美国医疗保障体制改革评析

美国医疗保障体制处于不断改革之中。克林顿政府试图推动的改革方案的核心是引入社会保险的要素，建立一个雇主缴费型的强制性医疗计划，从而实现全民医疗保障覆盖。该方案由于受到社会各界的普遍反对而被国会否决。小布什政府主张从推广健康储蓄账户、引入联合健康计划、改革医疗责任事故相关法律制度和采用新信息技术来改革美国的医疗保障体制。其医疗改革方案注重通过制度创新来降低医疗保险费用和减少医疗费用的浪费。但改革的最终结果，尚取决于医疗储蓄账户的运行效果及其规模、病人能否具有评估医疗服务质量的能力以及改革方案能否真正、有效地控制费用上涨这几个问题的真正解决。

Comments on Health Care System Reforms in America

American health care system is a typical market-based system.Its health care system is characterized by marketization,diversity,complexity and mixedness.Meanwhile,it is faced with such problems as dramatic increase in health expenditure,relative inefficiency and lack of equity.To solve these problems,its health care system is under constant reform.This paper first analyzes the problems in American health care system,then mainly introduces Clinton Administration's Health Care Reform Proposal in 1990s and Bush Administration's Reform Plans,and finally makes comments on these reforms.