美国医疗保健服务体系的形成、发展与改革

On the Formation,Development and Reform of American Health Care System

美国的医疗保健服务体系非常复杂,主要由医院部门、保险公司、管理机构组成。20世纪30年代前后,美国现代医保体系形成,运作方式与自由市场经济模式一致,以私营商业化为主体特征。第二次世界大战以后到1965年,是美国现代医保体系的发展时期,美国政府开始介入医保领域,颁布了政府计划,解决了老年人和贫困人群的医保问题,使美国医保体系发生了质的变化,形成了以私营商业性为主,政府公立计划为辅的医保模式。20世纪70年代起,由于医疗费用持续上升,医疗保险不能全民覆盖,美国历届政府开始关注医保改革。最近奥巴马总统的医保改革初获成功,预示着美国医保体系的历史将被改写。

The American health care system is very complicated,and is mainly composed of hospitals,insurance companies and management mechanism.The modern medical insurance system formed around 1930s and its mode of operation is identical with the free-market economy that features primarily private commercialization.From the end of World War II to 1965,the system had enlarged because of government plans,Medicare and Medicaid,which solved the medical insurance problems among the old and the poor.It is clear that the system had changed greatly and a new pattern formed with private and commercial operation being the main body and the public plan of the government being the supplementary.Since 1970s,due to the rising medical costs and the medical insurance coverage,successive administrations all pay much attention to the health-care reform.Recently,President Obama won initial success on the reform which indicates that the history of American health care system will be rewritten.