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Now to another major piece of this bill, Healthcare.
现在谈谈该法案的另一个主要部分，医疗保健部分。
As part of the package, Democrats are within reach of a longtime goal, allowing Medicare for the first time to negotiate drug prices that would start in 2026.
作为一揽子计划的一部分，民主党人即将实现一个长期目标，即首次允许美国联邦退休老人医疗保险(Medicare)从2026年开始就药品价格进行谈判。
48 million Americans get prescription drugs through Medicare part D nearly a third of all prescription spending in 2017, but Medicare has had no ability to negotiate prices.
2017年，4800万美国人通过联邦老年医疗保险药物计划获得处方药，占所有处方药支出的近三分之一，但联邦医疗保险无法谈判价格。
This bill would change that for some drugs.
这项法案将在这一点上改变某些药物。
The bill would also cap out of pocket drug costs for those on Medicare.
该法案还将限制那些参加联邦老年医保的人的药费支出。
And it increases help for low income families with new subsidies and extends affordable care act subsidies for the next three years.
它还通过新的补贴增加对低收入家庭的帮助，并在未来三年延长平价医疗法案的补贴。
Stacey do set Xena, associate professor of health policy at the Vanderbilt University School of Medicine, joins me now to discuss what all this means.
范德比尔特大学医学院卫生政策副教授史黛西·杜塞特·西纳现在和我一起讨论这一切的意义。
Stacy let me just ask you the big question.
史黛西，让我问你一个重要的问题。
How significant is this in healthcare?
这一改变在医疗保健领域有多重要。
This is a really big step forward in the Medicare program in particular.
这尤其是在联邦医保计划方面迈出了一大步。
So I would say huge.
所以我会说迈出了很大的一步。
Let's talk about it specifically, then so the drug market and Medicare's ability to now negotiate some prices.
让我们具体谈一谈，药品市场，联邦医保现在谈判一些价格的能力。
Some is this too limited to really affect the overall drug market.
有些实在太有限了，不能真正影响整个药品市场。
And then also, what do we expect manufacturers to do?
我们期望制造商做些什么？
Could they raise prices for everyone else?
他们会提高所有人的价格吗？
Very good questions.
非常好的问题。
Um, so this is a modest start, but I think you have to put it in context of the fact that when the Medicare part D program was first devised, they were banned explicitly from negotiating for drug prices.
嗯，所以这是一个温和的开始，但我认为你必须把它放在一个事实的背景下，当联邦退休老人医疗保险药物计划最初被设计时，他们被明确禁止就药品价格进行谈判。
So this is a huge step towards bringing drug price negotiation into the program.
因此，这是将药品价格谈判纳入该计划的一大步。
For the first time, it is a modest start.
这是第一次，这是一个温和的开始。
But part of that is to recognize the fact that we have limited information and research to understand the effects on innovation.
但部分原因是要认识到这样一个事实，即我们只有有限的信息和研究来了解创新的影响。
So this is a way to give us experience with drug prices, negotiation and to understand the balance that that takes when it comes to investment in the industry and about men of new drugs.
所以这是一种让我们在药品价格和谈判方面积累经验的方式，并且理解在涉及到对这个行业的投资和新药研发人员时所需要的平衡。
So for new drugs coming onto the market, they would have the ability to increase their prices.
因此，对于即将上市的新药，他们有能力提高价格。
But for existing drugs, they will also includes limits on price increases to the rate of inflation.
但对于现有的药品，还将包括对价格涨幅与通货膨胀率的限制。
And that again is a new policy for Medicare.
这也是联邦退休老人医疗保险的一项新政策。
It's something that we've had in the Medicaid program and has (reduced) resulted in a lot of savings for that program.
这是我们在医疗补助计划中已经有了的，并且已经为这个项目节省了很多钱。
So this would be a risk for brand new drugs, but not necessarily for any drugs that currently are on the market.
所以这对全新的药物来说是一个风险，但对目前市场上的任何药物来说都不一定。
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