在美国利润至上的医疗体系里，像巴迪亚医生(Dr. Luis Padilla) 这种对金钱置之不顾的医生非常少见。巴迪亚在华盛顿一个困厄潦倒的贫民区，哥伦比亚岭，做医生。他的病人大多数没有医疗保险或只有不足够的保险。到他的《团结医疗中心》看病的，90% 以上的病人是黑人和拉丁裔。
可是他发现，这种现象已渐渐改变了，越来越多看病的是欧裔人了。这个新现象，是当前美国医疗系统正在加速变化的缩影。他说，“他们是我的《煤矿里的金丝鸟》(Canary in the coal mine 灾难来临的先兆)。这些欧裔病人本来是有保险的，但他们被解雇后失去了保险，他们来看病时，好几个月都没吃了药，健康情况已进入很严重的处境。如果他们需要乳房X 光照或癌症治疗，这些昂贵的医疗费谁能付出来呢？”
注： 此文章部分摘自加拿大环球邮报专栏作者KONRAD YAKABUSKI 2010年3月20日发表文章 (Obama makes final push for health bill) 和CNBC.com 同日文章(After Decades of Failure - New Health Law Seems Near).
Zhao Jun, You know what they say about opening a can of worms. Haha.
I can see you feel very strongly about this topic, and so do most Americans (on either side of the ideological divide), obviously.
It’s too bad we (that’s the “royal” we, since Canadians don’t get to vote on this one) don’t get to choose between the war in Iraq/Afghanistan and Health Care Reform.
(I know, I know, the “war” too,is a can of worms. And, I might also add, that one is a legacy of the 2 Bushes, )
The crux of the problem is that the U.S. budgetary challenge is simply too humongous.
Now let’s see everybody fight over this one (i.e. the budget deficit).
Having said that, I am glad, Zhao Jun, that you chose my forum to speak up.
TCW: I guess I should keep my mouth shut about this topic after the heated debate at my blog, but just can't resist to comment one more time on this topic because of your reference to Medicare and Social Security in the text and the reference to CBO projection. I agree with Ouyang Feng, the comparison of this "reform" and the Medicare and Social Security is such an ironic one, because the other two are both broken beyond repair and we all know that (interestingly, no one is talking about fixing the social security system - why? And now the Medicare is going to get cut to finance this health care reform). So the media's praise of Obama's achievement as "another milestone in US history, just like Medicare and Social Security", just amuses me. I'm sorry- I'm a bit cynical here.
In terms of CBO projection, I just heard the other day that CBO "projected" in 1965 (the year Medicare was passed) that in 2010 (incidently, this year) the total spending of the Medicare system will be $60 billion. Guess how much the actual cost will be this year? $480 billion - 8 times their projection!!! I know out of all the federal agencies, the bipartison CBO's projections are the most reliable (isn't that scary? Just look at how the government keeps "adjusting" the unemployment rate every month, you know "cooking data" is not a specialty of the Chinese government), and projecting is a tricky game, I know, but doesn't that provide some context and caution if we just take their projection at the face value?
I have to say it again in the end, I'm all for providing healthcare for people who can't afford them, and I totally understand that if they don't have at least minimum coverage, the taxpayers are going to pay in the end one way or the other. I just don't think this way of creating an even bigger government agency and arbitrarily increasing tax (how do you impose "payroll tax" on income from divident, interest, and rental activities?!) is the way to do and is not sustainable at all. It will affect everyone pretty soon.
Sorry for the ranting. I just need to put those words out somewhere:)).
Sir/Madam, are you a Canadian? If you're not, then may I suggest you've been mis-informed? "Rethinking" is too strong a word. Universal health care is so entrenched here there would be riots in the streets if there was any hint of "rethinking". But it IS evolving. That's because cost containment is an important consideration. As will the U.S. version.
Please also see my answer to “buzz”.
Incidentally, the CBO projects a net surplus for the cost of health care reform over 10 years (though that estimate may be subject to debate), and the tax burden is to be borne largely by those making over $200,000/year.
Just for comparison, according to one estimate, the war in Iraq and Afghanistan has to-date cost $1.05 TRILLION and rising. Who do you thinking has been paying for that?
Ironicaly this article is written by a Canadian, whose country is rethinking its broken universal health care. Helping the poor is not mere chanting of "yes we can", and tax-hike will quickly effect to every citizen of USA.
I agree that healthcare must be taken care of. But it's such a profound reform, proper political consensus is very important. Railroading the opponents is a sure fire way to get into more trouble.
欧阳， You're absolutely right. Paying for entitlement programs is, as they say, always a "64,000-dollar question" (here's another English idiom for you, haha.) But, and this is a big BUT, if we believe in a humane society, then we must find the way. I think Obama (or whoever comes next) will begin to tackle it after Health care Reform. After all is said and done (that's another idiom), however, we cannot deny the historical significance of what President Johnson did. Don't you agree?
To remove "precondition exclusion", there must be universal insurance coverage. Otherwise it's just economically unfeasible. But to realize universal coverage, the cost must be covered (concealed) with other "reforms". So there is no easy solution.
It may not be good idea to equate Obamacare with Social Security or Medicare: both of these systems are in deep financial trouble now.
