthcare!
-我在努力 -听起来是个好主意
- I'm being used. - Sounds like a good idea.
看看它到底行不行的通 一切走着看吧
See if it works. Start something. Start a trend.
加拿大每个人都有公费医疗
In Canada they give everybody free healthcare.
-难道他们一开始就有吗-不 很不幸一开始也没有
- Doesn't it work up there? - No, unfortunately it doesn't.
我们需要等待几个月来接受治疗 但是在这里只需要几天或者一周就可以了
We wait months to get treatment you can get in a week or a few days here.
在加拿大一个心脏搭桥手术你可能需要等待九、十个月
In Canada you have to wait nine to ten months for bypass surgery.
许多加拿大人认为这个医保系统本身就存在问题
Many Canadians believe it's the healthcare system itself that's sick.
他们给医生支付的费用少了
They pay their doctors less.
一个外科医生一年没有几个病人
A surgeon can only do a certain number of operations each year.
但要维持的昂贵的设备却是如此之多
With only so many expensive new pieces of equipment.
在美国给你家宠物做个核磁共振都要简单得多
It's easier for your cat or dog to receive an MRl here in America.
整个渥太华只有一台化疗机器 你会因为癌症无法化疗等到死
You die of cancer waiting for chemo 'cause all of Ottawa has one chemo machine.
如果你认为公费医疗好 去问加拿大人
If you think socialized medicine is a good idea, ask a Canadian.
我知道问Bob和Estelle比问一般加拿大人更有用
I thought who better to ask than my Canadian relatives. Bob and Estelle.
但是他们不想跨越边境来美国
But they wouldn't cross the border into America.
而在加拿大的一家Sears百货商场和我见面
They wanted me to meet them at Sears. In Canada.
你们在这里做什么呢
What are you guys doing here?
-我们在买保险 -我们打算去美国见你
- We're buying insurance. - We're going to the States to see you.
那只需要跨过一条河
Right, that's just across the river.
是的
Yeah.
如果没买保险 你们就不愿意花两个小时到密歇根州去见我吗
You wouldn't go over to see us in Michigan for a couple of hours without insurance?
是的 我们不会去 我们坚信这一点 我们不会去的
No, we wouldn't. We're just adamant about it. We would not do it.
万一有人打到了我的嘴 或者其他 类似(没有医保保障)
If somebody punches us in the mouth or something, something like that...
你是不希望和美国医疗系统之类的打交道对吧
You don't want to get caught in the American health system thing?
我们对美国或美国人 或这类的一点意见也没有
We have nothing against Americans or America, or anything like that at all.
-我们是简单善良的人 -也不特别简单 但绝对善良
- We're a nice and simple people. - Not very simple, but certainly very nice.
我决定进一步探讨他们的反美观点
I decided to explore their anti-American views further.
有一盘加拿大美食陪伴
Over some fine Canadian cuisine.
我们有一个朋友去了夏威夷
We have a friend who went to Hawaii.
它在那里的时间里 头部得了点病
And he sustained a head injury while he was there.
当他把病治好了 想回来了
And before he was well enough to come home,
他收到了一张60万美元的帐单
he had chalked up a bill of over $600,000.
一个加拿大中产阶级怎么可能承担得起呢
So what middle-class Canadian could absorb that?
我对你们还需要担心类似这样的事情感到抱歉
I guess I feel bad that you would have to worry about something like that.
我们没有批判你的祖国 我们只是告诉你一些事实
We're not criticizing your country, we're just giving you the facts,
如果没有买保险的话我们付不起那医疗费的
that we could not afford to be without insurance.
-甚至只待一天 -只待一天也是
- Even for a day? - Even for a day.
为了进一步证明他们的观点 他们带我去了一家当地的高尔夫球场
To prove their point even further. They sent me over to a local golf course
去和曾在佛罗里达度假时出了高尔夫意外的Larry Godfrey谈一谈
to talk to Larry Godfrey. Who had a golfing accident while on vacation in Florida.
我听到了一声巨响 然后感到疼痛无比 肌腱突然断了
I could hear a noise and feel a pain, and the tendon snapped off this bone here
这个肌腱是连接它两头的肌肉的
that holds the bicep in place.
可以使两边的肌肉充满弹性
So this bicep muscle was released, like on an elastic,
但是在胸口的肌腱断了
and it ended up here on my chest.
-胸口的肌肉没弹性了 -是的 就在这里
- The muscle ended up in your chest? - Right. Ended up here.
像其他高尔夫球手一样 在去治疗之前
Like all good golfers. Larry finished his round
Larry还是先完成了一局高尔夫
before seeking medical attention.
治疗过程中 他得到了一个坏消息
That's when he got the bad news.
我本来一点也不担心 因为我买的是国际性的保险
I wasn't too worried as I had out-of-country insurance,
但是当医生告诉我医疗费是 2.3万到2.4万美元时
but when he told me it was 23 or 24,000, then l...
-2.4万 -是的 还是美元
- 24,000? - Dollars, yes.
所以说如果你在美国治疗 就要支付2.4万美元的医疗费
So if you'd stayed in the United States, this would have cost you $ 24,000?
如果你返回加拿大 那么加拿大就会替你支付这笔费用
Instead, you went back to Canada, and Canada paid your total expenses?
-对 所有 -政府出这笔钱 那你还要自己掏
- Everything. - Paid for the operation. It cost you?
-什么也不需要掏 -零
- Nothing. - Zero.
对 就是零 零
Zero. Zero.
我想知道为什么你指望那些本不需要出这笔钱的加拿大国民
I'm wondering why you expect your fellow Canadians, who don't have your problem,
我的意思是 为什么国民所交的税要用来支付你的医疗费用
why should they, through their tax dollars, have to pay for a problem you have?
因为如果他们也急需医治 我们也会伸援手
Because we would do the same for them.
这是不用犹豫的 也是我们一直追求到底的
It's just the way it's always been and it's the way we hope it'll always be.
是这样 但是如果你不得不自己支付这笔费用的话
Right, but if you just had to pay for your problem,
而不用去管其他人的 只管自己的事
and don't pay for everybody else's problem, just take care of yourself?
那样的话 很多人都承受不了那笔医疗费
Well, there are a lot of people who aren't in a position to be able to do that.
就需要其他人帮助他们了
And somebody has to look after them.
你是一个共产党员么
Are you a member of the Socialist Party?
-不 不是的 -绿党
- No. No. - Green Party?
也不是 实际上 我是一个保守党党员
No. Well, actually, I'm a member of the Conservative Party.
这不好么
Is that bad?
-没 只是觉得有点困惑 那么
- Well, it's just a little confusing. - Well...
这不应该啊 我只是认为
it shouldn't be. I think that...
有些地方的医疗保险制度确实存在问题 但决不会是加拿大
Where medical matters are concerned, it wouldn't matter in Canada
而党派 还不是看你自己自由选
what party you were affiliated with, if any.
对我们来说 就像我们在这看着美国
But, to us, as we look across the river here,
我们反观 为什么美国不相信在加拿大发生的这些
you know, why don't you think we don't believe that?
在这个问题上我们错在哪里
What's wrong on this issue with us?
我猜大概是权贵不想分享我们所信仰的：
I guess the powers that be don't share our beliefs
应该把医疗保健惠及全民
that healthcare ought to be universal.
加拿大也不是一开始就是这样的 直到Tommy Douglas的出现
I mean, Canadians didn't until we met up with a guy named Tommy Douglas,
他几乎每个人的改变了主意
who pretty much changed everyone's mind.
-就靠他一个人 -是的 就靠他一个人 他
- One guy? - One guy, yeah. One guy did it, he...
-他能接受我们的采访吗 很不幸 他已经去世了
- Can he come over and visit us? - He's dead, unfortunately.
事实上 他
In fact, he was...
他是近代对加拿大影响最重大的一个人
He's just most recently been revered as Canada's singular most important person.
-我们认为很多东西 -你的意思是从历史上看
- We think so much of... - You mean in your history?
在我们整个历史上来说
In our whole history.
-比你们的第一个总统还重要 -绝对是
- More than your first prime minister? - Absolutely, yeah.
比Wayne Gretzky还重要
Even more than Wayne Gretzky.
-不可能 -就是这样的
- No way! - Absolutely. Yeah.
-比Celine Dion更重要吗 -伟大的歌唱家 比Celine更重要
- More than Celine Dion? - Great singer. More than Celine, yeah.
-比Rocky和Bullwinkle还要重要 -可能吧
- More than Rocky and Bullwinkle? - Maybe.
加拿大安大略省伦敦市
一枚刀片这样下来 削到了我戴着的手套
As the blade went through, it caught the glove I was wearing
然后几乎完全切断了手指以及外面的手套
and it sliced through the entire group of fingers, completely taking them off.
我马上意识到我需要帮助
And I realized that I needed help immediately.
很显然 把断指 断臂或者是肢接上去
Obviously, putting on amputated fingers or arms or limbs
是一件很精细的工作
is one of the more dramatic things we can do.
如果要接5个手指的话 需要连续做24小时的手术
If you're looking at five fingers, you're looking at a 24-hour operation.
这需要4个外科大夫 以及相同数量的护士
There actually was four surgeons, as well as all the nurses
以及两个麻醉师一起来做这个复杂手术
and two different anesthetists to carry out an operation of that magnitude.
当Brad进来的时候 我们不会考虑他是不是付得起这笔医疗费
When Brad came in, we didn't have to worry about whether he could afford it.
他需要帮助 我们竭尽全力去帮助他
He needed help and we could concentrate on the best way to bring him through it.
我在美国碰到一个人他已经被电锯切下了两个手指
I met this American, he'd cut off the ends of two of his fingers with a saw.
当他到医院的时候 他们告诉他接一根手指需要花6万美元
So when he arrived at the hospital, they told him one finger's gonna cost $60,000,
另一根则要花1.2万美元
and the other one was gonna be $12,000.
因此 他必须选择接哪一根手指
He had to choose which finger he could afford.
把长的那根手指弯下去
Down. Bend the long finger down.
我们从不跟任何人说他的断指接不回去
We've never told someone that they couldn't put a finger back on
因为这是制度所不允许的
because the system wouldn't allow it.
我很高兴有那么一个机制 能使我给人看病没有后顾之忧
I'm very glad I work within a system that allows me the freedom to look after people,
也不用做你说的那样的选择
and not have to make choices like that.
看起来 我们所说的关于加拿大医疗体制都不是真的
It seems nothing we were told about the Canadian system was true.
可能是由于我选择了一个错误的城市
Maybe I was just in the wrong part of town.
因此我穿过这个城市 去了一家很拥挤的医院的候诊大厅
So I went across the city to a crowded hospital waiting room.
你必须在这里等多长时间得到帮助?
How long did you have to wait here to get help?
-20分钟 -45分钟
- 20 minutes. - 45 minutes.
-我在第一时间就的到了治疗 -你会发现这里太拥挤了
- I got helped right away. - You can see how crowded this is.
他们真的是在做一件了不起的工作
They really do an amazing job.
你来这家医院需要事先获得许可么
Did you have to get permission to come to this hospital?
-不用 -不用
- No. - No.
我们想去哪里就去哪里
We can go anywhere we want.
你们不用事先向保险公司证明什么吗
You don't have to get it preapproved by your insurance company?
-当然 绝对不需要 -你能选择看病的医生么
- Oh, heavens, no. - Can you choose your doctor?
-可以 -你要花钱么
- Oh, yes. - What's your deductible?
-不用 -我觉得我什么都不用
- Nothing. - I don't think we have any.
我不知道 据我所知 不需要自己掏钱
I don't know. I don't think there's any, as far as I know.
-看病需要花多少钱 -不用花一分钱
- So what did this cost? - Nothing.
我们知道在美国 国民要为看病花钱
We know in America people pay for their healthcare,
我觉得我无法理解这个 原因是我们不需要
but I guess we don't understand that, 'cause we don't have to deal with that.
我们这里可以医治帕金森病 中风 心脏病
And we're dealing with Parkinson's, stroke, heart attack.
我们是幸运的 真的 很幸运
We're very, very lucky. Really we are.
我的意思是 我们抱怨 我们可以抱怨一切 对吧
I mean, we complain. People complain about everything, right?
-是的 你是加拿大人 -但是总的来说 这是一个难以置信的机制
- Right, you're Canadian. - But on the whole, it's a fabulous system
确保了用最少 但是最出色的人来照顾他们
for making sure that the least of us and the best of us are taken care of.
事实证明 加拿大人的平均年龄比我们大3岁
It turns out that Canadians live three years longer than we do.
当你看到类似Erik这样的美国人 你就会相信这一点了
That's not hard to believe when you meet fellow Americans like Erik.
噢 英格兰 我们来到了这里
Oh, England, here we go
华盛顿奥林匹亚的Erik Turnbow(他们)拯救了他的一生
Erik Turnbow of Olympia. Washington. Saved up his whole life
以便他能在伦敦参观著名的Abbey路人行道
so that he could visit the famed Abbey Road crosswalk in London.
但是 这远远不够 他还想像披头士那样横穿马路
But it wasn't enough for Erik to just walk across the road like the Beatles did.
他喜欢用他自己的方式
He had to do it his own special way.
这个是Erik 正走在Abbey路的右侧
Here's Erik, about to walk on his hands across Abbey Road.
准备好了么
Ready?
啊
Ugh!
再来一次
Try it again.
不 我的手受伤了
- Are you in pain? - Yeah.
-很疼吗 -是的
这条路下面就有一家医院
在英国的医院 Erik不需要花一分钱
The British hospital didn't charge Erik anything for his stay.
所有的治疗和药物只用了十块钱
And only about ten bucks for all the way-cool drugs they gave him.
-你的整条手臂都挂了 -我很快就会好的
- You're all slung up. - I'm gonna be OK.
我决定去趟英国 弄明白医院是如何保持免费
I decided to go to Great Britain to find out how a hospital stay could be free.
居然会有只要10美元的医药费
And drugs could cost only ten dollars.
如果我来这 有一个处方 它需要30片 要花多少钱
If I come in here and I have a prescription and it requires 30 pills, how much is that?
需要6.65磅 这是标准收费
It's ￡6.65. That's the standard charge.
6.65磅 那是多少 10美元么
￡6.65? So that's what? Ten dollars or so?
-是的 -那我要是需要60片的 需要多少钱
- Yes. - What if I needed 60 pills, how much is it?
-一样 -120片呢
- Same charge. - 120 pills?
-还是6.65英镑 -这和你要多少没有关系
- ￡6.65 still. - Lt doesn't matter how many pills?
-是的 -那我要的是治疗HIV或者是癌症的药物呢
- No. - What if it's an HIV drug or a cancer drug?
依然是6.65磅
Still ￡6.65.
如果年龄低于16或高于60 他们连这点钱都不用付
If they are under 16 or over 60, they're automatically exempt.
照这个说法 只有那些有一定收入的上班族才需要付6 65磅
So only a working adult who earns enough money pays the ￡6.65?
其他人都是免费的
Everybody else gets medication free?
-也不要支付其他额外的费用 -不用
- No money being exchanged here? - No, nothing.
你没有付钱么 -我已经超过60岁了 不用付钱
- There's no money being exchanged? - I'm over 60. We don't pay.
那你的营业额记录表是用来做什么的
What's the purpose of the cash register?
我只想知道面包 牛奶和糖果放在哪里
I'm just wondering where's the bread and the milk and the candy in here?
我在这里找不到洗衣服用的洗衣粉
I can't pick up any laundry detergent here?
这里没有 我这里不卖那个好多年了 所以你找不到
No. I haven't been trained for that many years to be selling detergents, so no.
接下来我去了一家州立医院 隶属于国家公共医疗卫生部NHS
I next went to a state-run hospital. Operated by the National Health Service.
我的预产期在七个月后 这之前 我有六个月的带薪产假
I'm due in seven weeks and I get six months off, paid.
生完宝宝后 还有六个月的带薪产假 相当于休了一年
And then I can have six months off unpaid as well, so I'm actually taking a year.
在我的国家里 这个听上去很奢侈
Well, that sounds like a luxury where I'm from.
真的吗 美国不是这样的么
Oh, really, it's not like that in the US? No? Not at all, no?
那你住这里要花多少钱
So what do you pay for a stay here?
这里对所有人都是免费的
No one pays.
他们一直在问要付多少钱
They were asking how do people pay.
我说这些是 你不需要付 直接走就可以了
I said there isn't... You don't, you just leave.
这个有国家补助 到最后也不会给你帐单的
It's national insurance. There's no bill at the end of it, as it were.
即使有国家的补助 有些地方的开销也是相当大的
Even with insurance. There's bound to be a bill somewhere.
-请问财务处在哪里 -这里没有财务处
- So where's the billing department? - There isn't a billing department.
这里没有那种东西
There's no such thing.
你们的孩子看病花了多少钱
What did they charge for that baby?
-你说什么 -你在离开医院的时候 你花钱了么
- Sorry? - You gotta pay before you can get out?
没有 这个是NHS的事
- No. This is NHS. - No, no. Everything is on NHS.
你知道的 这里不是美国
You know, it's not America.
或许我在高物价地区运气会好点
Maybe I'd have better luck in the part where things get seriously expensive.
这家伙弄伤了脚踝 他需要花多少钱来治病
This guy broke his ankle. How much will this cost him?
急诊就诊的 做完手术他会支付巨额账单对吧
The emergency room visit. He'll have some huge bill when he's done, right?
在这里 在NHS医院治疗都是免费的
Here... NHS, everything is free.
我在问医院的收支情况 而你却在笑
I'm asking about hospital charges and you're laughing.
在急诊室里我从没有碰到过这种问题 这就是原因
I was never asked this question in the emergency department, that's why.
一切都免费 我开始有点儿崩溃了
I was starting to fall for this "everything is free" bit.
然后 我发现了这个
And then I discovered this.
这该是要病人缴费的地方了吧
So this is where people come to pay their bill when they're done staying here?
不 这是NHS下属医院 不需要缴费的
No, this is the NHS hospital, so you don't pay the bill.
你可以直接回家
You get to just go home?
既然都不用交钱 那这里为什么要叫 收银
Why does it say "cashier" here if people don't have to pay a bill?
出纳
我们需要的是一个在柜台后的小职员
All we have is a little man who stands behind a counter
如果有人不得不转院 他会把零钱给人们
and he gives people money if they've had to pay for transport.
需要出示以下材料
诊所接待员或病房工作人员签署的病人的出行申请表
你的上岗卡\书
请尽快给病人服务
给病人的出行报销
对那些需要换医院的病人 我们必须支付他们的交通费用
Those who have reduced means get their travel expenses reimbursed.
谢谢
Thank you.
因此 在英国的医院 钱不是病人给医院
So in British hospitals. Instead of money going into the cashier's window.
而是医院给病人
Money comes out.
出院的标准不是你是否付清了费用
The criteria for letting you out are not if you've paid,
标准是你是否康复 以及你是否需要去一家更好的医院
the criteria are, are you fit to go and are you going somewhere safe?
很显然 我在这里本身就是一个笑话
Clearly. I was just the butt of a joke here.
我需要找一个传统的美国人
What I needed was a good old-fashioned American
他或许会理解我
who would have some understanding.
我第一次来伦敦是1992年
I first came to London in 1992.
我刚刚搬到这里 在这里我有了3个孩子
And we just ended up staying and we had three children here.
3个孩子都是NHS下属的医院出生的
Well, I had them all on the NHS, which is the British National Health Service.
我像很多美国人一样 认为这里实行的也是公费医疗制度
I think, like a lot of Americans, assumed that a socialized medicine
这个应该是最基本的社会保障
was just bottom of the rung treatment,
这也是我最担心的一方面 就像以前对前苏联的担心一样
that the only way would be horrible and it would be like the Soviet Union.
我的意思是 那个
I mean, that's kind of how...
-这个很令人担心 我确实是这样想的 -我也是这么认为的
- And it's terrible that that's what I thought. - That's what I thought. Too.
有了孩子之后 回农场是很正确的
After having a baby. It's right back to the wheat fields.
(苏联歌曲)
我们种好我们的麦子
因为劳动最光荣
但凭我们谦卑的努力
一定能带领我们获得丰收
我们不会拒绝
我们答到:我们能用好它
丰收 丰收 继续装 继续装
指标已经完成
这就是我们的丰收 伟大的丰收
对我来说 反观美国
And then it occurred to me that back home in America.
很多事情都发生了变化
We've socialized a lot of things.
我们是消防员
我们拯救生命
即使是树上的小猫
我们是美国的教师
让美国的孩子们享受义务教育
我们是邮政服务人员
让你们能享受低廉的邮件服务
这是图书馆
这里你们能免费借书
我对拥有警察局 消防局和图书馆感到兴奋
I kind of like having a police department and fire department and the library.
我想知道的是 为什么我们就不能多一点社会性的免费呢
And I got to wondering. Why don't we have more of these free. Socialized things.
像公共医疗卫生
Like healthcare?
英国的全民公共医疗权利观念是什么时候产生的
When did this whole idea that every British citizen should have a right to healthcare?
如果你看看历史 你会发现它起源于民主主义
Well, if you go back, it all began with democracy.
前议员
在产生投票制以前 所有的权力都被富人掌控着
Before we had the vote all the power was in the hands of rich people.
如果你有钱 你就会有保险措施 可以享受教育
If you had money, you could get healthcare, education,
老了还可以很舒服的养老
look after yourself when you were old.
民主给了穷人选举的权利
And what democracy did was to give the poor the vote.
它把有钱人拥有的权力给了贫穷的人
And it moved power from the marketplace to the polling station.
从富人到穷人的转移
From the wallet to the ballot.
人们说起来都是很简单的
And what people said was very simple.
他们会说 在20世纪30年代 我们有大量的失业人员
They said, "In the 1930s, we had mass unemployment."
但是我们并没有人因为战争而失业
"But we don't have unemployment during the war."
既然杀人能使我们有工作
"if you can have full employment by killing Germans,
那为什么不多建医院 学校 招点护士和教师呢
why can't we have it by building hospitals, schools, recruiting nurses and teachers?"
如果你能搞到资金来杀人 你也能搞到资金来救人
lf you can find money to kill people, you can find money to help people.
是的
Right.
老工党 ...以此为傲
这个传单上写的真是 非常 非常直接了当
This leaflet that was issued was very, very straightforward.
-这是哪一年的 -1948年
- What year was this? - This was 1948.
新的国民医疗服务制度 从7月5号开始实施
''Your new National Health Service begins on the 5th of July.''
这是个什么东西 你怎么理解
''What is it? How do you get it?''
它会给你提供完全地 医药 牙齿护理
''lt will provide you with all medical, dental and nursing care.''
任何人 贫或富 男人还是女人 或是小孩 都能享有服务
''Everyone, rich or poor, man, woman or child, can use it or any part of it.''
不收取任何费用 除了个别特殊情况
''There are no charges, except for a few special items.''
没有参保限制 但这不是慈善机构
''There is no insurance qualifications, but it is not a charity.''
你主要是以纳税人的身份 支付费用
''You are paying for it mainly as taxpayers,
让你在生病时不会因为 医疗费用担心
and it will relieve your money worries in times of illness.''
总之 几句话把一切都说明白了
Now, somehow, the few words sum the whole thing up.
当他说到这 是从1948年开始的时候我吃了一惊
I was amazed when he said this all started in 1 9 48.
英国在二战中 遭受了毁灭性的打击
The British had come out of a devastating experience through World War II.
整个国家被毁 几乎破产
The country was destroyed and nearly bankrupt.
他们一无所有
They had nothing.
仅仅8个月的时间
In just one eight-month period.
over 4 2.000 civilians lost their lives.
超过4万2千平民失去了生命
我们在911事件中两小时中所经历的
What we went through in two hours on 9/11.
他们每天都在经历
they went through nearly every single day.
记得911之后我们的感受么 所有人都齐心协力
Remember how we all felt after 9/11? All of us pulling together?
我想这也是他们的感受
I guess that's how they felt.
战后他们决定齐心协力 做的的第一件事情
And the first way that they decided to pull together after the war
就是给每个人提供免费的医疗保险
was to provide free medical care for everyone.
撒切尔夫人就说过 NHS是我们手中拥有的保障
Even Mrs. Thatcher said, ''The National Health Service is safe in our hands.''
把选票投给妇女是没有争议的
lt's as non-controversial as votes for women.
现在没人会说 为什么女人也有选票
Nobody could say, ''Why should women have the vote?'' now.
人们不会这样说 起码在英国不会
People wouldn't have it, they wouldn't in Britain.
他们不会接受国民医疗服务制度的垮掉
They wouldn't accept the deterioration or destruction of the National Health Service.
要是撒切尔或是布莱尔 表示 我将废除国民医疗
lf Thatcher or Blair said, ''l'm going to dismantle national healthcare...''
那会引发一场革命
There would have been a revolution.
(BGM:Street Fighting Man)
2007丁亥年 新年就要新啤酒
一则美国医药协会对55到64岁年龄层人群进行的健康调查报告
A report from the AMA into the health of 55- to 64-year-olds
美英之间的疾病和缺陷
显示英国人要远比美国人健康
says Brits are far healthier than Americans.
我们调查的每一项疾病 美国患者都比英国患者多
For every illness that we looked at. Americans had more of it than English.
癌症 心脏病 高血压 脑中风 肺病
Cancer. heart disease. hypertension. strokes. lung disease.
美国人数据明显较高
all significantly higher for Americans.
甚至是最穷的英国人
Even the poorest people in England
由于环境因素他们只能享受全国最差的医疗条件
with all the environmental factors that give them the worst health in the country
也有可能比美国最有钱的人活的更久
can expect to live longer than the wealthiest people in America.
我很想知道 英国这种政府管理状态
I was wondering. though. what's it like for the doctors here in Britain.
下属部门的医生都生活得怎么样
who have to live under this kind of state control?
你是家庭医生
And you're a family doctor?
是的 在这我们叫做全科医生
Yeah, l suppose we'd call them GPs or general practitioners here.
-对 你们有家庭实习项目么 -是的 NHS组织的
- Right, so you have a family practice? - Yeah, it's an NHS practice.
我们有9个医生正在这个项目工作
We have nine doctors in that practice.
-政府发工资 -是的
- Paid for by the government? - Yeah.
你为政府工作 由政府支付薪酬的医生
You work for the government? You're a government-paid doctor.
有病人来找你 在给他们治疗之前 你用不
A patient comes to you. Before you treat them, do you have to call
用先给政府保险公司打电话咨询
the government insurance company before you treat them?
不用 我日常工作中根本不用理会钱的事
No, l don't deal with money at all on an everyday basis.
你有过拒绝需要帮助的病人么
Have you ever had to say no to someone who was sick and needed help?
-不 从来没有 -你有听说过
- No, never. - Have you heard of anyone
有人因为付不起医疗费而被请出医院么
being in the hospital and being removed because they couldn't pay their bill?
不 没有 而且我不会在那样的制度下工作的
No, never. And l wouldn't want to work in that system.
既然为政府工作 那你就得乘坐公共交通工具了
So working for the government, you probably have to use public transport?
不 我有辆车 用来工作
No. l have a car that l use and l drive to work.
老爷车
An old beater?
你住的地方一定很糟了
You live in a rough part of town?
我住的地方非常棒 叫做Greenwich(London)
l live in a terrific part of town. lt's called Greenwich.
很可爱的一栋房子 是三层楼房
lt's a lovely house. lt's a three-story house.
有多少亲戚跟你住一块
How many other families have to live with you?
我妻子和孩子 一共有四间卧室 就我们三人住
There's four bedrooms for my wife and my son. lt's just the three of us there.
- How much did you pay for that? - 550,000. Yes, almost.
-花了多少钱 -55万英镑是的 差不多
(合2007年的840万RMB)
那就是 一百万美元
So, a million dollars?
你是国民健康保险计划中由政府支付工资的一名医生
You're a government-paid doctor on a national health insurance healthcare plan,
-你住在一栋百万美元的房子里 -是的
- and you live in a million-dollar home? - Yes.
-我想我朋友们都会觉得我们过的不错 -是吗 怎么不错
- l think my friends think we do quite well. - Really? How well do you do?
l earn around 85,000, including pension.
我挣大概8.5万英镑 包括退休金
- £85,000? - £85,000 a year.
-8.5万英镑 -一年8.5万英镑
那里边包括了退休金 他们会发我
And that includes pension that they would pay in to me.
为这个项目工作的人差不多每年可以挣10万英镑
They probably earn just over £1 00,000 within my practice.
-10万英镑那差不多有20万美元 -是的 对的
- £1 00,000? So that's almost $ 200,000? - Yes, absolutely.
我们挣多少钱 取决于我们做的怎么样
The money that we earn, we get paid by what we do.
所以我们给病人治疗得越好 那我们也挣的越多
So the better we do for our patients, then the more we get paid.
- What do you mean? - There's a new system.
-具体怎么说 -这是一个新的制度
在这个新的制度中 如果你病人中血压正常的人越多
And in that new system, if the most number of your patients have low blood pressures,
或者是你让大部分病人戒掉烟
or you get most of your patients to stop smoking,
或者是你给他们做了心理健康评估
or you get your patients to have mental health reviews if they're unwell,
or low cholesterols, then you get paid more.
或者低胆固醇 那你就能拿到更多的钱
如果今年 你让你更多的病人戒烟了
This year, if you get more people that are your patients to stop smoking,
你能拿更多的钱 挣的更多
you'll get more money, you'll earn more?
噢 是的 完全正确
Oh, yeah. Absolutely.
所以美国的医生用不着害怕拥有全民公费医保了
So doctors in America do not have to fear having a universal healthcare?
不 我认为你要是想拥有2、3百万美元的房子
No. l think if you want to have two or three million-dollar homes
and four or five nice cars and six or seven nice televisions,
还有4、5辆好车还有6、7个电视机
那可能 你就得在其他什么 能挣这么多钱的地方开业
then maybe, yeah, you need to practice somewhere where you can earn that.
但是我认为我们在这过的很舒服
But l think we live comfortably here.
London is expensive, but l think we live comfortably.
伦敦消费很高 但是我觉得我们过的很舒服
百万美元的房子 奥迪 还有平板电视 你觉得一切都很好了
You're getting by OK on the million-dollar home, the Audi, and the flat-screen TV?
是的 这些就可以了
Yeah, we're coping with those.
我认为民主政治是这世界上最具革命性的事情
l think democracy is the most revolutionary thing in the world.
比社会主义 还是任何人的想法 都要具革命性
Far more revolutionary than socialist ideas, or anybody else's idea.
因为如果你有了能力 你可以用它来给你的团体争取利益
Because if you have power, you use it to meet the needs of your community.
这个选择的概念就像首府谈论的 你必须要有一个选择
And this idea of choice which capital talks about, ''you've got to have a choice,''
有了选择的自由才有 选择的机会
choice depends on the freedom to choose.
lf you're shackled with debt, you don't have a freedom to choose.
如果你债务缠身 你就没有了选择的自由
看起来似乎要是人人都债务缠身了 那么受益的就是组织
lt seems it benefits the system if the average person is shackled with debt.
People in debt become hopeless, and hopeless people don't vote.
负债的人变的绝望 绝望的人不会投票
他们一直在说人人都有权投票
They always say everyone should vote,
but l think if the poor in Britain or the United States
但是我想要是英国的或者美国的穷人
给能代表他们利益的人投票
voted for people who represented their interests,
那才会是场真正的民主革命
it would be a real democratic revolution.
他们不会让这一切发生的 所以继续让人们感到绝望 悲观
So they don't want it to happen. So keeping people hopeless and pessimistic...
See, l think there are two ways in which people are controlled.
我认为控制民众有两个方法
首先 让他们恐慌 其次 让他们受挫
First of all, frighten people, and secondly, demoralize them.
An educated, healthy and confident nation is harder to govern.
一个有着良好教育的 健康的 自信的国家是很难驾御的
而且我认为有些人会这样想:
And l think there's an element in the thinking of some people:
我们不希望人们都接受 良好教育 并且健康自信
''We don't want people to be educated, healthy and confident,
因为这些人会摆脱控制
because they would get out of control.''
全世界1%的人口掌握着80%的财富
The top 1 % of the world's population own 80% of the world's wealth.
人民能够忍受这个实在太难以置信了 但他们是穷人
lt's incredible that people put up with it, but they're poor,
they're demoralized, they're frightened.
他们受挫了 他们太恐慌了
因此 他们认为可能最安全的
And therefore, they think perhaps the safest thing to do
就是老实的接受并且怀揣希望
is to take orders and hope for the best.
你在美国的一生
怀揣希望正是我们所做的
And hope for the best is what we do.
right from the moment we're born.
打我们出生的那一刻起就是
We've got the worst infant mortality rate in the western world.
在西方国家里我们有着最糟糕的婴儿死亡率
A baby born in El Salvador has a better chance of surviving
萨尔瓦多新生儿的存活率都要比
底特律的高
than a baby born in Detroit.
But it gets better when we go to school.
但是进入学校以后情况要好点
Classrooms with 40 students. schools with no labs.
一个班40人 没有图书馆
难怪我们大多数的成年人在地图上找不到英国
No wonder the majority of our adults can't find Britain on a map.
But that's OK. There's always college.
但是没关系 总会有大学
我们毕业的时候 就已经陷入债务牢笼
By the time we graduate. our ass is so in hock.
我们在还没找到第一份工作时候 就负债累累
we're in debt before our first job.
我大概 负债3.5万美元 那是我大学3年级的时候
l'm at about... we'll say about $35,000 in debt. That's for my third year in college.
你将会被他们雇佣 因为你需要这份工作
You'll be the employee they're looking for - one who needs this job.
3904 3905
3,904, 3,905...
哪个老板不愿雇佣欠债数千美元的员工
What employer wouldn't employ someone thousands of dollars in debt.
因为他们不会惹任何麻烦
because they won't cause any trouble?
In addition to paying off your college debt. you need a job with health insurance.
除了要还你大学时期欠下的债务 你得找一份能提供健康保险的工作
要是丢掉那样一份工作 简直不敢想象 不是吗
It would be horrible to lose that job. wouldn't it?
想什么时候离开都行 你知道的 没有法律规定你必须在这工作
You can always quit, you know. There's no law that says you have to work here.
If that one job doesn't pay all the bills. don't worry.
如果那份工作支付不了所有的帐单 别担心
You can get another one. and another one. and another one.
你可以再找一份 然后再找一份 然后再找一份
我干三份工作 我感到对社会很有贡献
l work three jobs, and l feel like l contribute.
-你干三分工作 -三份工作 是的
- You work three jobs? - Three jobs, yes.
少见的美国人不是吗 我是说你那样做太不可思议了
Uniquely American, isn't it? l mean, that is fantastic that you're doing that.
睡觉吗
Get any sleep?
如果你失眠 那就吃药吧
If you're not sleeping. take pharmaceuticals.
你时刻都感到疲劳 感到悲哀
You're tired all the time. You feel sad.
如果你陷入过度的烦恼
If you suffer from excessive worry...
泛焦虑症
Generalized anxiety disorder.
那可能是成人注意缺陷障碍
It could be adult ADD.
-去看医生 -去看医生
- Ask your doctor. - Ask your doctor.
是的 去看医生 找他要更多的药品
Yes. ask your doctor. and ask him for more drugs.
那会让你形成依赖直到退休
That should keep you doped up until it's time to retire.
我有说退休吗
Did I say retire?
If you make it to 80. your pension will still be there.
如果你能一直干到80岁 你会一直有养老金
越来越多养老金被冻结
不像这些公司新来的员工 永远不会看到一分钱养老金
unlike the new employees for these companies. who'll never see a pension.
日产
联合航空公司
摩托罗拉
IBM
洛克希德·马丁航空公司
美国电路城公司
通用汽车公司
可口可乐
美铝公司
NCR美国500强
美利肯公司
杜邦公司
联邦快递
富达投资集团
好时
Sprint全球通信公司
But I'm sure our kids will take care of us. considering the great life we've given 'em.
但是我确信我们孩子会照顾我们的 考虑到我们给予他们伟大的生命
Remember. let's defeat the terrorists over there so we don't have to fight them here.
记住 先让我们打败那些小恐怖分子吧 就不用担心这些了
Kaiser Permanente是国内最大的卫生保健组织
Kaiser Permanente is the largest HMO in the country.
Dawnelle Keyes足够有钱而成为他们的保户
And Dawnelle Keyes was fortunate enough to be fully insured by them.
这是件好事 因为一天晚上 她18个月大的女儿Mychelle
It's a good thing. because one night. her 1 8-month-old daughter. Mychelle.
高烧超过了40℃
developed a fever of over 104.
所以像所有有责任心的妈妈一样 她拨了911
So. like any responsible mom. she called 9 1 1.
and the ambulance took Mychelle to the closest hospital.
救护车把Mychelle送去了最近的医院
医院查看了她的HMO
The hospital checked with her HMO
洛杉矶 中南区
他们被告知在Kaiser保险里 不包括各种检查费用和必要抗生素
and they were told that Kaiser would not cover the tests and the antibiotics
来治疗Mychelle
necessary to treat Mychelle.
她得带着女儿去一家联网内的 Kaiser公司下属医院
She would have to take her to an in-network. Kaiser-owned hospital.
Kaiser公司让我带着她去另一家医院
Kaiser said that l should bring her by car to the hospital,
and that she shouldn't be treated at Martin Luther King.
她不会被马丁路德金医院接收治疗
我不断的请求他们治疗 但是他们拒绝了
l just continued to ask them to treat her, and they refused.
我女儿的病加重了还有癫痫症状
My daughter got worse and she had a seizure.
Dawnelle求医生不要听Kaiser公司的 先医治她女儿
Dawnelle begged doctors to not listen to Kaiser and to treat her daughter.
我被请出了医院因为 他们觉得我是个威胁
l was escorted out of the hospital because they felt that l was a threat.
耽搁大概一小时之后 她被转到了Kaiser公司下属医院
After hours of delay. she was transported to Kaiser.
刚到那心脏就停止跳动了
and got there just in time to go into cardiac arrest.
They worked on her for about 30 minutes, trying to revive her.
他们花了30分钟 试图能挽救她
然后医生出来告诉我她已经断气了
And the doctors came in and let us know that she had expired.
我晕了 真的晕了 一切就像是幻觉
l was in a daze, a real daze. lt just didn't seem real.
我抱着她
l just held her.
l held her and l told her that Mommy tried her best to help her,
我抱着她告诉她妈妈已经尽力了
已经尽力让她得到应有的治疗
to make sure that she was gonna get the treatment she needed to receive.
还有很遗憾没能够帮助到他
And that l was sorry that l wasn't able to help her.
快回答
give the answer.
啊-噢
Uh-oh.
这是Karena和她的女儿Zoe
This is Karena and her daughter Zoe.
Karena is a graduate of Michigan State University.
Karena毕业于Michigan州立大学
在我的家乡Flint(Michigan州)长大
and a native of my hometown of Flint. Michigan.
Six months ago. Zoe. like Dawnelle's baby Mychelle.
6个月前Zoe和Dawnelle的孩子Mychelle一样
came down with a high fever.
发了高烧
她有一会停止呼吸了
What happened is she stopped breathing for a little while,
脸色发青 昏在我怀里
turned blue and passed out in my arms, which was...
我想这是我一生中最可怕的时刻
lt was the most horrible moment in my life, l think,
因为我觉得她已经死了或者濒死
just because l thought that she was either dead or dying.
还有我不知道应该干嘛
And l had no clue what to do.
在医院 他们给她吃退烧药
At the hospital, they gave her some medicine to bring the fever down,
做检查 抽了点血
and examined her, took some blood.
-她是怎么了 -喉咙发炎
- What was wrong with her? - lt was a throat infection.
But we stayed at the hospital from Friday to Sunday,
我们在医院一直从星期五呆到了星期天
-要有人看着她 -你呆了那么长时间
- just so they could keep an eye on her. - You stayed there that long?
是的 得有个人照顾她
Yeah. They just basically kept an eye on her.
在医院的三天一共花了你多少钱
And how much did all this cost you, the three-plus days in the hospital?
-没花钱 -没花钱
- Nothing. - Nothing?
-是的 一分钱也没花 -那是因为
- Nothing. Nothing at all. - And that's because?
-我住法国 -你住法国
- l live in France. - You live in France?
是的
Yeah.
啊 法国
Ah. France.
他们享受美酒 香烟还有美食
They enjoy their wine. their cigarettes and their fatty foods.
还有 就像加拿大人和英国人一样
And yet. just like the Canadians and the Brits.
they live much longer than we do.
他们比我们更长寿
Something about that seemed grossly unfair.
似乎不怎么公平
This is Alexi Cremieux.
这是Alexi Cremieux
他没有健康保险在美国度过了整个成人时期
He spent his entire adult life in the US without health insurance.
我在待了美国13年 我喜欢那儿的生活
l lived in America for 1 3 years. l loved my life there.
但是当我发现我得了肿瘤 而且我没有健康保险
But then when l discovered that l had a tumor and l didn't have health insurance,
很不幸 我得回来
unfortunately, l had to come back here.
Even though l had never paid taxes in France 'cause l never worked here -
尽管在法国我从来没交过税 因为我没在这工作过
我18岁就离开了 我没有社会保险编号
l left when l was 1 8, l had no Social Security number -
对他们来说 他需要治疗 他没有收入
for them it was, ''He needs treatment, he has no income,
所以我们准备给他治疗 他需要接受治疗
so we're gonna give him, you know, the treatment he needs.''
- How are you doing now? - l'm healthy now,
-你现在如何了 -痊愈了
but l had three months of chemotherapy.
但是我有过3个月的化疗
So after three months, l saw my doctor and he said, ''You wanna go back to work?''
3个月以后 医生对我说 你想回去工作吗
l said, ''No, l don't feel like it.''
我说 不 我感觉不太好
现在我还没准备好 他说 你要多久准备
''Right now, l'm not ready.'' He said, ''How much do you need?''
我说 我不知道 他说 3个月行吗
l said, ''Well, l don't know.'' He said, ''Would three months be OK?''
我说 我觉得3个月不错
l said, ''l think three months would be fine.''
他说 好 那就休息3个月 然后他给我写了张条
He said, ''OK, so take three months off.'' So he wrote me a note
拿着条就可以找老板要工资了
that l gave to my employer to make sure l got paid.
- So l went to the south of France... - Wait a minute, three months off with pay?
-接着我去了法国南部 -等一下 什么也不干也拿了3个月的薪水
是的 是的
Yes. Yes.
l get 65% paid by the government,
政府付我65%
and then the other 35% is paid by my employer.
剩下的35%由我老板付
To make sure you get 1 00%.
确保你能拿到全部工资
那时候是四月 又是春天了 所以我立刻动身 去吸收阳光
So it was April, it was spring again. So l started right away, sucking up some sun.
And that really helped me a lot, to recharge my batteries.
而且这真的帮助了我很多 让我涣然一新
l mean, it was like night and day. ln three months, l went from a 95-year-old man
我是说 就好像做梦一样 3个月的时间 我从一个95岁的老人
重新回到了35岁
to a 35-year-old man again.
那完全是因为我有时间照顾自己
But that's because l had that time to take care of myself.
我并不是在评价 美国的制度怎么样
l'm not in a position to make any judgment concerning the American system.
St.Antoine医院产科负责人
我觉得美利坚真是一个伟大 很伟大的国家
l think the United States is a great, great country.
美国人很棒 我真的很喜欢他们
Americans are great people. l really love them.
But as a doctor first, as a citizen second,
但是首先做为一个医生 其次一个公民
最后 作为一个病人
and eventually, as a patient third,
我很高兴我在法国
l'm very glad to be in France.
这儿简直有些奢侈
lt's kind of a luxury here.
如果你病了 走进一家医院 你就会得到治疗
You are sick, you step in a hospital, you get the care you need.
lt doesn't depend on your premiums. lt depends on what you need.
这与你的保险费无关 而是在于你需要什么
One of the principles is solidarity.
其中一个原则是团结
那些经济状况好的人给那些不富裕的人付钱
People who are better off pay for those who are worse off.
按你的意愿去消费 按你的需要获得医疗
You pay according to your means and you receive according to your needs.
你认为这在美国可行吗
Do you think that will ever work in America?
No.
不行
他几乎不能控制他那沸腾的反美精神
He could barely contain his seething anti-Americanism.
我不想再听下去了
And I just didn't want to listen to any more of it.
所以我找了一批我认识的
So I found a group of Americans currently living in Paris.
现在居住在巴黎的美国人来告诉我真相
who I know would tell me the truth.
五年前我被诊断出患有1型糖尿病
l was diagnosed five years ago with Type l diabetes.
- l was a bit nervous to tell them l had... - To tell the French?
-我有一点紧张去告诉他们我得了 -告诉那些法国人
有一个地方可以让你去核对是否患有慢性疾病
There's a place to check off if you have a chronic condition.
我害怕他们会让我支付更多的金钱
l was nervous that they were going to charge me more.
And instead, l went into a hospital, and had round-the-clock care.
相反的 我去了一家医院做了全天候的检查
他们在预防性的检查上做了数量惊人的工作
And they do an amazing amount of preventative care.
他们问我是否有病历史
They asked if you have a preexisting condition,
不是剥削你 而是给了你更多的帮助
not to punish you, but to give you more help?
-是的 -我在这家医院住了一年
- Yes. - l was in the hospital for a year.
当我刚住进去的时候 他们告诉我 别担心 好好休息
As soon as l was in, it was, ''Well, don't worry, just rest.''
-他们说 休息 -你一年之中的病假有多少天
- People said ''Rest.'' - How many sick days do you get a year?
-我想是无限制的 -无限制的
- l think it's unlimited. - Unlimited?
是的 怎么能限制病假呢 如果你病了那就是病了
Yes. How can you limit sick days? lf you're sick, you're sick.
我跟四个男孩去过急诊室几次
l've gone to emergency rooms numerous times, with four boys.
And have never waited more than an hour. Never.
我从来没有等待超过一个小时 从未
我可以打电话过去 医生会在半小时内过来我家里
l can call and somebody comes to the house in half an hour.
No way? Making a house call? At your place?
不可能吧 打个电话 在你自己家里
你们有多少人在家里打过电话叫医生过来的 不可能
How many of you have had a house call from a doctor? No!
3:00am last Friday. - And how much does this cost you?
-上星期五上午3点 -那你付了多少钱
- Nothing. - What's this service called?
-免费的 -这项服务叫做什么
急救中心 晚上好
我马上就到
我们现在去哪
Where are we going?
第15区
我们去看一个有腹部疼痛的男人
We are going to see a man who has abdominal pain.
家庭电话医生
-腹部疼痛 -是的
- Abdominal pain? - Yeah.
你呕吐过几次
2次
我能在你的臀部上打一针么
恩
急救中心是由Marcel Lascar医生40年前建立的
Lascar医生家的水管有问题
就在他家
然后跟一个24小时服务的水管维修公司打电话
他们派出的水管工 在一小时内就赶到了他家
在一个国家里你能在一个小时内 找到水管工
那医生为什么不能这样呢
我得走了 咱们走吧
-接下来我们去哪里 -下一个患者
- Where do we go next? - The next visit?
呼叫Bruce
8 L'Arcade街
马上到
( 爱是蓝色的 Vicky Leandros)
15分钟前他开始尖叫 因为他小弟弟太疼了
好的
我们现在去21 Turbigo St
我认为就是感冒
已经持续24小时了
还有别的症状么
谢谢你 晚安
我告诉每一个问我为什么在这个国家的人
l say to anyone who asks me why l'm in this country
那是因为这是我所知的最友善的一个国家
is that l think it's one of the friendliest countries that l know of.
And talk about family values - l mean, childcare, healthcare...
谈到家庭价值 我指的是 儿童监护 医疗保健
我们不用为托儿所的日托付钱
We don't pay for day care.
The day care where l send my daughter - and l was a teacher - standards are high.
我女儿的日托费用 我是一名教师 我是说这个标准非常高
So how much does it cost you to have two children here? How much per hour?
你的两个孩子得付多少钱 每个小时付多少
大概每小时1美元
这没什么
你对他们受到的照顾感到满意么
Are you happy with how they're cared for?
是的 我很满意
他们很专业
受过很好的训练
这里的工作人员虽然不像一个母亲 但非常亲近
我对他们有自信 满满的
在这里 我的孩子受到了一定条件的医疗和教育的照顾
Here, my kids are sure that they are going to get a certain level of care, education,
-对于大学 我就不必为此担心了 -你的意思是
- college l don't have to worry about... - What do you mean?
-免费的 -你开玩笑的吧
- lt's free. - You're kidding?
- You can get a college education for free. - No way.
-你能免费地获得大学教育 -不可能
-真的 -没有绝望的感觉
- Yes. - There's not a sense of desperation.
他们休息 他们享受生活
They rest, they enjoy life.
他们花时间去陪他们的孩子 他们有假期 有家庭时间
They spend time with their kids, there's vacations, family time.
-有多少带薪休假的时间 -至少五个星期
- How many weeks of paid vacation? - Minimum five weeks.
Five weeks? Minimum of five weeks?
五个星期 至少五个星期
如果你在一个大公司工作 一般会有八周到十周的带薪休假
lf you work for a large company, you get sometimes eight, ten weeks.
- Remember that there is a 35-hour week. - The productivity rate is so high here.
-要知道这里每周只工作35小时 -这里的生产力很高
我听说比美国的还要高
l read it was higher than the United States.
如果他们一周工作超过35小时 会有额外的假期
lf they're working more than 35 hours a week, they'll get extra days off.
对于兼职和全职员工是一样的
That is for part-time and full-time employees.
你会有五个星期的带薪休假即使你是兼职员工
You get five weeks paid vacation even if you're a part-time employee?
-当然 -每个人都这样
- Of course. - Everybody.
如果你结婚了 你还可以有额外的一周或者七天蜜月假期
lf you get married, you get an extra week or seven days for your honeymoon.
-加上你原来的5个星期 -你们度蜜月都有工资
- ln addition to your five weeks. - You're paid to take your honeymoon?
如果你搬家
Also if you move.
You mean if you move from one apartment to another?
如果你只是从一个住所搬到另外一个呢
有一天带薪
You get one day.
-你有一天时间去搬家而且他们付你工资 -这是这儿的法律规定
- You get a day to move and they pay you? - These are the laws here.
当我的女儿三个月大的时候 他们会派人过来
When my daughter was three months old, they sent somebody to you
告诉你一些注意事项比如如何照顾好你的孩子 每天都来 免费的
to give you tips on what to do with your child, every single day, for free.
And they'll come to your house and do your laundry!
他们来你家帮你洗衣服！
- They will! Sure! - No!
-会 他们确实这么做的 -不
停 停
Stop! Stop!
- When you have a baby. - When you have a baby.
-当你有一个小孩的时候 -当你有一个小孩的时候
What are you doing?
你在干什么
我在洗那位母亲给我的衣服
你从政府部门过来的
You from the government?
我受雇于政府
来帮助这些父母
-她还能做其他的吗 -如果我想的话 是的
- Can she do anything else? - lf l want, yes.
她 当然 照顾孩子
She's, of course, taking care of the children.
And l think if l ask her to prepare a meal for tonight,
我想我让她准备一份晚饭
she can do it.
她会这么做的
如果我要你今晚做一顿
胡萝卜大餐 你会做么
没问题
No problem.
她每两个星期来一次
She's coming twice a week.
每天做四小时 因此我可以做我想做的任何事
Four hours a day. So l can do everything l want,
为我自己 为家庭 为我丈夫 在这四小时之间
for me, for the house, for my husband, during four hours.
lt's very precious for me.
这对我来说很宝贵
你没有像这样的组织帮助你吗
You don't have any associations? Nothing to help like that?
在美国 如果你是一个新的妈妈
No. Nobody from the government comes to your home in America
没有人到你家里来帮你洗衣服
and does your laundry for you, if you're a new mother.
-这样一定很辛苦 -是的
- lt's difficult. - Yeah.
我在自己家里经历的 一些事情让我现在感到内疚
Something that l experience a lot of with my own family is guilt.
为我在年轻的时候
Guilt for being here almost,
就能享受到这样的好处
and seeing the advantages and the benefits l have at such a young age.
Things that my parents worked their whole life for and haven't come close to touching.
我的父母一辈子都辛勤工作都没有享受到
这真的非常辛苦 让你了解到
lt's really hard to know that you're here
自己处于特权的地位 你知道 不是生活在上流社会
in a very privileged position, you know, not living the highlife,
但是相对来说 无疑的 这看起来非常的不公平
but in comparison, definitely. And that seems completely unfair.
让这些事情在这里发生是由于
One of the things that keeps everything running here
is that the government is afraid of the people.
政府害怕人民
They're afraid of protests, they're afraid of reactions from the people.
他们怕人民抗议 他们怕来自于人民的反动
在美国 人们害怕政府 他们害怕运作不正常
ln the States, people are afraid of the government. They're afraid of acting up.
他们不敢抗议 不敢出门
They're afraid of protesting, afraid of getting out.
在法国 人们是这样做的
ln France, that's what people do.
16万名学生今日参加游行
在Bordeaux 超过2000人参加游行
以争取就业机会和公共服务
我们抗议恶化的工作条件
还有工资
我们想要什么
住房
为谁
为每一个人
今天我们希望法律认识到 我们的工作很危险
群众选择集体大喊大叫
停止工作 给自己放假
政府规定五旬节要工作
这是不能容忍的
免费的大学教育 免费的医疗保健
Free college education. free medical care.
政府雇用的保姆
government-issued nannies.
I began to wonder how do they pay for all this?
我开始想他们怎么支付所有的费用
And then I realized they're drowning in taxes!
我意识到他们被税务淹没了
我想看看这会对一个不错的法国家庭有什么影响
I wanted to see what effect this would have on a nice French family.
因此我就去寻找
so I went to find out.
-你好 欢迎 -你好 谢谢
- Hello. Welcome. - Hello. Thank you.
这里真好
lt's very nice.
这里是客厅
我们在这喝茶
喝点开胃酒
看看电视
-这是新的 -是啊
- lt's the news. - Yes.
What is your combined income for the two of you together for, say one month?
你们俩一共一个月的收入是多少
我们俩加起来一个月$8 000
All right. You're an engineer and she's an assistant? Not bad.
好的 你是工程师 她是助理 不错
这是Anthony的房间 他是最小的孩子
这是Alexander的房间
Alexander 看过来
你们的一个月供房的费用有多少
How much is your mortgage?
一个月1575美元
这是我们的卧室
- How many cars do you own? - Two.
-你们有几辆汽车 -2辆
你们欠医药费吗
Do you owe money from medical bills?
不 不 我们的医疗系统帮我出了
你们还有其他债务吗
ls there any other debt? Loans, anything?
不 没有什么债务
-只有这个房子 -你们还有其他什么开销吗
- Only the apartment. - What are your other expenses?
鱼
The fish.
鱼 蔬菜
Fish. Vegetables.
每个月在蔬菜上的花费需要很多
Vegetables are a big monthly expense for you.
- Yes. And fruit. Yogurt. - Yogurt.
-是的 还有水果 酸奶 酸奶
What are your other big expenses?
还有什么大笔的费用支出吗
度假
Very important.
很重要
这是我们去多米尼加旅游时带回来的
这是我的个人珍藏 我们旅游地的沙子
你瞧 这是从斯里兰卡带回来的
开普敦 南非
埃及
马萨伊马拉 肯尼亚
- Kenya? - We liked.
-肯尼亚 我们喜欢
- Are you happy? - Yes.
-你开心吗 是的
不然你觉得呢
( 我爱你 我也不爱你 Serge Gainsbourg Jane Birkin)
在看到这些以后 我开始想
After seeing all this. I began to wonder.
是不是有个理由让我们的政府和媒体
Was there a reason our government and our media
希望我们恨法国人呢
wants us to hate the French?
他们担心我们会变得
Are they worried we might like the French?
像法国人那样做事
Or like their ways of doing things?
这就已经足够让我放弃所谓的“自由”薯条了
It was enough to make me put away my freedom fries.
French fries即炸薯条 美共和党为表达对法国对伊政策不满 将French 改为Freedom
同时 在国内
Meanwhile. back at home.
医院找到了一直处理那些
hospitals had found a new way to deal with patients
没有医疗保险
who didn't have health insurance
洛杉矶 市中心
而且付不起医药费的病人
and couldn't pay their bill.
联合救援任务中心
l was standing against the wall and l saw a cab do a U-turn and pull up to the curb.
我当时站在墙的对面 看到一辆出租车反向转弯停在路边
我看到有什么要发生了 因为我感觉有事要发生
l watched to see what was happening 'cause l had a feeling what would occur,
这不是新鲜事了
'cause it's not a new thing.
他们停在那个黄色的消防栓旁边
They pulled up right here by this yellow fire hydrant
and dropped Carol off and immediately pulled away.
把Carol放下然后迅速走了
And as soon as they pulled away, she walked out into the street about up to here.
当他们离开的时候 她走到了马路中间 大概这个位置
然后她走到了车行道的这个地方 整个人都很困惑
She then walked all the way down to the driveway down here, completely confused,
has no shoes on whatsoever and just a hospital gown.
没有穿鞋子 只穿了医院的睡袍
睡袍很薄
And those gowns are thin.
当我们的一个职工走过去 问Carol是否需要什么帮助
That's when one of our staff members went and asked Carol if she needed assistance
发现她整个人分不清方向 不知道自己在哪里
and found out that she was disoriented and didn't know where she was.
Kaiser下属的Bellflower医院的员工把她放进了一辆出租车里
Kaiser Permanente in Bellflower hospital had put her in a cab
让他们直接把她送到病人待的地方
and directed them to bring her to this drop-off point.
但是在到达这里之前 她两只手腕上的标注医院名字的被拿走了
But the names of the hospitals had been taken off both bracelets before she arrived.
我看到其他穿过我们大门的人手上都有身份标志
l have seen others that have come through our doors who have lVs still in their arms.
They told me that. at their shelter alone.
他们告诉我
有超过50名的病人被医院扔下了
over 50 patients had been dumped there by hospitals.
我们没有什么选择 我们没有打开门让他们出去
The options are few. We either open the front door and let them out,
南加州医院协会
因为这十分不人道
which is not the humane thing to do,
or we try to find someplace for them to go.
或者我们找个地方让他们去
And right now, skid row is the best bed in town.
现在平民窟是这个镇上最好的待的地方
在我们今晚过去之前
The night before we were there.
南加利佛尼亚大学 国内最富有的一所私立学校
the county hospital run by the University of Southern California.
one of the richest private schools in the country.
经营的一所医院
在路边扔下了另外一个病人
dumped another patient off on the curb.
一个不能支付医药费的妇女
A woman unable to pay her hospital bill.
-你知道你是怎么到这里的吗 -坐出租车来的
- Do you know how you got here? - ln the cab.
- ln the cab? - From General Hospital.
-出租车 -从医院过来
They gave him the voucher.
他们已经付了车费了
He dropped me off there, he actually forced me out of the car.
他把我丢在这里 事实上他是强迫我从出租车里出去的
Ma'am, are you in pain right now? Are you in pain?
夫人 你现在难受吗 现在难受吗
-是的 -我们能为你做点什么
- Yes. - ls there anything we can do?
她在那个时候 肋骨断了 锁骨也断了
She, at this time, has broken ribs, broken collarbone,
市副检察长
她的侧面和头顶上
and stitches that are not completely healed
还有没有完全缝合的伤口
across the top of her head and on the side of her head.
我来问你 夫人 在丢下你之前
Now let me ask you, ma'am. Before they dropped you off,
did they ask you if you knew where you were going?
他们问过你是否知道自己去哪里吗
没有
No.
他们没有问任何关于你的方位的问题
They didn't ask you any questions about your orientation,
不管你是否知道接下来发生什么
or whether or not you knew what was going on?
没有 他们只是让我自己照顾好自己
No, they just told me to take care of myself.
May I take a minute to ask a question that's been on my mind?
我能花一点儿时间问一个一直困扰我的问题吗
我们是谁
Who are we?
这是我们应该变成的样子吗
Is this what we've become?
一个仅仅是因为公民付不起医药费
A nation that dumps its own citizens like so much garbage on the side of the curb.
就把他们像垃圾一样丢在马路边抛弃自己公民的国家
because they can't pay their hospital bill?
我一直认为 直到今天还相信我们是高尚而且慷慨的人
I always thought. and believe to this day. that we're a good and generous people.
这就是别人在遇到麻烦时我们所做的
This is what we do if somebody's in trouble.
有人生病了 我们一起帮助他
Anybody gets sick, we all get together and help.
People with a good heart...
怀着一份热心的人
You feel like you're sacrificing, but you get a blessing from doing this.
你觉得自己在牺牲一些东西 但是你得到别人的祝福
和一种精神
...and a good soul.
我们获得了很多的支持 我们会一直致力于帮助这些孩子
We've got a lot of support and we're gonna all keep working until we locate this child.
邻居会在任何时候向需要帮助的人伸出援助之手
Neighbors quick to lend a helping hand to anyone in their hour of need.
我给他们送饭 我的生活得到祝福
l deliver meals to them, but my life has been so blessed
that this is just the least that l can do.
这至少是我能做到的事
有人说你可以通过它如何对待穷苦人民
They say that you can judge a society
by how it treats those who are the worst off.
来判断一个社会的好坏
But is the opposite true? That you can judge a society by how it treats its best?
但是这是相反的事实 你可以通过它如何对待精英份子
来评价一个社会
Its heroes?
消防员和警察以及救援人员
The firefighters and police, rescue and recovery workers
代表着真正的英雄主义
have responded with true heroism.
lt was their initial heroism that thwarted the objectives of the terrorists.
他们最初的英雄主义是阻止恐怖分子的意愿
你是我们的英雄
纽约英雄 感谢你
没有受到尊敬 在很多时候牺牲了自己的安全
Without regard, in many instances, to their own safety and security.
- They truly are heroes. - We owe them everything!
-他们是真正的英雄 -我们欠他们太多了
Here they are, the men and women who have been on the front lines for New York,
我们在这里 那些为纽约站在最前线的人们
为我们所有的美国人 今晚是热诚为您
and for all of us in America! Tonight is dedicated to you!
5 年 后
911援救人员筹款活动
Don't forget about the raffles going on over there - one dollar each.
不要忘了那边的抽奖活动 一美元一次
抽奖
我在那里干了两年半
l spent two and a half years down there.
我的呼吸出现了问题
l got upper and lower breathing problems.
l need a double lung transplant, but was diagnosed with pulmonary fibrosis.
我两边的肺需要移植手术 但是我又被诊断出肺纤维化
l haven't slept in a bed in over five years, l sleep on a chair with a blanket,
我已经五年没睡在床上了 我盖着毯子睡在椅子上
因为我一旦躺下 我就无法呼吸了
because if l lay down l can't breathe.
There were hundreds of rescue workers on 9/ 1 1
911事件后有超过一百名的营救人员
他们不是政府人员
who were not city employees.
但是他们自愿去灾区帮助别人
but rather ran down to Ground Zero on their own to help out.
我们需要志愿者去帮助
We need volunteers for first aid!
And many developed serious respiratory illnesses.
很多人患上了严重的呼吸疾病
当时政府这么说:
That's when the government said.:
''They're not our responsibility because they weren't on our payroll. ''
这不是我们的责任 因为他们没有在我们的薪水册上
John Graham是 一名来新泽西Paramus的志愿急诊医士
John Graham is an EMT volunteer from Paramus. New Jersey.
当他听说世贸大楼被飞机撞击的时候 他正在下曼哈顿区
He was in Lower Manhattan when he heard the planes hit.
他立即冲到了现场
and rushed over to help.
He worked in the rescue effort for the next few months.
接下来几个月他帮助救援工作
但接着领取疾病补助金的时候却遇到了困难
but then had trouble receiving benefits for his illness.
They just deny you for any reason. lt's just a terrible waiting game.
他们用任何理由来否定你 这只是一场可怕的等待游戏
l really feel like they're waiting for you to die.
我真的感觉到他们在等着你死
lt's terrible. l never thought that we would do this,
很可怕 我从来没想过我们会这样
美国政府会这样做
that the United States would do this.
William Maher is a volunteer member of New Jersey's fire service.
William Maher是新泽西的一名救火志愿者
他在911的废墟堆里工作了2个月
He spent two months working near The Pile at Ground Zero.
recovering bodies or body parts. and it deeply affected him.
收拾尸体和残余的部分 这深深地影响了他
我经历了很多令人不安的梦
l'm experiencing a lot of disturbing dreams,
不管你怎么叫他们
or whatever you'd like to call them,
and it affected what l was doing at night,
这影响到了我夜里的行为
我自己不知道 因为我睡着的时候
and unaware of it because l was asleep
and l just kept grinding and grinding my teeth.
就只是一直磨牙
我上面的牙齿磨损的很厉害 很难修复了
The upper fronts are damaged, practically beyond repair,
because of my constant grinding over the last three years.
因为我在过去3年里一直不停地磨牙
我在之前工人待的地方试图申请911志愿者的救济金
l've been before a workers' comp board already for the 9/1 1 volunteers' fund.
l've been denied three times, and hopefully l will go on my fourth appeal soon,
我已经被拒绝了3次 运气好的话我即将进行第四次的尝试
如果我得拿到足够的文件
if l can get the necessary documentation.
当然 有五千万美元的救济金
Of course. there was a $50 million fund set up
用来帮助救援人员
supposedly to help rescue workers.
女士们 先生们 纽约市市长 George Pataki
Ladies and gentlemen, the governor of New York, George Pataki.
But the government. like the health insurance companies.
但是政府像医药保险公司
使得人们很难得到帮助
made it very difficult for people to receive help.
你必须要在废墟区待上一段时间
You have to have spent a certain amount of time at Ground Zero,
纽约市长
你必须要有足够的经历
you have to be able to establish that.
You do have to file an affidavit within the next year,
你必须在下一年有在废墟区工作的经验
relating your work experiences at Ground Zero.
来交一份陈述书
即使这些条件都符合了 也不是自动的
And then, even with all of that, it's not automatic.
There is a presumption when certain illnesses occur,
有一个假定 当疾病发生时
但是这个假定也可以被医疗证据反驳掉
but that presumption can be rebutted by other medical evidence.
We think it is a very fair approach that protects our heroes.
对于保护我们的英雄们 我们认为这是一种非常直接的方式
抱歉
l'm sorry.
Reggie Cervantes是911时的一名志愿医疗技师
Reggie Cervantes was a volunteer medical technician on 9/ 1 1.
有些时候根本没办法解决 水 止咳药 任何东西都没用
Nothing makes it go away sometimes. Not water, not cough medicine, anything.
lt's just burning in my throat and irritated and it just gets me to coughing.
就像我的嗓子受到刺激一样烧了起来 然后咳嗽就接踵而至
Sometimes l have trouble breathing 'cause l can't catch my breath.
有时我甚至呼吸都困难 因为我几乎吸不到空气
Reggie在第一现场 负责搬运尸体
Reggie spent her days at Ground Zero carrying bodies
还有照顾其他救援人员
and treating other rescue workers.
My airway was totally burnt that first week,
我的气管在那时的第一周 整个就像烧起来了一样
之后我就感到呼吸困难
and l had trouble breathing by then.
But we wanted to see if we could dig anybody up alive,
但我们想看看是否还能挖出生还的人
如果我们还有未救起的人的话 我们想看看是否还落下了生还者
we wanted to see if we had lost anybody, if we were still missing somebody.
我想要帮助他们 我为此接受了训练
l wanted to help. l was trained for this.
你看到有人需要帮助 然后伸出援助之手
You know, you see somebody who is in need, you help 'em.
Reggie在接受治疗上存在困难
Reggie had difficulty getting treatment.
虚弱而不能工作 还有没有收入来源
Too sick to work and with no income.
她被迫辞职
she was forced to quit her job.
然后利用自己的积蓄 带着孩子们搬出了这座城市
and used her savings to move her and her kids out of the city.
你很难知道应该怎么得到帮助
lt's hard to figure out how you're supposed to get help.
我们尝试着以正确的方式解决这件事
We're trying to go about it the right way.
But we're ignored.
但我们被忽略了
但并不是每一个人在911之后都会被政府部门忽略
But not everyone after 9/ 1 1 was ignored by the government.
911五周年纪念离我们不远了
We're now approaching the five-year anniversary of the 9/1 1 attacks.
乔治·沃克·布什 George Walker Bush
So l'm announcing today that Khalid Sheikh Mohammed,
我今天宣布Khalid Sheikh Mohammed
Abu Zubaydah Ramzi Binalshibh
Abu Zubaydah, Ramzi Binalshibh,
and 1 1 other terrorists in ClA custody,
还有其他11名在CIA监管下的恐怖分子
已被押送到了海军在关塔那摩湾的军事基地
have been transferred to the US naval base at Guantanamo Bay.
On that island are some of the world's most hardened enemy combatants.
那个岛上有这个世界上最坚毅的敌方战员
These detainees are deadly and include the 20th hijacker,
这些死刑犯都是致命的 包括了20名劫机犯
以及本·拉登的私人保镖
as well as a number of Osama bin Laden's personal bodyguards
and others who had a direct role in the September 1 1 attacks.
还有在911中扮演重要角色的一些罪犯
The kind of people held at Guantanamo include terrorist trainers, bomb-makers...
在关塔那摩湾关押的人中 包括了恐怖分子的训练者 炸弹制造者
Many of them have American blood on their hands and are the elite of al-Qaida.
他们许多人手上都沾有美国民众的鲜血 都是基地组织的精英分子
看起来我们有责任
lt seems to me we have an obligation
把他们当敌方战员来对待
to treat these individuals as enemy combatants.
And then I learned it wasn't all bad news at Gitmo.
之后我意识到关塔那摩并不都是坏消息
美国海军基地 古巴关塔那摩监狱
Detainees representing a threat to our national security
那些威胁了国家的安全拘留者
are given access to top-notch medical facilities.
可以享受到一流的医疗设施
当他们在外科病房中 有不间断的24小时的精细看护
They have acute care 24 hours a day, in which surgical procedures,
在拘留犯看管所里应有尽有
everything can be performed right there in the detainee camps.
This is the dental clinic, or the health clinic.
这里是牙科诊所 或者是医疗诊所
我们有理疗部门 带有数字X光的X光射线设备
We have a physical therapy department, X-ray capabilities with digital X-rays.
We have one single operating room.
我们有一个单独的手术室
拘留犯中健康人员的比例是一比四 非常高
Health personnel to detainee ratio is one to four, remarkably high.
They do sick call on the blocks three times per week, care for them there if they can,
我们每周进行三次会诊 尽量直接照看他们
or bring that detainee back to the clinic to be seen there.
或者把他们带到医疗室去检查
我们已经开始在那里对癌症进行检查
Screening for cancer has taken place.
结肠镜检查在那里也成为了 每日的常规检查
Colonoscopy is a procedure which is performed there on a routine basis.
那里有糖尿病 高血压以及胆固醇偏高
We have diabetes, high blood pressure, high cholesterol.
我们对拘留犯的体重和营养状况进行重点检测
We monitor the weight and nutrition of the detainees,
这样我们可以进行跟踪调查 来确定我们经常可以看见他们
so that we can track those detainees to make sure we see them frequently,
监视他们的实验室 以及他们的所有健康状况
monitoring their labs and their overall health.
他们的医疗方式 是我经历过最好的
Their medical attention... They get way better medical treatment than l've ever had.
－你觉得和美国的HMO模式一样好 －非常相像 先生
- You think it's as good as most US HMOs? - Certainly very similar and as good, sir.
l leave with an impression that healthcare there is clearly better
带着对保健措施非常好的印象我离开了
than they received at home,
至少比我在家能接受到的要好
其他很多人在美国接受到的医疗保障一样
and as good as many people receive in the United States of America.
哇 那么在美国的土地上 至少有个地方
Wow! So there is actually one place on American soil
具有全面的免费医疗保障
that had free universal healthcare.
这就是我们所需要知道的
That's all I needed to know.
我去了弗罗里达州的迈阿密市
I went down to Miami. Florida.
got myself a boat.
给我自己弄了艘船
and loaded up Bill.
载上Bill
Reggie还有John
and Reggie and John.
John, welcome, sir.
John 欢迎你
And anyone else I could find who needed to see a doctor and couldn't afford one.
还有其他所有我能找到需要看医生 却无力支付的人们
这么多人都来了 我得再多弄几艘船来
So many people showed up. I had to get a couple extra boats.
我打电话给丹佛的Donna Smith 她在接受9项不同的治疗
And I called up Donna Smith from Denver. who is now on nine different medications.
and asked her if she'd like to come along.
我问她是否愿意独自来一趟
我得知了她很乐意从她女儿的储藏室里面出来散散心
I figured she'd like to get out of her daughter's basement for a while.
好了 我们出发
All right, let's go.
海岸警卫队
你们要试图闯过去么
去关塔那摩湾怎么走 我们能去吗
Which way to Guantanamo Bay? Can we go?
我们不是要去古巴 我们要去美国
We're not going to Cuba! We're going to America!
是美国的领土
lt's American soil!
国土安全部
美国国土安全法 禁止这部电影的制作人 展示他们如何到达的目的地
我们成功了
We made it.
在那里 跑道在那里
There it is. There's the runway.
那里就是关押拘留犯的监狱
That's the prison over there where the detainees are.
- We're very close. - Yeah, we're very close.
－非常接近了 －对 非常接近
我想那座白色的建筑一定就是医院了
The white building is the hospital, l think.
好吧 出发
OK, let's go.
We commandeered a fishing boat and sailed into Guantanamo Bay.
我们征募了一艘船 然后划进关塔那摩湾
当我们接进水中的美国和古巴分界线的时候
As we approached the line in the water between the American and Cuban side.
有人告诉我们要小心水雷
we were told to be careful for mines.
请求进入 这儿有三个911救援人员
Permission to enter. l have three 9/1 1 rescue workers.
他们需要医疗检查
They need some medical attention.
这里有911救援人员 他们需要医疗检查
These are 9/1 1 rescue workers! They just want some medical attention!
那些基地组织分子接受的医疗检查
The same kind that al-Qaida is getting.
他们不需要比你们给那些坏蛋更高级的治疗 一样的就行
They don't want any more than you're giving the evildoers, just the same!
Hello.
嗨
在看守塔上的人没有回答我们 然而我们听到了警报声
No one in the guard tower was responding and then we heard a siren.
We figured it was time to get out of here.
我们觉得是该离开这里的时候了
但对这些病人该怎么办呢 没人来帮助他们
But what was I supposed to do with these sick people and no one to help them?
我是说 我们正处于荒凉的第三世界国家中
I mean. here we were stuck in some godforsaken Third World country.
还有共产主义者 没错 我小的时候这些人就想杀了我们
And communists. no less. When I was a kid. these people wanted to kill us.
我该怎么办
What was I supposed to do?
( I'll See You in C-U-B-A by Austin Lounge Lizards)
救护车
打扰一下 我们在找医生 古巴有医生吗
Excuse me, we're looking for a doctor. ls there a doctor here in Cuba?
任何医生
Any doctors?
那边墙角处有个医生
那边有家医院
那边有个药房
都在这个街区
All in this one block?
都在这 是的
通常每个街区都有个药房
附近都有家医院
好的 非常感谢
All right, thank you very much. Thank you.
OK. OK. I know what you're thinking. Cuba is where Lucifer lives.
好的 我知道你是怎么想的 古巴是撒旦(指卡斯特罗)待的地方
古巴
地球上最糟糕的地方 已建立的国家中最邪恶的一个
The worse place on Earth. The most evil nation ever created.
我们怎么知道的 因为这话我们已经听了45年了
How do we know that? 'Cause that's what we've been told for over 45 years.
一系列的攻击性导弹
A series of offensive missile sites can be none other
than to provide a nuclear strike capability against the western hemisphere.
只提供对西半球的核打击能力
l'm not gonna yield until Fidel Castro allows freedom on the island.
我是不会屈服的 直到卡斯特罗 能让岛上存在和平
暴君最后的一口烟
那是 你们会有指望的
That's a... You can count on it.
翻译君也不知道这句话什么意思 反正布什口误多
Put it in the bank.
把它放到银行里去
看起来卡斯特罗 让我们感到麻烦的是
It seems that what really bugged us about Castro
他推翻了我们支持的领导人的统治
was that he overthrew the dictator that we liked.
然后另一个我们不喜欢家伙代替了前任领导人 他本人
And replaced him with a guy we didn't like - himself.
现在 这么多年以后 有一件事情很清楚
And so now. after all these years. one thing is clear -
the Cuban people have free universal healthcare.
古巴人民有全面的免费医疗保障
They've become known as having not only one of the best healthcare systems.
他们不仅仅由于具有医疗保障系统而出名
还有在提供医生方面的最慷慨的国家
but as being one of the most generous countries in providing doctors
and medical equipment to Third World countries.
以及为第三世界国家提供医疗设备方面
在美国 医疗花费 人均为7 000美元
In the US. healthcare costs run nearly $7.000 per person.
But in Cuba. they spend only $ 25 1.
但在古巴 只有251美元
And yet the Cubans are able to have a lower infant mortality rate than the US.
并且在古巴婴儿的死亡率要低于美国
a longer average life span than the United States.
人均寿命也要强于美国
他们相信预防性的药物
They believe in preventive medicine.
And it seems like there's a doctor on every block.
看起来似乎每个街区都配有一名医护人员
他们唯一的过失就是医疗检查
Their only sin when it comes to healthcare
对于他们来说不是一份谋利的职业
seems to be that they don't do it for a profit.
有人现在需要医疗吗
Anybody need medication right now from the pharmacy?
－你是药剂师 －是的
- Are you the pharmacist? - Yes.
你有这个吗
Do you have this?
－和你的一样吗 －对 这个在美国卖120美元
- ls this one similar to yours? - Yeah. lt's $1 20 in the US.
－这个在美国卖120美元 －对
- This is $1 20 in the US? - Yes.
那个多少钱
3.2比索
- How much is that in American dollars? - lt's like five cents.
－要多少美元 －5美分
－5美分 －对 差不多
- Five cents? - Yeah. More or less.
那有个医生
我把她的名字给你
让她给你
至少2个处方
Thank you very much. Muchas gracias.
非常感谢 非常感谢
120美元是笔不小的数目
$1 20 is a lot of money
当你只拿1000美元的社会残疾人保障金 却一个月需要一两瓶
when you get $1 ,000 in social security disability and need one or two a month.
5美分 真是天大的笑话
Five cents here? lt's like the biggest insult.
lt just doesn't make any sense.
太不可思议了
真不可思议
lt doesn't make any sense.
我想买一箱然后带回家去
l wanna fill a suitcase up and go back home with it.
havana 医院
I took my group of sick Americans to a hospital
我带着这些生病的国人去了一家医院
to see if they could get some care.
去看看我们能否会得到救助
They didn't ask for money or an insurance card.
他们没有问我们要任何的钱或者是保险卡
姓名
Just their name...
仅仅是他们的姓名
生日
and date of birth.
还有出生日期
2月22日
这就是全部的手续
That was the entire intake session.
欢迎你们来这里
和其他病人一样
你们将得到最好的医疗护理
希望你们愉快地治疗
我们能做到的
我们都会全力做好
非常感谢你做的一切
Thank you very much for doing this.
我要求他们给我们一样的治疗
I asked them to give us the same exact care
they give their fellow Cuban citizens.
就像给他们的古巴市民那样
No more. no less.
不多 也不少
And that's what they did.
那也是他们所做的
我是Roque医生 我是一名国内的医学专家
l'm Dr. Roque. l'm an internal medicine specialist.
－John Graham －你感觉怎么样
- John Graham. - How are you feeling?
我的肺有问题 很痛
My lungs hurt. l have pain.
l get pretty severe nosebleeds at times.
我有时会大量鼻部出血
我晚上会有剧烈的头疼
l get terrible headaches in the night,
but l haven't been evaluated for the sleep apnea for nine years.
九年来我没有接受过睡眠期无呼吸检测
－嗯 我有 －许多针对肺部的医疗
- Yeah, l have... - Many medications for lung problems.
Almost every medication for lung problems, l've got.
几乎所有针对肺部的医疗 我都接受过
911之后 病症出现了 我开始掉牙
After 9/1 1 , things have happened, my teeth started falling out.
由于某些原因 (睡眠时)我开始不自觉的磨牙
Because of certain conditions, l was grinding.
There's one test that they recommended l take, it's about $5,000 to $ 7,000.
他们推荐我去接受一种测试 但那要花费我5000到7000美元
我咨询的那个牙医 他告诉我花费15000美元或者更多
The dentist that l talked to, it's like $1 5,000 or more.
两年来我没有接受任何医保 所以我没能完成测试的最后一部分
lt's two years l have no medical coverage, so l can't go for the last part of the test.
恩 不用担心 每一项指标都会被仔细测试的
没关系的 一切都会好起来的
lt's OK, everything's gonna be OK. Right?
嗯 我非常的
Yes. l am so...
lt's so hard for me to digest somebody saying it's free.
让我相信这一切都是免费的很难
Because 20 years of our lives have been spent fighting.
因为20年来我一直在不停的抗争
因此我非常的感激
So l am so grateful.
No, you don't need to say that.
不 不必那么说
- Thank you. Thank you. - OK.
－非常的感谢你 非常 －好的
振作起来 不要哭 一切都会好起来的 不是吗
Come on, don't cry. Everything's gonna be OK, right?
- Thank you. - At least what we can do, right?
－谢谢 －至少我们能做到的
古巴只是加勒比海中 一个资源匮乏的小岛
我们尽一切努力去保障人们的健康
而美国却不是这样
为什么我们能而你们不能
需要注意的是
因为一个国家越富有
就更应该照顾好它的人民
Reggie was diagnosed with pulmonary and bronchial problems.
Reggie接受了肺部和支气管的检查
The Cuban doctors gave her a treatment plan to follow back home.
古巴医生给了她 一个回家后的治疗计划
当然还有那些单价五美分的吸入器
along with some of those five cent inhalers.
William Maher接受了很多颈部和背部的治疗
William Maher received a number of treatments on his neck and his back.
医生去掉了他三年来由于外伤后压力过大 而损坏的牙
Having ground down his teeth for three years due to post-traumatic stress.
他带着两排全新的牙齿离开古巴
he left Cuba with a new set of teeth.
在他接受了一系列关于 心脏 肺 血液和胃部的测试后
After a series of tests on his heart. lungs. blood and stomach.
John now knew what his ailments were.
John现在才知道他的病痛究竟是什么
他拿到了一份必须严格执行的计划 他还接受了一系列的治疗
He was given a strict plan to follow. plus a number of treatments
他现在感觉比以前好多了
and was feeling better than he had in years.
古巴医生可以去掉Donna九项治疗的五项
The Cuban doctors were able to take Donna off five of her nine medications.
通过正确的测试给了她一个治疗计划
And with a correct diagnosis. gave her a treatment plan
使她能够过上正常人的生活
to help her live a more normal life.
当消防人员 护理人员到Havana时
When firefighters and paramedics in Havana
得知了911救援人员在城里
heard that the 9/ 1 1 rescue workers were in town.
they invited them over to one of their firehouses.
他们邀请这些人去他们的一个消防站
因此 在我们在那里的最后一天
And so. on our last day there.
as we arrived. they stood at attention
当我们到达时 他们立正姿势站在那里
因为 他说他们想向911的英雄们致敬
because. they said. they wanted to honor the heroes of 9/ 1 1.
你们来访我们非常荣幸
我们都记得911恐怖袭击的那一刻
给我们带来极大的悲伤
从人道的角度看
我们应该帮助进行救援工作
我们也是那么做的
世界的消防队员是一家
Si. somos familia. Y los hermanos que perdimos en las Torres Gemelas
是的 我们是一家 911中牺牲的消防员都是我们的兄弟
se sintio en el mundo completo.
他们仍然活在我们心中
The brothers we lost on 9/1 1 was felt around the world.
911中我们失去的兄弟 仍然活在我们心中
- Mis hermanos. - Mis hermanos.
-我们是兄弟 -我们是兄弟
Don't hesitate to hug a brother.
不要犹豫 快来拥抱他们吧
佩戴正压式空气呼吸器很重要 这样他们就不会像我一样
lt's very important for them to wear the SCBA so they don't end up like me.
－它们是呼吸器 －这些罐子
- They're lungs. - These tanks.
SCBA(正压式空气呼吸器) 带有呼吸装置
SCBA. Self-Contained Breathing Apparatus.
我们的车上也提供这个
Tenemos una reserva tambien en el carro.
很高兴能来这
Es un placer poder venir aqui.
Esto es lo unico que tenemos nosotros. . .
这是我们唯一能做的
F－F－F
F-F-F.
Three Fs.
三个 F
这是消防队的工作服 送给你们做纪念
If this is what can happen between supposed enemies.
如果这是和假想敌之间的故事
如果你的敌人能伸出援助之手
if one enemy can hold out his hand and offer to heal.
那么还有什么不可能的
then what else is possible?
That's when I heard that the man who runs the biggest
我听到的那个运营
anti-Michael Moore website on the internet
最大的反Michael Moore的网站
was going to have to shut it down.
要将网站关闭
他无法在继续运营下去 因为他的妻子病了
He could no longer afford to keep it up because his wife was ill
他们负担不起医疗保险的费用
and they couldn't afford to pay for her health insurance.
He was faced with a choice of either keep attacking me or pay for his wife's health.
他要选择的是 继续反对我 或者花钱给他妻子治病
Fortunately. he chose his wife.
可喜的是 他选择了他的妻子
这个站点可能将会关闭
但是看起来被迫作出 这样的选择似乎有些不妥
But something seemed wrong about being forced into such a decision.
你可以想象这对我而言有多重要 因而我在此请求
Why. in a free country. shouldn't he be able to have health insurance
为什么在如此自由的国度中 居然不能有医疗保险
我需要一个圣诞奇迹
and exercise his First Amendment right to run me into the ground?
正确的操作他的第一修正案 让我感到很困惑
亲爱的迈克 你个混蛋
所以我写了一张12000美元的支票 使他能够支付他妻子的医疗保险
So I wrote a check for the $ 1 2.000 he needed to keep his wife insured
以及治疗 然后以匿名方式寄给了他
and in treatment. and sent it to him anonymously.
感谢之辞 溢于言表
他的妻子身体好了起来 他的网站也依旧很火
His wife got better and his website is still going strong.
It was hard for me to acknowledge that in the end.
这令我到最后也不得其解
我们其实是一条船上的人
we truly are all in the same boat.
无论我们有多少不同
And that. no matter what our differences.
we sink or swim together.
我们的命运随着社会大势漂浮
就像其它任何地方的人一样
That's how it seems to be everywhere else.
他们彼此互相照顾 无论他们有何分歧
They take care of each other. no matter what their disagreements.
You know. when we see a good idea from another country. we grab it.
当我们发现其他国家一个好的想法时 我们就效仿
If they build a better car. we drive it.
如果他们创造了好车 我们就去驾驶
如果他们酿了一瓶更好的红酒 我们就一饮而尽
If they make a better wine. we drink it.
那么如果他们有更好的来医治病人的方法
So if they've come up with a better way to treat the sick.
去教育他们的小孩
to teach their kids.
去照顾他们的孩子
to take care of their babies.
简简单单的彼此厚待
to simply be good to each other.
那么我们还有什么烦恼
then what's our problem?
我们为什么不能做到
Why can't we do that?
They live in a world of ''we. '' not ''me. ''
他们生活在“我们”世界 而不仅仅是自己的世界
我们从来不忙于做决定 直到我们弄清楚最基本的问题
We'll never fix anything until we get that one basic thing right.
有权力的势力也不希望我们那样做
And powerful forces hope that we never do.
And that we remain the only country in the western world
我们因此便成为了西方世界独特的国家
没有免费的全民医疗保障
without free universal healthcare.
如果我们能够摆脱 那些令人窒息的医疗帐单
You know. if we ever did remove the chokehold of medical bills.
college loans. day care.
大学贷款 日常护理
还有其他一切使我们怕做出越轨之事的东西
and everything else that makes us afraid to step out of line.
那么 要当心了
well. watch out.
因为美国的新时代就要来临
'cause it'll be a new day in America.
In the meantime.
就在不远的未来
伦家也要让政府给我洗衣服 I'm gonna go get the government to do my laundry
导演 迈克尔·摩尔
( ''Don't Be Shy'' by Cat Stevens)
奥巴马医改计划是美国总统奥巴马选举时提出的政纲三大议题之一，在2010年3月获国会通过。该医疗改革是为没有医疗保险的美国公民提出医疗保障。法案初稿建设议成立公营医疗保险，管制私人市场转保，由私人健保转到公营健保。现时法案建议限制美国全民买健保，不容许保险公司因疾病等借口对受保人拒保，或擅自增加保费。
其改革目标主要有三个方面：一是给那些已有医疗保险的人提供安全保护。国家将通过专门立法，对保险公司的合同行为进行严格约束。保险公司不得因为投保人存在既往病史而拒绝承担赔付责任；不得因为投保人生病而取消其保险计划；不得因为投保人存在既往病史或发生疾病而限制其保障范围等。二是给那些没有医疗保险的人提供医疗保险，扩大医疗保险的覆盖面。三是控制医疗费用。降低不断上涨的医疗费用，降低医疗成本。
美国的伟大之处不在于它比其他国家更开明， 而在于其修复缺点的能力 亚历西斯·德·托克维尔
(1805-1859法国政治社会学家)
然而至今美国亦无全民公费医疗
(China also)
迈克尔 摩尔 新纪录片《Where to Invade Next》正在翻译...
( ''Alone Without You'' by The Nightwatchman)
( ''Ce Monde Absurde'' by Claude Francois)