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医保法令维权年老公民
Forty-five years ago, we made a solemn compact as a nation that senior citizens would not go without the health care they need.This is the promise we made when Medicare was born.And it’s the responsibility of each generation to keep that promise.四十五年前，我们郑重许诺要让我们国家的每一个年老公民获得应有的医疗保健。这是医疗保险诞生之初我们许下的诺言。也是每代人信守承诺的责任
That’s why a report iued this week by the Trus/tees who oversee Medicare was such good news.According to this report, the steps we took this year to reform the health care system have put Medicare on a sounder financial footing.Reform has actually added at least a dozen years to the /solvency ['sɒlvənsɪ] of Medicare – the single longest extension in history – while helping to preserve Medicare for generations to come.这也是为什么本周由医保监管第三方发布的报告是个好消息的原因。根据这份报告，今年以来我们在医疗保险系统所采取的一系列改革措施使得医疗保险获得了更加坚实的财政基础。改革实际增加了至少12年的医保偿付能力——这是历史上最长的单次延长——将为即将到来的数代人提供医疗保险。
We’ve made Medicare more /solvent by going after waste, fraud, and abuse – not by changing seniors’ guaranteed benefits.In fact, seniors are starting to see that because of health reform,their benefits are getting better all the time.在经历了浪费，欺诈和滥用之后，我们使得医保更有偿付能力——不是通过调整老人们已有的利益。实际上，通过医疗改革，一直以来，老人们获得了越来越好的医疗保健。
Seniors who fall into the ―doughnut hole很多医疗保险针对处方药所提供的补贴覆盖不到的部分‖ – the gap in Medicare Part D drug coverage ['kʌv(ə)rɪdʒ保险范围] – are eligible ['elɪdʒɪb(ə)l] 合格 right now for a $250(two hundred and fifty dollar)rebate ['riːbeɪt] to help cover the cost of their pres/criptions.[prɪ'skrɪpʃən]处方药
Now, I know for people facing drug costs far higher than that, they need more help.That’s why we negotiated谈判 a better deal with the pharmaceutical [,fɑːmə'suːtɪk(ə)l制药 companies for seniors.So starting next year, if you fall in the doughnut hole, you’ll get a 50-percent discount on the brand-name medicine you need.And in the coming years, this law will close the doughnut hole completely once and for all.陷入―甜甜圈漏洞‖——联邦医疗保险制度第四部分的处方药保险缺口——的老人们现在将有资格获得250美元的贴现以补偿他们在处方药上的支出。现在，我知道人民面对着远比这高 的药物支出，他们需要更多的帮助。这也是为什么我们为了老人们而与制药公司谈判以获得更好交易的原因。因此，从明年开始，如果你陷入甜甜圈漏洞，你将在你所需要的品牌药品上获得50%的折扣。在未来几年，该法律将一劳永逸的完全堵上这个甜甜圈漏洞。
Already, we have put insurance companies on notice that we have the authority to review and reject unreasonable rate increases for Medicare Advantage plans.And we’ve made it clear to the in/surers that we won’t hesitate to use this authority to protect seniors.我们已经告诫保险公司，我们有权审查和否决针对老人医疗保险优惠计划的不合理的费率调整。而且我们明确的告诉保险公司我们在保护老年人行使该项权力上绝不会犹豫。
Beginning next year, pre/ventive care – including annual physicals, wellne exams, and tests like mammograms ['mæməgræm] – will be free for seniors as well.That will make it easier for folks to stay healthy.But it will also mean that doctors can catch things earlier, so treatment may be le in/vasive and le expensive.从明年开始，预防保健——包括年度体检，身体检查，以及像乳房X射线检查之类的测试——也将对老年人免费。这将让人们更容易保持身体健康。但这同时也意味着医生们能更早发现苗头，而治疗也将具有更小的危害性花费也更便宜。
And as reform ramps up in the coming years, we expect seniors to save an average of $200 per year in premiums ['priːmɪəm]保险费 and more than $200 each year in out of pocket costs, too.在未来数年，随着改革的进一步推进，我们希望老人们每人每年能节省200美元的保险支出和200美元的自掏腰包支出。
This is poible in part through reforms that target waste and abuse and redirect those resources to where they’re supposed to go: our seniors.We’re already on track to cut improper payments in half – including money that goes to criminals who steal taxpayer dollars by setting up insurance scams and other frauds.And we won’t stop there.Because by preventing the lo of these tax dollars, we can both addre the runaway costs of Medicare and improve the quality of care seniors receive – and we can crack down on those who prey on seniors and take advantage of people.通过针对浪费和滥用以及重现配置这些资源到应该使用的地方：面向我们的老人，这是可以实现的。我们已经走上正轨，砍掉了一半的不合理支出——包括流向罪犯的钱，他们通过设计保险骗局和其他欺诈手段窃取纳税人钱财。我们不会在此止步。因为通过阻止这类的税金损失，我们不仅可以控制医疗保险的成本失控，而且可以改善老人们获得的保险的质量——我们将严厉打击那些掠食老人利益和占人民小便宜的人。
So we are no longer accepting busine as usual.We’re making tough艰难 decisions to meet the challenges of our time.And as a result, Medicare is stronger and more secure.That’s important.Because Medicare isn’t just a program, it’s a com/mitment to America’s seniors – that after working your whole life, you’ve earned the security of quality health care you can afford.As long as I am President, that’s a com/mitment this country is going to keep.Thank you.因此我们再也不会像往常一样接受现状。我们将做出艰难的决定来面对我们的挑战。作为结局，医疗保险制度将变得更加坚实更加安全。这很重要。因为医疗保险不仅仅是一项计划。这是对美国老年人的承诺——在你一生的努力工作之后，你应该享有你所能负担的安宁和高质量的医疗保健。只要我还是总统，国家将继续践行这项诺言。谢谢大家！
中国的新型农村合作医疗制度发展 国务院新闻办公室新闻发布会材料二
Material for the pre conference of the State Council Information Office II
The Development of
China's New Rural Cooperative Medical Scheme [skiːm]
2012年是新农合制度实施十周年。十年来，在各级党委、政府的高度重视和正确领导下，有关部门通力合作，农民群众积极参与，新农合制度建设扎实推进，取得了显著成效。
2012 marks the tenth anniversary of the implementation [ɪmplɪmen'teɪʃ(ə)n]实施 of the New Rural Cooperative Medical Scheme(NRCMS).Over the past decade, with Party Com/mittees and governments at all levels attaching great importance to NRCMS and under their strong leadership, relevant departments have given full cooperation and farmers have actively participated in the scheme.Therefore, NRCMS has made solid progre and remarkable achievements.一是实现全面覆盖，参合率稳定在较高水平。新农合制度自2003年开始试点，到2008年实现了全面覆盖，参合人口数从试点初期的0.8亿，逐年稳步增长，截至2012年6月底，参合人口达到8.12亿人，参合率达到95%以上。
First, NRCMS has almost realized universal coverage with the participation remaining stable at a high level.Since the pilot programs in 2003, NRCMS achieved a comprehensive coverage in 2008.The participation number has grown steadily every year, from 80 million in the early stage of the pilot programs to 812 million by the end of June 2012, with over 95% of the targeted population covered.二是筹资水平不断提高，保障能力逐步增强。新农合人均筹资水平由2003年的30元提高到2011年的250元。2011年，有13.15亿人次从新农合受益，次均住院补偿额为1894元。2012年，新农合政策范围内住院费用报销比例进一步提高到75%左右，最高支付限额提高到全国农民人均纯收入的8倍以上，且不低于6万。
Second, the financing continues to grow and the protection level improves gradually.The per capita
['kæpɪtə] cost of the insurance package increased from 30 yuan in 2003 to 250 yuan in 2011.In 2011, 1.315 billion person-times benefited from NRCMS with average hospitali/zation住院治疗 compen/sation补偿 amounting to 1,894 yuan.In 2012, the reimbursement [,ri:ɪm'bɜ:smənt]
报销for hospitali/zation costs will reach around 75%, with an annual payment ceiling上限 of no le than 8 times of farmer’s per /capita net income(no le than 60,000 yuan).三是确立了较为完善的符合中国国情的制度框架和运行机制。新农合建立了由政府领导，卫生部门主管，相关部门配合，经办机构运作，医疗机构服务，农民群众参与、费用补偿公开的管理运行机制；明确了以家庭为单位自愿参加，个人缴费、集体扶持和政府资助相结合的筹资机制；形成了以住院大额费用补偿为主，并逐步向门诊统筹扩展的统筹补偿模式，2011年在90%以上的地区开展了门诊统筹，参合农民受益范围更加广泛；建立了参合农民在统筹区域内自主就医、即时结报的补偿办法，2011年，已有超过2/3的省（区、市）实现新农合省市级定点医疗机构即时结报；建立了基金封闭运行机制和多方参与的监管机制；深入推进支付方式改革，2011年已有超过80%的地区开展了不同形式的支付方式改革，新农合制度合理有效控制医药费用的作用开始显现；积极推进商业保险机构参与经办新农合服务工作，探索―管办分开、政事分开‖的新农合管理运行机制。
Third, a comprehensive institutional framework and operational /mechanism ['mek(ə)nɪz(ə)m机制] is established in line with China's national conditions, i.e.led by the government;in the charge of health departments;supported by relevant sectors;operated by the insurance agencies;with services provided by the health institutions;participated by farmers and trans/parent透明 reimbursement[,ri:ɪm'bɜ:smənt]
报销of the medial costs.NRCMS is co-financed by individual contributions, farmers’ cooperatives and both central and local governments, with families participating on a voluntary basis.The coordinated compensation focuses on reimbursement[,ri:ɪm'bɜ:smənt]
报销for hospitalization costs and gradually expands to out-patient care.In 2011, over 90% of areas carried out out-patient compen/sation which benefited the farmers in a wider range.The insured farmers can choose independently the designated hospitals for treatment and get real-time reimbursement[,ri:ɪm'bɜ:smənt]
报销.In 2011, over 2/3 of provinces(autonomous[ɔː'tɒnəməs]
regions自治区 or municipalities[mjʊ,nɪsɪ'pælɪtɪ] 直辖市)adopted real-time reimbursement[,ri:ɪm'bɜ:smənt] 报销in their /designated制定 provincial and municipal [mjʊ'nɪsɪp(ə)l] hospitals市医院.The funds are operated in closed-end mechanism ['mek(ə)nɪz(ə)m机制]and supervised by multi-sectors.In 2011, over 80% of areas carried out various payment reforms, which supported NRCMS to effectively control the medical costs.Commercial insurance agencies are encouraged to involve in the operation of NRCMS, which explores the operational mechanism of ―separating supervision from operation, and separating government administration from medical institutions‖.今后一个阶段，结合中央深化医改的总体部署，我们将重点推进以下几方面的工作：
In the next stage,/ integrating整合 with the overall arrangements for deepening the reform by the central government, we will pre ahead in the following aspects: 一是稳步提高新农合筹资标准，2012年新农合人均筹资水平将达到300元左右，到2015年，新农合政府补助标准将提高到每人每年360元以上，个人缴费标准适当提高，并逐步探索建立与经济发展水平相适应的筹资机制。
First, the financing for NRCMS should grow in a steady pace.The fund pooled per /capita will reach 300 yuan by 2012.By 2015, government subsidies will reach 360 yuan per person per year.The individual contribution will grow as appropriate.A financing mechanism that suits the economic development in China will be gradually established.二是加强新农合精细化管理，严格基金使用管理，加强对定点医疗机构的监管；全面推行新农合省市级定点医疗机构和村卫生室的即时结报工作，逐步推行省外异地结报；加快新农合信息化建设，结合居民健康卡的发放，快速推进―一卡通‖试点工作；加强新农合与医疗救助等相关信息系统的互联互通，推行―一站式‖即时结算服务。
Second, the NRCMS should be meticulously[mə'tɪkjələs]精细化
managed, including strict utili/zation of the funds and enhancing supervision on designated hospitals.Real-time reimbursement[,ri:ɪm'bɜ:smənt]
报销should be established in designated provincial and municipal hospitals as well as village clinics acro the country.Reimbursement [,ri:ɪm'bɜ:smənt]
报销for medical costs outside of one’s registered province should be gradually realized.The information engineering of NRCMS should be accelerated, in combination with distributing the health cards for the residents, in order to pre ahead the all-in-one-card pilot program.The information systems of NRCMS and related schemes such as the medical aistance scheme should be better synchronized['sɪŋkrənaɪz]同步的 , to provide one-stop real-time compensation service.三是推进提高重大疾病医疗保障水平试点工作，将儿童白血病、肺癌等20种疾病纳入保障范围。贯彻落实六部委《关于开展城乡居民大病保险工作的指导意见》，做好大病保险与新农合大病保障工作的衔接，优先将这20种重大疾病纳入大病保险范围。
Third, the pilot program of compensation for major diseases should be promoted, including 20 diseases such as child leukemia[lʊ'kimɪə] 白血病, lung cancer etc.The Guiding Opinions on the Supplementary Insurance of Major Diseases for Urban and Rural Residents collectively iued by six ministries should be implemented.Supplementary Insurance should be well connected with NRCMS policy on the benefits for major diseases and should cover the mentioned 20 major diseases as preference.四是加快推进新农合支付方式改革，用总额预付、按病种、按单元、按人头等支付方式替代按项目付费，控制费用，规范医疗服务行为，提高基金绩效。
Fourth, NRCMS payment reforms should be accelerated, in terms of using pre-payment of total medical cost, disease-based payment, service unit-based payment and capitation to replace fee-for-service.The reforms aim to control medical costs, modify health service behaviors and enhance fund performance.五是加快推进委托有资质的商业保险机构参与新农合经办服务工作，扩大商业保险机构经办新农合的规模，建立新农合管理、经办、监管相对分离的管理运行机制。
Fifth, the engagement of entrusted qualified commercial insurance agencies in the operation of NRCMS should be accelerated;so as to establish an operational mechanism ['mek(ə)nɪz(ə)m机制] that to some degree separates the management, operation and supervision of NRCMS.六是认真总结新农合制度实施10年来的经验，推动《新农合管理条例》及早出台，尽快将新农合纳入法制化管理轨道。
Sixth, the experience of the last decade should be diligently studied to facilitate the formulation of the Regulations on Administration of New Rural Cooperative Medical Scheme.The administration of NRCMS should be legislated as soon as poible.实践证明，新农合制度符合农村实际，是现阶段农村居民基本医疗保障制度的重要实现形式。十年来，新农合制度从无到有，由小到大，对保障农民健康发挥了重要作用。作为新农合制度的主管部门，卫生部门将会同有关部门继续扎实推动新农合制度发展，促进农村居民健康水平稳步提高。
It has been proven that NRCMS, a suitable mechanism for rural China, is an important crystallization of basic medical insurance system for rural residents in current circumstances.In the last decade, NRCMS has grown up from a new born baby and is now playing a vital role for the health of the rural residents.As the competent authority of NRCMS, the Ministry of Health will collaborate with other related ministries to continue to promote its development and steadily improve rural residents’ health status.
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