U.S. medical reform (No. 9 of 2010)

 Text / Dai Lian
correspondents in China and the U.S. carried out one after the health reform process, the exploration of how the U.S. health care reform, perhaps to the ongoing health reform in China is not without benefit.
If March 25 as the Obama health care reform a stage victory in battle, then, Obama could have the last laugh? health care bill passed in the United States on the occasion, telephone interview with the digital connection in the Obama health reform act as the think tank of the U.S. health economists, Department of Applied Economics at Harvard University, Professor David. Cutler (David Cutler), Professor, Harvard School of Public Health William Hsiao (William Hsiao), Department of Economics, Princeton University professor Uwe. Reinhardt (Uwe Reinhardt), etc., at the same time, journalists were also interviewed in support of Republican and Democratic camps of the American people. We will provide you with a profound interpretation of In this campaign, Obama used the strategy and tactics of how to make health care reform has long been opposed to the many interest groups are no longer the fierce confrontation; and what factors make U.S. health care reform so difficult, and even still affecting the further implementation of health care reform bill.
In addition, shown in some of the essence of what seems common mystery; U.S. healthcare reform and healthcare reform in China has a kind of revelation.
medical reform in the power of the United States disputes
If the Republican Party in mid-2010 election to become the majority party, at the same time to win the next presidential election, Obama will be the fate of health reform is full of variables.
text / correspondents to wear cheap
3 25 March, the U.S. Congress approved a 3 23 Obama's health care reform bill has been signed last modified, the U.S. health care reform bill in the legislative process to complete the final declaration.
the more than 2,000 page bill introduced, How long? The answer can not to do the same. If in November 2008 for the origin of Obama, this time is 16 months. If the former U.S. President Theodore in 1912. Roosevelt proposed health insurance program for the country, women's suffrage, industrial safety conditions of workers and other social services to fight, this time 98 years.
broadly similar pattern over the past century: the fierce confrontation between the two parties, a number of interest groups oppose, support, wait, hundreds of hh media and a number of protracted bickering Democratic presidential efforts to no avail different again, this time, Obama won a narrow victory in a key moment, and eventually stumbled through a bill.
Princeton University economics professor Uwe > Insurance But They Many hospitals, particularly in the south of the hospital to resist the month, there are still 12 states in the southern half of the hospital refused to participate in The introduction has important historical significance. However, the bill signed by only the first step will be followed by the implementation of the law and specific rules, but the majority of health care reform bill in terms of the implementation period is 2014 years, and even some provisions of the implementation period is 2016.
5, Harvard surgeon A Tule. gamma Dr. Wan De in the Hospital in China, , A Tule. gamma Dr. Wan De published in the health care and increase revenues. This article became a catalyst for healthcare reform. It is reported that Obama was recommended by White House officials must read this article, the article some of the arguments in Congress, lawmakers have become a frequently cited argument.
with the case of the 1965 not the same as that in the health care reform bill through the process, nearly a century impede the process of health reform mm maximum force doctors, hospitals, health care institutions, pharmaceutical companies and other big interest groups, most of medical reform supportive or neutral attitude. One of the most obvious example is the March 19, in the health care reform bill through a crucial moment, the United States the two influential lobbying organizations mm great American Medical Association and American Association of Retired Persons are expressed support for medical reform bill, Obama reassures the Government.
Harvard School of Public Health, Robert. Brandon said: time, the crisis comes from partisan politics. , the Republicans dominated the 13 states of the United States Attorney General immediately announced plans to sue the federal government on the grounds that some provisions of health care reform bill in violation of the U.S. Constitution.
Republicans have not been the case by one vote. such a large split between the two parties and social fragmentation is rare in history, comparable only to the Civil War. said.
cost of more than 940 billion U.S. dollars or
crisis of opposition from the people. Obama campaign's health reform program gained widespread popular support, but since January 2009, the public health reform continued low support rate, the Obama health care reform bill signed by the week, public support rate bottomed out, only 40%. Today, there has been reversal of the contrarian, but the opposition remains high.
. As the authority of the U.S. health economics, Uwe for this reform are to provide policy advice to Obama. He had made a proposal mm Obama produce a popular version of the health care bill, to the people education, so that people truly understand the health care reform bill will give them what.
54-year-old Jill. Taylor is a lawyer in Utah, this is a high-income career, but she also felt from the medical Insurance of pressure. She told the . dollar cost of treatment, but recovered after the daughter is now difficult to get health insurance.
the insurance company Alabama wants to help the object of reform. but she not sure this is the correct solution method. My husband does not trust Obama, I still do not understand the program. way, health care reform bill in the first 10 years after the commencement of the U.S. government budget deficit would also reduce the 138 billion U.S. dollars.
former head of the House Budget Committee, but Holtz. Eakin . He said that the current reform bill did not spend all the calculations, the true cost of the next decade may be much greater than 940 billion U.S. dollars, and not only can not reduce the deficit, it will bring the federal government's new $ 562,000,000,000 deficit.
health care reform bill on the annual income of $ 200,000 or more groups of tax increases, but rising health care costs and concerns about the cost of healthcare is also worried that many middle-class tax increase.
at the Academy of Social Sciences Zhang Guoqing, research fellow at the U.S. view, the Obama health reform a top priority as the term said.
the founding of the United States by the national government were due to religious oppression or risk to the United States. They believe that the U.S. government should give everyone the greatest freedom, the Government should as small as possible. a member. He said: , is the British Crown against the heavy taxes. This is the foundation of our Nation. This has always been healthy, one day they will grow old too does not work, if, when they live in poverty, seriously ill, then, must be very helpless situation. support is based on the values established in the two world wars, the British officer to see the nobility of soldiers from civilians, strikes, again and again,UGG shoes, sacrificed on the battlefield, by the touch of class distinction on this bridge.
case of the United States different .1854, Franklin. Pierce presidential veto of a national mental health bill on the grounds that health problems can only be a private matter, any government intervention should be regarded as unconstitutional.
Most Americans agree with this approach. In 1912, before the federal government for the patient to take any legal sense does not help, this issue will be delegated to the federal government to solve the state, the state government and by private sector solution. those families can not afford the basic medical needs of elderly patients by private medical institutions, community and religious organizations to solve all this is logical. Medicine will be organized on a proposed health care condemned as , increase in the number doubled. However, the American Medical Association and other critics warn that it is satisfied the , which also mentions the freedom from want, including the right to a fair wage, the right to adequate food, clothing, housing and medical care.
such publicity caused the anger of Republicans. a New Yorkers complain that the freedom of speech and freedom of religion is good, but freedom from fear and freedom from want, freedom is people who rely on the government.
62-year-old Republican James divergence. But the U.S. is a democratic country, the implementation of the capitalist economic system, which is the foundation of our countries. And in my view, this basis should be retained. experience tells me that in the United States, if you work hard, you can have a good job, can buy a big house. Yes, men are created equal, but some people are more ambitious, more hard struggle, It should reward such people. that does not work so hard to get a lot of people do not. expect the government to provide everyone with absolute equality of service is not sensible. year-old Kristin to see is, help. Generally, they do not support him because they can not understand how Obama's policies will benefit them, or they do not believe these policies will really benefit them. But here, there is a special kind of United States Thinking about l mm a belief in the American dream r, that is, even if I am not rich, I may need social support, but I also do not want to if one day when I was among the list of wealthy, I have to pay Many of the tax. .
partisan consequences?
under the intense partisan struggle against the health care reform will be the Republican attacks on people or the Democratic Party's election, the Democrats cause the disadvantage. For the health care bill has passed, this partisan consequences of what will happen?
A Tule. gamma Dr. Wan De pointed out that the Republicans have the November mid-term elections make a medical reform bill on the abolition of voting time. In fact, if the Republicans won power again, they can not repeal the entire bill. For example, no one will force those with congenital diseases of children back to their parents insurance plans . However, the Republicans will change the health care reform but does not direct the key demands, such as: requirements of large enterprises to provide health insurance for their employees, requiring all individuals to buy at least a basic health insurance, as citizens can not afford insurance, subsidies, income of more than 250,000 U.S. dollars for the family to levy new taxes to make people without health insurance get insurance.
Cai Jiangnan that Obama's social reforms and political orientation and his racial identity, are the Republican Party can not tolerate The. under the iron heart of the Republican Party and Barack Obama against, so that he can not get achievements. Bush's two terms in the loss of both houses of Congress in the Republican Party the majority party status, hold breath at the end of the midterm Congressional elections to make a stand in the battle. In such a political background, the Republicans have the This expressed cautious optimism. A year later they lost the election, because in this year, Medicare has become popular. A similar situation may also occur in this reform on. so it is not clear whether the Democratic Party really in the fall lost. > Obama has a way of compromise for a considerable portion of the support of interest groups.
text / reporter wearing a cheap
fierce opposition from interest groups, is the president of the past century a number of U.S. medical reform and unsuccessful attempts main reasons. but this time, Obama clearly has support for interest groups has achieved victory.
health reform in the initial design of Barack Obama, a goal is to achieve universal health care, so that there is no 15% Medicare population by health insurance coverage; Another goal is to curb the excessive growth of medical costs. In addition, Obama also hoped that commercial insurance companies for provisions of the various unreasonable restrictions. These provisions include the refusal is unreasonable for the existence of congenital diseases insurance, limit the retirement of various kinds of conditions.
In this goal, this reform has been in promoting the initial fierce opposition from the insurance industry as to control medical costs and the cancellation of these two provisions of the insurance company is unreasonable the interests of the insurance company will make a great loss. pharmaceutical industry, physicians groups, older groups are dissatisfied with this, because to control medical costs will mean cheaper and more effective use of appropriate drugs, appropriate technology, change the ; the payment, but also on the Government's elderly AARP publicly expressed support for medical reform bill, even the pharmaceutical industry associations advertise, support passage of the bill, in fact, rarely seen in American history.
to the American Medical Association, for example, the number of Americans have Most members of the group of doctors has been demonstrated several times to prevent medical reform the smooth implementation of its energy, its influence can be traced back to President Roosevelt, the great reign of .1948 years, President Truman tried to formulate a national health insurance, the American Medical Association urged its members to to President also came forward to try to convince the American Medical Association support the changes to not easy.
this, China Europe International Business School Visiting Professor of Economics, Massachusetts Department of Health and Welfare Senior Fellow Cai Jiangnan that front, the main interest groups for support or neutrality. adopted a gradual improvement, public-private partnerships.
, Obama basically gave up. 45% of the ideal of reform. attempt based on Day, Clinton delivered a speech to Congress formally proposed to control medical costs. reforms introduced after a few months, the American Medical Association, insurance companies and small business owners Union and other organizations spent millions of dollars of publicity, attacking Hillary Clinton's big government, high taxes concerns about the tax burden, not Clinton's Health Security Act, passed by Congress.
powerful interest groups to lobby and take the secret strategies of radical management distracted by other major services, Congress, and can not explain to the American news media, and so the program.
Harvard University economist David. Cutler in the Clinton and Obama health care reform as an important think tanks in both. He told the large free, drafted by the Congress, his health reform plan, rather than drafting their own personal healthcare reform. Obama transparent government value the information from the outset the public.
Bama who each received, including the list of representatives of interest groups, the media will be released. support. Six groups, discuss the cost of medical treatment with the method. from June 10, Obama has started a similar run for president, 200 million throughout the country to mobilize grass-roots supporters in 50 states launched campaigns. At the same time, he also through the website, microblogging, etc. to communicate with the public.
give the government health insurance
However, communication does not easily compromise the interest groups. the people and interest groups to attack one of the focuses is on the establishment of Biden Plan system, any Americans through a new government health insurance, or licensed private insurance companies to obtain health insurance.
this proposal met with opposition from the American Medical Association June 11 In 2009, when the U.S. healthcare reform proposal was still being drafted, the American Medical Association issued a statement, agreed to achieve Medical Association presented a document to the Senate Banking Committee, wrote: 70% likely to squeeze the U.S. population to provide services of the private insurance industry, a large number of staff will then join the public insurance system, resulting in expansion of fiscal spending, the burden on taxpayers will increase. reform plan announced. and moderate Senate schemes, the House of Representatives direct the program to establish a affordable and help reduce healthcare costs.
announced the program shortly, many interest groups once again spoken out against. insurance companies believe that this is government intervention in the market measures, the Government intervention will disrupt the normal competition , resulting in reduced space for insurance companies, the profit damage; the pharmaceutical industry is concerned that the Government agency set up by public health insurance will become a monopoly buyer, low prices, and will join the demand for cheap goods, and directly affect their income .
At the same time, always on the an issue that this is a conspiracy by the government health insurance program, will gradually achieve world domination by the government universal health care plan, to the British-style national health care system.
against the result, Obama and the Democratic Party to make compromise.
2010 年 2 22, the first time Obama announced his own legislative proposals in detail, this program is more like a moderate Senate plan, no longer involved on the health care bill eventually passed, the Health Economics, Princeton University professor Uwe is a. ; This is the result of r l consultations, any legislation that requires such consultations to meet all the needs. meeting, Obama said in a speech at the meeting: health care reform bill to change the doctor's fees and reimbursement system.
Obama clearly said he hopes doctors, insurance companies and pharmaceutical companies to make some sacrifices. He was a tougher time meeting to show their position: to change the current payment system, because each of the services of doctors and clinics pay by way of the project resulted in waste and inefficiency. He called for using health insurance, and implementation of the requirement to receive government payments mm editor's note); also called for adjustment of Medicare payments to reflect advances in medicine, and improve the quality of medical services (mainly through pay for performance, reduce waste, the use of the latest drugs and technologies to assessed by the Medical Economics). However, these reforms will undoubtedly reduce the doctor's income.
for the proposal, said doctors were not enthusiastic support. media, when Obama talked about this part, the participants 500 representatives responded with silence.
2009, the U.S. health care costs up to $ 2,472,000,000,000 total, the proportion of GDP, from 16.2% in 2008 to 17.3%, far more than any other developed countries the proportion of medical costs and GDP . the high medical costs have constrained economic development in the United States.
payment, the payment is bound to cause changes in the doctor opposition. hospitals, pharmaceutical companies and other interest groups also expressed their opposition. Basically, he gave up that goal. health insurance legislation, became the first American model for universal health care reform. In Cai Jiangnan view, the Massachusetts health reform is actually a preview of the Obama health reform legislation.
step strategy. The first step to resolve the issue health insurance coverage, the second step to resolve the problem of controlling medical costs. Currently, the Massachusetts health reform has been basically completed the first step, the focus now turned to the reform of cost control. Obama is taken is the same strategy. persons will increase, equivalent to Medicare for medical services and various interest groups to expand the market, which can be supported by interest groups. However, if you can not effectively control the excessive growth of medical costs, more and more people will be unable to continue to purchase Medicare to universal coverage would not be sustainable. Therefore, the effective control of rising medical costs, universal health care reform will be facing a more difficult challenge. and once to control medical costs and rising health care costs, will be directly with the medical and health care side of the supply side direct conflict of interest. Therefore, to expand health insurance coverage and control costs in two stages, a purely strategic considerations. , this reform is still perilous, the most dangerous one, than the Massachusetts senator of the Democratic Party re-election to the Lok Ma accident. Caijiang Nan told the tradition, advocates the expansion of social security, to play an active role in support of the Government to provide more protection of socially vulnerable groups. Massachusetts, the Kennedy family, the spiritual leader of the Democratic Party, former President John. Kennedy's brother Edward. Senator Kennedy spent his whole life is spent struggle to achieve universal coverage.
a long time, the Democratic Party in Massachusetts, the majority party in parliament in the occupied position. Thus, the U.S. health care reform is not surprising departure from Massachusetts.
Obama will ...