奥巴马演讲 俄亥俄州民宅谈经济9
文章来源:未知 文章作者:meng 发布时间:2010-08-23 07:31 字体: [ ]  进入论坛

Q    Thank you.  I’m the practice manager at an ophthalmology(眼科学) practice at the Eye Center of Columbus, downtown(市中心区) .  It is a great facility that the city of Columbus helped us get in place.  There are over 30 ophthalmologists providing specialty1 care in separate practices, a state-of-the-art ambulatory(流动的,走动的) surgery center.  We see tens of thousands of patients a year.  And I think we do a very efficient job of providing quality care, over 300 people employed.  So I’m kind of on both sides of health care.

And when I started working for this practice 25 years ago, we are now getting reimbursed3 one-third of what we got paid for  -- I’m just going to pick cataract4(白内障) surgery -- yet our operating costs continue to go up.  My boss is kind enough to provide health care costs entirely5 for all of his employees.  How does he continue to do that when Medicare continues to reduce what they're paying, and there’s the threat of more cuts coming and the private insurance companies follow suit(跟着做) ?

THE PRESIDENT:  Well, it’s a great question.  And let me talk about Medicare generally.  Medicare I think is one of the cornerstones of our social safety net.  The basic idea is, you’ve been working all your life, you retire; just like you’ve got Social Security that you can count on, you’ve also got health care that you can count on and you’re not going to go bankrupt just because you get sick.

But in the same way that Social Security has to be tweaked(扭,拧) because the population is getting older, we’ve got to refresh and renew Medicare to make sure that it’s going to be there for the next generation, as well.  And the key problems are not just that more people as they retire are going to be part of Medicare.  The big problem is just health care inflation generally.  The costs of health care keep on skyrocketing.

Now, the way we’ve been dealing6 with it, which I think is the wrong way to deal with, is basically under-reimbursing our providers.  The right way to deal with it is to work with the providers to figure out how can we make the system less wasteful7, more efficient overall.  And that way we’re paying -- your boss, if he’s spending a dollar on care, he’s getting reimbursed(偿还,赔偿) a dollar.  But we’re also making sure that the care he’s providing is exactly what the person needs, and high quality for a better price.

And that’s part of what health care reform was all about.  I’ll just give you a couple examples.  One of the things that we were doing in Medicare was we were giving tens of billions of dollars of subsidies8(补贴,津贴) to insurance companies under the Medicare Advantage plan, even though that plan wasn’t shown to make seniors any healthier than regular old Medicare.

So we said, all right, we’re not going to end Medicare Advantage, but we are going to have some competitive bidding and we’re going to force the insurance companies to show us, well, what exactly -- what value are you adding?  How are you helping9 to make these seniors healthier?  And if you’re not helping, then you shouldn’t be getting paid.  We should be giving that money to the doctor and the nurse and the other people who are actually providing care, not the insurance companies.

Well, there was a lot of hue10 and cry about this, but it was absolutely the right thing to do -- because now we just found out -- the actuaries(精算师) for Medicare said the changes we’ve already made have extended the life of the Medicare trust fund for another 12 years -- which is, by the way, the longest it’s ever been extended as a consequence of a reform effort.

So we’ve made Medicare stronger just with some of the changes that we’ve already made.  But you’re absolutely right that we’re going to have to keep on making these changes to continue to make it stronger.  And that will affect not just Medicare; it will affect the entire health care system.

Because there’s no doctor out there who doesn’t see Medicare as the $800 gorilla11.  If Medicare is saying you’ve got to improve your quality and efficiency, then they will because they’ve got a lot of Medicare patients.  But they also have a lot of regular patients.  So hospitals, doctors, everybody starts getting more efficient as Medicare gets more efficient.  The key is making sure that we’re not just cutting benefits.

And, frankly12, this is an argument that I have with my friends in the Republican Party sometimes.  One big change that some of them have advocated is to voucherize the Medicare system. You basically -- instead of once you have Medicare, you knowing that you can take that and go get care anywhere you want, we would just give you -- all right, here is whatever it is, $6,000 or $7,000 or whatever.  You go shop and figure out what kind of best deal you can get.

The problem is, is that if Medicare costs -- if health care costs keep on going up but your voucher13(收据,证人) doesn’t keep on going up, you’re going to be in trouble.  And suddenly, you’ve got seniors who find themselves way short of what they need in terms of providing care.

We’ve got to change how the health care system actually operates.  And that means more prevention -- more preventive care.  It means better -- that we reimburse2(偿还,赔偿) people for checkups. It means we reimburse doctors when they’re consulting with people on things like smoking cessation(停止,中止) and weight control and exercise.

There are a whole bunch of things that can make us healthier, reduce our costs overall.  But unfortunately, the system doesn’t incentivize(鼓励,激励) them right now.  We need to change that.

Anybody have any last burning question?  That was technically14 the last question.  But this has to be like one that you’re just, man, I really need an answer for.


1 specialty SrGy7     
  • Shell carvings are a specialty of the town.贝雕是该城的特产。
  • His specialty is English literature.他的专业是英国文学。
2 reimburse 5Vixt     
  • We'll reimburse you for your travelling expenses.我们将付还你旅费。
  • The funds are supposed to reimburse policyholders in the event of insurer failure.这项基金将在保险公司不能偿付的情况下对投保人进行赔付。
3 reimbursed ca62e2177b2f3520aa42f86b71b836ce     
v.偿还,付还( reimburse的过去式和过去分词 )
  • Any out-of-pocket expenses incurred on the firm's business will be reimbursed. 由公司业务产生的开销都可以报销。 来自《简明英汉词典》
  • Employees are reimbursed for any legal fees incurred when they relocate. 员工调往异地工作时,他们可以报销由此产生的所有法律服务费用。 来自《简明英汉词典》
4 cataract hcgyI     
  • He is an elderly gentleman who had had a cataract operation.他是一位曾经动过白内障手术的老人。
  • The way is blocked by the tall cataract.高悬的大瀑布挡住了去路。
5 entirely entirely     
  • The fire was entirely caused by their neglect of duty. 那场火灾完全是由于他们失职而引起的。
  • His life was entirely given up to the educational work. 他的一生统统献给了教育工作。
6 dealing NvjzWP     
  • This store has an excellent reputation for fair dealing.该商店因买卖公道而享有极高的声誉。
  • His fair dealing earned our confidence.他的诚实的行为获得我们的信任。
7 wasteful ogdwu     
  • It is a shame to be so wasteful.这样浪费太可惜了。
  • Duties have been reassigned to avoid wasteful duplication of work.为避免重复劳动浪费资源,任务已经重新分派。
8 subsidies 84c7dc8329c19e43d3437248757e572c     
n.补贴,津贴,补助金( subsidy的名词复数 )
  • European agriculture ministers failed to break the deadlock over farm subsidies. 欧洲各国农业部长在农业补贴问题上未能打破僵局。
  • Agricultural subsidies absorb about half the EU's income. 农业补贴占去了欧盟收入的大约一半。 来自《简明英汉词典》
9 helping 2rGzDc     
  • The poor children regularly pony up for a second helping of my hamburger. 那些可怜的孩子们总是要求我把我的汉堡包再给他们一份。
  • By doing this, they may at times be helping to restore competition. 这样一来, 他在某些时候,有助于竞争的加强。
10 hue qdszS     
  • The diamond shone with every hue under the sun.金刚石在阳光下放出五颜六色的光芒。
  • The same hue will look different in different light.同一颜色在不同的光线下看起来会有所不同。
11 gorilla 0yLyx     
  • I was awed by the huge gorilla.那只大猩猩使我惊惧。
  • A gorilla is just a speechless animal.猩猩只不过是一种不会说话的动物。
12 frankly fsXzcf     
  • To speak frankly, I don't like the idea at all.老实说,我一点也不赞成这个主意。
  • Frankly speaking, I'm not opposed to reform.坦率地说,我不反对改革。
13 voucher ELTzZ     
  • The government should run a voucher system.政府应该施行凭证制度。
  • Whenever cash is paid out,a voucher or receipt should be obtained.无论何时只要支付现金,就必须要有一张凭据或者收据。
14 technically wqYwV     
  • Technically it is the most advanced equipment ever.从技术上说,这是最先进的设备。
  • The tomato is technically a fruit,although it is eaten as a vegetable.严格地说,西红柿是一种水果,尽管它是当作蔬菜吃的。
TAG标签: social Obama medicare