经济学人212:私人医疗保健 问题的解决者

 　　Private health care

　　私人医疗保健

　　The problem-solvers

　　问题的解决者

　　Hints of how to provide better health care for less money

　　有关花更少的钱获得更多的医疗保健的建议

　　CHENMED doesn't look like much. Its clinic north ofMiamihas a modest waiting area and circle of examination rooms. But every action is engineered and tracked. Jennifer Thomas, a senior executive, pores over data. Whiteboards on her walls are covered with diagrams, a vestige¹ from her days at McKinsey, a consultancy. “We've kind of figured it out,” she says.

　　CHENMED这家公司看起来和其他公司不太一样。它在迈阿密以北的一个诊所里，不仅有一个舒适的等候室，还有一个圆形的监查区。然而他们的每一个行动都是被好好设计和跟踪的。高级主管阵妮佛·托马斯。她墙上的白板上画满了图表，这是她在麦肯锡咨询公司工作时留下的习惯。“我们搞懂了这件事。”她说。

　　私人医疗保健.jpg

　　“It” is how to care for the most expensive patients in the world's most expensive health system. ChenMed is devoted² to poor elderly people who may have half a dozen chronic³ conditions. It profits when they are kept well and their health-care costs are kept low. Clinics like ChenMed are the exception, not the rule. But the company is one of many that provide a hint of how American health care might work better.

　　“这件事”是指如何在世界上最昂贵的医疗系统下照顾诊费最高的病人。ChenMed致力于照看那些全身都是慢性疾病的贫困老年人。只有把人照顾得好且所用医疗费用低时公司才能获利。像ChenMed这样的诊所是一个特殊的例子，不是普遍地规律。然而这家公司和其他众多的公司一样，可以为美国医疗体制更好地运行提供一些建议。

　　ChenMed is led by Christopher Chen, a doctor and the son of the company's founder⁴, a Taiwanese immigrant. Other members of the Chen family hold senior positions, but they have been joined by high-flying executives and management consultants⁵, lured⁶ by ChenMed's model and the promise of profits as the company grows.

　　ChenMed是由台湾移民克里斯托弗·陈领导的。他是公司创始人的儿子，同时也是一名医生。陈家族的其他职员都持有高级职位，ChenMed向他们展示了公司未来的发展模型，并保证随着公司的发展，利润会不断增加。他们被此吸引，加入了该公司，成为了雄心勃勃的公司高管和管理顾问。

　　The idea is simple. Medicare, the public health programme for the elderly, has a growing share of patients who use government money to buy private insurance. ChenMed contracts with those insurers, most of which pay a capped rate for each patient, and then plies⁷ patients with primary care to keep them out of hospital. ChenMed has vans to take patients to and from its clinics—lack of transport often keeps elderly patients from seeing their doctors. Once at the clinic, patients wave a card at the front desk and are automatically checked in. Staff perform a tightly choreographed⁸ routine, with data fed back to Ms Thomas and others to find further improvements.

　　这个想法很简单。由于针对老年人的医疗保险和公共卫生计划的不断发展，越来越多的患者拿政府的钱来购买私人保险。ChenMed和那些保险公司签订合同，其中大部分为每位患者支付一个最高金额，然后为患者配备初级的护理，让他们出院。ChenMed还有专用的货车带患者往返于患者的住处和诊所，因为缺乏交通工具是阻碍老年患者就医的一个常见问题。到了诊所，患者在前台刷卡就能自动登记。员工遵循一个严格设计过的步骤，然后把数据反馈给托马斯女士和其他人，以便寻求进一步改善。

　　Examination rooms circle a central hub so that doctors can confer easily with assistants and specialists. A mobile app lets doctors see patients' medical records and refer to clinical protocols⁹. The clinic has a pharmacy¹⁰, so doctors give patients pills directly and answer any questions; failing to take medicine often sends patients to hospital. Most administration is centralised elsewhere, so staff at the clinic devote their attention to treatment.

　　监察室环绕着一个中心呈圆形排列，这样医生可以方便地和助手和专家探讨问题。一个移动应用程序能让医生看到患者的医疗记录并参考临床方案。不按时吃药是患者在医院反复折腾的重要原因之一，所以，诊所配有自己的药房，医生可以直接给患者开药并回答患者提出的所有问题。大部分政府部门的精力都集中在其他地方，所以诊所的员工专注于治疗。

　　This seems to work. Medicare patients at ChenMed spent nearly 40% fewer days in hospital than the national average. Thanks to a venture with Humana, a big insurer, it has expanded to three dozen clinics. Dr Chen is bullish. “We don't see why we can't grow by 300% to 400% over the next five years,” he says.

　　这样做似乎很有效果。在ChenMed就医的医疗保险患者相比全国水平而言，在医院少呆了40%的时间。由于一个大保险公司胡玛纳的加入，ChenMed名下已经有两36家诊所，陈博士很乐观，他说“我们不明白我们为什么不能在未来的五年内增长300%到400%。”

1 vestige   

n.痕迹，遗迹，残余

参考例句：

• Some upright stones in wild places are the vestige of ancient religions.荒原上一些直立的石块是古老宗教的遗迹。
• Every vestige has been swept away.一切痕迹都被一扫而光。

2 devoted   

adj.忠诚的，忠实的，热心的，献身于...的

参考例句：

• He devoted his life to the educational cause of the motherland.他为祖国的教育事业贡献了一生。
• We devoted a lengthy and full discussion to this topic.我们对这个题目进行了长时间的充分讨论。

3 chronic   

adj.(疾病)长期未愈的，慢性的；极坏的

参考例句：

• Famine differs from chronic malnutrition.饥荒不同于慢性营养不良。
• Chronic poisoning may lead to death from inanition.慢性中毒也可能由虚弱导致死亡。

4 Founder   

n.创始者，缔造者

参考例句：

• He was extolled as the founder of their Florentine school.他被称颂为佛罗伦萨画派的鼻祖。
• According to the old tradition,Romulus was the founder of Rome.按照古老的传说，罗穆卢斯是古罗马的建国者。

5 consultants   

顾问( consultant的名词复数 )； 高级顾问医生，会诊医生

参考例句：

• a firm of management consultants 管理咨询公司
• There're many consultants in hospital. 医院里有很多会诊医生。

6 lured   

吸引，引诱（lure的过去式与过去分词形式）

参考例句：

• The child was lured into a car but managed to escape. 那小孩被诱骗上了车，但又设法逃掉了。
• Lured by the lust of gold,the pioneers pushed onward. 开拓者在黄金的诱惑下，继续奋力向前。

7 plies   

v.使用（工具）( ply的第三人称单数 )；经常供应（食物、饮料）；固定往来；经营生意

参考例句：

• The ship plies between London and Sydney. 这船常航行于伦敦与悉尼之间。 来自《简明英汉词典》
• The bus plies from the station to the hotel. 这辆公共汽车往来于车站和旅馆之间。 来自辞典例句

8 choreographed   

v.设计舞蹈动作( choreograph的过去式和过去分词 )

参考例句：

• There was some carefully choreographed flag-waving as the President drove by. 总统的车经过时，人们按精心编排的动作挥舞着旗帜。
• Achim had choreographed the dance in Act II himself. 阿希姆自己设计了第2幕的舞蹈动作。 来自辞典例句

9 protocols   

n.礼仪( protocol的名词复数 )；（外交条约的）草案；（数据传递的）协议；科学实验报告（或计划）

参考例句：

• There are also protocols on the testing of nuclear weapons. 也有关于核武器试验的协议。 来自辞典例句
• Hardware components and software design of network transport protocols are separately introduced. 介绍系统硬件组成及网络传输协议的软件设计。 来自互联网

10 pharmacy   

n.药房，药剂学，制药业，配药业，一批备用药品

参考例句：

• She works at the pharmacy.她在药房工作。
• Modern pharmacy has solved the problem of sleeplessness.现代制药学已经解决了失眠问题。