转载：Feldstein关于医疗保险的文章

Faith

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http://zuyeyeblog.spaces.live.com/Blog/cns!41919DE4E9624322!174.entry

Mankiw的Blog引用了他在哈佛的同事Feldstein的一篇关于医疗改革的文章(链接)。下面是Feldstein关于目前政府支付的医疗保险的看法

“Government now pays for nearly half of all health care in the U.S., primarily through the Medicare and Medicaid programs. The White House predicts that the aging of the population and the current trend in health-care spending per beneficiary would cause government outlays for Medicare and Medicaid to rise to 15% of GDP by 2040 from 6% now. Paying those bills without raising taxes would require cutting other existing social spending programs and shelving the administration's plans for new government transfers and spending programs.”
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“The rising cost of medical treatments would not be such a large burden on future budgets if the government reduced its share in the financing of health services. Raising the existing Medicare and Medicaid deductibles and coinsurance would slow the growth of these programs without resorting to rationing.”

和我前两天关于美国医疗改革的看法一样，Feldstein也认为要么增加税收，让美国进入欧洲那样的社会福利制度，要么减少政府提供的医疗保险福利，不然政府就要破产了。和我一样，Felstein也相信由政府垄断提供医疗服务不是什么好的解决方案。另外他提到了英国的全民医疗保险。英国政府决定什么疾病“值得”治疗，什么“不值得”。对于费用太高的疾病，政府不会支付治疗费用。我曾经在英国呆过几个月。室友告诉我政府提供的医疗服务质量极差。头痛脑热的小病排队要排半天。生大病也要排队不说，住院了还要和若干人共用一个病房。所以很多人尽管有名义上的全民医疗保险，仍然又买了私人提供的保险。这就是典型的供不应求现象。需求和供给没法对应而价格又不让调整来出清市场，大家只能通过排队来分配资源。

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