摘要
老年保健计划 (简称Medicare)是美国社会保障制度的一个主要组成部分 ,其目的是为了保障老人和残疾人士的福利 ,让全社会来分担他们的医疗费用负担。本文回顾了老年保健计划的建立和发展 ,以及在各个总统任期内所经历的改革 ,指出它目前所面临的问题是如何在医疗费用不断上升的情况下满足老年人和残障者医疗服务的长期需要。鉴于近来有不少改革方案提出 ,本文对这些改革方案进行评析 ,并指出改革的目标不应该放在削减医疗服务费用上。改革的着眼点应是如何重新安置现有的社会资源以支付因医疗技术更新而不断上升的费用。本文认为 。
The Medicare program is a major component of social insurance in the United States. Enacted in 1965, it provides health insurance to two groups of people - people of 65 and above, and disabled people. Its purpose is to increase access to quality health care by the elderly and disabled people, and to reduce their associated financial burden. In the past 37 years, Medicare has experienced reforms in terms of its benefits provided, population covered and payment system. With the fast growing population of 65 and older and a rapid rise of health care cost, a major concern about Medicare is whether there will be enough resources to meet the health care financing needs of the disabled and elderly over time. Recent studies propose various solutions to avoid bankruptcy of the Medicare program in the long run. This study examines these proposed reform plans and points out that rapidly rising cost should not be the target of the reform. A market-oriented approach to solving the Medicare financing problem could lead the reform to a wrong direction. On the other hand, proposals calling for altering the tax revenue base to allow for generating needed revenue should be a feasible and desirable alternative.
出处
《美国研究》
CSSCI
北大核心
2003年第1期81-94,共14页
The Chinese Journal of American Studies
