VOA标准英语2012--Free Health Clinic Treats Uninsured Americans

 

Free Health Clinic Treats Uninsured Americans

For 25 years, Wilber Smith of Arlington, Virginia, had health insurance through his job as a steam engineer. Then he lost his job and his insurance. A few months later, he was diagnosed with cancer. He tried to get health insurance, but he says he was turned down by every provider he contacted. Sales people told him his pre-existing health condition -- cancer --barred him from obtaining coverage¹.

"It was no everywhere and a quick no," he recalls. "They were like, 'Now? Now you are coming to us?' I never needed it before because I had always had it."

Smith then found his way to the Arlington Free Clinic in Arlington, Virginia, where he went through chemotherapy and radiation treatment for free, paying only $5 each for some prescriptions² and nothing at all when he couldn't afford to pay. The clinic, which treats 1,600 of Arlington's roughly 20,000 uninsured, is funded mostly by foundations and private donors³.

"Most of our patients work," says Jody Kelly, director of Clinical Administration at the Arlington Free Clinic. "That's perhaps a myth about people at free clinics. That they don't have jobs."

Kelly says the clinic's patients include day laborers⁴, nannies, painters and housekeepers⁵ -- people in jobs where employers don't typically provide health coverage.

And, Kelly says, by the time patients reach her door, they are already very sick. 

"Our patients typically face the choice of buying food, paying rent or seeing a doctor, and you are probably going to take care of the other two before you come here, " she says. "We have a lot of diabetics, people with cancer, diagnosed or undiagnosed, high blood pressure. It's one of those things that kind of builds on itself because you are ill and you are not treated, and then you get more ill."

Extending health care coverage to more of the 50 million people in the United States without health insurance is part of President Barack Obama's sweeping⁶ healthcare reform legislation. It's called the Patient Protection and Affordable⁷ Care Act, widely known as "Obamacare," and it is set to take effect in 2014. But the U.S. Supreme⁸ Court will rule Thursday on the constitutionality of the law.

The legislation not only would extend coverage to more uninsured Americans but also expand the government's free health care service known as Medicaid to millions of low-income childless adults who currently don't qualify. Parts of the law are popular, including a provision that allows adults under age 26 to stay on their parents' health insurance plans. 

Other aspects are more controversial. At the heart of the new law is what's called an individual mandate⁹. It requires all U.S. citizens to purchase health insurance either through private companies, their employer or state-sponsored exchanges. Failure to do so is subject to fines.

Supporters of the mandate say it's critical to the law's success, because it increases the number of people paying for insurance while making sure that healthy people don't opt¹⁰ out until they need it. But 26 states have rejected this part of the legislation. And they argue that, if the individual mandate is ruled unconstitutional, then the entire law must go. Critics of the mandate say Republicans and Democrats¹¹ alike oppose it.

"Repubilicans are against it because they see it as an impingement on their personal freedom," says Ed Haislmaier, who works on healthcare policy at the conservative-leaning Heritage Foundation in Washington. "The Democrats are against it because they don't like health insurance companies in the first place, and they don't like to be told they have to go buy from someone they don't like."

Haislmaier and his colleagues at Heritage support a more consumer-driven system, where patients have a wide variety of healthcare plans to choose from, outside of what their employers offer. In this scenario¹², people who have always been covered remain covered, even if they get sick.

"What has happened in this system for too long is that the patient has kind of been second or third in line behind everybody else," Haislmaier says. 

In the consumer-directed plan he envisions, there might be one health insurance company that cares for all diabetics, for example. If you are a diabetic, that company would offer the most competitive rates and the lowest-cost medications for your condition. Your employer wouldn't matter. Liberals see this as a way to free employers from providing health insurance to their workers.

Meantime, each day at the Arlington Free Clinic, the waiting room fills with patients. Most have been chosen by lottery¹³. 

"We get about 150 people here a month who would like to become patients, and of that number, we can take only about 25," Jody Kelly says.

Wilbur Smith falls into a category that President Obama's legislation is designed to help cover: people who are not poor enough to qualify for Medicaid but too poor to afford health insurance on their own. Under the president's plan, Smith would be insured, even with his pre-existing cancer. But Smith says that even if he had secured health insurance, he would have struggled to pay the premiums¹⁴, which can cost many thousands of dollars each year.

He says he never thought much before about health insurance. And people who criticized the health care system annoyed him. 

"I had always had it and I thought, 'What are they complaining about?'" he says. "You don't get hurt, you don't fall down but so many times, an accident here or there, what are they complaining about?"

Now he knows.

His cancer makes it difficult for him to talk, but he says he is grateful for the care he has been receiving.

"It's a big burden lifted," he says. 

There are a multitude of theories on how the Court will rule Thursday. Will it uphold the legislation in full or strike it down in full? Will parts of the law survive and, if so, which parts? No matter what the court decides, a study by the Pew Research Center says the public won't be happy. Pew researchers found that fewer than half of Americans will approve of the court's ruling. 

1 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。

2 prescriptions   

药( prescription的名词复数 )； 处方； 开处方； 计划

参考例句：

• The hospital of traditional Chinese medicine installed a computer to fill prescriptions. 中医医院装上了电子计算机来抓药。
• Her main job was filling the doctor's prescriptions. 她的主要工作就是给大夫开的药方配药。

3 donors   

n.捐赠者( donor的名词复数 )；献血者；捐血者；器官捐献者

参考例句：

• Please email us to be removed from our active list of blood donors. 假如你想把自己的名字从献血联系人名单中删去，请给我们发电子邮件。
• About half this amount comes from individual donors and bequests. 这笔钱大约有一半来自个人捐赠及遗赠。 来自《简明英汉词典》

4 laborers   

n.体力劳动者，工人( laborer的名词复数 )；（熟练工人的）辅助工

参考例句：

• Laborers were trained to handle 50-ton compactors and giant cranes. 工人们接受操作五十吨压土机和巨型起重机的训练。 来自《现代英汉综合大词典》
• Wage-labour rests exclusively on competition between the laborers. 雇佣劳动完全是建立在工人的自相竞争之上的。 来自英汉非文学 - 共产党宣言

5 housekeepers   

n.（女）管家( housekeeper的名词复数 )

参考例句：

• Can you send up one of your housekeepers to make bed? 请你派个女服务员来整理床铺好吗？ 来自互联网
• They work as gas station attendants, firemen, housekeepers,and security personnel. 本句翻译：机器人也能够作为煤气站的服务员，救火队员等保安作用。 来自互联网

6 sweeping   

adj.范围广大的，一扫无遗的

参考例句：

• The citizens voted for sweeping reforms.公民投票支持全面的改革。
• Can you hear the wind sweeping through the branches?你能听到风掠过树枝的声音吗？

7 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。

8 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。

9 mandate   

n.托管地；命令，指示

参考例句：

• The President had a clear mandate to end the war.总统得到明确的授权结束那场战争。
• The General Election gave him no such mandate.大选并未授予他这种权力。

10 opt   

vi.选择，决定做某事

参考例句：

• They opt for more holiday instead of more pay.他们选择了延长假期而不是增加工资。
• Will individual schools be given the right to opt out of the local school authority?各个学校可能有权选择退出地方教育局吗？

11 democrats   

n.民主主义者，民主人士( democrat的名词复数 )

参考例句：

• The Democrats held a pep rally on Capitol Hill yesterday. 民主党昨天在国会山召开了竞选誓师大会。
• The democrats organize a filibuster in the senate. 民主党党员组织了阻挠议事。 来自《简明英汉词典》

12 scenario   

n.剧本，脚本；概要

参考例句：

• But the birth scenario is not completely accurate.然而分娩脚本并非完全准确的。
• This is a totally different scenario.这是完全不同的剧本。

13 lottery   

n.抽彩；碰运气的事，难于算计的事

参考例句：

• He won no less than ￡5000 in the lottery.他居然中了5000英镑的奖券。
• They thought themselves lucky in the lottery of life.他们认为自己是变幻莫测的人生中的幸运者。

14 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》