经济学人108:美国的健康保险 章鱼博士

 　　Business Health insurance in America The doctor octopus¹

　　商业 美国的健康保险 章鱼博士

　　Obamacare is making health insurers bigger

　　奥巴马的保健计划正在使健康保险公司变得更加庞大

　　THE future of Barack Obama's health law is uncertain.

　　奥巴马健康法案的前景还不明朗。

　　Its main provisions will not come into effect until 2014; the Supreme² Court may strike it down before then.

　　其主要条款要到2014年以后才会生效；并且在生效之前也可能会被最高法院枪毙。

　　But America's insurers are already transforming.

　　尽管如此，美国的各大保险公司已经随机而动了。

　　They were big before; now they are growing bigger.

　　过去，它们很庞大，现在则正在变得更大。

　　On October 24th Cigna, an insurer based in Connecticut, said it would pay $3.8 billion for HealthSpring, which offers services and insurance to the elderly.

　　十月二十四日，坐落在康涅狄格州的保险公司Cigna声明，它将为收购HealthSpring支付38亿美元，后者的主要业务是为老年人提供服务和保险。

　　It is the latest deal to extend insurers' tentacles³ into new areas of health care.

　　这是Cigna公司拓展健康保险新领域的最新举动。

　　The question is whether they might actually improve it.

　　问题是它会不会真的去提高该领域的服务质量。

　　Good, cheap health care has long eluded⁴ America.

　　长期以来，美国都没有既好又便宜的卫生保健项目。

　　Doctors are paid for each service, so they deliver as many as possible, necessary or not.

　　医生的每项服务都是付费的，因此，不管有没有必要，他们都会推销尽可能多的服务项目。

　　Insurers protect margins⁵ by micromanaging claims and hiking premiums⁶.

　　保险公司靠权利的细微调控和额外费用的大幅提高来保障利润。

　　These perverse⁷ incentives⁸ are addressed, faintly, by Obamacare.

　　奥巴马健康法案中模糊地提到要改革这些不当的动机。

　　For example, there are pilots to reward hospitals for the quality rather than the quantity of their care.

　　比如，法案中的一些导则规定，奖励那些致力于提高服务质量而不是服务数量的医院。

　　Mostly, however, the reform deals with the symptoms of muddled⁹ incentives: high premiums and poor access.

　　但是，大部分的改革内容则是针对那些让人不解的怪症，即高额的额外费用同时又难以得到的健康保健服务。

　　For insurers, reform holds opportunity and peril¹⁰.

　　对于保险公司来说，改革即润育着机会同时也存在风险。

　　From 2014 the law will require everyone to buy health insurance and offer subsidies¹¹ to those who cannot afford it.

　　法律规定，从2014年开始每个公民都要买健康保险，同时对于那些支付不起保险费用的公民给与补贴。

　　As more people buy insurance, firms' revenues will more than double to $1.2 trillion by 2019, predicts the Boston Consulting Group.

　　波士顿咨询公司预计，截止到2019年，当更多的人买保险之后，保险公司的收益会达到一万两千亿美元，是现在的两倍多。

　　However, profits will be squeezed, thanks to a new tax, a minimum standard for benefits and new scrutiny¹² of increases in premiums.

　　但是，由于新税法，利润上限制度和新的监管酬金增长制度的实施，保险公司的利润将会缩减。

　　Faced with all this, insurers are keen to diversify¹³.

　　面对这些新变化，保险公司都热衷于多样化的经营。

　　Many are hedging against a volatile¹⁴ private market by turning to the public one.

　　为了预防私营市场的不稳定性，许多公司转向了国营（政府经营的）市场。

　　More states are asking insurers to run Medicaid, the programme for the poor.

　　更多的州政府要求保险公司经营管理针对穷人的医疗补助项目。

　　HealthSpring will help Cigna tap the market for Medicare Advantage, private plans that use public money to cover the old.

　　HealthSpring帮助Cigna叩响了公共市场医疗保险优越性的大门，即通过私企的计划方案，来达到利用公共资金服务老年人市场的目的。

　　Humana, already a leader in public health programmes, has bought two Medicare firms this year (so far) and WellPoint has bought one.

　　已经是公共健康项目领头羊的Humana公司，今年（截至目前）已经收购了两家医疗保险公司；WellPoint公司也收购了一个。

　　For these insurers, Medicare Advantage gives access to baby-boomers.

　　对于这些保险公司来说，医疗保险优越性给它们打开了面向婴儿潮时期出生的人群。

　　It is also a testing ground for Mr Obama's new health "exchanges", where consumers will be able to buy health insurance from 2014.

　　同时，这也是奥巴马新健康"契约"的试验场，新契约规定从2014年开始消费者都将能够购买健康保险。

　　Both are highly regulated markets that court consumers directly.

　　两个业已高度规范化的市场将同时直接服务于消费者。

　　Insurers are spreading into new businesses. Last year Aetna bought a health information technology (IT) company.

　　保险公司也正在将其业务扩展的新的领域。去年Aetna公司收购了一个健康信息科技公司。

　　Humana recently bought a chain of clinics. Its new Medicare plans both provide care and pay for it.

　　Humana最近也收购了一个连锁经营的诊所，它的新型医疗保险计划是即提供健康服务项目，同时也提供支付服务费用的项目。

　　The thinking is that this will give Humana the means to keep more of its customers healthy.

　　思考一下可知，这将给Humana公司更多的手段，去保证其客户得到更多的健康服务。

　　Others are doing the same.

　　其他公司也正在做和Humana公司一样的事情。

　　UnitedHealth Group, the biggest health insurer, has been extending its reach for some time.

　　美国最大的健康保险公司，联合健康集团（UnitedHealth Group）拓展其业务已经有一段时间了。

　　Two non-insurance subsidiaries already account for 20% of its $94 billion annual revenue:

　　其两家非保险业务的子公司的营业收入已经占了其年度营业额940亿美元的20%，

　　OptumInsight, an IT business, and OptumHealth, which owns doctors' groups and provides services to help hospitals improve care.

　　这两家公司分别是OptumInsight，一家IT公司，和OptumHealth，一家拥有医生团队并且为医院提高健康服务提供支持的公司。

　　These ventures do not just create new revenue streams, argues Sheryl Skolnick of CRT Capital, a broker-dealer. They strengthen United's main business.

　　经纪公司CRT Capital的Sheryl Skolnick说，这些风投不仅仅创造了新的公司收入，它们巩固了联合健康集团的主营业务。

　　This is most obvious when OptumHealth buys a doctors' group.

　　最明显的例子是OptumHealth收购了一个医生组织。

　　In August it announced that it would acquire Monarch¹⁵ HealthCare, in California.

　　今年八月份，OptumHealth宣布它将收购位于加州的Monarch HealthCare。

　　Bart Asner, Monarch's chief executive, predicts that Optum will help his doctors be more efficient, monitor patients' conditions and keep them healthier.

　　Monarch的首席执行官Bart Asner预计，OptumHealth公司将会帮助他的医生更加高效，并协助医生监护病人，使病人变得更健康。

　　United will enjoy revenue from owning Monarch.

　　联合健康公司将会很高兴分享拥有Monarch公司而带来的收益。

　　But as one of six insurers that contracts with Monarch, it will also benefit from patients' lower costs.

　　但是作为与Monarch公司签订合约的六个保险公司之一，它也将会从更低的病人服务价格中"受益"。

　　This virtuous¹⁶ circle extends to hospitals that United does not own.

　　这种良性循环扩展到了不属于联合健康集团的医院。

　　Historically insurers have fought with hospitals over payments.

　　历史上保险公司总是在支付费用的多少上与医院开战。

　　But now insurers are testing pay-for-performance contracts.

　　但是现在，保险公司正在实验按绩效付酬的合约。

　　Hospitals can use Optum's services to improve their operations, creating new revenue for Optum and new savings¹⁷ for United's insurance business.

　　医院能够利用Optum的服务来提高它们自己的服务质量，这样在为Optum创造效益的同时也为联合健康集团的保险业务节省了开支。

　　This strategy might begin to align¹⁸ the insurer's interests with those of its former adversaries¹⁹.

　　这项策略可能会开始将以前互为对手的医院的利益与保险公司的利益拉到同一条船上。

1 octopus   

n.章鱼

参考例句：

• He experienced nausea after eating octopus.吃了章鱼后他感到恶心。
• One octopus has eight tentacles.一条章鱼有八根触角。

2 supreme   

adj.极度的，最重要的；至高的，最高的

参考例句：

• It was the supreme moment in his life.那是他一生中最重要的时刻。
• He handed up the indictment to the supreme court.他把起诉书送交最高法院。

3 tentacles   

n.触手( tentacle的名词复数 )；触角；触须；触毛

参考例句：

• Tentacles of fear closed around her body. 恐惧的阴影笼罩着她。
• Many molluscs have tentacles. 很多软体动物有触角。 来自《简明英汉词典》

4 eluded   

v.（尤指机敏地）避开( elude的过去式和过去分词 )；逃避；躲避；使达不到

参考例句：

• The sly fox nimbly eluded the dogs. 那只狡猾的狐狸灵活地躲避开那群狗。 来自《现代汉英综合大词典》
• The criminal eluded the police. 那个罪犯甩掉了警察的追捕。 来自《现代英汉综合大词典》

5 margins   

边( margin的名词复数 )； 利润； 页边空白； 差数

参考例句：

• They have always had to make do with relatively small profit margins. 他们不得不经常设法应付较少的利润额。
• To create more space between the navigation items, add left and right margins to the links. 在每个项目间留更多的空隙，加左或者右的margins来定义链接。

6 premiums   

n.费用( premium的名词复数 )；保险费；额外费用；（商品定价、贷款利息等以外的）加价

参考例句：

• He paid premiums on his life insurance last year. 他去年付了人寿保险费。 来自《现代英汉综合大词典》
• Moves are afoot to increase car insurance premiums. 现正在酝酿提高汽车的保险费。 来自《简明英汉词典》

7 perverse   

adj.刚愎的；坚持错误的，行为反常的

参考例句：

• It would be perverse to stop this healthy trend.阻止这种健康发展的趋势是没有道理的。
• She gets a perverse satisfaction from making other people embarrassed.她有一种不正常的心态，以使别人难堪来取乐。

8 incentives   

激励某人做某事的事物( incentive的名词复数 )； 刺激； 诱因； 动机

参考例句：

• tax incentives to encourage savings 鼓励储蓄的税收措施
• Furthermore, subsidies provide incentives only for investments in equipment. 更有甚者，提供津贴仅是为鼓励增添设备的投资。 来自英汉非文学 - 环境法 - 环境法

9 muddled   

adj.混乱的；糊涂的；头脑昏昏然的v.弄乱，弄糟( muddle的过去式)；使糊涂；对付，混日子

参考例句：

• He gets muddled when the teacher starts shouting. 老师一喊叫他就心烦意乱。
• I got muddled up and took the wrong turning. 我稀里糊涂地拐错了弯。 来自《简明英汉词典》

10 peril   

n.(严重的)危险；危险的事物

参考例句：

• The refugees were in peril of death from hunger.难民有饿死的危险。
• The embankment is in great peril.河堤岌岌可危。

11 subsidies   

n.补贴，津贴，补助金( subsidy的名词复数 )

参考例句：

• European agriculture ministers failed to break the deadlock over farm subsidies. 欧洲各国农业部长在农业补贴问题上未能打破僵局。
• Agricultural subsidies absorb about half the EU's income. 农业补贴占去了欧盟收入的大约一半。 来自《简明英汉词典》

12 scrutiny   

n.详细检查，仔细观察

参考例句：

• His work looks all right,but it will not bear scrutiny.他的工作似乎很好，但是经不起仔细检查。
• Few wives in their forties can weather such a scrutiny.很少年过四十的妻子经得起这么仔细的观察。

13 diversify   

v.（使）不同，（使）变得多样化

参考例句：

• Our company is trying to diversify.我们公司正力图往多样化方面发展。
• Hills and woods diversify the landscape.山陵和树木点缀景色。

14 volatile   

adj.反复无常的，挥发性的，稍纵即逝的，脾气火爆的；n.挥发性物质

参考例句：

• With the markets being so volatile,investments are at great risk.由于市场那么变化不定，投资冒着很大的风险。
• His character was weak and volatile.他这个人意志薄弱，喜怒无常。

15 monarch   

n.帝王，君主，最高统治者

参考例句：

• The monarch's role is purely ceremonial.君主纯粹是个礼仪职位。
• I think myself happier now than the greatest monarch upon earth.我觉得这个时候比世界上什么帝王都快乐。

16 virtuous   

adj.有品德的，善良的，贞洁的，有效力的

参考例句：

• She was such a virtuous woman that everybody respected her.她是个有道德的女性，人人都尊敬她。
• My uncle is always proud of having a virtuous wife.叔叔一直为娶到一位贤德的妻子而骄傲。

17 savings   

n.存款，储蓄

参考例句：

• I can't afford the vacation,for it would eat up my savings.我度不起假，那样会把我的积蓄用光的。
• By this time he had used up all his savings.到这时，他的存款已全部用完。

18 align   

vt.使成一线，结盟，调节；vi.成一线，结盟

参考例句：

• Align the ruler and the middle of the paper.使尺子与纸张的中部成一条直线。
• There are signs that the prime minister is aligning himself with the liberals.有迹象表明首相正在与自由党人结盟。

19 adversaries   

n.对手，敌手( adversary的名词复数 )

参考例句：

• That would cause potential adversaries to recoil from a challenge. 这会迫使潜在的敌人在挑战面前退缩。 来自辞典例句
• Every adversaries are more comfortable with a predictable, coherent America. 就连敌人也会因有可以预料的，始终一致的美国而感到舒服得多。 来自辞典例句