医疗保险改革的征途及其境界——奥巴马医改方案评述

Route for Medical Insurance Reform and the Ultimate Goals Comments on Obama′s Health Care Reform Program

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 Obama＇s health care reform has caught wide attention, as health care reform has al- ways 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 Obama＇s 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 in- surance 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 wouldn＇ t suffer from illness or minimally suffered from illness, and those suffered from illness would have ready access to health insurance services.