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  • Today I'd like to talk to you about

  • the woman in the picture behind me.

  • Her name is Hosepha.

  • And she was born in Cuba

  • several years before the communist revolution.

  • The late 1970's,

  • she would then decide to leave

  • everything she knew behind,

  • determined to give her family a chance

  • at a better life in the US.

  • She also happens to be my grandmother

  • and one of the most important figures

  • in my life as I was growing up.

  • Some of my happiest childhood memories

  • were simply getting to come home,

  • every day from school, to be given

  • a huge big hug from my grandmother.

  • But that hug would one day turn my life upside down.

  • You see, as my head brushed up against a side of hers,

  • I felt a big lump.

  • When I asked her what it was

  • she said it was nothing,

  • but I would later go on to overhear my family

  • talking about a tumor and cancer.

  • I can't begin to describe to you

  • what I felt in that moment.

  • My grandmother was my whole world

  • and as I stood in that doorway listening

  • I was paralyzed with fear.

  • I begged and pleaded with my grandmother

  • that she'd go to the doctor,

  • but the harsh reality was that

  • my family simply couldn't afford it.

  • And in my young mind

  • the concept of my grandmother's life

  • hanging in the balance over a question of money

  • didn't make any sense to me.

  • It was perhaps the first time in my life

  • I had ever felt powerless.

  • Powerless over my circumstances,

  • powerless at my inability to do anything

  • for someone that meant so much.

  • And I remember desperately wanting a way out.

  • Sometime later, that way out would come

  • thanks to the chanced generosity of a family friend,

  • to whom I'll forever be thankful

  • for what he did for my grandmother.

  • But, are we comfortable with that?

  • With the notion that a person's life

  • potentially hinges on the means they have?

  • That wealth so directly determines

  • something as basic and fundamental as health?

  • At the time, I never questioned that reality.

  • As a kid, I simply internalized my experience

  • and became intensely focused on the only thing

  • I felt I had any control over, my education.

  • It wasn't until many years later,

  • upon arriving at Stanford,

  • and taking a health policy course

  • that I would come to feel empowered

  • to revisit and question that reality.

  • For ten weeks I sat in class horrified

  • and fascinated by what I learned.

  • Horrified by the scale upon which

  • I saw my own family's health struggles

  • writ large across our nation.

  • But fascinated by the potential of policy

  • to have such far reaching positive effects

  • on the lives of so many people.

  • I began to wonder if the current state

  • of health care was truly inevitable,

  • or if a different reality was possible.

  • And my search for an answer to this question

  • would lead me to work

  • over the last four years in five countries,

  • spanning Europe, Asia and Africa.

  • And today I'd like to take you on that journey

  • to three of those places.

  • First on my list was France,

  • which I had learned had been ranked as having

  • the best health care system in the world,

  • by the World Health Organization in 2000.

  • And what struck me the most,

  • working in a Parisian hospital, was not

  • only how accessible health care was for everyone,

  • but how universally agreed upon it was

  • among the French that it should be.

  • This is something that I would later go on to know

  • about the Japanese health care system,

  • while I was living and working in Japan for one year.

  • Here was a country with some

  • of the world's best health outcomes,

  • longest life expectancy,

  • one of the lowest rates of infant mortality,

  • had managed to achieve universal coverage

  • at a time when Japan was still rebuilding itself,

  • after World War II.

  • And yet manages to spend half of what

  • the Unites States spends on health per capita.

  • As I reflect on these experiences with you,

  • I don't mean to oversimplify the issue

  • or lead you to believe that I think that

  • what has worked in one country is

  • directly adaptable or transferable to another.

  • The more countries and systems

  • I've had the opportunity to study

  • the more I've come to appreciate just how

  • truly complex the issue of health care is.

  • But I've also come to believe that

  • what's possible in terms of health care access

  • is largely dependent on what societies choose to value

  • and make possible for their populations.

  • The best example I can think of this is Rwanda,

  • where I recently worked with

  • the Clinton Health Access Initiative.

  • A country ravaged by genocide

  • less than 20 years ago.

  • 10% of its population murdered,

  • with more than half of its population

  • still living in poverty.

  • The house I lived in didn't have running water

  • or direct access to paved roads.

  • I was fortunate to have electricity,

  • the only house in the district to have it.

  • And yet, even in the absence of

  • so many resources and basic necessities,

  • they felt it was so indispensable

  • that everyone should have a basic

  • minimum level of health care

  • that they chose to make it possible.

  • Now I'm not saying that I think that

  • Rwanda's health care system is perfect.

  • Much work still remains to be done.

  • But considering that they have

  • an annual health budget of $56 per person

  • I'd say they are doing pretty well.

  • And the world is taking notice.

  • Something that seemed so impossible

  • just a few years ago,

  • the notion that developing nations

  • could achieve universal coverage,

  • is now not only increasingly being regarded as feasible,

  • but as the next step in continuing

  • to make sustainable global health progress.

  • That perhaps has been the biggest

  • take home lesson for me.

  • Where there's a will there's a way!

  • In the US, this doesn't seem to be a question of resources.

  • According to the World Health Organization's

  • 2010 World Health Report,

  • the United States spends over

  • 2 trillion dollars a year on health care,

  • out of a global 5.3 trillion.

  • That's approximately 40% of all the money

  • that is spent all over the world on health.

  • In one country, in our country.

  • And yet somehow, 50 million Americans

  • slip through the cracks, remaining uninsured.

  • In the words of one of my Rwandan colleague, he said,

  • "Rayden, if your country can't do it, then who can?"

  • And when I think about this issue from that perspective,

  • the question I find myself asking is not

  • whether we can afford to insure a basic

  • minimum level of health care for everyone,

  • but whether we choose to make that possible.

  • Last year, a man in North Carolina robbed a bank,

  • demanding one dollar, hoping

  • to be sent to prison

  • so that he could receive medical attention

  • for a growth in his chest

  • he couldn't afford to treat on his own.

  • How desperate does a human being need to be,

  • need to feel,

  • to be willing to trade his freedom

  • for his health?

  • I came to share my story with you today

  • because despite how divisive the issue

  • of health care in our country has become,

  • I believe that we profoundly want

  • and can aspire to more than the status quo,

  • that a world where poverty of wealth

  • does not necessitate the poverty of health is possible.

  • A world where people like my grandmother

  • do not need to forgo potentially life saving treatment

  • because of a lack of resources.

  • But this doesn't become possible

  • because a few policy makers, doctors,

  • health economists, advocates get together

  • to engineer a perfect solution.

  • Truly sustainable changes, I believe,

  • are first dependent on what we all,

  • as a society, choose to value

  • and believe to be possible.

  • What do we value?

  • What do we choose?

  • Thank you.

  • (Applause)

Today I'd like to talk to you about

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B1 INT US grandmother health rwanda horrified poverty spends

【TEDx】Health care is more than just policy: Rayden Llano at TEDxStanford

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    SylviaQQ   posted on 2015/09/10
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