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THE ORGANIZATION AND FINANCING OF TODAY'S MEDICINE
当代医疗制度与资金投入
Patients, as well as their representatives in government, industry, and managed-care organizations, are concerned about the rising cost of medical care.
政府、产业、管理型医疗保险代表以及病患都对不断增加的看病价格给予了高度关注。
The total bill for health care in America now rises at a rate of about 10 per cent per year, an increase that seems to continue unabated.
在美国，医疗开销以每年10%的价格增长，而这一趋势还将继续下去。
Federal legislation instituting diagnosis-related groups (DRC's) has clearly moderated the rise of hospital costs, but physician costs continue to rise at an ever-increasing rate.
联邦立法已经开设了诊断相关组，并已经降低了医院开销，但是内科医生的开销仍然在不断增加。
Every student of medicine should ask if this is realistic.
每一名医学学生都在问这是不是真的。
Is it sustainable? Is it defensible?
是可持续性的？还是有可解决的办法？
What will be the limits?
范围到底在哪？
Patients already ask, “Can I really afford the best doctors in the most prestigious practices, in the most famous medical centers?”
病患在问，“我能去最好的医疗中心，最好的科室，找最好的医生看病吗？”
“Can I afford to be referred to a subspecialist?”
我有钱去看那些专业医师吗？
“Can I afford to be out of work and in the hospital?”
我能支付得起不上班在医院看病的开销吗？
“Can I afford to pay my rising insurance premiums?”
“我有钱支付不断增长的保险吗？”
“How much deductible on my insurance can I afford?”
“保险中的扣除条款我能支付得起多少？”
Worse yet, an increasing number of patients have to make choices between seeking medical and dental care and getting food, clothing, shelter, and other essentials of daily living.
更糟糕的是，有许许多多的病患不得不在看病，看牙和基本日常生活之间做出选择。
These issues have become major concerns in American households and clearly represent one of the most disturbing weaknesses in our economy,
这些问题已经成为美国家庭关心的主要问题,并且是美国经济中最令人担心的薄弱环节，
of which now nearly 12 per cent ( by annual gross national product) is devoted to health care, up from 8 per cent in 1975.
医疗费用所占每年国民生产总值的比例已由1975年的8%增加到现在的12%。
Over the last two to three decades it has been a goal of the United States to promote ever increasing quality and cost-effectiveness of health care for all.
在过去的二三十年中，美国的目标就是要为全体民众提供质量高，成本高效益的医疗制度。
Unfortunately, we have failed miserably.
不幸的是，我们遭遇了惨败。
The USA spends more per capita on health care than any other nation in the world.
美国是全球个人医疗开销最大的国家。
Yet in the major indices of health our population ranks nineteenth！
但是在主要医疗指数上，美国民众排在了第19位！
At the same time we continue to see a wasteful maldistribution of physicians both by specialty and geographically and a growing number of medically indigent and medically uninsured people in our nation.
与此同时，无论在专业还是在地域上，内科医生的分配不合理，没有保险，没钱看病的人数还在不断增加。
Somehow, the costs of what we are trying to achieve—even though the goal is commendable — are not being placed in proper perspective by the medical profession, health-care managers, and representatives of the people in order to provide suitable care for all.
尽管我们要实现的目标值得赞扬，但是我们要实现的看病价格并没有得到医疗人士、医疗卫生监管人士、以及代表的认真对待。
Unfortunately，in the present system the real needs of the populace are not always met by affordable services.
不幸的是，就目前的制度而言，大众所能够支付得起的医疗费用无法满足人们的要求。
At the same time, overutilization of medical services may be the very engine that drives up the total cost of health care delivery.
与此同时，医疗服务的过度使用或许也是增加医疗费用的引擎。
With the passage of the Medicare program for the elderly and the Medicaid plan for the poor by Congress in 1965,
1965年，美国国会通过了补助老人的退休医疗福利，以及补助穷人的穷人医疗补助，
we had hoped as a nation that we were moving toward a more just and efiicient system.
我们希望美国的医疗系统能够变得更加公正，更加有效。
In fact, the opposite has been the trend.
但是事实上，我们却背道而驰。
This societal goal must now be readdressed reformulated, and restructed in terms of modern needs,
就社会需求来讲，我们应该通过重组来实现社会目标，
reflecting fairly and fully measured cost-benefit ratios for every form of medical service.
全面反映医疗服务的成本与效益比例。
译文属可可英语原创，未经允许，不得转载。
