医疗保险改革的征途及其境界——奥巴马医改方案评述.docxVIP

医疗保险改革的征途及其境界——奥巴马医改方案评述【内容提要】美国总统奥巴马的医疗改革之所以在美国国内乃至世界层面引起广泛关注，一是因为美国的医疗保险体系有其特殊性；二是医疗改革是一个世界性难题。长久以来，不少国家试水医疗保险改革，但告成功者屈指可数。本文通过对奥巴马医疗改革的背景、内容和悬念等问题的分析和研究，认为无论是美国还是其他国家，医疗改革的最终目标都是为了实现医疗保险制度的“三个转变”，即由疾病保险向医疗保险的转变；由医疗保险向健康保险的转变；由健康保险向健康管理的转变。健康保险的最高境界应该是推进健康管理，提升健康水平，享受健康服务。使那些没有得到健康保险保障的人能够得到健康保险保障；使那些已经得到健康保险保障的人尽量地不生病或少生病；使那些一旦生病的人能够尽快地得到健康保险服务。American president Obamas health care reform has caught wide attention, as health care reform has always been a worldwide difficult problem and, at the same time, the American health care system has its unique characteristics. Many countries have tried their best to resolve the health care problem, but few have succeeded. This essay analyzed and researched the background, contents and concerns about Obamas Health care reform. It argued that ultimate goals of healthcare reform, no matter for the United States or other countries, were to realize three conversions, namely, from sickness insurance to medical insurance, from medical insurance to health insurance and from health insurance to health management. And the highest level of health insurance was to promote health management, improve health level of the general public, and enable them to enjoy good health, so that those uncovered by health insurance would be protected with health insurance, those covered by health insurance wouldnt suffer from illness or minimally suffered from illness, and those suffered from illness would have ready access to health insurance services.【关 键 词】医改/优势/劣势/医疗保险?health reform/advantages/disadvantages/medical insuranceEE875UU8377686?[中图分类号]F840.32　[文献标识码]A　[文章编号]1004-3306(2010)03-0115-07?从竞选总统时的到处游说，到走马上任后的继续推进，再到2010年2月22日弥合众、参两院医疗改革方案分歧的美国国会新医疗改革方案的发布，美国总统奥巴马的医疗改革在经历了艰难曲折之后，终于取得了阶段性成果。奥巴马的医改方案不仅给美国国内带来不小的震动，而且在世界其他国家也引起了广泛的关注。医疗改革是一个世界性难题，分析和研究奥巴马的医疗改革，不论是对于了解国际医疗改革的发展方向，还是对于寻找中国医疗改革和医疗保险的发展路径，都是一件很有意义的事情。?一、医疗改革的背景?奥巴马总统进行医疗改革的直接原因在于，美国的现行医疗保险制度在发展过程中暴露出诸多弊端，需要政府从制度层面进行必要的修补。美国是发达国家中唯一没有建立全民医疗保险的国家。近些年来，批评美国医疗保险体制负面效应的声音越来越多。尽管美国早已实施了“管理式医