美国医疗系统（American Medical System）
Medical system in the United States
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打主意There is a cour on medical policy that describes the structure and functioning of the American health care system, the interaction between patients and health care providers, and the role that they play in the health care system. The United States does not currently have a national health care system, and only two Medicare and Medicaid are federally managed medical organizations. Although they are part of social welfare, the former belongs to the elderly medical care, the latter to the disabled and low-income families.
The medical administration is cloly related to the daily lives of the American people, affecting the patterns of medical referral, the extent of physician prescribing, and the chances that patients will receive appropriate care. In the 90s, the American Medical System plunged into a dilemma of medical waste and unequal allocation of medical resources. Some have a complete health care who accept unnecessary medical rvices; while others have no insurance (1996, more than 40 million Americans without health insurance or medical insurance), is not perfect, they receive the necessary medical rvi
ces were deprived of their rights. Over the past few years, however, there has been a landmark change in the health care system in the United states. This major reform stems from a new concept, "Managed care"". Managed care has developed new interactions between American patients, insurance companies, and health
care workers.
Traditionally, employers for their employees to pay the medical insurance premium to the insurance company, the insurance company (the insurer) payment for medical rvice providers (including physicians, hospitals, home - care, nursing, home institutions or pharmacy). Under the system, the doctor decides what kind of treatment, treatment, and who should provide medical care. Medical costs are usually decided unilaterally by providers of medical rvices, and insurance companies simply pay medical bills. If the cost is too high, the insurance company will increa the premium for the following year (premium). Under the Managed care system, institutions that ttle patient health costs will play the role of managing patient care. Employers and insurance companies don't just pay medical bills. They also decide how much medical care they should give to patients, what medical rvices, and who should provide them with treatment. In other words, employers and insurance companies will determine the way health care providers receive income and how they pay. Therefore,
聚会玩的游戏 managed care can be said to be a major change in the American Medical system. In the past, medical professionals, especially physicians, decided that the rights of medical behavior were no longer. Doctors and employers, as well as insurance companies, share their decisions. This profoundly changed the doctor's role in the medical system.
肉糜炖蛋Payment system for medical care
There are four kinds of payment system in American Medical care:
1) out - of - pocket payment,
2) individual, private, insurance,
3) employment - bad group private insurance
天空之神4) government financing
The first is the simplest payment system - just as consumers buy goods and rvices directly. However, bad on veral characteristics, medical care is different from the general consumer behavior. For example, medical care is the basic human needs, and not a luxury; so if the patient is
unable to bear the medical expens, there must be a different from the out - of - Pocket payment system to help patients to pay for medical expens and medical needs; and expenditure cannot advance estimates and lection; and when patients receive treatment, often lack the treatment knowledge; not to mention the people do not know what time they will be hit by illness or injury.
The cond is private insurance - in addition to patients and medical staff, the insurance company is on the one hand to collect premiums, on the other hand, pay the patient's medical expens to the medical institutions.
The third is Employment--bad group private insurance - the employer pays all or part of the medical premium for the employer. Health insurance provides a mechanism for allocating medical resources to people who really need it, not on their ability to pay medical bills. In other words, the premium fund is redistributed from the healthy person to the patient, while
the health care system helps the person who cannot pay the medical expens to share their expens. However, the positive significance of health care in this respect has sometimes become its fatal injury. The original is to solve the Out - of - Pocket payment system, the patient can not afford the high medical costs will lead to control medical expens, but the dilemma. Becau under
情感语录与感悟
this system, patients don't have to pay for their own medical bills themlves, so virtually everyone will increa the number of visits. Together with medical institutions turning to insurance companies, they can easily rai medical costs. Therefore, bad on the consideration of business competition, insurance companies have to lower their premiums to attract young, healthy or low-risk groups. By contrast, the elderly and the sick are becoming less and less able to pay high premiums. In order to cope with the new problems, there are fourth kinds of payment systems, namely Tax - financed government health insurance: Medicare and Medicaid. Medicare's rvices are for the elderly, funded from social curity taxes, federal taxes, and premiums paid by beneficiaries. The Medicaid is run by the state government, targeting low-income people, with federal taxes and state taxes.
In our impression, the United States is a country with a sound social welfare system, and the medical care system should be no exception. But in 1996, nearly 1/6 of Americans had no medical insurance. The main reason is that in the employment--bad system, some employers are reluctant to insure their employees (the reason is rising year by year reduced premium and enterpri scale makes the employer cannot afford); or some people belong to non employees, or is in a state of temporary unemployment. Although the people could not
afford the premiums for private health insurance, they failed to meet standards that could benefit fro
m Medicare and Medicaid.
阿炳二胡As a result of the recent economic downturn, many people have been forced to change jobs, divorce or retire early becau they have been forced to retire by lay off,
初一周记500字Suspension or even permanent loss of coverage. But even with health insurance, most insurance companies now restrict access to the care they need. The reason is that in order to reduce expenditure, the insurance company does not cover certain treatments or examinations, such as injection prevention and mammograms. They also reject the cover pre-existing dia, and limit the amount of benefit (benefit), or adopt the co payment system.
Reimburment for medical expens (reimburments)
We mentioned different medical payment systems and the problem of high medical costs. The main reason for this problem stems from the high costs of medical and medical reimburment (reimburments) for physicians and hospitals. As a result, new approaches to reimburment are being developed to stem the growth of medical costs. And the new methods are the main features of managed care. The methods include:
tfboys偶像手记Fee-for-rvice, episode, of, illness, Diem, payment, capitation, salary (or, global, budget). In the form of reimburment for the first fee-for-rvice, the medical unit is paid on the basis of individual visits, EKG checks, or treatment procedures. Under the Payment per procedure system,
