根據(jù)新的研究，全民醫(yī)保每年將拯救68,000多人的生命，節(jié)省4500億美元

根據(jù)新的研究，全民醫(yī)保每年將拯救68,000多人的生命，節(jié)省4500億美元

Epidemiologists from the Yale School of Public Health, University of Florida, and University of Maryland School of Medicine, have calculated that a single-payer universal health-care system in the US would likely lead to a 13 percent saving in national health-care expenditure and prevent more than 68,000 unnecessary deaths. By replacing premiums, deductibles, co-payments and out-of-pocket costs with a progressive tax system, Medicare for All will not only save the average family around $2,400 a year, but also give lower-income families access to the services they need, the researchers say.

耶魯大學(xué)公共衛(wèi)生學(xué)院、佛羅里達(dá)大學(xué)和馬里蘭大學(xué)醫(yī)學(xué)院研究人員說(shuō)，在美國(guó)，單一支付款的全民醫(yī)療保健系統(tǒng)可能會(huì)使全國(guó)醫(yī)療保健開(kāi)支節(jié)省13%，并避免6.8萬(wàn)多不必要的死亡。通過(guò)用累進(jìn)稅制取代保險(xiǎn)費(fèi)、免賠額、共同支付和自付費(fèi)用，全民醫(yī)保不僅將為普通家庭每年節(jié)省大約2400美元，而且還將使低收入家庭獲得他們需要的服務(wù)。

Katy Pallister

Published in The Lancet, the study first sets out the current state of affairs. Over 78 million Americans (24 percent of the US population), do not have adequate access to care. This number includes over 37 million Americans who have no health insurance at all. However, the situation could get worse. “The move to repeal the Affordable Care Act by the Trump administration will further jeopardize the health care of 21 million Americans,” the researchers warned in the paper, which would “exacerbate health-care inequities.”

發(fā)表在《柳葉刀》雜志上的這項(xiàng)研究首先闡述了當(dāng)前的情況。超過(guò)7800萬(wàn)美國(guó)人(占美國(guó)人口的24%)沒(méi)有足夠的醫(yī)療服務(wù)。這個(gè)數(shù)字包括3700多萬(wàn)沒(méi)有醫(yī)療保險(xiǎn)的美國(guó)人。然而，情況可能會(huì)變得更糟。“特朗普政府廢除《合理醫(yī)療費(fèi)用法案》的舉動(dòng)，將進(jìn)一步危及2100萬(wàn)美國(guó)人的醫(yī)療保障，”研究人員在論文中警告說(shuō)，這將“加劇醫(yī)療不公平”。

A single-payer, universal health care system in the U.S. would save >68,000 lives and more than $450 billion annually, writes YSPH Prof. Alison Galvani and colleagues in the current issue of The Lancet.

YSPH教授Alison Galvani及其同事在最新一期的《柳葉刀》雜志上寫道，美國(guó)的單一付款人全民醫(yī)療體系每年將拯救6.8萬(wàn)人的生命，節(jié)省4500多億美元。

Already the USA ranks poorly for many public health indicators, such as preventable deaths, infant survival, and maternal mortality, given its national health expenditure is higher than any other country. Repealing the Affordable Care Act would result in an additional loss of more than 38,500 lives, the team writes in their paper. However, employing the Medicare for All Act would save over 68,500 lives, compared to the status quo.

美國(guó)在許多公共衛(wèi)生指標(biāo)上的排名已經(jīng)很低，比如可預(yù)防的死亡、嬰兒存活率和產(chǎn)婦死亡率，因?yàn)槊绹?guó)的國(guó)家衛(wèi)生支出高于其他任何國(guó)家。該小組在他們的論文中寫道，廢除《合理醫(yī)療費(fèi)用法案》將導(dǎo)致38500多人的額外死亡。然而，與現(xiàn)狀相比，實(shí)施全民醫(yī)療保險(xiǎn)法案將挽救68,500條生命。

This life-saving effect that the Medicare for All Act would achieve is calculated from just one group of people: those that are uninsured. In this group, people are reported to experience a 40 percent elevation in age-specific mortality risk. If all Americans became insured, the universal coverage would save tens of thousands of lives, and around 1.73 million life-years annually.

《全民醫(yī)療保險(xiǎn)法案》所能達(dá)到的這種拯救生命的效果，僅僅是從一群人身上計(jì)算出來(lái)的:那些沒(méi)有保險(xiǎn)的人。在這一組中，據(jù)報(bào)道，人們?cè)谔囟挲g的死亡風(fēng)險(xiǎn)方面提高了40%。如果所有美國(guó)人都上了保險(xiǎn)，全民醫(yī)保每年將挽救數(shù)萬(wàn)人的生命，并可延長(zhǎng)約173萬(wàn)年的壽命。

Accompanying the paper is an interactive tool, called the Single-Payer Healthcare Interactive Financing Tool (SHIFT). Here, the economics of the Medicare for All Act can be analyzed using a number of parameters involving the health-care budget, expansion in service use, and revenue generation. Across a wide range of assumptions, projections from SHIFT indicate net savings for the health-care system. In the researchers' base case the savings would include $59 billion on hospital care, $23 billion on physician and clinical services, $217 billion on overheads and $177 billion on prescription drugs.

本文附帶了一個(gè)交互式工具，稱為單一支付者醫(yī)療保健交互式融資工具(SHIFT)。在這里，全民醫(yī)療保險(xiǎn)法案的經(jīng)濟(jì)效益可以通過(guò)一系列參數(shù)進(jìn)行分析，這些參數(shù)包括衛(wèi)生保健預(yù)算、服務(wù)使用的擴(kuò)大和收入的產(chǎn)生。通過(guò)一系列廣泛的假設(shè)，SHIFT公司的預(yù)測(cè)表明，醫(yī)療系統(tǒng)將會(huì)有凈節(jié)省。在研究人員的基本情況下，將節(jié)省590億美元的醫(yī)院護(hù)理，230億美元的醫(yī)生和臨床服務(wù)，2170億美元的日常開(kāi)支和1770億美元的處方藥。

Previous objections to Medicare for All based on the expectation of rising costs are mistaken, write the authors. Although further opposition from health insurance and pharmaceutical industries should be expected, the authors believe that “the moral imperative to provide health care as a human right, not dependent on employment or affluence,” should counterbalance any concerns.

作者寫道，先前基于成本上升預(yù)期而反對(duì)全民醫(yī)療保險(xiǎn)是錯(cuò)誤的。盡管醫(yī)療保險(xiǎn)和制藥行業(yè)可能會(huì)進(jìn)一步反對(duì)，但作者認(rèn)為，“提供醫(yī)療服務(wù)作為一項(xiàng)人權(quán)的道義責(zé)任，而不是依賴于就業(yè)或富裕”，應(yīng)該能夠抵消任何擔(dān)憂。

Lead author of the study Professor Alison Galvani shared a clip of Democrat presidential nominee candidate Bernie Sanders discussing the paper in Carson City, Nevada at the weekend on Twitter.

該研究的主要作者Alison Galvani教授周末在推特上分享了民主黨總統(tǒng)候選人伯尼·桑德斯在內(nèi)華達(dá)州卡森市討論該論文的一段視頻。