Hey there! And welcome to the BigAppleSchool podcast – the weekly English show where we speak about everything under the sun. The major goal of this show is to help you improve your English and of course learn something new. My name’s Katya, I’m your host, and today with me…
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So and now we are going to start talking about something really topical – healthcare. So and I think the most logical maybe question that I can ask you – what is the healthcare system like in your countries?
Well in the UK we have the NHS, the national health service and that was established in I believe in 1948. This was just after the second world war when there were a lot of soldiers who needed care because they had injuries from the war et cetera.
And this has been with us ever since. It’s a publicly funded healthcare service, there are pros and cons to it. But the greatest thing is that if you ever get injured, you can get free healthcare any time.
Wait, what about before 1940?
Before… So I think it was 1948, so I think before then I think everything was a private system, I think you had to pay for doctors.
So basically if you’re poor, you’re dead.
Kind of. Well it depends what your illness is. If you have polio or tuberculosis, then good luck to you, but.
Not to laugh about polio or tuberculosis.
Not to laugh, yeah, definitely not.
So and what about the US? Briefly.
Well I think we could summarize it by saying we don’t have a national health service and that makes a gigantic difference. The word that comes to mind about the American system is patchwork.
I thought you would say capitalism, but…
Well, let’s just call it patchwork. If you wanna be an economist, call it capitalism, but let’s just call it patchwork. Which means that it is because of capitalism I guess and some of the ways that Americans think about their government.
We don’t totally trust anything much to the government except defense and certain basic things, so we don’t wanna do medicine that way. And it makes the system extremely inefficient.
And very patchwork, when I say patchwork, patchwork is the idea of like when maybe somebody makes a quilt, right, that you’re gonna sleep under and you take pieces of this and pieces of that and a piece of cloth and an old piece of jeans material and a piece from an old dress.
And you sew it together and there it is! It’s one system but it’s made up of innumerable parts that don’t work very well together and depending on where you are in your economic life and so forth, your position, you can be doing well under the system and have a great system. And you can also be doing pretty badly.
When you say that there’s no national health service, does that mean that it’s only privately owned clinics? Aren’t there like public hospitals?
Yeah, there’s all kinds, all kinds of systems. There is federal, as far as funding systems, right, it’s… I guess it’s mostly the funding, the money comes from… A lot of it comes from the federal government but the organization of it is by the market as they say which means again, capitalism and that means that there are a lot of different ways that, let’s say, there’s 6 hospitals in a small city and that means that one of them might have its origins in maybe the church, some kind of like a catholic church.
Another might have all of different kinds of systems an get some funding from the city, some from the county, some from the state, some from the federal, right. But it’s a very difficult system. And hard for people to understand. And again where you are, if you have, it’s…
I don’t wanna get, because it’s so complicated, that’s why I’ll just stay with the word patchwork which means it’s kind of a mess, it’s not very effective. It spends huge amounts of money and yet the level of people’s care on average is not great. I think it’s the country something like 22nd in the world as far as normal measures, it’s rather low.
Yeah, it’s, I mean, and meanwhile it’s spending probably 50% more than anybody else per capita. So it’s just incredibly inefficient and sort of poor results. Unless you’re at the top and then the system’s great. I mean, they’ve got research.
Yeah, that’s the upside of the American healthcare service is that… Well, not service but services, is that they lead the world in research and a lot of people, well, not a lot of people, but sometimes there are famous news stories where people with rare illnesses in the UK beg to go to the US because…
That’ the upside. But the downside is that it’s so expensive for the average citizen.
Yeah, it’s rough. It’s too expensive. I mean, if your insurance, paying for insurance, I guess, is the next question. But it’s very-very expensive.
So what happened after the second world war with all the injured soldiers in America? Were they taken care by the military or?
Yeah, there’s n entire system, again, it’s an entire system that is federally funded and it’s totally actual independent hospital system called VA – Veterans Administration. And it would have probably reason at that time, I don’t know the history of it.
But I mean it’s got its own everything. So if somebody was in the military at any point of their life then they qualify for VA and it’s not as good as, you know, some of the private systems.
I also think that soldiers coming back from war is not something, not a usual case. I mean that was at the time something, well, I don’t even know how to express that. Topical at the time, so it’s like covid right now.
So we know that the US healthcare system is so expensive and getting, you know, any kind of help is expensive. But I know that now people who have covid, they don’t have to pay for being in a hospital, for example, and things like that. They do get the bills but then they usually, you know, they don’t have to pay them, at least not most of it.
I think that’s true. I hope it’s true. I think it’s true.
Well I don’t know about every single case, but most of them now. Again there are always a lot of details into it, but for example if you have no insurance or you have an insurance from a big company, you’re covered. You are covered. But if you have an insurance with a small company, then you have to apply for something, for some kind of help, because small companies cannot afford paying for every single patient.
Right. It’s just, I don’t even know. It’s so complicated that we’d have to be here all day just to try to understand some parts of the patchwork. I mean it really is, it’s inefficient, but it’s also got some of the advantages of, you know.
There’s so much money in the system because, you know, everything is so expensive that you can spend money on research, you can spend money on, you know, latest technologies and all of this which is great.
But if you can’t get insurance or if it’s just too expensive or it’s taking too much of your income or the company can’t afford it or whatever the thing is, which is the case for a significant number of people, oi it’s just not, I don’t know. Nobody would call it a great system as it is.
So, I mean, obviously we could be talking about this for hours, but what do you think the solution is? I mean everyone has their own opinion because in England, or the UK, the national health service probably would not exist if it were not for the second world war.
So the reason why it exists is because there was an impetus there to create such a service, because there were so many injured people. If that had not been there, then perhaps the NHS would not exist.
Well in the United States oddly, for little history of this that I know, but our system in which companies used to provide and still do, like more than 50% or something companies pay for employers’ healthcare. That came out of World war II. And it came out of the fact that wages were fixed during the war, right, because…
You just can’t have, prices on a lot of things were fixed. Which is not how American system works, it is the market. But what employers could do to compete, to attract personnel, they could offer benefits like healthcare.
Which then the system was not expensive, right, so that a company could provide healthcare for their employees and it wasn’t a backbreaker like it is now. And now it’s just, it’s extremely expensive, you know.
I can give an example. So for example the first year that I was in the US I had, I don’t even know what kind of insurance I had because it was provided by the Fulbright grant so we didn’t have to worry about that, so. But the second year my employer paid for my insurance and I found out that it was… for 9 months it was around $6 000 which is a lot.
But I knew that that would cover almost anything, you know. And that year when I had to go to the ER, after that I got the bill for like $1000. I didn’t pay any of it except for the co-pay which was $50.
But the next year I had to find an insurance on my own cause my employer couldn’t provide it for legal reasons, so and the cheapest one that I found that would cover, you know, at least something, should something happen, was around $150 per month. And that was considered…
Oh wow, that’s extremely cheap, yeah.
That’s impossible. It must’ve had no coverage and $10 000…
Yeah that was the one I had when I was living in Vegas, I paid about $150 a month, but the co-pay would be, if anything happened to me, I’d be paying up to $20 000.
Yeah something like that.
Luckily, within my time in the US I didn’t have, you know, the need to go and check this out.
Well you could’ve returned from the visiting the united States with a gigantic debt.
Oh yeah, oh yeah, I actually know people who…
I suppose it could happen.
….who happened go through that. But I remember when I found out how expensive the insurance is, you know, during my second year, I was talking to our administrator and I said I really hope that nothing happens to me.
She was like Katya, if I were you, I would use this insurance to the max since, you know, the employer pays for it. You need any kind of test? Do it! It’s gonna be covered!
And don’t worry, they’re ready to give you the test, it’s not even matter.
It’s like, you know… I remember when I… Cause that year I was living in a dorm and since I was living in a dorm, I had to have certain, you know, vaccines, like measles and whatnot. And I had all of them covered, you know, because I am responsible, but there was one missing.
The shot that you can’t get in Russia so and they were like we need to do it. And I’m like okay, how much is it? They’re like oh it’s covered by the insurance, I’m like go for it, I’m ready, whatever that is. So but yeah.
So they would check you before, so you need to show all your vaccination certificate, so?
Yeah, since I was going to live in a dorm I had to provide all the information on my vaccination history.
What if you lost your certificate?
Well, before coming to the US you’d better find, you know, the info on it.
Oh right, didn’t realize that.
But yeah, usually we have some kind of…
Right, check your list. Let’s see.
So yeah. And I remember I had one shot missing, but I got it in Russia cause in Russia you get them for free. You don’t have to pay for it, it’s provided. Speaking of actually! How much do you know and what do you know about Russian medical system?
Well I know you have a baseline free, yeah, free system. But a lot of people tend to go private here. That’s what I believe.
If you can afford it, yeah. Private, I mean.
Well, I don’t want to speak ill of…
Well if you don’t, I will, come on!
I mean at least there is a free, there is like a basic level of care. At least you can get an ambulance and not have to worry about it, generally speaking.
Well you have to worry about the ambulance.
And hope the driver doesn’t crash on ice or something. I mean at least Russia does have that which…
You’re absolutely right, yeah.
Which is something to be grateful for nonetheless. I mean I guess in that sense it’s more comfortable than living in America, for basic healthcare I guess. Like if you break your leg, you’re not gonna end up with a huge bill.
So and as for emergency health care, perhaps, maybe it’s better to live here. I mean I haven’t broken my leg yet, I don’t really.
Well I hope you won’t, please, don’t.
Please keep it that way. Keep up good record.
Actually, you’re absolutely right, we do have free medical care. We have public hospitals. And in general I would say that when it comes to some emergency you don’t have to worry. So if you break a bone, you’re covered. It’s fine.
But again, as you said, it’s absolutely correct that we tend to go private hospitals, why? Because unfortunately doctors in public hospitals are not paid enough, they are not paid at all basically. Because it’s such a miserable salary that they get.
So most of them tend to move to private sector. And because there they have potential, they have opportunities to improve, to study, to get a decent salary, to, you know, provide for their families. And that’s why we tend to go to private clinics.
If you can afford it, but a lot of people can’t afford it.
Exactly, exactly. So, well.
How much would a GP, a general practitioner doctor, get in Russia, in a public system?
Well I think it’s around the minimum, like 15 thousand per month.
Oh really? You get 15 thousand?
But you can’t even rent an apartment.
You can’t. That’s the thing. So it’s absolutely, you know.
And you have a tremendous case load, it’s not like you’re not seeing patients or…
Yeah, the workload is horrible.
And is accommodation provided? Or stuff like that?
You survive. That’s what you do basically. So people either have to rent rooms or, you know, they hope.
Or they have their partner. You know, people tend to have their apartment one way or another. That’s…
Yeah, but the conditions that they work in…
And specialists, if you need anything beyond your local or your терапевт, your GP, it’s bad. I mean they just turn out… The city system is…
Yeah, I’m afraid people sometimes borrow money to get some kind of, you know, to go to a specialist in a private clinic.
Or they just fight the system. I mean there is a certain, as I understand, there’s like quotas for certain things.
There are, there are. But then again, how much time do you have? If you know you have the time… But honestly, I mean, I don’t want to speak ill of anyone who is working in the medical sector.
No, no, they’re working on dedication is what they’re working on.
But I tend to mistrust the results and some of the doctors in the public sector. Why? Because I have a bright example, you know, so my dad had for about a year he had some pains in his leg. He visited the local GP in his public clinic next to…
No, no, here in Novosibirsk already. So and they told him oh you know, it might be the old age, you need to exercise more. There’s nothing. They had all kinds of tests, nothing. So they were like - exercise. So he did. It started to get worse. So he tried several doctors in public sector. Everyone said – you’re fine, it must be something, you know.
Only then one single doctor sent him to a private doctor in a private clinic who, you know, sent him to get the right tests. And it turned out to be cancer in its terminal stage, so it was already too late. One year! We lost one year that could’ve changed the whole story.
So after that, so when my mom had some kind of health problem she’s like I’m not going to the public sector, no way. So for some basic things, you know, if you have some kind of a cold, or a flu, yes. Cause, you know, in this case it’s fine. But anything out of the ordinary – uh-uh! No!
So, yeah, the process of diagnosing things in the public service is not particularly good.
I mean they are used to just handling a lot of, just huge patient load, and just to some people you can just tell well it’s just age. What do you expect? You’re X age, you gotta hurt. Things are gonna hurt, you’re not young anymore.
Yeah it’s not cause the doctors themselves are bad, it’s because…
No, no, the doctors… A lot of times… I mean they’re doing the best they can.
Also in a public sector they’re given around 8 minutes per patient. What exactly can you find out within 8 minutes?
But, actually, a lot of places now, a lot of companies provide insurance for their workers that covers private clinics. Not public, but private. So usually, you know, you can get this insurance after 3 or 4 years of working, so that, you know, you don’t get it straight away in most of the companies and then the further you work, the longer you work, the better the insurance is.
So let’s say my sister has been working in a company for 11 years now, her insurance is fantastic. So it’s… She has to pay, let’s say, 10% of each visit or each procedure, but it’s not much, if you look on a bigger scale. And they have an opportunity to get the same insurance for their immediate family, so that being parents, children and parents.
Sisters, unfortunately, do not qualify, which is very sad, cause I really hoped I would be able to. But yeah, so some of the companies do provide that.
I would say some of the companies. But companies that you would think would be doing this, are not doing this. Cause I know people.
Yeah, yeah, definitely, not even most of it. But some of the companies, yeah.
Right, so I don’t know if it’s an exception, I don’t know what the rule is, but certainly know people who said they do not have good coverage or no coverage or they’re just in the public system and that’s just not a great place to be.
Speaking of price. I actually have a little quiz which, well… It would actually be fun if we had somebody who hasn’t been to the US over here, cause you know, but anyway. So I’m gonna name certain types of procedures and you can try to guess how much that would cost, averagely. And I used to prices for Massachusetts, cause, you know.
It’s all about Massachusetts.
Smile came across both of our faces when we heard of Massachusetts.
I actually have a question to both of you – do prices vary greatly from state to state? Cause I do not know.
Yeah and they vary in the state, I mean, again, it’s part of the complete mess and even, you know, one person can go to two different hospitals in the same city and it’s completely different. Completely different.
So when I was looking up information, I got the minimum, I got the maximum from different sources and got the average.
So that, you know, it’s not the minimum, it’s not okay. So what about, let’s say, shoulder or knee X-ray?
So we’re supposed to guess? In Massachusetts?
I would’ve gone about 400, I don’t know, 200?
Do I get anything? I get to go to Massachusetts.
You did not guess right! You do not get any brownies points right now. But what about Russia then? Private sector in Russia, same procedure.
And you’re absolutely right.
Alright, alright, I’m getting a free X-ray, VIP.
I’m gonna count, you know, the points. Whoever wins.
But I get the trip to Massachusetts, so. I’m way ahead. Show your X-ray!
It’s like they’re joking, you know, like what do you want to get for you birthday? And you’re like full MRI please.
Speaking of which, how much do you think an MRI is? Full body MRI.
Or in the United States? In Massachusetts.
Well, okay, I can just tell you the average for the Massachusetts and then you’ll try to guess how much it is in Russia. So in Massachusetts average price for MRI is $300 and…
Well I’m surprised it’s that cheap.
Yeah I thought it’d be more expensive than that,
Definitely. You sure about that one?
Full body MRI? Or just like your head or something?
No no, well it’s said to be full body MRI. Of course there are prices that are 1500, but it depends on the hospital.
Well there’s probably different fees in that bill that haven’t been included.
The actual use of the machine itself is 300, but you probably have to pay…
Do you want us to run the machine without you? 300. Do you want to be…
Do you want to turn the machine on or not? We’ve done a study and found that the results are much better when we turn the machine on, that’ll be another $300. But it’s up to you.
So what about Russia? Well, Novosibirsk, cause prices in Moscow tend to be higher.
Well I’d say probably $70.
No. Higher than that, more.
See, thank you Ben for… I’m going for the free body MRI. It’s like a game show, let’s turn it into a game show. It would have to be, I don’t know, $150?
Exactly! So it’s around 12 000 rubles as of now. So yes, still not something many people can afford to just on the go. But, you know.
As much as can afford all the MRI, body MRI.
What for asthma? It’s a good question actually, I have… You don’t have asthma Gary, do you?
Thus we do not know the price for an inhaler.
We can call somebody who has asthma.
You can just guess. In the US it’s apparently around $300. What about Russia?
Yeah, right, you’ve been doing great.
I don’t know, I don’t know, $40?
4. $4-5. A simple inhaler, for asthma, $4-5.
$4-5? Oh jeez, it’s pretty…
It’s around… Starting with 300 rubles and then more, but yeah.
So, okay, I’ve got two more. Well I’m not gonna ask you about calling an ambulance cause we know in the US it’s a couple of thousand, in Russia it’s zero. What about a pack of two epiPens? In the US as of right now, this year, the average is around…
So the average in the US right now is $600 for two.
So that means that they’re buying it from somewhere else. I assume the reason the inhalers are $4-5, there is some Russian…
Yes, yes. But EpiPen tends to be something that is imported into Russia.
Oh my. Okay, one last one. Childbirth.
Oh in America probably you pay several grand for that? 7 grand for that?
And then it can go up to 40 000. For a baby.
Can you imagine? What if you have twins?
Do you have a bigger bill for twins?
Yeah, how do they handle that?
If I were to give birth in America I would just have to go and share.
Ben if you gave birth in America or Russia that would be quite an event that’s for sure.
Oh, for sure. But what about mother Russia?
But I believe there’s a big push to, well, I bet the Russian government wants the people to have more babies here. So I believe it’s…
Oh yeah there have been all kinds of talking in the government as to taxing women over 23 who do not have children. There have been a talk of sending women over 23 who do not have children to the army. So.
Yeah that sounds progressive.
It’s what now? The moment they do that I’m getting out of here. Like the very same day, I’m like byeee.
I wanna see you in служба, that would be…
I don’t, thank you very much. Oh no no no no no no. So Ben, I have a question. After living in the US and, you know, seeing all these prices and paying for the insurance – did that make you more grateful about the NHS?
Yeah, to be honest, yeah. Previously I used to moan a little bit about the NHS and then you realize it’s actually a really good system. The only trouble with it is that it could collapse at any moment.
Because it is so deeply in debt that if the UK government does not get its act together at some point, how on earth is it gonna continue on in the future? So that’s the big problem in the NHS. So it’s great you can not worry about breaking a leg or get an ambulance or, yeah, that’s great. But at the end of the day hopefully it survives.
The last time I checked… I mean I don’t keep up with the figures, but it’s billions upon billions of pounds in debt. And one day perhaps the UK government might default on its loans and who knows? It might collapse.
Well let’s hope it doesn’t, it sounds scary.
Well that’ll be a negative. Let’s call it a negative, so, potential negative.
Yeah, it’s a huge potential negative. There are others systems which, perhaps, better, for instance the Dutch system, where every citizen has to pay I believe 80 euros a month. But everything’s free after that. That seems maybe a little bit more sustainable.
Yeah, well, it probably has to do with the overall level of taxation, probably, they’re funding it from other places. Yeah.
I know for instance cigarettes in the UK are crazy expensive. Last time I checked it was a few years ago, a pack, 20 pack costs, at least in Central London, I think a Marlboro costs about 16 pounds.
Yeah, sounds about right.
So it’s 1600 rubles. So a lot of that is tax that goes to the NHS.
Let’s be fair, if it is so expensive, maybe , hopefully, fewer people will smoke.
It would… I’m sure, well, fewer people are smoking. I mean, just…
Cause if I had to… Cause in Russia there are so many people who smoke, let’s say, half a pack a day, a pack a day even. But then if you, you know, do the calculation, if you do that in the UK, 16 pounds per day just on, you know…
In here it’s like 100 rubles.
Right, I mean, you’d really have to want to smoke, right.
I know that in the US it’s also relatively expensive, it’s around.
It’s much cheaper than in the UK though.
It’s like ten dollars a pack.
Yeah, like $10-12 a pack.
Which is absurd, you know.
I actually remember. So my dad was a smoker. And when I went to London he was like can you bring me a pack of cigarettes just to, you know, compare. So I brought him a pk of cigarettes and he was like oh, it’s such a different, you know, texture and everything and I got the same brand of Marlboro.
And he was like how much was it? I’m like 12 pounds. He was like okay. Then, you know, it dawned on him, like wait a second! Is it more than a thousand? I’m like yeah. He’s like I’m gonna smoke one, like, one cigarette per month out of this pack.
They are so expensive! You know we once were joking like if we counted and calculated the whole, you know, the amount of money my dad spent of cigarettes throughout his life, I think he would be able to buy a car with that.
Oh yeah, that’s expensive.
Smoking for 49 years, at some moment a pack a day. A lot.
It depends on the price of the cigarettes, but you know, I don’t even know, wat is a pack of cigarettes now here? 150 rubles?
Yeah, something around that.
Yeah I think something like that.
Which is still… That’s not totally cheap, that’s still 2 dollars…
That’s one pound fifty. If you said that to anyone in London you smoke for…
Well my friend in the US was a smoker, and while she was a smoker, every time I went there she was like bring me cigarettes. Jesus, okay. And apparently you’re allowed to bring two blocks, so…
Yeah two bricks I think they’re called, yeah. A brick of cigarettes.
We call ‘em a carton, yeah.
Carton, a brick. We call them a block.
A block. That’s very sort of descriptive. Right. A square, a rectangle.
Do you think that people who smoke or people, you know, who lead an unhealthy lifestyle should pay more for their insurance and more for the healthcare?
You know, I mean, in the United States they do. It’s…
Yeah if you smoke you have a higher premium.
Definitely. Add that to the $10/pack of cigarettes, you know, I mean you really gotta be addicted or love smoking or whatever it is.
That’s the problem the NHS faces, for instance, if you’re severely overweight, how are you going to… I mean, they obviously have a higher… They take a higher toll on the NHS and how are you gonna to factor that in? It’s kind of…
Well it’s simply the fact that if it’s universal, you just treat people. And what’s complicated in the United States is okay, you have to factor that in and keep all kinds of records to figure out what is the risk.
So you got all these different insurance companies and you’ve got the government and, I mean, it’s just incredibly complicated. What it is in Britain is just expensive, right. It’s expensive everywhere and it’s just a question of who’s paying.
Coming back to smoking. I think the tax raised by cigarettes is something around 7 to 8 billion pounds a year. It pays for itself with the NHS. But other illnesses related to unhealthy lifestyles perhaps don’t pay for themselves.
And what about dental care? So… I love it how…
Look at that knowing smile. It’s the Massachusetts smile. Dental care? Yes!
So is it crazily expensive too and is it usually included in the insurance? Can you get dental care for free? So what’s the situation like?
Well in the UK I know, it’s not completely free on the NHS. You can get heavily discounted dental care on the NHS. A lot of people if they wat to, for instance, get root canal, then they go to Hungary or they go to Poland where it’s much cheaper and the quality is just as good.
I know, actually, my dentist told me that within the last two years he’s had many patients from Italy coming here. Cause it’s cheaper to fly all the way to Siberia and get your teeth fixed than do that in Italy or…
Yeah, and the quality’s just as good.
So which says a lot about… And I do, I know that people in the US do the same thing. Maybe they don’t go to Eastern Europe perhaps, but they do go to other countries.
They might somewhere else, somebody might go somewhere else. It’s… Dental is usually, it’s another aspect of medical, it’s not included normally in health insurance. It’s another expense and if you pay for it yourself it’s of course expensive, quite expensive.
And that might… If you know you have a procedure and you know the procedure can be done elsewhere for really cheap, I guess, just make the judgement and make the trip. But.
Again, a friend of mine, she lives in Boston. She had to have an implant and it was $4500. In Russia, in a private clinic, it’s usually around, from 1 to 2 thousand per tooth.
Yes, yes. Yes. Yes, yes. I wish it was rubles, but no no no. I’m sorry I need to take a minute and go cry in that corner for a second if you don’t mind. Well technically in Russia we can get dental care for free, but you need to go to a public clinic which is in the neighborhood where you have your registration in.
So only in this case you can have it for free. Although nowadays I think you still have to pay for the materials which is, of course, not that much. But again – public clinics do not have good equipment.
So they don’t get enough funding from the government, thus they have old equipment, old materials as a rule. But our private clinics… Really, the ones that I have been to, they are fantastic.
But you have to pay. For example now I am, well, my plan is… I’ve been to a dentist he said okay, to deal with everything we have in here, you need around $2000. I’m like cool, guess what I don’t have? $2000 of course. So now I’m thinking between getting a loan just to, you know, deal with that.
Thank you mom who didn’t check her teeth before getting pregnant and while being pregnant. You know that… Well, I was born in Yakutsk. And people in there, women who give birth, the thing is that they don’t get enough vitamins, enough sunshine, basically, with the food available there, especially at that time,
you had to have and you had to take special level of care of your teeth if you want a baby to have good teeth. My mom didn’t, so I don’t.
Yeah. But, yeah. So there is a stereotype, since we’re speaking about teeth, that Americans, I don’t know about Britain, but Americans are crazy with extra white teeth and in general they are crazy with, you know, dental care and, you know, all these preventative measures.
Well the Americans have a delightful stereotype about British teeth.
Well people in America laugh at British teeth. I mean I think it’s different now, but Brits are renowned for having terrible teeth.
Well that’s what I’ve thought, that’s what I’ve heard.
I think it was in the Simpsons actually, I saw a Simpsons episode many years ago. I think, I believe it was the Simpsons where they portrayed the Brits as having terrible teeth.
Austin Powers, has anyone seen Austin Powers?
Long time ago, yeah. There’s a scene where he breaks a mirror with his bad English teeth.
I consider myself an American, a lifelong American, and I can honestly say I have no stereotype about, I don’t think I have.
Yeah, I’m just holding back and I don’t wanna offend you. I have no concept of…
Interesting. In Russia a lot of people have a stereotype about Americans, for example, that they have fantastic teeth. Always, you know, just perfect. Every time you ask somebody about perfect teeth they’ll say something like well you know, like you see in American movies. It seems like most Americans have perfect teeth.
Okay, well, American movies, yeah. Alright. But real people, I mean it’s not like an average American just say man, I gotta have great teeth. You know, just killer white teeth.
So it’s mostly like god, I have to take care of my teeth cause I can’t afford getting dental care.
Yeah that’s typically what I remember is the mentality.
Right right right. Ben’s got an amazing set of stereotypes he’s accumulated.
Well to be fair when I lived in Vegas, the sin city, people did all sorts of terrible things with their teeth there. Sin city is probably not the best representation.
Somehow I didn’t think of Las Vegas is man, people’s teeth, you should see the way they live in there.
In California across the border the teeth are much better.
What do they do? What do they do? Let’s not get into it.
Are you sure you wanna know?
I’m sure I don’t wanna know.
No, I’m just kidding, just kidding.
Alright, good. Good coinage.
Actually, I have one more question. So when you want to go to a dentist or any kind of a doctor – do you have to wait for like months and months and months? Or can you get an appointment for like tomorrow or the same day?
Well in England people are on the waiting list for operations for a long-long time, so if you want to have your hip replaces for instance, you can be waiting 5+ years. That’s the downside to the British system. Whereas in the American system if you have the money, you’re in the door.
Yeah I don’t associate particularly long wait, but high cost, yeah. I don’t know, it depends on the doctor and so forth. I think you may not be able to get in there tomorrow. I mean I have done occasional minor, very minor medical things, dental things and it’s better to have…
Depends on where you live and a bunch of other different things. My mother lives, it’s a little bit seasonal and so people get things done. Then it can be harder to get an appointment, but thankfully I haven’t had the use of system very much. By the way I spent almost my entire adult life, half my adult life uninsured.
Oh really? Well, that’s risky, you love risks!
Just take one look you say man, there’s a guy that’s living on the edge. Right, look at wild look in his eye.
So true, so true! That’s exactly what you think when you look at Gary.
That’s right. That business with cutting glass with your teeth – no problem.
Cause I heard stories from a friend of mine who lives in Poland and she said if you want to see a specialist, like a cardiologist, you have to wait a month or two months sometimes. I’m like by that time I wouldn’t need a cardiologist I think.
It’s either gonna pass or I won’t need any kind of medical help anymore. Whereas in Russia, well at least in public clinics usually there’s some kind of a quota, so you can wait for like a week, sometimes, you know, if it’s some kind of a specialist that does not have much of a time maybe or a lot of people waiting, so it can be like two weeks, three weeks.
If it’s private clinic, I mean, if it’s like a specialist who’s much needed, it can be up to a month, but in general sometimes you can get to see a GP in a private clinic the next day. Without a problem. So yeah, it all depends.
But I remember in my childhood there was a very limited quota for dental service in, you know, in children’s hospital. So my parents had to wake up at like 4 or 5am, go stand in line till 7am till the hospitals, the clinics opened.
And it was not guaranteed that they would get this, it’s like an appointment confirmation or something. Yeah, so. Lovely.
What was it like in the Soviet Union? Was it better or was it about the same?
I’m not sure to be honest. I only know about dental care. You had this situation of getting the quota. But I don’t know.
I think that the medical system here I’ve heard was probably worked better then right. They didn’t have kind of a brain drain, that took the doctors out of the scene. Probably the system was better financed.
I only know that yeah, it was better financed cause we did not have private sector as such. So there was good equipment, decent salary at that time. But then everything just went down the hill for some reason.
Alright, and speaking of health problems, so we have mentioned smoking and how that can lead to, you know, different diseases. So what do you think are the most common diseases in general and, let’s say, most common causes of death? We do not include covid right now I think, but other than that.
Well I guess obesity perhaps.
Yeah. Or complications of obesity, heart disease and…
Actually this is the first place that is taken by cardiovascular diseases. Okay.
And… What else is there? Cardiovascular and…
One of the most common, yes. They say that in general the statistics is that 1 in 2 people, 1 in 3 people is going to be affected somehow by cancer – either having someone close or getting it, you know, themselves. So it’s so widespread.
Actually I had a conversation with a student of mine on the topic of medical care and we talked about cancer how you know some people say like, oh, people get cancer more now, like, in our age.
I’m touching wood right now.
So it’s like it’s not really the case, the case is that we have better diagnosis right now. So people just get diagnosed these days. Compared to 100 years ago.
And people just live longer. And there’s a whole lot of things going.
So yeah, this is one of the top 10 causes. Then we have well, diabetes as well. And kidney diseases, so this is like the top 5. How can we actually live longer? So how can we not get any of those horrible diseases and live to be a 100?
Eat your veg, go for a run.
You know what? I remember… Not directly related to the topic of medicine, but I remember several years ago I came across a book in a bookshop which was called, well, the miracle of morning, something like that.
So and it was called how to get up early every day and do everything you planned. And I was like oh, sounds interesting, I should get it. Only later I found out that the original name was 5AM miracle. But anyway, so the author says…
Yeah, you could tell, the sales were not too brisk of the book.
The author says – to be energetic and healthy you have to get up at 5am, drink a smoothie, have some fruit, go for a run, you know, get back, have another fruit, have breakfast. And it’s really easy to say when you live in California for example, but when you live in Siberia with 9 months of winter, this is not what you can easily do, you know. Go for a run in -40C? Nah.
Some people say you have to sleep as much as possible, some people say you need to…
Well, sleep is important.
Yeah, sleep is, I mean, if I can get the opportunity to sleep, I’ll take it. I mean…
Yes, the sincerity in that expression.
There’s a man who is ready to sleep.
Actually we had a podcast, an episode about, I think it was with Maria and Ken and we talked about sleep deprivation. And you’d be surprised – if you get less than 6 hours of sleep on, you know, on a regular basis, it increases the risk of a stroke by 4.5 times! So, you know, at the same time you can get even diabetes as a result of sleep deprivation.
Yeah, sleep is a serious think for sure.
So get up at 5am – no-no.
Well, get up at 5am if you went to bed at…
Right-right. Well you’d have to go to bed at 8.
Well that’s the problem with this whole new hustle culture, so everyone knows what hustle culture is – people say get up at 4am, 5am, get through the day, hustle hustle, but..
Productive productive productive!
Yeah. And obviously it’s good to be productive but maybe not having enough sleep is not an efficient way to go about your life.
No, that would be an inefficient way overall.
Yeah, cause being productive is cool and all, but yeah. You don’t get enough sleep…
Well you won’t even be productive. You know, I mean, if you’re running on 6 hour sleep, you will specifically not be productive.
Some people are fortunate in that, they just don’t need much sleep.
Some people, yeah, some people.
Yeah. For instance, a former controversial British prime-minister Margaret Thatcher, she famously only slept 2-3 hours a night.
But that’s more of an exception.
Yeah, that’s an exception. For sure.
Rather than a rule. Okay, we’re gonna actually put it off until just several minutes later. But I want to mention two more categories of people. So who are hypochondriacs and are you one of them? Who wants to explain?
Well hypochondriac is somebody who thinks they have many diseases. They’re very worried about their condition, they read about something, some new popular ailment and they assume that they have it cause they have some symptom that is described, so they think well I have that too.
So a hypochondriac is just somebody who thinks they have many diseases when they may not have any or just one.
Have you ever been one? Are you one?
Only occasionally on Google, let’s say if something happened and you type in on Google oh what’s this problem?
You kinda anticipated my question, cause I had a question about the second category of people now. So in addition to hypochondriacs, we now have cyberchondriacs who are people who google their symptoms. And then they think they have…
Yeah, never google your symptoms. You know. But you know, that reminds me of… I think it was Three Men in a Boat when the man got a medical encyclopedia and he realized that he had absolutely every single disease in there except for one, which was the handmaid… the maid’s something. I don’t remember but yeah, every single one of them.
Yeah, the handmaid’s syndrome, right.
Have you ever of Three Men in a Boat?
I’ve heard of it but don’t know anything about it.
I have… Maybe I had heard of it, but it’s a thing here. I think it’s because it has sort of a socialist kind of undertone, it was… It was part of the Soviet… In my first year that I came here I had to teach, I had to use this textbook, English textbook that, you know, it was straight out of the, I can’t remember, Arakhin… Was it Arakhin?
Ah, Arakin. The holy bible of everyone who’s studying at the faculty of foreign languages.
Well how do you think I know that, you know?
Yeah you came by it honestly. Well anyway and Three Men in a Boat was…
I know, I know, second year book.
And everybody said that well, that’s… And I understood that that was something soviet approved, right?
You bet it. But yeah, we actually had to learn an extract from it by heart.
It was not the best textbook but it’s still being used widely.
Cause in 1995 I thought okay, surely…
It’s gonna be for quite a long time until it’s… The hole bible of the faculty of foreign languages, all across the soviet countries. I thought it was only Siberia, but no. Whoever I talk to in different parts of Russia, even in Kazakhstan.
Well, sure. It would be… It’s a soviet approved, right.
Alright. So and now what about living to be a 100, so you said eat your fruit and veggies, go for a run. So but there are places in the world that in general have more centenarians than any other place, so let’s say Okinawa in Japan or there is… a couple of islands, there a couple of islands in Greece.
So what makes them different from other places? Why are there more people who live longer there?
Well, part of that maybe like diet, you know, I mean the famous Greek Mediterranean diet. It’s supposed to be low in cholesterol, which is heart disease and things like that. And so it’s healthy in that regard, I read a thing about that.
And it’s old communities and so people have a sense of community, they belong there and it’s, you know, besides the health it’s good air, you know, sunshine and all of these things that are kind of favorable. So there’s a lot of factors there that would, you know. It helps socially, the social part of it, you know, which I think it’s a commonality with some parts of Japan they said.
Actually so these places have been called the Blue Zones and there’s one scientist who did a research on that, so on the Blue Zones and his team and him they kinda came up with, what is it, Power9. So nine things, nine aspects of your life that can help you to, you know, live longer. And I would like to mention these nine and I would like us to discuss them, so what we think.
So the first power out of this Power9 is move naturally, meaning you don’t need to do a workout on the machines or, you know, go for a run, do a marathon. But move naturally, so what do you think about it?
To be honest I don’t see a problem with that, I mean as long as you don’t just sit there all day.
Right, if you’re somebody that’s living in a blue zone. Why are they called blue? What’s blue?
Maybe it’s about the water, cause all pf these places have access to water. Cause there are places in Puerto Rico, in California, but the place in California is also, like, you know, has access to water, so, maybe that’s why they’re called Blue Zones.
Okay. But moving naturally, I think the main thing is probably to move, you know, which is the problem with older people that they lost some mobility and…
I mean look, now we work online, it’s a problem for all of us.
Yeah, yeah, no, it’s a problem.
I’ve just had a thought. So maybe if you live by the sea, maybe it’s, I mean, the rhythm of the sea maybe gives you a better circadian rhythm. I’m not sure, maybe it has something to do with that.
But I have, you know how they say you have to take, let’s say, 10 thousand steps per day to be in general healthy, do you know this, I don’t know, this stereotype. Or, I don’t know, just a saying. But I have a question. If I, let’s say, take these 10 thousand steps, okay, perfect. But what if I do that in a highly polluted street of Krasny Prospekt? Does that have any kind of positive effect on my health?
Well I would go one street over, either Michurina or Sovetskaya.
00:58:35 K: Well you get the point Gary!
It’s not about the street, but about…
Yeah, yeah, Krasny Prospekt is bad, too many cars in proportion, but I think the main thing is just the activity level has to stay up, has to stay quite high. And when you get older you just have to, you know, sort of consciously decide to do that, because you don’t have a work and, you know, whatever the thing is.
So you have to force yourself to do that. Whether it’s on a machine, you know, but the main thing is to be in motion. But maybe moving naturally would be even better.
So the second one is 80% rule which means that you have to, you know, finish your lunch, dinner, whatever, when you’re 80% full. So that you don’t overeat which of course brings the question how do you understand it’s 80% and not 50 or 60, but okay. So what do you think?
I mean when I eat I just eat like crazy.
He eats 120% of what any normal person…
When he’s eating, he’s eating.
I remember you told me that in a hotel where you worked…
And if I was running, I’d be running as fast as I could, I’m eating, go away, leave me alone.
Or running to food, you know.
That’s right, make your motion toward the food, yes.
Oh my. Alright, so the third one…
Good idea, just quit before you’re full.
Yeah. So don’t… Cause I know that it takes some time for the body to understand that it’s full. So it’s better to, yeah.
Yeah, that you can measure. Am I full. Ben looking at me now.
I mean it just sounds really boring.
Well, that’s… We don’t promise you excitement in this. We’re not saying live a long exciting life.
Live a long, incredibly boring tedious life on some Greek island, that’s how you do it.
Because when I see pelmeni, they’re gone.
Now I understand how to get Ben to places. Like, you know, just tell Ben there’s going to be pelmeni there. He’s like I’m there.
Yeah, the bar, the all you can eat pelmeni bar. Right, that’s what got him. … all you can eat pelmeni bar.
Buffets are amazing, I live for the buffet.
Alright, so the third one is belong meaning you have to find some kind of a community where you belong. And that goes together with the next one which is right tribe. Or you have to find the right community, not somebody who, you know, takes you down and make you, you know, subconsciously do some kind of, you know, have bad habits or whatever, lead an unhealthy life, but yeah. Belong and right tribe. So what do you think? I think Gary you have mentioned it not long ago.
Yeah I think I just mentioned it right now, but that yeah, it is important to have that social connection and ideally that would be something that was all your life and all. But if you can find the connections later in your life, it would seem like a positive…
I guess, yeah, people help each other, you can’t just do everything alone.
Yeah. So the next one is purpose, meaning that people who have some kind of a purpose that, you know, makes them get out of the bed in the morning, they tend to live 7 years longer than those who don’t. Have you found the purpose? Do you have the purpose?
Great! So the next one is leaning towards plant-based food, so rather than meat-based food. So what do you think about that?
This is a very controversial subject. Some people say eat only meat. I don’t know if you know Joe Rogan, the famous podcaster in America. He’s strictly eats meat.
Not to talk about other podcasts, to talk about other podcasts.
Exactly, we’re not endorsing other podcasts.
That’s right. In fact I’ll endorse against Joe… No, never.
Jordan Peterson, are you familiar with Jordan Peterson?
I think that’s a really-really bad idea.
What is he? 50? 60? Something like that.
Yeah, it doesn’t sound like he’s gonna make it to 70.
Well who knows. I mean, he’s a very skinny diet, but he has health problems, he does.
Well if he only eats meat, duh!
I know you’re a really smart guy, you’re on podcast, let’s use their powerful brain to talk about…
Well he didn’t always eat a strictly carnivorous diet, he started eating a carnivorous diet after he had a health problem and he says it secured him in some ways. But some people say vegan diet’s the best, other people say the fruitarian diet’s the best. I mean if you look at Steve Jobs, he became obsesses with eating really healthily, especially when he developed his cancer. And yeah, I mean there are so many different opinion on diets.
That’s a very controversial topic, a very controversial.
Yeah, as far as a general principle. I think that’s… That sounds like a good general principle.
Maybe not, you know, switch completely to plant-based food, but, you know.
I watched a Youtube channel with this Australian cyclist, he’s a very, either love it or hate it, he’s like Marmite if you know that expression.
But he is a strict vegan and he says you have to eat as many carbs and as many natural sugars as possible. And that you just stay away from fats if you can except for natural fats. And he says the reason that more people are tired every day cause they don’t eat carbs, they don’t eat sugars and some people would go to war with him over that.
But he’s a very healthy guy, he gets a lot of people on weight loss programs and he’s very successful.
Well we’re not getting deeply into that. So the next rule is loved ones first, meaning, you know, you have to spend time with your loved ones, with your family rather than, you know, work too much for example.
Sounds like a good principle.
I think this is… If you have seen all these interviews with people, you know, who are in their 90s and they are asked about their regrets, a lot of them say like I wish I had spent more time with the family rather than staying, you know, at work until late. And we have two more. So the next one is called downshift, which means destress or find some ways to destress and reduce stress in your life.
Oh absolutely. That’s probably the most important.
We should put it Power 1 – destress.
It’s important, yeah. Stress is a killer.
It is. Actually if we are to believe the statistics, more than 40% of all the diseases, minor and major, can be, you know, stress-related. Well I mean, not directly, but there’s stress.
Stress is just an aggravator of everything. It’s just, you know, it puts tension on the whole system.
Yeah, it exacerbates everything.
And the last one is one of the most controversial ones, cause it’s called wine at 5. And according to this research moderate drinkers tend to live longer than non-drinkers. But moderate, moderate, I think this is important to highlight.
Well in France people tend to have a higher life-expectancy and they drink a lot of wine there. Well not a lot of wine, but they have a glass or two every day, maybe a cigarette. At the end of the day they have a pretty long life.
We had a very, we had a very heated debate about it with Mike in our episode about alcohol, so, you know, he explained how that works and how that is no more than a marketing strategy of companies.
I think… Of course you can find studies on everything, but I think that they may have kind of debunked the wine story, right. That in fact if you actually do the standard, you know, clinical way of doing it, it doesn’t really do that. It sounds like it should, and the French certainly think, along with their cigarette, right.
Well this is what the power 9 is and then you can choose whatever principle, you know, relates best to you. So alright, so that was the BigAppleSchool podcast and today we discussed the healthcare and medical… Well, health and medical care.
And I wanna ask you, Gary, Ben, so what do you think is the main, let’s say, idea or the thought that you are getting from this episode. So for you personally – what are you going to remember about this episode after we’re done?
Don’t break your leg in America.
Well don’t have health problems in America I should say.
And don’t call an ambulance! Ever!
Oh, let’s see, what’s the main thing that I’m gonna take away… Talk to me tomorrow, I’ll know what I thought about, or maybe.
So next time we make a podcast with Gary the first thing I’m gonna ask, no matter what the topic is gonna be – Gary, what do you remember about our episode?
If you think this is a blank answer, just try that. Right. Now I completely remember everything.
Alright. Actually, thinking about what mine would be.
Yeah what’s yours? Come on! What’s yours? What’s your takeaway here?
Be responsible about your teeth.
Responsible about your teeth.
Don’t go to your dentist once every 5 years, you know, do that regularly.
As someone who’s about to get a loan for that, you know, a piece of advice.
Closing with the wise piece of advice.
Exactly. I’m full of wisdom.
Here it is, distilled to a perfect form.
Full of wisdom in wisdom teeth.
That’s a good one, that’s a good one.
Hit the stop button right now.
Alright. So, dear listeners, thank you for listening and remember if you struggle to understand our conversation, you’re always welcome to our website which is…
Well, Gary, then you are welcome to our website.
Yes, I’ll be on the website.
/podcast! If you hadn’t cut me off, I would have…
So yeah, you can find full scripts of each episode there, so you can read and listen and that’s just amazing. So also, if you want to get more content which will help you learn English, you can follow us on social media such as Instagram, Vk, Youtube, Telegram and so on. Just again, search our name, which is, Gary?
Which is my name or the name of the podcast?
The name of the school, Gary!
Oh, BigAppleSchool, BigAppleSchool. Ben, what do you think the name of the school is?
For those who have missed it. Alright. So that was Katya and my guests for today were…
So stay tuned and we’ll see you around!