the underway the was it didn't city a rear diginero is in the grip of an intense heat wave scientists, a warning that temperatures could rise above what the human body can withstand. impact is especially severe for those who live in the poor neighborhoods. when i cannot get reports out from you as temperature sore and we are interested in narrow crowds flocked to the beach, killing nearly every centimeter of sand before seeking relief. and let's see what happened. the hills in the maze of bricks and concrete that mixed up, plus senior producer, largest 5 ballot for slum the heat is suffocated. right side of the house is a peck tightly together. the streets are narrow and there are no trees to cool. the air. on top of that, we face water shortages. for villa is divided into 6 is in each one and he gets 3 days with a 4th to the 4th replenished. 70 year old and he's affected by

a boss that is one of thousands of people facing another day without water. the taps in her neighborhood have run dry. she has no choice but to make several trips down the hill to collect water from friends and family who have some despair. it's exhausting to truck up and down carrying all these bottles. it's so hot and people need water for everything, drinking bathing. you have to make a choice either get the water or risk dehydration and getting sick. more than 80000 people cost see a home and many like it is that bad, you are desperate for the heat waves and scorching temperatures in southern brazil have 4 schools to quote real students. tell us. many of their classmates went home early because they couldn't bear the heat. i. yes, there's no air conditioning, no funds or we can do is try to cool ourselves down with all hands. we do urologist

war and the temperatures will only increase in the coming days. is the speed you just because we're experiencing brick wood heat waves and it's all links to climate change. this january was the contest since the copernicus institute began tracking temperatures. in february is expected to be even hasa speaking to last year. brazil has entered a he twice this year. there have already been 3 and 2025 has just begun monetary and i'll just euro. we have just a narrow that's it for me, you can find more information on our website down to 0 dot com and all of your devices can use continues. hurry retoma, craig, off the street with us. thanks very much indeed towards the the, the

imagines getting sick and ending up not just in a hospital bank for medical debt is the number one cause of insolvency in the west and for millions of people, a trip to the doctor can lead to a financial nightmare leaving many wondering who's the health care system, we are designed to help and these forces, and this is district the do you want to know how bad health care is in america? here's how bad it is. for the one visit. $34000.00.

88000 is not good for united health care is denying me life. changing in life saving surgery, the health care system in this country is made for profit is not about caring about the health of the citizens. it's about squeezing every shop of money that every done that a person has. the people in the us have been dealing with a health care system dominated by private insurers for years. they've been facing sky high costs and endless clean denials. but the recent killing of the united healthcare c u in december last year has brought renewed attention to just how much anger people feel toward an industry that seems to care more about prophets than their patients. joining us today to give us some insight into america's health care

system, our doctor, eric reinhardt, a social psychiatrist, who was also a political unto apologist and bailey and vincent, a writer dancer, and choreographer was battling cystic fibrosis. and who's gonna tell us more about that? i think you both so much for your time, bailey. let me start with you. you have a hearing impairment as a result of your medical condition. and so you are reading my lips right now, which makes your participation in today's show, even more special for us. you were living proof of how insurance companies can make life quite difficult for those with a chronic condition. would you mind sharing with us what it means to live with cystic fibrosis and what does do to you and how have insurers at times failed to help you? yes, so the student takes like burrows. this is a genetic condition and impacts. basically all of my systems, all of my major,

oregon. so i've had many work and you moved i many, many operations. i call myself with ionic battery. now they have many robotic parts . and just last year alone, as a good example, i was in the hospital, i think 9 different times i had maybe 6 to 7 major surgeries and i still am working. and being a mom in terms of how insures impact me were for us. it honestly denying bags live saving operations and live saving medications. i've had friends who do things that they probably shouldn't do. i had other cystic fibrosis patients drive across state lines to try to bring me medications that were approved for that. and not for me that my positions wanted me to take, but that how difficult it is. it feels like roque medicine at times in the us

because we are told now for things that could genuinely extend our lives. that is, it's a crazy picture that your paint to be frank before the show we have a chat and you told us you were forced to file for medical bankruptcy. what happened for you to come to that decision? honestly it feels that it wasn't even a decision around like it was made for me because all it takes is for me, i was in the eyes the you and it occurred in john dale. and that's all it really takes for the average family. and these giant bills begin to snowball, and because it's already a full time job to keep up with your health. if you have a chronic condition in the us. it's such a full time job that i wish that we had someone who was

a manager in the middle to help location. it's just for myself, personally, i have a cleaning, but then to see multiple different specialists through that. like outside of that, the clinic, they're not all housed within the clinic. and every single one of those specialist has a portal that i have to maintain. and remember the password for the difference and difficulties with reaching those places. different co pay is different, you know, amounts of tank of gas. it takes to get there. and it just snowballs to a point where it's better to, uh, you know, spend money on your electricity bill or the groceries. and you really feel like you don't have a choice and you're a smile while you talking to me about these challenges that seems so painful at times. speaks volumes about your resilience as well. you've been speaking and sharing some of the stories and challenges on social media. i wonder if it helps

what kind of feedback and maybe a community did you manage to create? yes, i think that is been worth being transparent, even though it's always difficult to do so in today's day and age. because fortunately, there are a lot of parents of young children who is chronic illness, who will reach out and say that they're thankful to be able to sort of glimpse into their child's future and see that they might still be able to be a parent if they get so lucky and they might be able to still pursue their passions and they get so lucky. and that essentially we can still have pursues, even in the pin. i think a big thing that i found i'm wanting to do in terms of the health care costs here, is i sometimes will share the amount that it takes to kind of just one day as a patient. so i'll take one ordinary day and i'll share exactly the amount of the

tank of gas it took to get there. how much it took to feed myself about day, how much that co pay was, how much the medications prescribed. and by the end of the day, you have a really large bill and that's just a singular day of trying to stay alive, the price of the way. and again, there are millions of people out there like you trying to stay alive, which is why we wanted to do this show also on social media, we came across this former united healthcare employee, sharing her perceptions of the system from the inside to take a look as well, i work for united healthcare for ones, maybe 9 months. here's my story. i work in the medical claims department and went through training for about 2 to 3 months to get out on the claims rep for and was taught so many different ways to deny every policy is completely different. so there was thousands of policies that we had to kind of memorize which was

impossible, but they demanded it. i could not stand to be a part of that company any longer was for 9 months i was in and out. so what i did learn was how to fund insurance companies. what did i need to say? what do i need to submit differently? now the ceo of united health care group for the parent company, all united health care has acknowledged back in december that the health care system does not work as well as it should. eric, you practice psychiatry, can you tell us your biggest challenges when dealing with the current system delays and denials, like bailey was describing for herself. as you know, as soon as the doctor submits a psychiatrist, we actually don't know how to effectively help people. this is often difficult because we don't have enough evidence. our drugs aren't good enough. but the most frustrated scenario is when you do know exactly what somebody needs and you know

what to help them. but their insurance is getting in the way of being able to get it to the you prescribe of medication to somebody who is severely depressed, who is suicide is just kind of a very serious suicide attempting that hospitalized. and you believe that this medication is going to be very, very important for that. and then there are insurance companies that they're going to cover. but they require 1st, a prior authorization, which means that they are going to have their own employees to evaluate whether they think this drug is merited or not. despite the fact that i have to spend hours with this patient and use my clinical judgment, that unemployed to use decided this is the best medication. and then i have to wait for the insurance company, decide whether they agree or not. and they can just disagree. and then i can appeal that, but that might take days that might take weeks and they might still disagree. and then meanwhile, the patients is waiting for something that they are hoping to be able to get. but i can't assure them they are going to get this isn't incredibly frustrating. so that's also a daily scenario. the clinicians not just psychiatrist the all conditions across

the us raising extremely frustrating for you so, so sorry to interrupt. extremely frustrating to you. and i imagine it's really dangerous for the patients and i wanted to share something else with you guys. this particular clip is one of the reasons we actually decided to do this show and it's on how the doctors as are describing also struggle when it comes to making sure their patients get the care. they need to take a look. i just said to biology and to bilateral physics cleaners for patients. and i've never had this happen before, but during the 2nd, do you point out a phone call into the operating room saying that united healthcare wanted me to call them about one of the patients who was having surgery today, who was actually sleep having surgery right. and um, you know, so they had to call right now. so i scrubbed out of my case and i called united healthcare. and the gentleman said he needed some information about her wanna know

diagnosis and whether the whether her impatience they should be justified. and i was like to understand that she's asleep right now and she has breast cancer . and so the gentleman said, actually i don't, that's a different department. that would know that information. and i was like, well, if she does need to stay overnight tonight and um, you have all the information with you because i got approval for the surgery and i need to go back and do with my patient. now, after this video went viral, that doctor said she received a letter from united health care, asking her to remove the video and correct what the insurance company described as misleading information. she responded saying that her patient stay was still denied and that she will continue advocating for her patients. i'm eric. i know you are not a surgeon, but i was wondering if there are stories of patients that have stayed with you precisely because you felt like perhaps you lost them. right. they,

they didn't come back or they were tired of waiting does. does this actually happened? and what are the real consequences? this is extremely common, we call it to become a loss to follow up in psychiatric care. this is extremely common because often somebody is condition as an obstacle to seeking care. somebody has shame around it, or somebody has a chronic psychotic disorder, and they don't think very clearly and when they are getting what they need, american support they need. it's even more difficult for them to get back to care. but even in more ordinary kind of physical, logical medical conditions being last follow up is quite common. and it's because it's extremely disheartening to put yourself there to go see care and to be extremely afraid of what you're facing and then be told, well, i don't know what's going to happen. i don't know what i can provide for you. i don't know if you're surgery that, that may save your life is going to be approved or not, but come back in 2 weeks. so we'll talk about it again. and then you'll get another

bill for that. remember, we talked about it again in 2 weeks. that's discouraging for patients and patients will often across the us to go look for alternative forms of care because this is not a very emotion thing, let alone medically satisfying situation. and this is in part why you have such an investment, billions and billions of dollars in alternative care services, some of which have extraordinarily bad evidence and are themselves very exploited up a patients are so vulnerable. they are made so vulnerable fire for private healthcare systems that are easily taking advantage of by somebody else who can tell them, you know, pay me this money and i will assure you that you will get x, y, z care of. so this, this produces a very, very political population that is easily manipulated by individuals like r f k junior right now who has been appointed or seems set to be confirmed as the head of a h h s. and he was a major public concert agent. and i, i wonder, oh the impact i'm so sorry, it's in terms of, i wonder,

what is the impact in terms of, of the trust between a patient and a doctor as well. right? because you're, you're basically trusting that professional with your life. um uh, unitedhealthcare is actually a threatening legal action. so i wonder if your risk anything just by being here and talking to us about these things so openly is there pressure of the us medical profession is extremely high or the call and it's very rigid and it has a very vague notion of professionalism that lives at the center of the field. so criticizing the profession, criticizing our hospital ministry, there's criticize the university administrators for academic medical centers or insurance companies, is not encouraged and people do face repercussions, but as off there, so you won't publicly hear about them. but i certainly encountered, there's a lot of other conditions in the us to speak out about our systems and their corruption are targeted for,

for retribution of various mm. not encouraged. it's a very polite way of putting her diplomatic way of putting it. a guest on bailey americans are paying almost double for health care. then say someone in france where i used to live and triple what you would pay in italy. as you can see here, the average cost per person a year in the us is around $12000.00. compare this to, to kids, which it tons up to around $1000.00. even the cost to have a child in the us is dramatically higher compared to other countries. take a look at us. how much does it cost to get 1st in your country? it was almost $40000.00. so i had my 1st 2 children in england where the cost was 0 on my says child in new york because it was $30000.00 because i'm from london. it

costs you know, things to get faster because of the night to cisco and tiny free time emergency situation. hot insurance coverage. so i paid the $380.00. well i gave birth and try. so everything was covered with $24000.00. a lot of was covered by health insurance, but despite of that, i think our cost was around $16000.00 over $20000.00. we have universal health care and health insurance covers pretty much most of it. basically would you say women are disproportionately affected by the current context? yes, very much. so my, my best friend is an occupational therapist. she has worked really hard her whole life. she's worked with deaf children and she just had her 1st baby and got a $30000.00 bill. and that's as someone who spends her life just pouring back into society and for community, which is a travesty. also, when it comes to women,

we have obviously the risks that come with our reproductive health care. but we also end up often sometimes sorry, dr. reinhardt, but we end up living longer than men. so we had longer live that's not accounted for in our health care. we have, we often spend our time caring for other people's needs. so we're less likely to tend to our health care needs. as far as i know, and we often make less, not often we do make less and so that alone, all does the contribute to. yes, it's very difficult to be a woman in america. i'm have any really at all. and some other shocking numbers we came across one in 5 claims on health care and don't golf, where we're fortunately denied back in 2023. all of these denied claims. and the lack of health insurance in general has led to people finding other ways to fund

their medical care. in 2021, approximately $650000000.00 or about one 3rd of all funds raised by go fund me. went to medical campaigns. this has money, regular people are pulling together to support one another because they have no other choice. i mean this is again so unthinkable. eric, when we're talking about a rich country like america a yeah, it's a consequence of decades and decades as normalizing for a for profit health industry in which still today over 30000000 people have no health insurance. and also just having health insurance does not guarantee one carrier as barely is made extremely clear from her chromos. you're still subject of the insurance company. what this causes is for people to suffer from delayed access to care, the advancement of disease, distrust of

a health care system. it keeps them from it when they need it, and that the ultimate care that they then need is more intense and it's more expensive. this is why we spend $2.00 to $3.00 times more than pure countries per capita of healthcare. and why are outcomes are at the same time that we spend so much more money far inferior. and for a long time, a medical bill could actually ruin your credit score in america. take a look at this. if you have medical bills that are impacting your credit score, good news. that is no longer the case. that is right this you have to be just announced that they are taking out medical bills from credit reports. this is actually the biggest thing to happen in medical bills, medical debt, in a very, very long time. this little does 2 big things. one, it prohibits lenders from considering medical information on your credit score. do it benz medical debt from being able to be reported on your credit report. obviously there's some great news, but another thing is it's about on time. because the idea that medical bills impact

your credit score negatively is absurd. no one that chooses a medical emergency and it shouldn't impact your ability to get home or get a car or anything like that. a credit score should be an indication of your financial responsibility and you're getting sick has nothing to do with that. eric, this is now at risk of being reversed under the new administration. i was wondering if politics, how much of all this is, is political, right and, and how come, as you said, after so many years of, of understanding that this system is just not working. how come, nothing has been done of the us spends, i believe, of the $4.00 trillion dollars and health care every year. and that produces a norm as profits for a lot of actors. hospital ceos are very commonly making, $5.00 to $15000000.00. non profit academic medical centers will often have

effectively profit. we don't call them perhaps because they're nonprofit, a revenue streams to give them the family a $1000000000.00 or profit year. that's not uncommon. so there's so many actors who benefit from the trash that the system and has been so accept it for so long by power for people in the system, like doctors and doctors lobbies that it's, it's extremely deep interest. another important part of this is the way that we talk about this in us media and us politics and popular culture is as if it is just a natural condition. and a very unfortunate tragic one, not a political condition. so during cold weather during the present debates, people often doctor's public comforters will decry the so called politicized nation of public health, which is extremely misleading, because all of this is fundamentally political from the beginning of the most important factor shaping human health in america. like everywhere, well are political, they are the political determinants of health and systematically. we denied his realities and disabled people from that addressing it. i wanted to get

a final word from both of you in terms of what can be done, bally what reforms, what changes would you like to see in the system? i'd say we have to start realizing that the brain that we use, or we say health as well, is actually the exact opposite, well is health in america. so if i were able to, as a hoard produce more readily or a floor and different sorts of treatments, it definitely probably could go further and creating a lot less frequency surgeries and invasive procedures. i think another thing that's deeply tragic is what we're doing to the health care workers to the doctors and nurses, and staff and janitors. everyone is involved in keeping people alive in the us.

because if i have a major spine surgery but then recently i couldn't afford the physical therapy after it. i off, i couldn't afford to go to my toe stop appointment because the gas was just too much that week. so i think it didn't just, it's not just to the patients but to our entire community and society the, the global soul that supposed to be pulling together. eric, um, can anything be done? if it takes a long time, what reform would you like to see? and i think we have to pinpoint the actors who benefit from the corruption of the current system and hold them accountable and not wait for them to change the system . recognize that the people who brought us here are not going to get us out. they have too many perverse incentives to perpetuate the system. i think right now it's extremely important to not allow ourselves to be deceived by people in the trop administration who are looking to exploit the very reasonable anger that americans

feel and to use it to then destroy the few remaining public care systems that we have. so what we need to do right now, i think, is very strongly defend against the destruction of medicare medicaid, a whole lot of basic social care services, the trump administration is going after. and then we also need to give to the american public a different vision. so yes, your anger is justified, it's right, but you need to focus it in the right direction and on the right people and demand universal health care and demand social welfare systems that prevent medical needs from a rising. but you can't do the, the 2nd one, the social effects while taking away health care. because in the meantime, thousands, perhaps millions of people will die. that's a eugenics program. that's the topic, ministrations agenda. so we have to find that and give a positive vision of a different kind of future and which we build a universal health care system and universal social therapist, dr. eric bailey. thank you both so much for your time. thank you for being part of

the stream today. and thank you all for to me and keep the conversation going online. you can use the hash tag or the handle a stream for that. take care and i'll see you soon. i on the perilous journey is taken by countless refugees. danger to make me perhaps worse than death is the survivor. the syrian refugees seeking answers, searches for disappeared. sister, mine may suit a witness documentary on a just from the impact of the us selections, the escalating conflict in the middle east. and the urgency of climate action

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