美国国家公共电台 NPR India Aims For The World's Biggest Health Care Overhaul

 

DAVID GREENE, HOST:

We have brought you more than a few stories about the Affordable¹ Care Act, or Obamacare. But Modicare, nicknamed for India's prime minister, Narendra Modi, is actually the biggest government health plan in the world. Modi wants to give poor Indians health insurance they can use to buy private care. NPR's Lauren Frayer reports.

MIHIR DALAL: This is the largest physical medicine and rehab unit in the private space in India.

LAUREN FRAYER, BYLINE²: Dr. Mihir Dalal shows me around Mumbai's Kokilaben Ambani Hospital. It's one of the top hospitals in Asia. There's a robotics rehab unit and a state-of-the-art cancer center. They also do gender³ reassignment surgery here. There are marble hallways, free Wi-Fi.

DALAL: So we are in the lobby. We have a large waiting area.

FRAYER: Looks like a hotel lobby.

DALAL: Chandeliers, large French windows. We have the Starbucks cafe.

FRAYER: Private hospitals like this one cater⁴ to paying customers. Medical tourists come from as far as the U.S. to get hip⁵ replacements⁶ and other surgery much cheaper than back home. But most locals cannot afford this. Ninety percent of Indians go to public hospitals. Care in those is free but nowhere near as sophisticated.

In a one-room house in a Mumbai slum, Shaheen Khan sits cross-legged on the cement floor in pain. She's got gallstones.

SHAHEEN KHAN: (Speaking Hindi).

FRAYER: She explains how her family rushed her to the city's Sion Hospital, a government facility, back in June. Doctors told her they would operate, but after eight days, they discharged her. There weren't enough beds. Patients were sharing mattresses⁷ on the floor.

KHAN: (Through interpreter) They said we don't have space in our hospital. There are so many patients, and there's a risk of infection spreading. So it's better for you to go home, they told me.

FRAYER: They said they'd call when a bed opens up. It's been six weeks. Her phone hasn't rung. Shaheen is a widow unable to work living off her brother. Just like in the U.S., illness often bankrupts whole families in India. People like Shaheen are the target of Prime Minister Narendra Modi's new health plan, offering the poorest half of India - more than 500 million people - health insurance to apply toward private care.

(SOUNDBITE OF ARCHIVED RECORDING)

PRIME MINISTER NARENDRA MODI: (Speaking Hindi).

FRAYER: "Health care should be accessible and affordable," the prime minister said in a radio address this spring. Each family would get more than $7,200 in annual coverage⁸, he said, which might not buy a lot of health care in the U.S. but goes a long way in India. The program is expected to roll out by the end of this year. Modi is running for re-election next year.

RAVI RAMAMURTI: This is a very nice appealing from a political perspective, as you can imagine.

FRAYER: Ravi Ramamurti is a professor of international business who's studied India's health system and its government hospitals.

RAMAMURTI: They are poorly staffed. Equipment there often doesn't work. They have employees who sometimes don't show up. Even the poor, if they can at all find the means, often will look for a private solution.

FRAYER: Modicare could help them, and it's easier to shepherd patients into less crowded, private hospitals then revamp all the public ones.

(CROSSTALK)

FRAYER: A hundred miles outside of Mumbai, a big, rural government hospital is completely full and a bit chaotic⁹ - a world away from the private hospital's marble lobby. There's a bloody¹⁰ gurney in the hall here. But every patient we approached was satisfied with their care.

SURESH JAGDALE: Health scheme - it's total free.

FRAYER: Because it's totally free says the director of the Nashik District hospital, Dr. Suresh Jagdale. He feels proud. India is a developing country that has managed to provide free health care, however rudimentary. Now Modicare seeks to improve it. India spends only about 4 percent of its GDP on health care. The U.S., by contrast, spends nearly 17 percent. Ravi Ramamurti, the health care expert, says the Indian government can afford Modicare, at least for now.

RAMAMURTI: One or two billion dollars is not more than what the Indian government can afford. But these programs have a way of exploding over time. Then it can actually get to be a bigger constraint¹¹. These are programs you can never pull back.

FRAYER: For Modi, this is good politics. For India, this may be a giant step toward better health care for 1.3 billion people. Lauren Frayer, NPR News, Mumbai.

1 affordable   

adj.支付得起的，不太昂贵的

参考例句：

• The rent for the four-roomed house is affordable.四居室房屋的房租付得起。
• There are few affordable apartments in big cities.在大城市中没有几所公寓是便宜的。

2 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

3 gender   

n.（生理上的）性，（名词、代词等的）性

参考例句：

• French differs from English in having gender for all nouns.法语不同于英语，所有的名词都有性。
• Women are sometimes denied opportunities solely because of their gender.妇女有时仅仅因为性别而无法获得种种机会。

4 cater   

vi.(for/to)满足，迎合；(for)提供饮食及服务

参考例句：

• I expect he will be able to cater for your particular needs.我预计他能满足你的特殊需要。
• Most schools cater for children of different abilities.大多数学校能够满足具有不同天资的儿童的需要。

5 hip   

n.臀部，髋；屋脊

参考例句：

• The thigh bone is connected to the hip bone.股骨连着髋骨。
• The new coats blouse gracefully above the hip line.新外套在臀围线上优美地打着褶皱。

6 replacements   

n.代替( replacement的名词复数 )；替换的人[物]；替代品；归还

参考例句：

• They infiltrated behind the lines so as to annoy the emery replacements. 他们渗透敌后以便骚扰敌军的调度。 来自辞典例句
• For oil replacements, cheap suddenly looks less of a problem. 对于石油的替代品来说，价格变得无足轻重了。 来自互联网

7 mattresses   

褥垫，床垫( mattress的名词复数 )

参考例句：

• The straw mattresses are airing there. 草垫子正在那里晾着。
• The researchers tested more than 20 mattresses of various materials. 研究人员试验了二十多个不同材料的床垫。

8 coverage   

n.报导，保险范围，保险额，范围，覆盖

参考例句：

• There's little coverage of foreign news in the newspaper.报纸上几乎没有国外新闻报道。
• This is an insurance policy with extensive coverage.这是一项承保范围广泛的保险。

9 chaotic   

adj.混沌的，一片混乱的，一团糟的

参考例句：

• Things have been getting chaotic in the office recently.最近办公室的情况越来越乱了。
• The traffic in the city was chaotic.这城市的交通糟透了。

10 bloody   

adj.非常的的；流血的；残忍的；adv.很；vt.血染

参考例句：

• He got a bloody nose in the fight.他在打斗中被打得鼻子流血。
• He is a bloody fool.他是一个十足的笨蛋。

11 constraint   

n.(on)约束，限制；限制(或约束)性的事物

参考例句：

• The boy felt constraint in her presence.那男孩在她面前感到局促不安。
• The lack of capital is major constraint on activities in the informal sector.资本短缺也是影响非正规部门生产经营的一个重要制约因素。