Health Insurance

Hello everyone, welcome back to EnglishPod.

My name is Marco.

Katarina- And my name is Katarina.

So today we've got a great upper intermediate level lesson for our learners and we're talking

about what?

Marco- Healthcare.

Katarina- Okay, this is a very important topic because it's been in the news recently, especially

in the context of American politics.

And so I don't know if you've heard things about this listeners, but the healthcare is

a very hot topic.

Marco- Exactly.

So basically what we're talking about is health insurance, whether it's private health insurance

or you know, like a standard national insurance program.

Katarina- Exactly.

And so your country might have a private option where you can pay a private company for insurance

or public option like England or Australia, where your country will actually provide healthcare

for you at no extra cost.

Marco- Very good.

So it's an interesting topic.

Why don't we jump directly into the dialogue and we'll be back to explain a couple of things.

Katarina- Hey, honey, how was your day?

Marco- It was all right.

I ran into Bill and we got to talking for a while.

He's in a bit of a jam.

Katarina- Why?

What happened?

Marco- Well, his son had an accident.

Bill doesn't have health insurance.

This really got me thinking and I wondered if we shouldn't look into a couple of different

HMOs.

Katarina- Yeah, you're right.

We aren't getting any younger and our kids are getting older.

Marco- Exactly.

I searched on the web and found a couple of HMOs with low copays and good coverage.

The deductibles are low too.

Katarina- Sounds good.

Although, do you think we can qualify for insurance?

Those insurance companies are real pirates when it comes to money.

Marco- Well, we don't have any pre-existing illnesses or conditions, so we should be fine.

Katarina- I wish our company or country provided us with healthcare.

Marco- Not in a million years.

All right, we're back.

So a lot of interesting vocab here.

Why don't we take a look at it real fast in Language Takeaway.

Language Takeaway.

Katarina- Okay, Marco, this first phrase or acronym actually is three words that go together,

HMO, and they're very, very common when you're talking about healthcare.

Marco- Right.

So an HMO means health maintenance organization.

Katarina- Okay, and so this is a part of the health insurance topic where we're talking

about a company that will provide health insurance.

Marco- Right, so it's a company that provides health insurance, basically.

And if you go up to an HMO, some of the information that you'll receive is, for example, what

your co-pay will be.

Katarina- Okay, so sometimes with a private option, when you pay a company to give you

health insurance, you can get a lower rate if you help pay for some of your care.

So for example, a co-pay on a broken arm might be $20, but you pay $20, that's your

co-pay, and your health insurance company pays the rest.

And so sometimes co-pays are really high, they're really big, and that's kind of a bad

deal because if you hurt yourself, you don't want to pay a lot.

But sometimes there's no co-pay, in which case your company will pay for all of the

coverage.

Marco- All right, so another very similar word is a deductible.

Katarina- Okay, so a deductible is something that is fixed and it's in your insurance policy.

That means in the contract that you make with the insurance company, the deductible will

be stated.

So for example, my insurance plan, I have maybe a $500 deductible.

That means that in any situation, I get hurt or I get sick, I pay for the first $500 of

care and then my insurance company pays for the rest.

So if I have to have a $1,000 surgery, I pay $500 and then my insurance company pays the

other $500.

Marco- Okay, very good.

And well, you have these deductibles and everything and that depends on your coverage, right?

So coverage, how much the HMO covers you.

Katarina- That's right.

And so you can find this also in your contract with your insurance company and coverage will

include or not include something.

So coverage, for example, in a healthcare plan does not usually include your teeth.

That's a separate kind of insurance.

But a coverage can include emergency evacuation from a situation or ambulances, for example.

And so coverage is what is included in your insurance plan.

Marco- Okay, very good.

And our last word for today is to qualify for.

Katarina- All right.

So you might have heard this phrase before in the context of sports or academics.

So he qualified for a scholarship or she qualified for the varsity volleyball team.

But in this case, to qualify for is to be able to use.

Marco- To be eligible for.

Katarina- To be eligible for.

Marco- So sometimes HMOs like in, for example, the United States will not accept a person

who has maybe some health problems already because that would be too much of a risk,

right?

For the company.

All right.

Katarina- That's right.

Or you could qualify for a reduced rate because you have a very good health history.

Marco- Okay.

So this is very interesting.

And we have a couple of other phrases that are very related to this language.

So why don't we move on now to Fluency Builder.

Katarina- Fluency Builder.

Marco- All right.

So in Fluency Builder today, let's take a look at our first phrase.

We got to talking for a while.

Katarina- Okay.

We could say, for example, we started talking or we were talking for a while.

But this is a very spoken language kind of phrase where we'd say, we got to talking.

Marco- Right.

So it's not really grammatically correct because you would say we started talking.

But sometimes people say we got to talking.

So we got into a conversation, right?

Katarina- That's right.

And usually it's about something.

So we could say, yeah, we got to talking about how we both went to the same high school.

Or we got to talking about this movie that we both saw.

Marco- Okay.

Very good.

And well, they got to talking for a while and apparently his friend was in a bit of

a jam.

Katarina- Okay.

Jam is a food.

You can eat it.

You put it on bread.

Marco- Like marmalade, right?

Katarina- Exactly.

And to be in a jam is a fix or a difficult situation.

So it has a very different meaning and I want to warn you about that first.

But to be in a jam or to be in a bit of a jam is to be stuck.

Marco- Okay.

So you're in a difficult situation.

You have some problem.

Katarina- Yeah.

So, Marco, I'm in a bit of a jam here.

Can I get your help with something?

Marco- All right.

Very good.

Okay.

And then the guy was talking about insurance and he said, this really got me thinking.

So we got the verb got again there.

Katarina- All right.

So got me thinking.

That means I started thinking about something.

So when we were talking about jam a minute ago, it got me thinking about how much I love

breakfast.

Marco- Very good.

So you would use it in that way, right?

Katarina- Like it reminded me.

Marco- It reminded me or I started to really think about something.

Okay.

And our last phrase is a pre-existing illness.

Katarina- All right.

So to exist is to be, to be around, pre-existing means existing before something else.

And so you often hear this in terms of insurance when someone asks you about your pre-existing

condition.

So that means if I'm signing up for an insurance plan, health insurance plan, and I have an

interview with you, Marco, and you ask me this question.

Marco- What is your pre-existing condition?

Katarina- That means what diseases or health problems do I have right now?

Prior to signing up for this insurance.

And I say, Oh, I don't have any.

And you're very happy because that means I'll be cheap.

But if I say, Oh, I have diabetes, then that is something that the insurance companies

don't like because it's expensive.

Marco- Right.

Because you're more probable of getting sick or something like that.

Katarina- Right.

So diabetes or cancer or Lyme disease, these are all pre-existing conditions.

And usually pre-existing conditions are diseases or health problems that you have that won't

go away.

Marco- Okay.

Very good.

All right.

So we have a lot of words, a lot of phrases here.

Let's listen to the dialogue one last time and we'll be back.

Hey, honey, how was your day?

It was all right.

I ran into Bill and we got to talking for a while.

He's in a bit of a jam.

Why?

What happened?

Well, his son had an accident.

Bill doesn't have health insurance.

This really got me thinking.

And I wondered if we shouldn't look into a couple of different HMOs.

Yeah, you're right.

We aren't getting any younger and our kids are getting older.

Exactly.

I searched on the web and found a couple of HMOs with low copays and good coverage.

The deductibles are low too.

Sounds good.

Although, do you think we can qualify for insurance?

Those insurance companies are real pirates when it comes to money.

Well, we don't have any pre-existing illnesses or conditions, so we should be fine.

I wish our company or country provided us with health care.

Not in a million years.

All right.

So the health care issue is pretty heated debate now in the United States because many

people don't have health care and it's not very accessible, right?

That's right.

It's a huge debate because it's very, very divided by party lines.

We say there's the Republicans on the right and there's the Democrats on the left and

the Democrats want a public health care option.

They want health care to be available for everyone for free.

And many of them do.

And a lot of Republicans say, no, it should be private because if it's private, there's

competition and that means there's better health care.

And so there's a really big debate and people are getting very angry about it.

Yeah.

And I think it's something that's very interesting and most importantly, seeing the difference

of health care systems around the world, right?

So for example, our listeners, they are from everywhere in the world.

So we would like to know what the health care system is like there.

Do you have free universal health care in your country or do you also have to pay for

private companies or private health insurance?

And if you have one or the other system, do you think it's a good thing?

Do you think it's a bad thing?

What do you think needs some work?

Right.

I definitely agree with universal health care.

I think it's a relief because it's like one thing less to worry about.

I can't imagine like, you know, if I don't have health care right now and I'm not covered

by a private company and something happens to me tomorrow, then you know, what's going

to happen?

And I think it's a basic human right personally.

So I think it's in the best interests of a country to invest in it because it means that

their people are more productive and happier.

And healthier.

Yeah.

All right.

So that's all the time we have for today.

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