新医改中英文对照评论
奥巴马的新医保计划(中英对照)
原文The President’s PlanPublished: February 22, 2010Perhaps if Senator Edward Kennedy had lived longer, or the election to choose his successor had turned out differently, President Obama’s decision to have Congress take the lead on health care reform would have looked like a political masterstroke. It didn’t turn out that way.It is a relief to see Mr. Obama fully engaged.The president was right to invite Republican leaders to a health care summit this week. He should hear them out but also challenge them — directly — to come up with credible ideas that would both expand coverage for tens of millions of uninsured Americans and begin to rein in out-of-control medical costs. For too long they have been allowed to obstruct and demagogue.And Mr. Obama will need to keep pushing in the days that follow and stiffen the spines of any wavering Democrats.Most important, Mr. Obama needs to clearly explain the stakes to the American people. Reform is essential for Americans who have no health insurance. But it is just as crucial to the millions more who are just one layoff away from losing their coverage, and many millions more who watch with fear as the cost of care and their insurance premiums rise relentlessly.•Mr. Obama took an important step on Monday by issuing, at long last, his own detailed proposals for reform.The most basic facts to keep in mind are that Mr. Obama’s plan, which builds on a sound bill already passed by the Senate, would provide coverage to morethan 30 million uninsured people while reducing future deficits and beginning to rein in medical costs.Mr. Obama’s plan also adds important new features that should make it more attractive to House Democrats and to the general public.His boldest new idea is to give the federal government powers, in conjunction with state insurance regulators, to reject excessive premium increases. Anyone who read in horror, as we did last week, about rate increases of up to 39 percent for some California clients of Anthem Blue Cross should find that idea a particular relief.For low- and moderate-income people worried that they will be forced to buy insurance they can’t afford, a proposal of his would beef up tax subsidies to help them buy policies and make the penalties for ignoring the mandate somewhat less onerous.For older Americans, Mr. Obama would gradually close the so-called doughnut hole, a gap in Medicare’s drug coverage that leaves many elderly beneficiaries unable to pay for their medicines.For deficit hawks, Mr. Obama would retain an important cost-control measure: a proposed tax on high-cost, employer-sponsored insurance policies. But he would make it more palatable to workers by raising the thresholds and delaying imposition of the tax for all workers — not just those in unions —until 2018. That retains its ability to lower costs over the long term.His plan also provides important relief for cash-strapped states that say they can’t afford to expand their Medicaid rolls — another essential step to covering the uninsured. It would give a generous matching-fund rate to all states to cover newly eligible enrollees, and it jettisons the special deal granted to Nebraska — to win Senator Ben Nelson’s vote — that would have hadWashington paying the full cost, in perpetuity, of just one state’s Medicaid expansion.•The president’s proposals are far from perfect. We wish he had included a public plan. And we regret that he accepted the Senate’s decision not to require employers to provide insurance. He would boost the payments required of employers whose workers end up needing public subsidies to help them buy their own coverage.In all, the administration estimates the cost of Mr. Obama’s proposals — $950 billion over 10 years — would be more than offset by new revenues and would reduce the deficit by $100 billion over the next decade and by about $1 trillion in the decade after that.As they consider all this, Americans also need to keep in mind what Republican leaders mean when they talk about health care reform. All of their ideas have these basic facts in common: they would not reduce the number of uninsured Americans substantially; they would not guarantee affordable coverage for people with pre-existing conditions; they make only feeble attempts to rein in medical costs; and their proposals to slow the rise in the cost of premiums would mostly benefit the healthy. That is not enough.Mr. Obama’s proposals provide a firm basis for both the Senate and House to move forward with comprehensive reforms. If the Republicans resort to filibusters to block passage, the Democrats should use a budget reconciliation procedure that requires only a majority vote for passage in the Senate.This may be the last best chance for decades to come to reform the nation’s broken health care system. Mr. Obama and Democratic leaders should fight to win.译文奥巴马的新医保计划Published: February 22, 2010要是参议员爱德华·肯尼迪（Edward Kennedy）目前依然健在，抑或选举其继任者的结果与现在不同的话，那么奥巴马总统要求国会率先支持医改方案的决策就如一招政治妙棋，而不会变成这个样子。
[精彩]医疗改革-五项重点改革英文版
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打印本文关闭窗口□□□□□□改□□□□□□□□□□2009□2011□□□□□文文章来源：国家发改委网站更新时间：2009-4-8 21:43:31□□□□□□□□□□□□□□□□□□□□r □□□□□□□□□□r□□r□□□□□□□□□□□□□□□□□□r□□□□□□□□□□□r□□2009-2011□According to the Opinions of the CPC Central Committee and the State Council on Deepening the Health Care System Reform (hereinafter referred as “the Opinions”), five reform programs should be carried out with emphasis from 2009 to 2011. Firstly, accelerate the establishment of the basic medical security system. Secondly, preliminarily set up the national essential medicines system. Thirdly, improve the grass-roots health care services system. Fourthly, grad ually press ahead with the equalization of basic public health services. And fifthly, push forward pilot projects for public hospital reform.The implementation of the five priority reform programs aims at effectively solving the problem of “difficult and costly access to health care services”, whi ch arouses intense public concerns. In promoting the establishment of basic medical security system, all urban and rural residents will be included into the s ystem to effectively reduce the burden of drug expenses on the individuals. In establishing the national essential medicines system, and improving the gras s-roots health care services system, it will be made more convenient for residents to accessing health care services; the role of the traditional Chinese medic ine (TCM) will be brought into full play and the prices of health care services and drugs be reduced. In promoting the gradual equalization of basic public h ealth services, all urban and rural residents should be entitled to basic public health services, for prevention of diseases to the maximum extent. In carrying out pilot projects for public hospital reform, efforts will be made to improve the service quality of public health care institutions and to meet the demand of the people to have “convenient and affordable access to health care services”.The implementation of the five priority reform programs aims at actualizing the commonweal nature of health care undertakings, and is characterized by th e salient phased features of a reform. Making the basic health care system as public goods to the general public and providing everyone with basic health ca re services, is a major reform from concept to institution in the development of China’s health care sector, which meets the fundamental requirement in imp lementing the Scientific Outlook on Development. As an arduous and long-term task, the health care system reform shall be promoted with specific emphas is in different phases. Fairness and effectiveness should be appropriately balanced. The fairness issue will be tackled at the early stage to guarantee the basi c demands of the people for health care services, which will be followed by a progressively increased benefit level along with the social and economic deve lopment. Efforts will be made to gradually address the issue of integration among the urban employees’ basic medical insurance, the urban residents’ basic medical insurance, and the New Rural Cooperative Medical Scheme. Social capital investment in the sector will be encouraged to develop multi-level diver sified health care services. Efforts will be made to utilize health care resources of the whole society in an all-round way to improve service effectiveness an d quality and meet the various demands for health care services of the people.The implementation of the five priority reform programs is to enhance the operability of the reform, highlight the priorities, and to push forward the compre hensive reform in the health care system. Establishing the basic health care system is an important institutional innovation, which is a pivotal step in the co mprehensive reform of the health care system. The five priority reform programs involve key links and areas such as building up the medical security syste m, secured pharmaceutical supply, price formation mechanism of health care services and drugs, construction of health care institutions at grass-roots level s, reform of public health care institutions, mechanism of investment in health care, development of the health care workers’ team, health care administratio n system and etc. The purpose of prioritizing the five reform programs is to fundamentally change the situation of no medical security for some urban and r ural residents and the chronic inadequacy of public health care services, reverse the profit-orientated behaviors of public health care institutions and drive th em to resume their commonweal nature, effectively tackle the prominent problems in the current health care sector, laying a solid foundation for realizing t he long-term objectives of the health care system reform.□□□□□□□□r□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□d□□□□□□□□r□□□□□□□□□(i) Expanding the coverage of the basic medical security The urban employees’ basic medical insurance (hereinafter abbreviated as UEBMI), the urban residents’ basic medical insurance (hereinafter abbreviated as URBMI), and the New Rural Cooperative Medical Scheme (hereinafter abbreviated as NRC MS) will cover all urban and rural residents within three years, each with the coverage rate over 90%. Retirees of closed-down and bankrupted enterprises a nd employees of enterprises in difficulties will be covered by UEBMI in about two years. Those who cannot be covered by UEBMI should be entitled to U RBMI, with the permission of provincial level government. Retirees of closed-down and bankrupted enterprises should be entitled to the benefits of the basi c medical insurance regardless of the premiums affordability by these enterprises. To enable insurance participation, appropriate subsidies shall be given by the central government to retirees of closed-down and bankrupted state-owned enterprises in financially constrained regions. The UEBMI system will be im plemented universally in 2009, which will also cover all the on-campus college students. Efforts should be made to vigorously promote UEBMI participatio n by employees of economic entities of non-public ownership, temporary contract workers and migrant rural workers. For those with employment difficulties, the government will subsidize their participation in UEBMI if they are eligible according to the Employment Promotion Law. Temporary contract worke rs should volunteer their participation in either UEBMI or URBMI. Those migrant rural workers with difficulty in participating UEBMI, can opt for URBM I, or NRCMS in their registered permanent residence.(ii)mproving the basic medical security level Efforts will be made to improve the fund-raising standard and benefit level of URBMI and NRCMS. By 2010, subsidy on URBMI and NRCMS by government budgets at various levels will be increased to 120 Y u an per person per annum, and premium paid by individuals should be appropriately increased, with specific standards set up by provincial governments. The proportion of hospitalization expenses reimbur sed by UEBMI, URBMI and NRCMS will be increased step by step within the scope of policy. The scope and proportion of reimbursement for outpatient e xpenses will be expanded. The maximum amount payable by UEBMI and URBMI shall be increased to about six times of annual average salary of local e mployees and disposable income of residents respectively. The maximum amount payable by NRCMS shall be increased to over six times of the per-capita net income of local farmers.(iii) egulating administration of basic medical security funds In the administration of various basic medical security funds, the principles of “determin ing expenditure by revenue, balancing expenditure and revenue and pursuing slight surplus” should be followed. Efforts should be made to maintain reason able control over annual balance and accumulated balance of UEBMI and URBMI accounts, and in localities where there is an over surplus of balance, mea sures such as raising the benefit level should be adopted to reduce the balance to a reasonable level step by step. For NRCMS, the surplus of the pooling fun d of the current year shall be capped within 15%, the accumulated surplus shall not exceed 25% of the current year’s pooling fund. The risk adjustment fun d shall be institutionalized for basic medical insurance funds. The fund balance status shall be made public regularly. The fund pooling for basic medical in surance shall be upgraded, and funds for UEBMI and URBMI respectively should be preliminarily pooled at the municipal (prefecture) level by 2011.(iv) mproving the urban and rural medical aid system Efforts should be made to effectively utilize medical aid funds and streamline procedures for ex amination, approval and the delivery of such funds. Financial assistance should be provided to members of urban and rural households receiving the minim um living standard allowance and those entitled to “five guarantees” to secure their participation in URBMI and NRCMS. For members of economically str ained households, the subsidization standards on out-of-pocket medical expenses will be gradually raised.(v) mproving service uality and management of basic medical security o cal governments should be encouraged to actively explore establishing a ne gotiation mechanism between medical insurance handling institutions and providers of health care services as well as reforming ways of payment, and to rat ionally determine the payment criteria for drugs, health care services and medical materials, and to containing the cost. Efforts should be made to improve medical security services, promote the application of the “All-in-One Card” (a multi-purpose card) among insurants, and realize direct settlement between medical insurance handling institutions and designated health care institutions. Farmers participating in NRCMS should be allowed to access designated he alth care institutions within the pooling area, and referral procedures for accessing health care services beyond the county should be streamlined. An accoun t settlement mechanism will be established for treatment from allopatry, and for relocated retired insurants, methods should be explored to settle account in the same locality where treatment is received. Efforts should be made to formulate methods of transferring and connecting basic medical insurance account s so that the problems in transferring basic medical security accounts from one region to another, or from one system to another, of those temporary contrac t workers including migrant workers, can be resolved. Proper connection should be made among UEBMI, URBMI, NRCMS and urban-rural medical aid. E fforts should be made to explore and set up an integrated basic medical security management system for urban and rural areas, and gradually integrate the a dministrative resources handling and managing basic medical security. On the premises of ensuring safety of the funds and effective supervision, efforts sh ould be made to explore entrusting qualified commercial insurers to provide various medical security management services in the way of government purch asing medical security services.□□□□r□□□□□□□r□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□d□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□d r□□d□□□□□□□□□□□□□□□□□□□□□□□□□□□□r □□□□□□□□□□□□□□□□□□□□□□□□□□□□d□□□□□□□□□□□□□□□□□d □□□□□□□□□□□□□□□d□□□r □□□□□□□□□□□□□□□□□□□d□□□□□□□□□□□d □□□□r□□□□□□d□□□□□□□□□□□□□□□□□□□□□d□□□□□□□□□□□□□ r□□d□□□□□d □□d □□d□□□d r□□□□□r□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□d□□□□□□□□□□□d □□□□□□□□□□□d □□□□r□□ 2009□(vii) reliminarily establishing a secured supply system for essential medicines Efforts should be made to bring into full play the role of market forces in pushing forward merger and restructuring of pharmaceutical manufacturing and distributing enterprises, and to develop unified distribution and achieve o perational scale; encourage retail pharmacies to develop chain operation. The professional pharmacist system should be improved and retail pharmacies, as of required, must be staffed with certified pharmacists, who can provide patients with consultation and guidance in purchasing drugs. Essential medicines u sed in government-run health care institutions, shall be purchased through open tender organized by institutions designated by provincial governments, and unified distribution by distributors selected through the open tender is also required. Manufacturers and distributors bidding for tender should have appropriate qualifications. In purchasing drugs through open tender and selecting distributors, the principles of nationwide unified market, equal participation and fa ir competition among enterprises of different ownerships and regions should be applied. Both the purchaser and seller should sign the contract according to the result of tender, and strictly implement the contract. Essential medicines required in small amount could be designated to manufacturers through tender. Efforts should be made to improve the national reserve system of essential medicines, strengthen supervisions over drug quality, and conduct sampling insp ection on the quality of drugs regularly and make the result open to the public.The central government determines the guiding retail prices of essential medicines. Based on the result of tender, provincial governments set the unified pur chasing prices within the range of the government-guided prices, with the distribution charge included in the purchasing price. G o vernment-run health care institutions at grass-roots levels shall sell drugs with zero mark up. L o cal governments are encouraged to explore purchasing means of further reducing the prices of essential medicines.(viii) Establishing priority selection and rational utili ation system for essential medicines To meet the demand of patients, all retail pharmacies and h ealth care institutions should store and sell the national essential medicines. The utilization rates of essential medicines in health care institutions at various levels should be regulated by government health departments. Starting from 2009, essential medicines should be stored and used in all government-run heal th care institutions at grass-roots levels. All other health care institutions must use essential medicines as regulated. H e alth departments of the government s hould formulate guidelines and prescription formularies of essential medicines for clinical use so as to strengthen guidance and supervision over medicatio n. Patients are allowed to purchase drugs in retail pharmacies with prescription. All the essential medicines are included in the drug reimbursement list of b asic medical security, with the reimbursing rate much higher than that of non-essential medicines.□□□□□□r□□□□□□□□□□□□□□□□□□□□□□□□□□r□□□r□□□□□□□□r□□□-r□□□□□□□□□□(ix) trengthening construction of grass roots health care institutions Efforts should be made to improve the three-tier rural health care service networ k, and give full play to county-level hospitals’ leading role. The central government will give full support to the construction of around 2000 county-level h ospitals (including TCM hospitals) within three years, and at least one hospital in each county should reach the level of a standard county hospital. Construc tion standards for township health care centers and community health centers should be improved. In 2009, the construction of 29,000 township health cent ers supported by the central government planning should be completed, and support will also be given to the renovation and expansion of over 5000 lead to wnship health centers, with one to three centers in each county. V i llage clinic construction in remote and border areas will be supported, and each administr ative village will be equipped with one clinic nationwide in three years. 3700 urban community health centers and 11,000 community health stations will ne wly built or renovated in three years. The central government will support the construction of 2400 urban community health centers in regions with difficult ies. The health care resources should be restructured in areas with excess public hospitals resources, for the purpose of strengthening health care institutions at grass-roots levels. Through ways of service purchasing, the government compensates public health services provided by grass-roots health care institutio ns run by non-government sponsors. The government will compensate basic health care services provided by non-government institutions through channels such as basic medical security funds and by means including signing designated health care insurance contract. Q u alified health care professionals are enco uraged to run clinics or establish their individual practice.(x) trengthening the team of grass roots health care or ers Efforts will be made to work out and implement the plans of free of training general prac titioners and recruitment of certified practitioners for rural areas. The plan is to train 360,000 health care professionals for township health centers, 160,000 for urban community health institutions and 1.37 million for village clinics in three years. The system of counterpart aid between urban and rural hospitals will be improved. Each urban tertiary hospital shall provide long-term counterpart assistance to about three county-level hospitals (including township healt h centers where conditions allow). Efforts will be made to implement the project of “10,000 doctors providing health care assistance to rural areas”, and im prove the quality of county-level doctors with further training in large urban hospitals, or with standardized training for resident physicians.Efforts will be made to effectively implement the policy that doctors in urban hospitals and disease prevention and control centers shall work for at least on e year in rural areas before obtaining intermediate or senior professional titles. G r aduates from medical universities are encouraged to work in health care in stitutions at grass-roots levels. Starting from 2009, the government will compensate tuition fees and student loans for those medical graduates who voluntee r to work for at least three years in township health centers in mid-western regions.□xi) eforming the compensation mechanism for health care institutions at grass roots levels The operational costs of health care institutions at grass-roots levels shall be compensated through service charges and government subsidies. W i th regard to government-run township health centers, urban commu nity health centers and stations, the government is responsible for their basic construction, equipment purchase, staffing costs, and public health service cost s, in accordance with state regulations, and the compensation will be delivered through ways such as fixed amount funding for designated items and service purchasing. The salary level of health care workers should be in line with the average salary level of staff of local public institutions. The service charges ofgrass-roots health care institutions shall be set according to the costs after deduction of government subsidy. As long as drugs are sold at zero price margin, the revenue from drug sale will no longer be compensation sources for funding grass-roots health care institutions, and drug discount shall not be accepted. Efforts will be made to explore separated management of expenditure and revenue of health care institutions at grass-roots levels.The government provides rational subsidies to rural doctors for providing public health services. The criteria shall be regulated by the local government.(xii) ransforming the operation mechanism of health care institutions at grass roots levels e alth care institutions at grass-roots levels shall provide low-cost services for urban and rural residents by using appropriate techniques, appropriate equipments as well as essential medicines, and promoting the us e of TCM including ethnic minority traditional medicines. Township health centers shall change their way of services, organizing mobile medical teams to r ural areas. The urban community health centers and stations shall provide on-the-spot services and household visits for patients whose movement is restrict ed because of illness. L o cal governments are encouraged to formulate diagnosis and treatment criteria for health care institutions at different levels, carry o ut pilot projects of “initial diagnosis at community health centers”, and establish dual referral between grass-roots health care institutions and superior hospi tals. Efforts will be made to completely implement staff recruitment system, establish the human resources management system that allows two-way move ment of staff flow, improve the income distribution system, and establish the evaluation and incentive system with service quality and quantity as the core, and job responsibility and performance as the basis.□□□□r□□□□□□□□□□□r□d□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□r□□□□□(xiii) overing both urban and rural residents ith basic public health services The items of basic public health services will be defined and the conten t of services specified. Starting from 2009, residents’ health record will be gradually established with standardized management nationwide. Actions should be taken to conduct regular health checkup for senior citizens over 65, carry out regular growth checkup for infants and children under three, conduct regula r prenatal examination and postnatal visit for pregnant and lying-in women, and provide guidance of prevention and control to patients with diseases such a s hypertension, diabetes, mental disorders, H I/AIDs, and tuberculosis. Efforts will be made to disseminate health care knowledge, and establish CCTV health channel in 2009. Both central and local media shall intensify publicity and education on health care knowledge.(xiv) ncreasing ma or national programs of public health services Efforts will be made to continue implementing major public health programs such a s prevention and control of major diseases including tuberculosis and H I/AIDs, national immunization program, hospitalized delivery for women in rural areas. The following projects will be launched starting from 2009: supplementary vaccination of H e patitis B for individuals under 15; eliminating the hazards toxication by coal-burning fluorosis, supplementary intake of folic acid for rural women at the preconception and early pregnant stage for the purpose of preventing birth defect; cataracts cure for economically constrained patients; improving water supply and toilet facilities in rural areas.(xv) trengthening capacity building of public health services Priority will be given to improving facilities of specialized public health institutions for mental health care, maternity and child heath care, health supervision, family planning, etc. Efforts will be made to enhance the capacity of forecasting and early-warning of and responding to major diseases as well as public health emergencies; proactively promote the application of methods and techniques of disease prevention and care with TCM; implement the compensation policy for staff working on high-risk post in infectious disease hospitals, plague-contr ol institutions, schistosomiasis-control institutions and other disease prevention and control institutions.(xvi) Ensuring funding for public health services The government will provide fully from the budget the costs of specialized public health institutions re lated to staffing, development and construction, general administration expenses and business operation, and the service revenue of these institutions shall b e turned over to a special fiscal account or integrated into budget management. Free basic public health services shall be provided to urban and rural residen ts item by item. Funding standard for basic public health services will be increased. In 2009, the average per capita public health funding shall be no less th an 15u an, and no less than 20 Y u an by 2011. The central government will grant subsidies to the regions with financial difficulties through transfer payme nts.□□□□□□□□r□□rd □□□□□□r□□□□□□□□r □□□□□□□□□□□□□□ r□□□r□□□□□□□□□□□r□□□□□□□□□□□□□□□□□□□□□□□□□□□r□□□□□□□d □□□□r□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□r□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□r□□□d □r□□□d□□□□□□□□□□□□□□□□□□□□d □d□□□□□□□□□□□-□r□□□□□d □□□r□□□□□□□□□□□□□□r□□□□□□□r□□□□□□r□□□d □□□□□□□□□□□□□□□r□□□□□□□□□□□□□□□r□□□□□□□□□□r□□□□□□□□□r□□□□□□□□□□□□□□□d □□□□□□□□□□□□□□□□□□□□□d □□□□r□□□□□□□□□r□□□□□□d□□□□□□r□□□□□□□d □□□□□□□□□□□r□□□□□□□□□□ r□□□□□□□□□□□□□□□□□d r□□□□□□□□□□□□□□□□□□□□□□□□□□□r□□□d □□□□□□r□□□□□□d □□ d□□□□□d□□□□□□r□□r□□□□□□□r□□□□□□□r□□□□r□□□□□□□□□□□□□□□□□d □□□□□r□□□d□□□□ r□□□r□□□□□□□□□□□ r□□□□r□□□□□□□□□□□□□d □□□□rr□□d □□□□□□□□□□□□□□□□□□r□□□r□□□□r □□□□□□□□□□□d □□□□□□□□□□□□□□□□□□□□r□□□d□□□□□□□□□□ d□□□r□□□□□□□□r □□□□□□□□□□□r□□□□□□□□□r□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□r □□□□□□□□r□□□r□□r□□□□d □□□□□□□□□□□□□□□□□r□□r□□□□□-□□□□d □□□□r□□□□□□□□□□□□□□□d□rd□□□d □r□□□□□□□□□□□□□□r r□□□d□□□□□□□□□□□□□□□□□□d □□□□□□□□□□□□d□□□□□□□□□□r□□□□□□□r□□□□□□r□□□d □□□□□□□r□□□□□□□□□□□□□□□-□□□□□r□□□□□□□□□□d□□□d□□□□□r□□□□□d □r□□□□□□□□□r□□□□□□□□□□□□□□□□□□□□□□□□r□□□r□□□□□□□□□□□□□□□□d □□□□r□□□□□□□□d□□□□□□□□r□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□□ d□□□□□□□□□□r□□□□□□□□□□d□□□□□□□□□□d □□□□□□□□□□□□□□□□□r□□□□□□□□□□□□d□□□□□□□□□□□□□□□□□□□d □□ r□□□□□□□d□□r□□r□□□□□□□□□□□□□□□□□□□□□□□□□□d□□□□□□□□d □□□r□□r□□□□□□□□□□□□□□□□d □□□□□□□□□□□□□□□□□□ r□□□□□□□□□□□□□□□□□□□□□□ r□□□□□□□□□□□□□□□□□□□r□□□□□□□□□□□□□□□□□□□□□□□□□□□□Efforts will be made to explore and establish the public hospital quality regulation and assessment system with the joint participation of government health departments, medical insurance institutions, social assessment institutions, representatives of the public and experts. Strict hospital budget and expenditure and revenue management should be exercised and costing and cost-control strengthened. H o spital information disclosure should be universally implemented for public monitoring.(xviii) romoting the reform on the compensation mechanism of public hospitals Efforts will be made to gradually transform the three compensation c hannels of public hospitals, namely service charges, revenue from drug price margin and fiscal subsidy, to two channels, i.e. service charges and fiscal subsi dy. The government shall support public hospitals for basic construction and large-sized equipment procurement, development of key research subjects, cos ts for retirees in conformity with state regulations, and compensation for policy-related losses, etc.; grant special subsidies to public health services delivere d by public hospitals; ensure funding for public services designated by the government, such as emergency rescue and treatment, foreign aid, assistance to r ural and border areas; offer preferential investment policy to TCM hospitals (including ethnic minority hospitals), women and children’s hospitals, and hos pitals specialized in prevention and treatment of communicable diseases, occupational diseases, mental disorders, etc. The construction scale, standards and loan-taking behaviors of public hospitals should be strictly controlled. The separation of health care services and drug sale should be promoted, gradually re scinding the drug price margin, and banning the acceptance of any drug procurement discount. The revenue reduction and losses incurred from the reform s hall be resolved through introducing prescription fees, readjusting the charging criteria for some technical service, increasing government investment, and e tc. The prescription fees shall be integrated into the reimbursement scope of the basic medical insurance. Efforts will be made to actively explore various ef fective means of separating health care services and drug sale, appropriately increase the price for health care technical services, lowering the price of drug s, medical consumables and examination by large-sized equipment, and conduct regular costing of health care services and sound assessment of the efficien cy of health care services.The special-needs services offered by public hospitals shall be no higher than 10% of the total health care services provided. L o cal governments are encour aged to explore and establish the mechanism for pricing health care services through the consultation of all stakeholders.(xix) ccelerating the formation of a health care structure featuring multiple hospital sponsors The provincial health department shall specify, in con junction with the departments concerned and in light of regional health planning, the quantity, layout, number of hospital beds, allocation of large-sized equ ipment, and major functions of public hospitals within the provincial jurisdiction. Efforts will be made to actively and steadily transform some public hospit als to non-public institutions, formulate the structural reform policy measures for public hospitals, and ensure that the value of state-owned assets be mainta ined and the legal rights and interests of employees safeguarded.Non-public investors are encouraged to sponsor non-profit hospitals. Non-public hospitals are entitled to the same treatment with their public-owned counte rparts in terms of designation of medical insurance eligible institutions, approval of research projects, professional titles assessment and continued educatio n, and both types of hospitals shall be treated equally in terms of service access and supervision. The preferential taxation policies for non-profit hospitals s hall be implemented, and the taxation policy for for-profit hospitals shall be improved.The pilot projects for public hospital reform will be launched in 2009, and popularized in 2011.□□□□□□□□□□rd□□□□□□□□r□□(xx) einforcing organi ation and leadership The State Council will form a leading group on deepening the health care system reform to organize and c oordinate the reform work. The relevant ministries under the State Council should waste no time in formulating relevant supporting documents. G o vernments at various levels, should strengthen leadership, organization and implementation, and accelerate the progress of the priority reform programs.(xxi) ntensifying financial support o vernments at various levels should conscientiously implement the health investment policies of the Opinions, read just the expenditure structure, transform the investment mechanism, reform the compensation methods, ensure funding for the reform, and increase the bene。
美国“新医改”评析
美国“新医改”评析作者：应丽来源：《时代金融》2012年第36期【摘要】医药卫生体制改革是一项重大的民生工程，对改善民生、扩大内需、促进经济社会平稳较快发展等具有重大的现实意义。
美国积极推出医疗保险改革，力求建立政府主导的全民医保制度。
本文从美国医改背景出发进行分析，阐述美国医改方案的主要内容，并从医改的主要影响主体角度对美国医改进行分析评价。
【关键词】医药卫生体制改革美国医改全民医保一、美国医改背景（一）医疗费用高，参保比例低：美国医疗费用高昂，据2000年世界卫生组织统计，美国人均医疗费用支出水平在所有的OECD成员国中居第一位。
从2000年到2008年个人卫生支出增长了60%，卫生总费用占美国GDP的15.2%，在2015年预计将达到20%，远远高于世界上其他发达国家。
美国是世界上唯一没有建立全民医疗体系的发达国家，近年来，美国政府每年投入医保资金高达2万亿美元，占国内生产总值的16%，但美国仍有近5000万人没有医疗保险，约占总人口的19%。
（二）美国经济状况：全球金融危机导致美国经济大萧条，2009年美国国内生产总值增长率为-2.4%。
美国失业率不断上涨、家庭收入减少，越来越多的人无法承担高昂的医保费用，造成缺乏医保的人数逐渐增多，不利于社会稳定发展。
2000年基于雇主的医疗保险占67.1%，而2009年则下降到55.8%。
金融危机背景下，企业经济效益低、财政压力大，不少企业因经营亏损而破产。
有专家认为，导致美国企业大量破产的主要原因不是金融危机，而是高比例的医疗保险费用，使企业因财务压力较大而最终破产。
（三）医改民心所向：尽管美国在医疗保健方面花费大量资金，但保健质量常落后于其他发达国家，患者对医疗服务满意度较低，由于医疗事故，每年有4.6万到9.8万患者死于非命。
大多数美国民众都对美国医疗保健系统提出质疑。
据调查显示，只有40%的美国消费者对美国医疗保健满意，而澳大利亚消费者为73%，丹麦为91%，大部分美国民众认为医疗保健应该完全改革。
中英文对照版__医改意见
Opinions of the CPC Central Committee and the State Council on Deepening theHealth Care System Reform中共中央国务院关于深化医药卫生体制改革的意见In the spirit of the 17th CPC National Congress, for the purpose of establishing a health care system with Chinese characteristics, of gradually realizing the goal that everyone is entitled to basic health care services, and of raising the health level of the Chinese people, we hereby put forward the following opinions on deepening the health care system reform.按照党的十七大精神，为建立中国特色医药卫生体制，逐步实现人人享有基本医疗卫生服务的目标，提高全民健康水平，现就深化医药卫生体制改革提出如下意见。
I. Fully recognizing the importance, urgency and arduousness of deepening the health care system reform一、充分认识深化医药卫生体制改革的重要性、紧迫性和艰巨性The health care sector is a major livelihood issue, as it is closely related to the health of billions of people and the happiness of every household. To deepen the health care system reform, quicken the development of health care sector, meet the people’s ever increasing health care demands, and continuously improve the people’s health is an inevitable requirement of implementing the Scientific Outlook on Development and accelerating economic and social development in a coordinated and sustainable manner, an important measure to maintain social fairness and justice and improve the quality of people’s life, and also a major task of building moderately prosperous society in an all-round way and constructing harmonious socialist society.医药卫生事业关系亿万人民的健康，关系千家万户的幸福，是重大民生问题。
UnitedStatesObamacare美国奥巴马医改
United States Obamacare 美国奥巴马医改Experimental medicine 实验医学A year after the big launch, is Obamacare working? 实施一年的奥巴马医改到底奏效吗？TEXAS has a higher share of uninsured citizens than any state in America. 堪萨斯州未参与医疗保险的人数比美国其他任一州都多。
Until recently Shane, a 38-year-old from Houston, was one of them. 直到近期来自休斯顿38岁的谢恩才刚刚参保。
I just couldn't afford it, he says. 他说，我只是无法负担医疗保险费。
Shane has HIV; his job does not cover him. 谢恩是艾滋病患者，他的工作薪金无法负担他的医药费。
Because of his illness, insurers would offer him only a costly plan with limited benefits. 由于他的疾病，保险公司只愿意提供有限福利但保费昂贵的保险方案。
Such discrimination is now illegal. 但是现在，这样的歧视是非法的。
Since January the Affordable Care Act, better known as Obamacare, has required insurers to charge the healthy and the sick the same price. 自今年一月平价医疗法案，即人们熟知的奥巴马医改要求保险公司向患病及健康的投保人收取同样的保费。
For the first time in 20 years, Shane can afford health cover. 这是20年来首次谢恩能够支付得起他的医疗费用。
美国医改相关论文中英文
Clinical Therapeutics/Volume 35, Number 4, 2013Editor-in-Chief’s NoteHealth Care ReformHealth care and health policy continue to be controversial domestic issues in the United States. Despite a slowingin the rate of growth of annual costs, most Americans feel that their budgets are strained by what they have to payfor health care, and most employers feel that their share of these costs for their employees is excessive. Currently, many Americans still do not have health care coverage. In an effort to remedy such concerns, a series of laws wereenacted in recent years. The first of these, the American Recovery and Reinvestment Act, was signed into law byPresident Obama in 2009. In 2010, after considerable conflict and disagreement, the Preservation of Access to Carefor Medicare Beneficiaries and Pension Relief Act became law. Also in 2010, the Patient Protection and AffordableCare Act and the Health Care and Education Reconciliation Act were signed into law. Although these new laws (taken together, they are often called Obamacare) should have a positive and beneficial impact on the health careof most Americans, there will be many challenges to these efforts as their provisions are phased in over the nextseveral years.Before we can have meaningful reforms, we must make improvements in our study designs and assessmentinstruments. Comparative effectiveness research (CER) is considered by many to be a key component of reform. However, there are limitations to analyses that use secondary databases and nonrandomized, controlled studies. Furthermore, how variables such as adherence, duration of exposure, and definitions, as well as types of outcomes, are handled can substantially affect the validity of CER. The articles by Campbell et al and Cohen in this issue arethoughtful commentaries on CER. These are among a collection of very scholarly reports in this issue assembled byour Topic Editor for Pharmacoeconomics and Health Policy, Denys T. Lau, PhD.We are pleased to be one of a select group of journals who are publishing the Consolidated Health EconomicEvaluation Reporting Standards (CHEERS) statement by Don Husereau, BScPharm, MSc, and colleagues. Thisvaluable document is intended as a guide for future researchers.Finally, we must consider all of the areas not addressed by health care reform. Here arewe have stricter bicycle helmet laws? Will weever have realistic shelf-life regulations for medicines? How can we reduce the number of accidental gun-relatedinjuries? Will we ever have electronic medical record systems that can bridge across institutions and practices? Iinvite any of our readers who have solutions to these and other unaccounted for costs to the health care system tosubmit letters to the editor.Richard I. Shader,MDEditor-in-Chief REFERENCES1.Shader RI. Good news and disappointing news: a new era in health care delivery. J ClinPsychopharmacol. 2010;30:223–224.2. Shader RI. The cart before the horse?Health insurance reform before health care reform.J ClinPsychopharmacol. 2009;29:413–414翻译：临床治疗/35卷，第4期，2013首席编辑的注解医疗改革医疗保健和卫生政策在美国国内仍然是争议的问题。
中美医改方案比较研究(全文)
中美医改方案比较研究(全文)一、中国医改的内容――四项改革(1)理念创新：基本医疗卫生制度成为公共产品。
以前“看病难、看病贵”成为困扰城乡居民的社会问题。
新医改方案则体现了公益性。
包括最低收入阶层的全民，将享有基本医疗卫生服务的基本权利，也标志着政府职能向服务型政府的转变。
(2)全民医保：缓解“看病贵”顽疾的良药。
中国将逐步建立覆盖全民的基本医疗保障制度，首次实现医保的全覆盖。
建立覆盖全民的医保制度，目的在于实现医药费用的合理分担，这是解决老百姓“看病贵”最核心的措施。
(3)服务均等：首次确立基本公共卫生服务均等化目标。
新医改规定城乡居民享受统一卫生服务。
(4)医药分开：建立基本药物制度遏制虚高药价。
实施基本药物制度，对医保药物将实行统一招标、配送，将规范药品流通，遏制虚高药价。
增设药事服务费，推行医药分开。
二、美国医改流程分析(1)扩大医疗保险覆盖面。
政府扩大Medicaid和SCHIP计划，强制大中型企业必须给职工购买医疗保险，对小企业提供职工医疗保险补助。
实现全国保险交换，允许民众可以从国有和私有公司中自由转换或购买保险。
(2)降低成本，提高效率。
推广标准化的电子医疗信息系统，减少医疗保健成本。
确保医疗机构为患者提供尽可能好的医疗服务，包括预防和慢性病管理服务。
改革市场结构以促进竞争。
(3)提高税收，增加政府收入。
奥巴马医改准备金的一半将来自于税收的增加：一是奥巴马在预算案中要求国会提高富裕人群的所得税，将这部分政府收入用于医疗保健领域改革，确保更多低收入人群享受到相关服务。
二是奥巴马还打算对企业实行“排污超标购买制”。
医疗改革的另一部分资金将来自于提高效率，降低成本产生的结余。
三、中美医改方案对比分析中美两国的医疗卫生领域在以下几个方面存在共同缺陷：人口基数大，贫富分化急剧，支付不起医疗费用的人越来越多；医疗卫生领域的支出日益增多，但政府在该领域的支出不足；医疗效率低下。
以下就医改方案实施后中美两国的医保流程进行对比分析：1.医保资金的来源。
中英医疗制度对比 英文版
盛雪20110100137 Comparison of Healthcare System between the UK and ChinaIn Britain’s healthcare system, National Health Service(NHS) is so significant a existence to be ignored. It you happen to have watched the open ceremony of 2012 London Olympics, you may still remember one splendid performance, which aims to pay tribute to those nurses from NHS who have been working hard for the nation’s health since 1944. As regards China, a nation with a much harder life, its healthcare system is not that mature or excellent. But the whole nation have witnessed China’s progress in modifying its medical-care system. The New Rural Cooperative Medical Care System, as a 2005 initiative to overhaul the healthcare system, is a strong evidence for China’s good job in promoting its medical care system. I will compare the healthcare system in the UK and China in three aspects as follows: operating ideas, operating patterns and challenges.Operating ideas:Britain: NHS’s core idea is to provide universal healthcare to all the legal residents in UK. It is primarily funded through the general taxation system. And it is believed in Britain that healthcare system shall be comprised of three sub-systems: local primary service, regional treatment service and central hospital service.China: Cooperative Medical System (CMS) is established to offer basic medical security for all the workers both in cities and in towns. Medical expenditure of each individual is shared proportionally by the country, enterprise and the employee himself. Besides How much the employee would benefit from the system depends properly on how much he contributes to the nation. Furthermore, it is required in China that local administrations, enterprises and agencies shall anticipate in local Social Medical Insurance, to standardize the amount of money people shall pay and help implement related policies.Comparison: Three major differences can be concluded from their operating ideas. Compared with the ideas of China, Britain’s vision has a wider coverage. NHSmanages to serve all the people in the UK, including farmers, people without ability to work as well as disadvantaged groups, some of which are neglected by China’s healthcare system. Secondly, NHS has various medical services, like primary care, in-patient care, long-term healthcare, ophthalmology, and dentistry. As to china, only basic medical insurance is available instead of actual treatment services. At last, funding for each system is obvious not alike, which will be discussed further.Operating patterns:Britain: NHS consists of organizations at all levels: public hospitals, all sorts of clinics, Community Medical Center and Nursing Home etc. These organizations work for British people, concerning with daily medical services, with both the consultation and reservation fee not required. More specifically, everybody in Britain can register with a local GP, namely General Practitioner, who is well-trained in medical and can give advice and treat basic illnesses. GPs are paid by the government according to how many their patients they have. Their services come free of charge.In Britain, Social Security Tax, as an income for government, is levied exclusively for NHS. 82% of NHS funding comes from government fiscal allocation, 12% from National Insurance contributions. Other less significant sources of income include charging overseas visitors and their insurers for the cost of NHS treatment, charges to patients for prescriptions and dental treatment, hospital car parking, patient telephone services, etc.China:The Basic Medical Insurance Fund is implemented by the combination of unified social adjustment and individual account, meantime collected in principle by prefecture-level department. All employers and employees in cites and towns are obliged to pay for the Basic Medical Insurance Fund. At present, the employers will pay for employees’insurance by extracting 6% from employees’salary, and employees pay for themselves by 2%, which will be deposited into individual account. While, the money paid by the employers will be divided into two parts: pooling fund and individual account. Pooling fund has a standard minimum and a cost limitation,mainly functioning for hospitalization expenses and some of the chronic-disease treatment fees. Individual account is responsible for general out-patient expenses. Comparison:People in the UK can receive equal medical care in regardless of people’s social statues or how much money they have. In this respect, British healthcare system is far more fair than China. But, the drawbacks are clear too, in that public sectors operate with a relatively low efficiency. As a result, people often have to wait for a long time to receive treatment. At the same time, medical-care personnel do not get payments equal to their labor, most of the time, which reduces their activity and enthusiasm. China’s way of operating, in some way, avoids these aforementioned problems, but have other big issues: regional imbalance in terms of healthcare development, insurance fund malapportioned so on and so forth.Challenges:Britain: Primarily, To control the funding in an efficient way is very difficult for NHS. Over-supply would produce a heavy burden for the government, which is not good for the sustainability of the system. Funding-deficiency would damage the quality of the services, which would induce complains from citizens. At the moment, UK is quite a scrooge in funding, producing a number of quite expected troubles, such as canceled operations and poor nursing care. Errors by doctors who are either too pressed for time or inadequately funded are also a growing problem. Studies indicate up to 15 percent of all patients in Britain are diagnosed incorrectly or have ailments that are overlooked. Finally, the quality of care is uneven, because local authorities decide which medications or treatments are available.China: What kind of healthcare one would receive relates to his profession, where he was born and what kind of office he is working for: state-owned or private. In my opinion, this is not as fair as Britain. I can’t agree anymore that people shall receive as much as they give. But, in a world everyone is seeking for humanity, wealthy people should pay more and receive the same as the poor. This is a indirect but positive way for the rich to help the poor. I think it is a big challenge for China to minimize theclassifying section in healthcare system. Another big challenge lies in putting-cart before-the-horse phenomenon in the function of administrations and enterprises. Enterprises have to undertake their employees’ healthcare procedures, which should be handled by the administrations. As a result, the development of these enterprises slows down gradually. Last but not least, distribution of healthcare resources is unreasonable, so is cost burden for each person. Thus, remote areas can not enjoy a qualified medical service most of the time.There is no justification to rank these two systems because I am sure that each healthcare system is formulated according to other social patterns, like education, culture, history, laws and so on. But comparing is meaningful because we can learn from each other by doing so. And as long as the government put people’s well-being as the first priority, as long as the government can acknowledge the need to make things better, people in that country would live a happy life, and of course enjoy a better healthcare service.参考文献：∙[英国医保模式对我国医保制度的启示与借鉴] 顾海，鲁翔，左楠- 《世界经济与政治论坛》- 2007年5期。
专家解读中美新医改异同,您认同吗？
专家解读中美新医改异同，您认同吗？中国新医改正在紧锣密鼓地推行，而美国的新医改尚处在“征求意见”的阶段。
虽说美国与中国的可比性不高，但同是医改，毕竟有不少事情是相通的。
本文试图用中国新医改的语言解读一番美国的新医改。
或许能从美国的经验教训中汲取一些可供中国借鉴的东西。
中美新医改“征求意见”方式不同中美两国政治体制和公共政策决策机制不同，因此其“征求意见”的特色也有所不同。
在中国，公共政策的主要制定者是行政部门，“征求意见”颇为集中化且讲究不争论，各类研究机构（智库）和有关协会撰写“万言书”，均以内部报告的方式递交有关政府部门。
在政策定案之后，有关建议书也鲜有公开发表，只是有些媒体披露一鳞半爪。
美国公共政策的“征求意见”过程不仅分散，而且充斥着激烈的争论。
美国总统看起来权力很大，但对公共政策，大多只能提出“征求意见稿”。
定稿者是国会；当然，总统如果不满意国会的定稿，可以动用否决权。
对有关公共政策的议案，国会议员首先要公开争论一番。
民间智库、利益相关者的协会、学者们也会利用各种场合，大张旗鼓地辩论。
国会有时也会邀请各方人士，举行公开听证会。
中美搞新医改都因看病贵，但看病贵的缘由不同美国为什么要搞新医改呢？其中的缘由同中国有几分相似，但也有不同。
中国是“看病贵”、“看病难”，美国主要是“看病贵”，看病并不难。
中国人看病贵的主要原因，或者说老百姓不满的主要原因，是所谓的“供方诱导的过度消费”，即医疗机构普遍多开药、开贵药、多检查。
而这种情形在美国即使有，也的确是少数。
美国人看病贵，主要原因如下：1、美国医生的收入相当高。
2、美国的创新多，新药、新技术层出不穷，新的东西自然就贵。
3、美国医疗服务的品质比较高，不仅乱哄哄的医院很罕见，而且病人哪怕是在乡村诊所看病，如果病情危急需要紧急转院，就会有直升飞机降临。
美国政府以相对高薪聘请医生们去农村及偏远地区服务。
4、美国不流行多吃药，但流行多检查，主要原因是为了防范患者诉讼，这就是所谓“防范性诊疗”。
的医疗卫生事业白皮书汉英对照版
的医疗卫生事业白皮书汉英对照版The document was prepared on January 2, 2021《中国的医疗卫生事业》白皮书White Paper: Medical and Health Services in China中华人民共和国国务院新闻办公室26日发表《中国的医疗卫生事业》白皮书。
全文如下：The State Council Information Office of the People's Republic of China on Wednesday published a white paper on the medical and health services in China.Following is the full text of the white paper:中国的医疗卫生事业（2012年12月）中华人民共和国国务院新闻办公室Medical and Health Services in China(December 2012)Information Office of the State CouncilThe People's Republic of China目录Contents前言一、卫生基本状况二、医药卫生体制改革三、传染病防治与卫生应急四、慢性非传染性疾病防治五、妇女儿童健康权益保护六、中医药发展七、卫生国际合作结束语前言Foreword健康是促进人的全面发展的必然要求。
提高人民健康水平，实现病有所医的理想，是人类社会的共同追求。
在中国这个有着13亿多人口的发展中大国，医疗卫生关系亿万人民健康，是一个重大民生问题。
Good health is a prerequisite for promoting all-round development of the person. And it is a common pursuit of human societies to improve people's health and ensure their right to medical care. For China, a large developing country, medical and healthcare is of vital importance to its population of over billion, and is a major issue concerning its people's well being.中国高度重视保护和增进人民健康。
各国医疗卫生体制改革以及对中国医改的一些看法
各国医疗卫生体制改革以及对中国医改的一些看法第一篇：各国医疗卫生体制改革以及对中国医改的一些看法各国医疗卫生体制改革以及对中国医改的一些看法医疗卫生体制改革是一个世界性难题，世界上许多国家爱都曾进行过或者正在进行医改。
医改之路五花八门，下面先就结合老师上课所讲解的内容以及我自己课下所查阅到的资料，对一些代表性的国家的医疗卫生体制及其改革模式做一个简单总结。
一、国家医疗服务模式（英国）。
即英国、北欧、南欧以及其他众多英联邦国家和地区实行的所谓“国民健康服务”，也被称之为“英国模式”。
这种模式最显著的特点就是“医药分家”——医生开药方，患者独立到药店购置药品。
因为政府对药品价格的管制十分严格，所以很少有医生乱开药、开贵药的现象。
这种模式最大的优点是其广泛性和公平性。
英国政府通过税收资助全国性医疗服务，国家医疗预算根据全国各地的人口进行按需分配，从而保证了每个人平等享受国家医疗服务。
然而，随着英国人口的增加和百姓健康要求的提高，完全依赖国家的“国家卫生服务体系”逐渐不堪重负，其弊端逐渐显现。
第一，政府承担了大部分的医疗费用，而医疗费用几乎无限度的增长对国家财政带来了巨大的负担，也成为了该模式最大的困扰。
第二，医疗服务微观效率低。
由于医疗属国家经营，医护人员获得的报酬与其劳动量并不挂钩，因此医生工作积极性差，医疗服务效率低下。
第三，医疗需求过度。
实行几乎免费的医疗服务，导致公众对医疗服务的过度需求，进而造成医疗服务供给不足。
鉴于这些问题，上世纪八十年代撒切尔执政时向医疗领域导入了市场机制，也由此形成了英国社会目前“富人去私立医院看病，穷人到免费医院排队”的局面。
面对这种局面，布莱尔政府发布了“国家卫生服务体系”现代化改革五年计划，承诺将该体系改造成为以病人为核心、真正有效率的二十一世纪医疗服务，要“再次成为全世界羡慕的对象”。
但知道今天，这些改革措施仍然没有解决“国家卫生服务体系”的矛盾。
目前，还有数十万患者等候治疗，候诊时间至少为半年。
翻译资格考试初级英语笔译练习题：中国医疗改革.doc
2019年翻译资格考试初级英语笔译练习题：中国医疗改革汉译英1、然而，政府主导的医疗改革如果仅仅意味着加大对医疗市场的限制的话，那我们可要三思而后行了。
2、农民不断适应新的潮流，农村生活亚在发生巨大变化。
3、发展中国家的人口占全世界总人口的75 010，其国民生产总值却只占20%。
除非采取措施改变这一局势，否则南北冲突只会使全球更不安全。
4、看来政府所谓的特选委员会还未曾征询公众的意见，就已经决定了要向政府建议实行哪一项医疗改革计划。
5、新型的合作医疗制度将有助于防止农民因病致贫、因病返贫。
6、不解决农民的看病问题，就很难最终实现中国社会的全面小康目标。
7、我国的农村人口超过9亿。
虽然他们的收入远比城镇居民要低，抗风险的能力更差，但是长期以来，他们却不能像城镇居民一样享受基本的医疗保障。
8、他说对了，尽管事情的发展与他预计的方式并不一样。
9、由于中日双方尚难以达到互信，因此会特别关注对方的力量发展和如何使用这种力量的意图。
10、我们认为，强加层层规定和限制的做法是错误的。
11、而日本也需要从中国的快速经济增长和充满活力的改革中获益，这又成为日本发展对华关系的根本利益所在。
12、政府想做却又无法做到的事情，自由的市场可以做到。
13、如何利用和借鉴日本的工业化技术和经验来加快中国工业化就成为我国发展对日关系的根本利益所在。
参考译文1、We must think twice, though,before embarking on reform if that means imposing further restrictions on our healthcare markets.2、Farm life is changing considerably as farmers adjust to new trends.3、The North-South conflict can only pose heightened dangers for the entire global. Community unless some steps are taken to change a situation where 750/0 of the wo rld’s population have only 20% of the world’s gross national product.4、It seems that the government’s so-called Blue Ribbon Commission has already decided what plan it will propose without undertaking any public consultation.5、The new cooperative medicare system will help prevent farmers from falling into or falling back to poverty because of catching diseases.6、It is hardly possible to realize a relatively rich Chinese society in overall scale without a solution to farmers’ medicare p roblem.7、China has a farmer population of over 900 million, who werenot entitled, for a very long period of time, to the basic medical insurance as urban people were, although they were more vulnerable because of their far lower income.8、He’s ri ght, though not in the way he intended.9、Since mutual trust has not yet been achieved, both sides will be especially concerned with the other’s growing power and how that power could be used.10、The wrong way is to impose layer after layer of regulations and restrictions.11、While on Japan’s part, it is of fundamental interest to benefit from China’s rapid economic growth and energetic reform.12、Free markets do what governments mean to do - but can’t.13、The fundamental interests of Ch ina’s relations with Japan lie in how to make use of and learn from Japan’s technology and experience to accelerate China’s industrialization.。
美国医改新评论
美英两国医改新动向及对中国医改的启示来源：作者：蔡江南发布时间： 2011-02-24 点击率：发表评论最近美国和英国的医改都有一些比较大的动作，在各自国内产生了极大影响和震动。
与此同时，中国的新医改也在艰难的向前推进，在取得了一些初步进展后，下一步的深化改革却举步维艰。
本文对于美英两国医改方面的新动向做一个简单介绍，然后来看一下他们对于中国医改有什么启示。
一、美国医改：公私合作，扩大医保2011年1月31日，美国弗罗里达州联邦地方法院做出宣判，不仅认为奥巴马医改立法中强制个人购买医保的规定违宪，而且认为由于整个奥巴马医改立法是一个整体，所以需要全部推翻。
目前美国有26个州向联邦地方法院提出上诉，除了一个州以外，提出上诉案的25个州都是共和党掌权。
在已经做出宣判的4个联邦地方法院中，两个民主党的法官宣布上诉案败诉，两个共和党的法官宣布胜诉。
接下来，美国联邦政府将向申诉法庭提出申诉，最后还需要上联邦最高法庭进行裁决。
最后结果如何还是一个悬案，取决于最高大法官之间的争斗和表决。
但是根据分析，最高法庭判决整个奥巴马医改立法都违宪的可能性不大。
除了法庭上的斗争外，美国两党在国会中也在进行有关奥巴马医改立法的斗争。
去年共和党在中期国会竞选中赢得了众议院多数党的地位，马上在今年1月19日晚上投票，以245票对189票，通过了废除奥巴马医改立法的议案。
除了3位民主党人支持共和党之外，投票完全是以两党来分野的。
共和党又在参议院中推动类似的投票，最后民主党以51比47的多数，使得共和党的提案失败。
奥巴马总统本身享有否决权，也将有效阻止类似法案在国会通过。
因此，共和党在国会中的行动在更大意义上是一种宣传，是为2012年美国总统大选挑战奥巴马连任做准备。
奥巴马本人深知围绕医改立法斗争上蕴含的深远意义，因此他在1月25日晚上发表年度国情咨文时，直接向两党、更是直接向全国人民，表达了他对于医改立法的态度。
他表示任何东西都可以改进，任何人如果有改进医改立法的好点子，能够改进医疗、使得医疗更便宜的话，他都愿意与其一起进行改进。
经济学人读译Health-care reform中国医改Heroes dare to cross深渊何惧,英雄敢渡津
Health-care reform中国医改Heroes dare to cross深渊何惧，英雄敢渡津Two articles examine the crisis in China’s health-care system. In the first we look at how China pays the bills.这期的《经济学人》发表了两篇审视中国医疗系统的文章。
首先让我们了解一下中国将如承担医疗费用。
Jul 21st 2012 | BEIJING | from the print editionSO INSPIRED was China’s health minister, Chen Zhu, by a new push to reform the country’s dysfunctional health-care system that he wrote a poem. “Wind and thunder move across the country, health reform brings good tidings,”[1] read the first lines of the paean, dutifully printed on the front page of his ministry’s newspaper. But few share Mr Chen’s optimism. The latest phase of China’s health-care reforms could prove difficult, as hospitals and doctors are asked to end their financial dependence on medicine sales. The wind and thunder could drown out the good tidings.过去中国的卫生部部长陈竺提起中国糟糕的医疗体系时非常激动。
奥巴马医改中英版课件
奥巴马医改(中英版)
第九页，共二十页。
中产阶级、富人忧心忡忡 The middle class and the rich person are heavy-hearted
除不得不缴纳更多税收来为穷人享受医保“埋单”外，中产阶级 (zhōngchǎnjiējí)、富裕阶层还担心，大量穷人在获保后涌入医疗服务市 场，而医疗资源相对有限，富人们曾经享受的VIP式服务将可能不复存在
共和党极力阻挠医改
中产阶级、富人忧心忡忡
The Republican Party obstructs the healthcare reform vigorously.
奥巴马医改(中英版)
4
第四页，共二十页。
The middle class and the rich person are heavy-hearted
奥巴马医改(中英版)
第六页，共二十页。
共和党极力阻挠医改
The Republican Party obstructs the healthcare reform vigorously.
共和党极力(jílì)阻 挠医改，有党派 思维作祟，但更 因执政理念不同。 共和党人一直主 张"小政府大市场 "，而医改将形成 强势政府，对社 会生活和经济产 生过分干涉，违 背资本主义自由 市场经济的原则
The reformation of the medical treatment faces lots of obstacles. How did Obama succeed in breaking out of the crisis ?
奥巴马医改(中英版)
第一页，共二十页。
Made by 402
American former presidents had tried to carry out health reforms in the past years but they failed. So many people at all levels reject the health reforms. Obama faced the same difficulties. Why did the health reforms were obstructed heavily even it is good to American? Why Obama got approval this time with solid opposition?
新医疗模式的英文作文
新医疗模式的英文作文英文回答：In the evolving landscape of healthcare, innovative models are emerging to address the challenges and complexities of the modern healthcare system. These new models prioritize patient-centered care, leverage technology, and promote collaboration to improve health outcomes and patient satisfaction while reducing costs.1. Value-Based Healthcare (VBHC)。
VBHC is a healthcare delivery model that focuses on providing patients with high-quality, cost-effective care. It rewards providers for delivering value, as measured by patient outcomes, rather than the volume of services provided. This approach encourages providers to prioritize preventive care, patient engagement, and evidence-based practices.2. Pay-for-Performance (P4P)。
P4P is a payment model that ties reimbursement to the quality of care provided. Providers are rewarded for achieving specific performance targets, such as improving patient outcomes, adhering to clinical guidelines, and providing timely access to care. P4P incentivizes providers to focus on delivering high-value care and improvingpatient satisfaction.3. Accountable Care Organizations (ACOs)。
医改：另一种表达
医改：另一种表达新的医改要充分利用政府作用和市场机制，利用大国的规模优势。
如果能搭上信息化的平台，并利用好中医文化，中国医疗可以实现跨越性的发展中国的卫生总费用中，政府支出仅占17%左右，而发展中国家的平均水平是40%(数据来源：卫生部)卫生总费用占GDP比重(2003)：中国比阿富汗还低（来源：世界卫生组织(2006)）“政府失责”和“市场失灵”南方周末：您认为目前中国医疗体制的病症在哪里？原因是什么？您开的药方又是什么？李玲：病症表现为看病贵、看病难，医患关系紧张、一些健康指标下降等。
病因还是我国的医疗体制出了问题。
最根本的是“政府失责”和“市场失灵”，把市场和政府最不好的方面结合起来了。
首先是政府责任的问题：改革开放近30年，对医疗卫生事业的定位一直不明确。
我们把医疗卫生称作“事业”，就应该提供公平、可及、可支付的服务，但是在这个过程中，政府投入却一步步下降。
1978年，全国卫生总费用中政府支出的比例是32.3%，到2000年，下降到历史最低点15.5%，现在也只恢复到17%，比阿富汗还要低，更低于大多数中等收入国家。
第二是市场失灵。
公立医院顶着公立的帽子，实际上基本是独立的市场主体，自负盈亏，赚多少就花多少、发多少、做多少基础设施改造，公益性淡化。
财务、基础设施投资、利润的分配等应该政府掌握的权力不恰当地下放给了医院，而人事权却往往不在医院。
国际普遍经验是，不能用利润动机来激励医院，这是和企业最大的不同。
美国、加拿大、德国、法国分别有85%、95%、84%、81%的医院是非营利医院，不允许分红，花的每一分钱都受到严格的监管。
理论和各国实践都证明，医疗是市场失灵的领域。
我们把这个市场失灵的领域交给市场，同时监管远未到位，所以病因是“政府失责”和“市场失灵”并存。
处方还要从这两个角度入手，让政府真正回归政府职能，同时科学设计和维护市场机制，而不是引入那种放任自流的、盲目的市场。
换句话说，要政府主导，同时要充分利用市场机制。