美国医疗改革之民众的困惑(视频)

美国医疗改革之民众的困惑(视频)

[本期导读] 美国医改终于艰难地通过了参议院审议. 本期节目选自"CNN American Morning", 是主持人T.J.Holmes和Kiran Chetry对CNN医学通讯员Sanjay Gupta的采访,来解答公众对医改的疑问以及探讨医改都会带来哪些变化, 时间约3分半.

HOLMES: Welcome back to the Most News in the Morning.

As the Senate health care bill moves closer to a full vote (ph) by Christmas Eve, a lot of people out there -- a lot of you wondering how it might change your life, your budgets, the quality of your care you receive (ph) if this thing happens to get passed.

CHETRY: Which it's looking more and more likely that that will happen. So we're paging our Dr. Gupta this morning, CNN's Chief Medical Correspondent. He's answering your questions from Atlanta. Hey, Sanjay.

DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Good morning.

CHETRY: All right. So let's get right to it. The first one comes from Tom in Mountain View, Arkansas, and he writes, "My wife and I operate a restaurant (small) and earn about 50--60K annually. Is there a ball park figure of our projected costs should this bill, as presented, pass Congress?"

GUPTA: It's a great question. We're getting questions from small business owners quite a bit.

Let me point out a couple of things. Right now, there's another procedural vote happening even as we're -- we're talking, and after the Senate vote happens, this has to still go through what's called reconciliation and then go to the president's desk. So, I point that out because some of the details obviously are still being worked out.

The key number for the small business owner, Tom, to remember is the number 25. If you have fewer than 25 employees, in the Senate bill there's nothing that mandates that you buy health care insurance for your employees. If -- also, if you make less than -- if you make $50,000 or less a year, you can qualify for federal subsidies to help your employees get health care insurance, about $1,000 to $2,000 per employee. So, specifically, that number, 25, is sort of key there, Kiran, for -- for Tom and other small business owners.

CHETRY: Got you.

HOLMES: All right, Dr. we've got another one here from Daniel. He sent us this e-mail. His question is, "If someone can't be denied for preexisting conditions, what is the motivation for a lower income individual to pay for health care insurance? Doesn't this make paying into an insurance plan unnecessary?" Essentially asking, well, why -- why would I pay? Shouldn't I just wait until I get sick, essentially?

GUPTA: That's exactly right. That's exactly what he's asking, and this has been a criticism of this particular bill. Could you, quote-unquote, "game the system?"

Well, there's a couple of things to keep in mind. First of all, when we talk about mandates for health care insurance, that means people have to have health care insurance if they can afford it. That's what they're talking about here with regard to the mandate. And, again, that's been a controversial issue.

But what that means, more specifically, is if you don't buy health care insurance, there is a penalty involved. It's either $750 or 2 percent of your income, whichever of those numbers is greatest. Now, the second part of that is if you can't find health care insurance at all. It's just too expensive or it's more than 8 percent of your income, you can get subsidies. You can get what's called a hardship exception and subsidies to help pay for health care insurance.

But the -- but the interesting thing here is -- well, and Kiran, I talked about this a few days ago, is let's say you -- you buy health care insurance because you just got sick, you get better and then you cancel it. That -- that sort of gaming of the system is also going to be deterred, they say, by another penalty which prevents that sort of thing, buying it and then canceling it immediately. So, a couple of penalties built in there and an exemption as well for people who simply can't afford this.

HOLMES: All right, just a couple of the many questions I know a lot of folks have about it. We appreciate you breaking it down, simplifying as you always so. Dr. Gupta, thank you so much. We'll see you again soon, buddy.

GUPTA: All right. You got it.

CHETRY: Thanks, Sanjay.

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美国民众收到圣诞大礼 参院通过全民医改法案

转自新浪网 http://www.sina.com.cn

对奥巴马和美国民众来说，这或许是有史以来最好的圣诞礼物——当地时间昨天上午7时15分，美国国会参议院以60票赞成、39票反对的结果通过了奥巴马支持的全民医疗改革法案。

该法案将与11月众议院通过的医改法案版本合并，最终达成一个妥协版本并在明年1月送呈奥巴马签字生效。届时，美国将继其他发达国家之后，健全医疗体系，实现94%国民有保险。

正准备动身前往夏威夷欢度圣诞假期的奥巴马称，此次投票让美国“终结了近一个世纪的争斗”。他也表示，自1912年西奥多·罗斯福之后，所有的美国总统都试图改革医疗系统，但都失败了。

美国媒体评价说，医改法案的最终通过将成为美国里程碑式的事件，并确立奥巴马的政治遗产。

啃下这根难啃的骨头，只当一届总统也情愿

美国的医疗改革并非始于奥巴马，历史上，杜鲁门、罗斯福、克林顿等多位美国总统都曾尝试推进，但无不以失败告终。打着“变革”旗号上台的奥巴马却主动捡起了这根难啃的骨头，发誓要推进医疗保险改革：“如果任内能完成医保改革，即使只当一届总统也心甘情愿。”

里德唱票紧张得口误

参议院民主党领袖哈里·里德在参议院大约4周辩论过程中忙得团团转。24日唱票表决时，里德作为第一名表态者，竟然脱口说“反对！”虽然他迅速改口说“支持”，但仍引起会场一片哄笑。里德低头，笑得尴尬。

问与答

美国当前医疗系统的结构是怎样的?

与其他发达国家不同，美国没有全民医疗保障，大部分人透过雇主买保险。在3亿美国人中，估计2008年有4630万人无医保。

美国医疗系统的问题是什么?

美国现行的医疗保健体系存在医保费用不断上涨和数千万美国人未能享有医保的矛盾。

参议院的医改方案内容是什么?

在未来10年内，美国将耗资8710亿美元对医疗系统进行彻底的改革，让美国人享受内容最为广泛的医疗保险，特别是将未享受医疗保险的3100多万美国人纳入医疗保险体系；

通过实施新法案开征新税和进行其他一些改革，在十年时间内使美国的联邦赤字比之前减少1320亿美元；

将大幅扩展美国联邦政府针对穷人的医疗补助计划的覆盖面；

同时，中、低收入者有望通过税收补贴参与这项新出台的强制性医疗保险。

规模较大的企业如果不向员工提供应负担的医疗保险，员工将有权利凭此项法案要求政府帮助支付医疗保险费。

欢迎大家到讨论小组坐坐，你可以了解到更详细的新闻背景以及更多关于美国医改的细节.

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