MS: As a nation, America seems to want it all. Patients want the best medical treatment, but are shocked when the bill comes in.
Jereen Williams: We started getting these, you know, surprise bills. And I thought, “Wait a minute, you know, we're insured!”
MS: Doctors want to provide the latest medical treatment, but say reimbursements they receive from health insurance companies are not enough to cover their expenses or keep them in practice.
DE: There's going to have to be some type of arrangement in the way doctors are paid.
MS: Small business owners say they want to provide medical coverage for their employees, but are finding it hard to sustain their share of the cost.
Amy Milstead-Ellzey, Vice President, Milstead Automotive: It's terrible! We can't afford a 44% increase on medical insurance, so that in turn makes us have to start looking elsewhere for different plans. It makes us have to cut the plan back some.
MS: Nationwide, polls have shown that most Americans want improvements made in their healthcare system. President Barack Obama has signaled to Congress that decades of rising cost for a medical system which does not treat everyone fairly must end.
BO: The cost of our healthcare has weighed down our economy and our conscience long enough. So, let there be no doubt, healthcare reform cannot wait, it must not wait, and it will not wait another year!
MS: Jonathan Weiner is a professor of health policy at the Johns Hopkins School of Public Health in Baltimore, Maryland. He says the biggest challenge in health reform is making sure that everyone is included; that no American be shut out from some kind of medical coverage, whether it be private insurance or government-funded, because of a pre-existing medical condition or low income.
JW: For the many - 40, 50 million of Americans that don't have insurance - of course, that's the Number One issue: getting them covered. And without a health insurance card, it's not as if we don't care for people without insurance cards, the care is sporadic and often incomplete. And they get half the healthcare that those of us with insurance cards get.
MS: Weiner believes the eventual legislation will include the working poor, who earn too much to qualify for the government assistance program called Medicaid. He says they will be enrolled in some kind of other public option program or private insurance plan.
JW: That's going to be one of the most positive changes in healthcare that I think every American should be very pleased to see: that health insurers must take you, without regard to your disease.
MS: Weiner also says for too long, the American healthcare system has paid medical fees based on the severity of the patient's illness, and far less for prevention of chronic diseases.
JW: Right now, doctors get paid more and more for ordering tests. The sicker their patients become, the more they get paid. We need to shift to a system that rewards efficiency, rewards making people healthy.
MS: President Obama says his healthcare proposals would cost about $900 billion over the next decade, funded in part by money already allocated in the existing healthcare system. Critics say the existing system is wasteful, inefficient, full of unnecessary administrative costs, and steered by poor management. Patients and their insurers, they say, pay inflated prices for medical care that is sometimes not appropriate, as well as for the care of others who are uninsured. In a joint address to the U.S. Congress on September 9, President Obama said it has been almost a century since another president, Theodore Roosevelt, first called for healthcare reform.
BO: I understand how difficult this healthcare debate has been. I know that many in this country are deeply skeptical that government is looking out for them.
MS: It could be months before some kind of consensus is reached on healthcare reform; if it is reached at all. Melinda Smith, VOA News.
标题
U.S. Healthcare System Debate (VOA)
视频介绍
Voice of America - June 17, 2009
U.S. doctors want to provide the latest medical treatment, but say reimbursements they receive from health insurance companies are not enough to cover their expenses.
Speaker #1: Melinda Smith (MS), Reporter, VOA News
Speaker #2: Dr. David Ellington (DE), Primary care physician, Lexington, Virginia
Speaker #3: Barack Obama (BO), President of the United States of America
Speaker #4: Jonathan Weiner (JW), Professor of Health Policy, Johns Hopkins School of Public Health
