Obama care 资料Word文档格式.docx
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Obama care 资料Word文档格式.docx
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insurancemodel,butthisisknownasadvancedmedicalinsurancemodel,notonlyfailedtocoverallcitizens,themedicalrisksseventhnationalsfailedtogetanyformofinsurancecoverage,butalsoleadtothosewhoenjoymedicalinsurancemedicalcostscontinuetorise.Atpresent,themainproblemsofthefirst,incompletecoverage,fairandpoor.TheUnitedStatesistheonlydevelopedcountriesdidnotimplementuniversalhealthinsuranceornationalhealthservicesystem.TheU.S.governmentspecificallyforthemilitaryandveteransestablishedmedicalinstitutions,providingdirectservices;
specificallyfortheelderlyandthepoorhealthrisksprovidesinsuranceprotection.Americangeneralpopulationhealthriskcanbeprotectedbywayofpurchaseofprivatehealthinsurance.Accordingtoofficialstatistics,thereare44millionAmericancurrentlyenjoyingpreferentialgovernmenthealthinsurancefortheelderlyandpersonswithdisabilities"
M(healthcaresystem);
thereare61millionpoorpeopletoenjoy"
(Medicaid)offershealthinsurance;
thereare163millionpeoplebelowtheageof65gethealthinsurancethroughemploymentrelationship;
another18millionpeopleintheinsurancemarkettobuyhealthinsuranceontheirown.However,thereareabout46millionpeopleintheUnitedStates,lackofmedicalriskprotection.Theproportionaccountedformorethan15percentoftheAmericanpopulation,ofwhich80%ofworkingfamilies.Second,thecostrisesandinefficient.AccordingtoWorldBankstatistics,theU.S.healthcareexpendituresin2005grossdomesticproduct(GDP)was15.2percent,percapitahealthspendingreaches$6,350.Incontrast,otherhigh-incomecountriesoverthesameperiodofthesetwosetsofdatawere11.2%and$3,830.U.S.healthcareisnotonlyexpensive,butalsolessthanideal.IntheUnitedStates,wasborntheaveragelifeexpectancyislowerthanthesameperiodofnationalexpectationsinmostEuropeancountries.In2006,theaveragelifeexpectancyofAmericansbornwas77.8years,whiletheaveragelifeexpectancywasbornthesameperiodoftheUnitedKingdom,France,Germany,theNetherlandsandItalywere79.1,80.6,79.1,79.7and81.1yearsofage.191MemberStateshealthcaresystemrankingsreleasedWorldHealthOrganizationin2000,theUnitedStatestoppedthelevelofpercapitahealthexpenditures.Whetherpatient-centeredsortofreactionontheindexranked7th.America'
shealthcareoverallperformancerankinginthefirst37MemberStates,whilerankinginthehealthlevelisrankedNo.72.Third,themodelchange,theproblemcontinued.Developmentoftheworldexperiencedareplacementhealthinsurancebusinessmodelintwo:
First,"
reimbursement-type"
healthinsurancemodel;
secondisthe"
healthinsurancemodel.Reimbursement-typemodeltomanagedcareparadigmshift,istheworldofhealthinsurance,butalsoaninnovativeAmericanhealthinsuranceinthedevelopmentprocess.Fourth,thefinancialcrisis,theconflictintensified.TheinternationalfinancialcrisisoriginatedintheUnitedStates,leadingtoarisingunemploymentrateintheUnitedStates,reducinghouseholdincome,makingmoreandmorepeoplecannotaffordmedicalinsurancecostsbornebytheoriginal.Statisticsshow,thereareabout1.4millionpeopleintheUnitedStateseverydayduetotheaboveproblemsandlosehealthriskprotection.Thislackofhealthcareofthegrowingnumberofincreasinglybecomesocialstabilityunfavorablefactors.StudieshaveshownthatpovertycausedAmericanfamilies,theproportionofAmericancompaniesalsorapidlyoccursduetounbearableburdenofhealthcarecostsbankruptorlosschanges.Backin2007,ledtheUnitedStatesfiledforbankruptcybusinessorhome,thereare62.1%ofthefinancialcrisisstemsfromthe"
Medicalcostsaretoohigh,"
ratherthantheoutsideworldcalled"
houseprices"
or"
investmentassetsshrink."
BecausetheUnitedStatesEmployersmustprovidehealthinsurancefortheiremployees,soemployeeshavemedicalinsuranceexpensesforthoseoperatingsmaller,poorereconomicenterprisecausednosmallfinancialpressure.Outbreakofthefinancialcrisis,makingthesituationevenmoreserious.Thepastfiveyears,theUnitedStateshasacasebecausethemedicalcoststoohighanoperatinglossofmorethanathirdofSMEshavehappened.Second,thecontentofthehealthcarereformprocessintheimplementationofhealthcarereform,PresidentObamalearnedinthe1990sduringthereignofPresidentClinton'
shealthcarereformfailures,takesomenewactionstrategy.Forexample,inordertoavoidconfrontationbetweentheWhiteHouseandCongressappearonreform,PresidentObamainprincipleitdoesnotgiveupthebigpremiseofthespecificdraftingoftheimplementationofthereformprogramtoCongress,sothereisaparliament,theHouseofRepresentativesandSenatehealthcarereformbilltwophenomena,whilein2010two
NewmedicalreformprogramannouncedbytheendofMarch22,twobillscoexistence.HealthcarereformplanpassedbytheHouse,itscoreistocreateafederallyregulatedhealthinsurancemarket,thingstosellhealthinsurancebypublicinsuranceagencyestablishedbytheGovernmenttocomplete.TheActrequiresthevastmajorityofAmericanswhobuyhealthinsurance,cannotaffordinsurancepremiumsforfederalfunding.Largercompaniesorcompaniesmustprovidehealthinsurancetotheiremployees,ortheywillbefined.Federalgovernmentemployeescanbuyhealthinsuranceforsmallcompaniesorsmallbusinessestoprovidesubsidies.Actprohibitstheprevioushistoryoftheinsuranceindustrytothebuyersrefusetosellinsurance,isnotsubjecttothegroundsofgenderormedicalhistorypremiums.10yearsaftertheimplementationoftheAct,thetotalspendingwillreach$1.2trillion,thiscostwillbeotherwaystoraisetaxincreasesonthewealthybyreducingfederalspendingandhealthcareprojects.Billonceimplemented,willenablecurrentlynohealthinsurancein360046millionAmericansgethealthinsurancepeople,sothatnationalhealthinsurancecoveragefromthecurrent85percentto96percentexpansion.InaccordancewiththeprovisionsofhealthcarereformbillpassedbytheSenate,andallAmericansshouldhavehealthinsurance,thefederalgovernmentwillprovidelow-incomepopulationsMedicaresubsidies.AsmostAmericansthroughtheemploymentrelationshipandaccesstohealthinsurance,sotheAct,thegovernmentcanthroughaseriesofincentivestoencourageorpromotebusinessesprovidehealthinsurancetotheiremployees.AndhealthcarereformaspassedbytheHouse,thebillprohibitsinsurancecompaniesduetothepresenceoftheinsuredperson'
sownhealthproblemsandrefusecoverageorraisepremiums.Thebillplanstospend$871billiontransformationofthehealthcaresysteminthenext10years,makingthemedicalbenefitssystemencompassesvirtuallyallAmericans.30millionpeoplewithouthealthinsurancebenefitstheUnitedStateswillthereforegetinsurance.Financialsourcesoffundinghealthcarereformismainlythehighsurchargetaxhealthinsuranceplans,insurancecompaniesandmedicaldevicemanufacturerstopay.However,thecontentofpublichealthcareconcernhasnotbeenincludedintheselectionofthehealthcarereformbill,butsaidthetwoprivateinsurancecompanieswillbeimplementedunderthesupervisionofgovernmentagenciesplan,atleastoneoftheprogramshouldberuninanon-profitbasis.ObjectivesObama'
shealthcarereformthreehealthcarereform,Inshort,therearethreemainaspects:
First,toprovidesecuritytothosewhohavehealthinsurance.Countriesthroughspeciallegislation,thecontractofinsurancecompaniesconductstrictconstraints.Underthenewreformprogram,theinsurancecompanymaynotexistbecauseofpasthistoryoftheinsuredrefusestoassumeresponsibilityforpayment;
notcancelbecauseofillnessinsuredinsuranceplans;
notexistbecauseofpasthistoryofthepolicyholderortheoccurrenceofdiseaseandlimititsscopeofprotectionandsoon.Otherwise,wouldbeconsideredillegal.Second,forthosewhodonothavehealthinsurancetoprovidehealthinsurance,expandingthecoverageofhealthinsurance.ThenewhealthinsuranceplanrequiresthateveryonehavehealthinsuranceforeveryAmericancitizenisbotharightandaresponsibility.Forthosewhostilldonotgethealthinsurance,thegovernmentwillcreateanewinsurancemarketsforindividualsandsmallbusinessesatacompetitivepricetobuyhealthinsurance,butnotbecauseofunemploymentorconversionworkandlosehealthinsurance.Thethirdistocontrolmedicalcosts.Reducerisinghealthcarecosts,isaworldwideproblem,buttheproblemisparticularlyevidentintheperformanceoftheUnitedStates.Controlhealthcarecosts,reducehealthcarecosts,bothPresidentObamahealthcarereformweightgoals,butalsotheimportantpartofhealthcarereform
建立全民医疗保障体系,一直以来是美国人的一个梦,尤其是美国民主党近一个世纪以来的梦想,也是美国很多经济学家和卫生学家所致力推动的。
奥巴马的上台以及当前所面临的严峻的经济危机,似乎给了美国一个极好的改革机会,于是奥巴马推出了他的医改方案,其宏伟目标主要是两个——“广覆盖”和“低成本”,最终目的是为美国全民提供“可以负担得起”的医疗保险。
但是无论在通过医改方案的过程中还是在推行的过程中都遇到了不可忽视的阻力,奥巴马的医改计划能否顺利进行,能否真正能带给美国人福利,将试目以待。
历史编辑
1912年,时任美国总统的罗斯福(TheodoreRoosevelt)对德国总理俾斯麦(OttoVonBismarck)40年前提出的改革表示赞同,从而想要通过新的医疗保险政策。
但这些政策由于其后辈——1913年起担任美国总统的伍德罗·
威尔逊(WoodrowWilson)的反对未能得以实施。
1933年,美国前总统罗斯福的侄子——同样身为美国总统的富兰克林·
D·
罗斯福(FranklinDelanoRoosevelt)提出了帮助美国步出1929年经
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