浅析美国医改的效益及借鉴意义

美国于当地时间2010年3月21日通过了酝酿已久的医改法案,本法案的通过成为美国各界普遍关注的焦点,也引起了世界各国的关注。为了使人们能够从卫生政策角度了解这项法案,本文从社会效益和经济效益两方面对医改法案作了介绍,包括:保险支付、保险公司责任、药品补贴、人力资源配置、公共卫生、服务质量、税收、保险欺诈和成本控制。分析了美国医改对中国医改的借鉴意义,提出了适当加大政府对大病、慢病和弱势群体卫生投资的重要性。同时卫生服务系统的规划要考虑成本控制措施,如加强预防和疾病控制、减少浪费和诱导需求。在卫生改革过程中引入质量管理手段和医疗信息化管理是医疗卫生发展的趋势,也是中国卫生事业管理发展的必由之路。

The benefits of healthcare reform in United States and its implication to China

On March 21,2010,United States passed the long-awaited healthcare reform bill. The bill has become the center of attention among all stakeholders both in US and worldwide. This paper introduces the social and economic benefits of the US healthcare reform from health policy perspectives,including insurance payment,the responsibilities of insurance companies,Medicare Part D drug reimbursement,staffing,public health,quality of care,taxation,insurance fraud and cost control. The lessons China could learn from the US healthcare reform are discussed. Authors stress the importance of increasing government funding for costly treatment,chronic diseases,and the uninsured that needs financial aids during China＇s healthcare reform. In addition,strategic planning also needs to include cost containment mechanisms,such as health promotion and disease prevention,reduction of waste,fraud and physician-induced demands. It is essential to consider quality improvement and implementation of health information technology in the healthcare reform and the sustainability of healthcare management in China.