醫療保險---沒錢大鍋

追寻者

银狐的报道（转载）快而准！比看报纸省事。谢谢！

oscar

Most Americans do have medical insurance coverage. Out of a population of almost 300 million in the U.S., it is estimated that 43-45 million people are uninsured. But it is not the poor people that have problems – it is the lower middle class. The U.S. government has two insurance programs, Medicaid and Medicare. Medicaid provides free medical insurance to low income families, while Medicare provides very low cost, highly subsidized insurance to the retirees. And if you don’t qualify for either government program, then hopefully your employer provides medical coverage. The vast majority of large companies provide medical insurance to the employees and their families. But most small companies and many mid-size companies do not have medical insurance.

So if you are poor, you are protected. If you are old, you are protected. If you are rich, you don’t care about insurance since you can always pay out of your pocket. If you are in the middle class, and your employer does not have medical insurance, then it becomes a really big problem because medical insurance is so expensive and many middle income people cannot afford it. The only saving grace is that, under federal law, all hospitals must treat patients who seek help in the hospital emergency room, whether the patient can afford to pay for the treatment or not. If the patient cannot pay, the hospital generally absorbs the loss.

If you have medical insurance, the American system is pretty good, since you have access to some of the best hospitals and most advanced procedures in the world. But the casualties of this system are the 43-45 million uninsured Americans, and the American companies that must spend a huge sum of money to insure a large percentage of the American population. The high cost of providing medical insurance has become a major issue for American companies, which have to compete with foreign companies that do not have that burden.

Canada, Japan, and most European countries have national insurance coverage for all citizens. That system, too, has its drawbacks. Everyone in the country is guaranteed a minimum level of medical care. But in a sense, medical care is rationed, and patients sometimes have to wait for months for some services, such as doing an MRI scan, or some non-emergency procedures.

Oscar

雨露

欢迎 Oscar 加入我们的大家庭。请问 Oscar 你是好莱坞明星之一吗？因为这名子太亮丽了。
除了上述的保险计划外，几年前又多了一项（健康家庭计划－Healthy Families Program HFP),这计划是加州政府针对低收入推出的儿童全面医疗保险计划。它包括健康、视力和牙齿，而且保费很低。年龄从零至十九岁生日之间，同时必需为加州居民，家庭年收入需低于联邦贫穷线的25％，这些是主要条件，如能通过就可以得到廉价的保险。

銀狐

Oscar兄:很多謝你!為大家長細報道了,北美洲的醫療保險制度,你的報道及長細的解說,同學門對北美洲的醫療保險制度,有了一定的認識.Oscar Thanks again!

雨露:為我们大家報道了美國加州---有關健康家庭计划保险.加州的同學你門用得著嗎?多謝你!

銀狐

二○○○年世衛組織對成員國衛生籌資與分配公平性的評估排名中，大陸名列第一百八十八，在一百九十一個成員國中倒數第四.

報告指出，十多年來，大陸醫療體制患了「美國病」，即費用大幅攀升、醫療服務非常不公平、資源利用效率低下、民眾健康指標停滯不前，甚至惡化.
針對醫療體制弊端，報告提出若干建議：一、針對醫療保障成為「富人的俱樂部」，必須打破城鄉、所有制等界限，建立覆蓋全民、一體化的醫療衛生體制，這樣不僅可以實現社會公平，保障全體公民的基本健康權益，也可以避免體制分割所造成的利益集團分化，以及由此產生的矛盾和衝突。更重要的是，通過城鄉一體化的醫療衛生體制建設，可以真正保護農民權益.
二、目前全大陸百分之八十的醫療資源集中在大城市，其中百分之卅又集中在大醫院；反觀全大陸人口三分之二的農村居民所花費的醫療費用，不到城市居民的三分之一.新的改革框架，必須將醫療衛生服務分為公共衛生、基本醫療服務和非基本醫療服務三個層次.

在公共衛生服務方面，包括計畫免疫、傳染病控制、婦幼保健、職業衛生、環境衛生和健康教育等，應由政府向全體社會成員免費提供。在基本醫療方面，以政府投入為主，針對絕大部分的常見病、多發病，為全民提供所需藥品和診\療的基本醫療服務.

三、醫療費用居高不下，主要原因是藥品濫用及藥品價格失控。目前大陸的藥品銷售主要通過醫師處方，由於醫師收入與醫療服務收入緊密掛勾，誘使醫師「開大處方、多做檢查」，其中最普遍的是「醫藥合謀\」，靠向患者出售特別貴重的藥品牟利.按照新的制度設計，徹底實行醫藥分開，政府工作重點應注意營利性醫療服務機構，在調整醫療服務價格的基礎上，嚴格限定醫院的收入比例，全面推行醫藥分開，並輔以嚴格的價格監管和懲戒手段，解決「醫藥合謀\」問題.


［此帖子已被 銀狐 在 2005-8-1 9:07:04 编辑过］