2022-10-21 06:17:52 |
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THEORGANIZATIONANDFINANCINGOFTODAY'SMEDICINE
今世医疗轨制与资金投入
Patients, aswellastheirrepresentativesingovernment, industry, andmanaged-careorganizations, areconcernedabouttherisingcostofmedicalcare.
当局、财产、办理型医疗保险代表和病患都对不竭增长的看病代价赐与了高度存眷。
ThetotalbillforhealthcareinAmericanowrisesatarateofabout10 percentperyear, anincreasethatseemstocontinueunabated.
在美国,医疗开消以每一年10%的代价增加,而这一趋向还将继续下去。
Federallegislationinstitutingdiagnosis-relatedgroups(DRC's) hasclearlymoderatedtheri搜索引擎优化fhospitalcosts, butphysiciancostscontinuetoriseatanever-increasingrate.
联邦立法已开设
了诊断相干组,并已低落了病院开消,可是内科大夫的开消依然在不竭增长。
Everystudentofmedicineshouldaskifthisisrealistic.
每名医学学生都在问这是否是真的。
Isitsustainable? Isitdefensible?
是可延续性的?仍是有可解决的法子?
Whatwillbethelimits?
范畴到底在哪?
Patientsalreadyask, “CanIreallyaffordthebestdoctorsinthemostprestigiouspractices, inthemostfamousmedicalcenters?”
病患在问,“我能去最佳的医疗中间,最佳的科室,找最佳的大夫看病吗?”
“CanIaffordtobereferredtoasubspecialist?”
我有钱去看那些专业医师吗?
“CanIaffordtobeoutofworkandinthehospital?”
我能付出得起不上班在病院看病的开消吗?
“CanIaffordtopaymyrisinginsurancepremiums?”
“我有钱付出不竭增加的保险吗?”
“HowmuchdeductibleonmyinsurancecanIafford?”
“保险中的扣除条目我能付出得起几多?”
Worseyet, anincreasingnumberofpatientshavetomakechoicesbetweenseekingmedicalanddentalcareandgettingfood, clothing, shelter,
andotheressentialsofdailyliving.
更糟的是,有许很多多的病患不能不在看病,看牙和基今日常糊口之间做出选择。
TheseissueshavebecomemajorconcernsinAmericanhouseholdsandclearlyrepresentoneofthemostdisturbingweaknessesinoureconomy,
这些问题已成为美国度庭关切的重要问题,而且是美国经济中最使人担忧的亏弱环节,
ofwhichnownearly12 percent( byannualgrossnationalproduct) isdevotedtohealthcare, upfrom8 percentin1975.
医疗用度所占每一年国民出产总值的比例已由1975年的8%增长到如今的12%。
OverthelasttwotothreedecadesithasbeenagoaloftheUnitedStatestopromoteeverincreasingqualityandcost-effectivenessofhealthcareforall.
在曩昔的二三十年中,美国的方针就是要为全部公众供给质量高,本钱高效益的医疗轨制。
Unfortunately, wehavefailedmiserably.
不幸的是,咱们遭受了惨败。
TheUSAspendsmorepercapitaonhealthcarethananyothernationintheworld.
美国事全世界小我医疗开消最大的国度。
Yetinthemajorindicesofhealthourpopulationranksnineteenth!
可是在重要医疗指数上,美国公众排在了第19位!
Atthesametimewecontinuetoseeawastefulmaldistributionofphysiciansbothbyspecialtyandgeographicallyandagrowingnumberofmedicallyindigentandmedicallyuninsuredpeopleinournation.
与此同时,不管在专业仍是在地区上,内科大夫的分派分歧理,没有保险,没钱看病的人数还在不竭增长。
Somehow, thecostsofwhatwearetryingtoachieve—eventhoughthegoalisco妹妹endable— arenotbeingplacedinproperperspectivebythemedicalprofession, health-caremanagers, andrepresentativesofthepeopleinordertoprovidesuitablecareforall.
虽然咱们要实现的方针值得赞美,可是咱们要实现的看病代价并无获得医疗人士、医疗卫生羁系人士、和代表的当真看待。
Unfortunately,inthepresentsystemtherealneedsofthepopulacearenotalwaysmetbyaffordableservices.
不幸的是,就今朝的轨制而言,公共所可以或许付出得起的医疗用度没法知足人们的请求。
Atthesametime, overutilizationofmedicalservicesmaybetheveryenginethatdrivesupthetotalcostofhealthcaredelivery.
与此同时,医疗办事的过分利用也许也是增长医疗用度的引擎。
WiththepassageoftheMedicareprogramfortheelderlyandtheMedicaidplanforthepoorbyCongressin1965,
1965年,美国国会经由过程了补贴白叟的退休医疗福利,和补贴贫民的贫民医疗补贴,
wehadhopedasanationthatweweremovingtowardamorejustandefiicientsystem.
咱们但愿美国的医疗体系可以或许变得加倍公道,加倍有用。
Infact, theoppositehasbeenthetrend.
可是究竟上,咱们却各走各路。
Thissocietalgoalmustnowbereaddressedreformulated, andrestructedintermsofmodernneeds,
就社会需求来说,咱们应当通太重组来实现社会方针,
reflectingfairlyandfullymeasuredcost-benefitratiosforeveryformofmedicalservice.
周全反应医疗办事的本钱与效益比例。