经济学人:美国中期选举将至 全民医保项目何去何从?(1)

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"Medicare for all" “全民医保”

How to turn a meaningless slogan into something worthwhile 如何将无意义的口号变得有价值

Senators Bernie Sanders, Elizabeth Warren and Cory Booker are all for it, as are Kamala Harris and Kirsten Gillibrand. 参议员伯尼·桑德斯、伊丽莎白·沃伦以及科里·布克都支持“全民医保”，贺锦丽和陆天娜亦是如此。

"Medicare for all" has also become a rallying cry for many Democratic activists¹ as the mid-terms approach. 随着中期选举的临近，“全民医保”也成为很多民主活动人士的战斗口号。

Like "repeal² and replace", the Republican Party's three-word proposal for improving on Obamacare, "Medicare for al" sounds good but is largely meaningless. 像共和党关于改进奥巴马医改的提案“废除和替换”一样，“全民医保”听起来不错但毫无意义。

Ask any five Democratic senators what they have in mind and you will get five different answers. 任意五位民主党参议员对此都会有五种不同的意见。

The urge to reform American health care deserves support. 美国医疗改革需要更多推动力的支持。

America is the only rich country to lack universal coverage³. 美国是唯一一个没有全民医保的富裕国家。

Even in a booming economy, 12% of American adults remain uninsured. 即使在经济繁荣时期，仍有12%的成年人没有医保。

Though the best care they receive is world-beating, the system as a whole has high costs and disappointing results. 虽然他们的医疗水平是世界一流的，但是整体医疗系统成本高昂，成果不尽人意。

America spends 17% of GDP on health care, the highest of any rich country, 美国在医疗保健上的支出占GDP的17%，是所有富裕国家中最高的，

but in return achieves an average life expectancy⁴ no better than that of the formerly⁵ communist countries of eastern Europe. 但作为回报，其人均预期寿命并不比东欧前共产主义国家高。

Even Americans with good insurance plans find dealing⁶ with their providers maddening. 在美国，即使是拥有良好保险计划，也恼火于与保险公司打交道。

Hence the urge to tear up the whole system and start again. 因此，有一种想要摧毁整个系统重新开始的冲动。

Mr Sanders has done the most to popularise Medicare for all. 桑德斯在普及全民医保的时候做的最多。

He proposes converting the government scheme for the elderly into a single-payer system funded from general taxation⁷, as in many European countries. 提议，像许多欧洲国家一样，把政府为老人设定的计划转变为由一般税收资助的单一支付者制度。

Private companies would still provide the care, unlike Britain's NHS, but individuals would no longer buy health insurance through their employers. 他与英国国家医疗服务体系不同，这个计划同意私人公司仍将提供医疗服务，但是个人将不再通过雇主购买医疗保险。

This plan appeals to Democrats⁸ scarred by their experience with Obamacare, an incremental⁹ reform that worked with the grain of America's market-based system but which Republicans successfully targeted as unjust. 这一计划吸引了因奥巴马医改计划而受创的民主党人，奥巴马医改是一场渐进式的改革，这与美国市场经济体制一致，但共产党人却将其视为不公正。

To avoid repeating the same mistake, the thinking goes, Democrats need a big-bang reform that cannot be unpicked later. 按照这种思路，为避免重蹈覆辙，民主党人需要一项以后不能被取消的大改革。

Its backers point to polls showing overwhelming support for Medicare for all. 支持者指出，民调显示全民医疗获得了压倒性支持。

 

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