VOA标准英语2013--缺少改革奥巴马医改将带来更高成本

 

Without Reform, Obamacare Could Raise Health Care Costs

Since enrollment² began in the new U.S. health care program known as "Obamacare" last week, thousands of uninsured Americans have been signing up for coverage³ - even while Congressional opponents have partially⁴ shut down the government in a bid to repeal⁵ the law.  This initial success at expanding coverage could end up alienating⁶ the vast majority of Americans by significantly raising their healthcare costs.

The Affordable⁷ Care Act - popularly known as "Obamacare" - makes it possible now for James Matthews to get coverage through the expanded federal Medicaid program for low income families - even though he has been diagnosed with diabetes⁸.

“I’m excited to know that they can’t use that pre-existing condition as a way to discriminate⁹ against me and not provide insurance or to limit my coverage because I do have diabetes,” he said.

And Ny Whitaker, a self-employed single mother, will now receive a federal subsidy¹⁰ so she can purchase private insurance  being offered on newly created health exchanges.

“I think it’s time for us to just take care of our citizens and make sure everyone is insured and we have a level playing field.” she said.

But if Obamacare is successful only in expanding coverage to those in need of health care, the program will likely fail in the long run.

Christopher Condeluci is a former counsel to the Senate Finance Committee that helped develop the Affordable Health Care Act.

“If more people are covered by health insurance and they utilize¹² health care services to a much greater degree than we would have ever expected, that’s going to put inflationary pressure on health care spending and that’s going to increase the cost of health care overall and that’s going to impact everybody,” he said.

That's why the health care law mandates¹³ that even young healthy individuals must enroll¹ to share the costs - or pay a fine if they do not already have health insurance.

But Condeluci said because it was now illegal for insurance companies to refuse coverage, many healthy people may just pay the $95 fine, or one percent of their salary whichever was greater, and then joined a plan if they became sick.

“There is a bit of a moral hazard. Somebody goes without health insurance but yet can get it when they get sick.  That results in adverse¹⁴ selection or that results in higher utilization¹⁵ of medical services which raises costs for everybody across the board,” said Condeluci.

Obamacare is based on the successful system developed in the northeastern state of Massachusetts under then-Republican Governor Mitt¹¹ Romney.  But Romneycare, as it's called, can impose greater penalties for non-compliance. 

Condeluci said reforms were needed to make Obamacare economically viable¹⁶ in the long term. But in these politically divisive times, they are unlikely to be enacted¹⁷.

1 enroll   

v.招收；登记；入学；参军；成为会员（英)enrol

参考例句：

• I should like to enroll all my children in the swimming class.我愿意让我的孩子们都参加游泳班。
• They enroll him as a member of the club.他们吸收他为俱乐部会员。

2 enrollment   

n.注册或登记的人数；登记

参考例句：

• You will be given a reading list at enrollment.注册时你会收到一份阅读书目。
• I just got the enrollment notice from Fudan University.我刚刚接到复旦大学的入学通知书。

3 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。

4 partially   

adv.部分地，从某些方面讲

参考例句：

• The door was partially concealed by the drapes.门有一部分被门帘遮住了。
• The police managed to restore calm and the curfew was partially lifted.警方设法恢复了平静，宵禁部分解除。

5 repeal   

n.废止，撤消；v.废止，撤消

参考例句：

• He plans to repeal a number of current policies.他计划废除一些当前的政策。
• He has made out a strong case for the repeal of the law.他提出强有力的理由，赞成废除该法令。

6 alienating   

v.使疏远( alienate的现在分词 )；使不友好；转让；让渡（财产等）

参考例句：

• The phenomena of alienation are widespread. Sports are also alienating. 异化现象普遍存在，体育运动也不例外。 来自互联网
• How can you appeal to them without alienating the mainstream crowd? 你是怎么在不疏忽主流玩家的情况下吸引住他们呢？ 来自互联网

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 diabetes   

n.糖尿病

参考例句：

• In case of diabetes, physicians advise against the use of sugar.对于糖尿病患者，医生告诫他们不要吃糖。
• Diabetes is caused by a fault in the insulin production of the body.糖尿病是由体內胰岛素分泌失调引起的。

9 discriminate   

v.区别，辨别，区分；有区别地对待

参考例句：

• You must learn to discriminate between facts and opinions.你必须学会把事实和看法区分出来。
• They can discriminate hundreds of colours.他们能分辨上百种颜色。

10 subsidy   

n.补助金，津贴

参考例句：

• The university will receive a subsidy for research in artificial intelligence.那个大学将得到一笔人工智能研究的补助费。
• The living subsidy for senior expert's family is included in the remuneration.报酬已包含高级专家家人的生活补贴。

11 mitt   

n.棒球手套，拳击手套，无指手套；vt.铐住，握手

参考例句：

• I gave him a baseball mitt for his birthday.为祝贺他的生日，我送给他一只棒球手套。
• Tom squeezed a mitt and a glove into the bag.汤姆把棒球手套和手套都塞进袋子里。

12 utilize   

vt.使用，利用

参考例句：

• The cook will utilize the leftover ham bone to make soup.厨师要用吃剩的猪腿骨做汤。
• You must utilize all available resources.你必须利用一切可以得到的资源。

13 mandates   

托管（mandate的第三人称单数形式）

参考例句：

• Individual mandates would require all people to purchase health insurance. 个人托管要求所有人都要购买健康保险。
• While I agree with those benefits, I'm not a supporter of mandates. 我同意上述好处，我不是授权软件的支持者。

14 adverse   

adj.不利的；有害的；敌对的，不友好的

参考例句：

• He is adverse to going abroad.他反对出国。
• The improper use of medicine could lead to severe adverse reactions.用药不当会产生严重的不良反应。

15 utilization   

n.利用，效用

参考例句：

• Computer has found an increasingly wide utilization in all fields.电子计算机已越来越广泛地在各个领域得到应用。
• Modern forms of agricultural utilization,have completely refuted this assumption.现代农业利用形式，完全驳倒了这种想象。

16 viable   

adj.可行的，切实可行的，能活下去的

参考例句：

• The scheme is economically viable.这个计划从经济效益来看是可行的。
• The economy of the country is not viable.这个国家经济是难以维持的。

17 enacted   

制定（法律），通过（法案）( enact的过去式和过去分词 )

参考例句：

• legislation enacted by parliament 由议会通过的法律
• Outside in the little lobby another scene was begin enacted. 外面的小休息室里又是另一番景象。 来自英汉文学 - 嘉莉妹妹