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美平价医保令许多人望而却步

While technical problems with the web site have plagued the initial implementation¹ of the Affordable² Care Act -- President Obama's health care program, there are other consequences of this complex system of private insurance and government subsidies³ that are coming to light. Thousands of healthy Americans are losing their current insurance and may have to pay higher premiums⁴ for new health care coverage⁵.

奥巴马总统的“平价医保法”刚刚推出，就遇到一大堆技术问题。除此之外，这个复杂的由政府补贴的私人保险系统的其他后果也正在显现出来，成千上万身体健康的美国人将失去他们目前的保险，而为新的医保付更高的保费。

Andrew Leonard is a 26-year-old information technology consultant⁶.  He's losing his health coverage because it does not meet the standards required under the Affordable Care Act, also known as Obamacare.  Leonard says a new plan will cost him three times as much, and the only expanded coverage he will receive is for medical care for children.

26岁的伦纳德是一名信息技术顾问，他可能丢掉现在的医保，因为他的医保不符合平价医保法中制定的标准。伦纳德说，他得为新医保交三倍的保费，而保险内容仅仅是增加了子女的医药开支。

“I don’t have any kids, and, when I do have kids, I would probably get their own insurance plan or change it at that point," said Leonard. "Why do I have to change it now?”

“可我根本没孩子。等将来有了孩子，我会给他们买保险或者到时候再换保险。我为什么现在就得换呢？”

More than three million Americans are now losing insurance plans that do not comply with the new health care law, seemingly contradicting a promise made by President Obama during his reelection campaign that ‘if you like your health care, you can keep it.’”

现在有300多万美国人会丢掉他们所谓不符合新医保法的保险，这似乎背离了奥巴马总统竞选连任时的承诺。他当时说：“如果你们喜欢自己的保险，就继续保留它。”

Dr. Kavita Patel, a health care reform expert at the Brookings Institution, says in many cases new policies are required under Obamacare to ensure equal coverage for men and women, with children or without, to equally share costs.

布鲁金斯学会医改专家帕特尔博士说，根据平价医保法，很多人需要购买新的保险，以确保男性和女性、有子女或没有子女，都得到平等的医疗照顾，并平等地分担开支。

“You shouldn’t have to pay more just because you are a woman, which is what had been happening before. So, as a result, we have a much more nationwide policy that does not necessarily penalize⁷ you for being a woman, and as a result of that we’ve got benefits that apply to both men and women," said Patel.

“你不必像过去那样，仅仅因为是女性就要付更多的钱。所以，我们现在有一个更大范围的全国性政策，不会因为你是女性就惩罚你，男性和女性会得到同等的医疗照顾。”

But she says these changes should not significantly increase the cost of plans and that most young people will qualify for a government subsidy⁸ when they enroll⁹.

但是帕特尔说，这些变化不应当大幅度增加医疗保险开支，大部分年轻人参保时都将符合得到政府补贴的条件。

Critics of Obamacare, like Republican Senator Lamar Alexander, say the law is too complex and gives government too much control over the system.

共和党参议员亚历山大等持批评立场的人说，奥巴马医保法过于复杂，而且给予政府太多的控制权。

“It's a law transforming our health care delivery system in the wrong direction, we believe, by increasing premiums, canceling insurance plans, destroying relationships with doctors, raising taxes," said Alexander.

“我们认为，这是一个把我们的医疗系统引向错误方向的法律，因为它将提高保费，取消很多人的保险计划，破坏与医生的关系，增加人们的税负。”

Andrew Leonard says if he can’t find an affordable alternative, he may drop his insurance completely and pay a fine for not having coverage.

伦纳德说，如果找不到其他负担得起的保险，他可能干脆不买保险，交罚款算了。

“I haven’t researched it enough, but if it ends up being that it is cheaper to go without health insurance, I just won’t go to the doctor most of the year. And if something happens, you know, I’ll hold off as much treatment until open enrollment¹⁰ comes along," he said.

“我还没做足够的研究。不过如果没有医疗保险更省钱，我一年里基本上不去看医生就是了。假如真有什么事，我就尽量推迟治疗，等下一年度开放投保时再说。”

Dr. Patel says these technical glitches¹¹ and policy cancelations could threaten the entire system if they discourage young and healthy Americans from enrolling¹².

帕特尔说，如果这些技术故障和一些保险被取消使年轻人和身体健康的人不愿意投保的话，整个系统就会有危险。

“I think all of this is causing, causes me great concern that people are now feeling that the promise about having affordable health care is not attainable," she said.

“所有这些都让我非常担心，人们现在可能觉得所谓平价医疗照顾难以持续。”

She says over time Obamacare will stabilize¹³ costs if these problems are addressed and more people enter the marketplace.

帕特尔说，假以时日，如果这些问题得到解决，更多人参保，奥巴马医保将会使保费稳定下来。