為什么大家不去追究醫(yī)療費用如此昂貴的根本原因，而是只要求全民醫(yī)保，直接解決問題呢？

Joshua Light
Hospitals and doctors hire more peoplle for paperwork to minimize their liability - lawyers are always in the wings
Health insurance is siloed in the states. Open it to a national market, increase competition, lower costs, sll that
It isn’t greed driving it - it’s liability. Put a cap on settlements for medical liability
 
醫(yī)院和醫(yī)生雇傭更多人來處理文書工作，以減少他們的責(zé)任——律師總是在背后支持。
美國的健康保險在各州是獨立的。開放到全國市場，增加競爭，降低成本，等等。
這不是貪婪推動的——是責(zé)任問題。對醫(yī)療責(zé)任賠償設(shè)定上限。
 
Margot Conard
Your desire is one of the intensions of having universal health care, I think. In the United States, we treat healthcare as a weird combination of being insurance supported and as such, seeing little market forces and so not responding to market forces, and those without health insurance who see full market forces.
Most Americans get health insurance through the employer of at least one head of household. Mothers with little support and the disabled and /or elderly mostly get health insurance through Medicaid and /or Medicare.
 
我認為你想要的其實就是全民醫(yī)保的目標之一。在美國，我們將醫(yī)療保健視為一個奇怪的組合，既是由保險支持的，但卻缺乏市場力量，因此沒有響應(yīng)市場力量，那些沒有醫(yī)保的人則完全受到市場力量的影響。
大多數(shù)美國人通過至少一位家庭成員的雇主獲得健康保險。那些缺乏支持的母親、殘疾人和/或老年人主要通過醫(yī)療補助和/或醫(yī)療保險獲得健康保險。
 
Elliot Easton
Why not just follow what all other economic competitors have long known and follow their example since they spend far less on their healthcare systems and have far better outcomes and customer satisfaction?
17% of our total healthcare costs are in administrative fees. That’s a minimum amount. Administrative costs for Social Security and for Medicare are 3–4%. Those are two socialized programs.
 
為什么不按照所有其他經(jīng)濟競爭者早已知道的做法，效仿他們的例子呢？他們在醫(yī)療保健系統(tǒng)上的支出遠低于我們，且結(jié)果和客戶滿意度要好得多。
我們醫(yī)療保健總成本的17%是行政費用。這是最低金額。社會保障和醫(yī)療保險的行政費用是3-4%。這兩個是社會化項目。
 
We spend almost 20% of our GDP on healthcare. The next most expensive system is the Netherlands at 14%. The rest of our competitors are between 10–14%. What do they all have in common but don’t share with the US? They don’t have profit-driven systems. We do.
In a nutshell, those are the reasons why our system is so expensive in comparison to all our healthcare systems in the economically developed world. The only solution is a government-funded universal healthcare system.
 
我們將接近20%的GDP花在醫(yī)療保健上。下一個最貴的系統(tǒng)是荷蘭，為14%。其他競爭者的醫(yī)療保健系統(tǒng)費用在10-14%之間。它們有什么共同點，卻沒有與美國分享？它們沒有以盈利為驅(qū)動的系統(tǒng)。我們有。
簡而言之，這些就是為什么我們的系統(tǒng)相比經(jīng)濟發(fā)達國家的所有醫(yī)療保健系統(tǒng)如此昂貴的原因。唯一的解決方案是政府資助的全民醫(yī)保系統(tǒng)。
 
Cameron Fraser
Because people know the cause and the demand for universal healthcare is a demand to get rid of what makes health care so expensive. What you need to get rid of is the two key for profit elements… for profit hospitals, and for profit health insurance.
 
因為人們知道原因，而要求全民醫(yī)保的訴求就是要擺脫那些讓醫(yī)療如此昂貴的因素。你需要去除的兩個關(guān)鍵的盈利元素是……盈利性醫(yī)院和盈利性健康保險。
 
Kim Wegenke
What do you suppose will happen when you just get rid of those insurance companies that are adding 25 to 30% to your healthcare expenses? You will have to get another group to handle those payments. The government is doing that job for a 3% fee for 15% of the population now. Maybe you could offer that service to the rest of us and see which offer the customers prefer in a capitalistic manner, rather than use government sanctioned monopolies that don't have any incentive to lower prices.
 
你認為當你去掉那些讓你醫(yī)療支出增加25%到30%的保險公司時，會發(fā)生什么呢？你將不得不找另一個團體來處理這些支付?，F(xiàn)在政府為15%的人口以3%的費用做這項工作。也許你可以為我們其他人提供這個服務(wù)，看看在資本主義方式下，顧客更喜歡哪種選擇，而不是使用政府批準的壟斷機構(gòu)，這些機構(gòu)沒有任何激勵去降低價格。
 
Blair Blakely
Well, you see, we already know why health care in the U.S. is so expensive. It’s health insurance companies.
Get rid of the thing that makes healthcare so expensive in the U.S.? That's what Universal Healthcare would do.
 
你看，我們已經(jīng)知道為什么美國的醫(yī)療保健這么貴了。那就是健康保險公司。
去掉那些讓醫(yī)療保健如此昂貴的東西？這就是全民醫(yī)保將會做的事情。
 
Pawel Spoon
somewhere i did read last week that the actual problem with humanity is not the greed but to envy, sorry for my bad english.
and the whole discussion in us about universal healthcare proves that right.
you are so busy with no-to-have-to-pay-for-somebody that you miss the whole point
you are a society of loners, so no society at all.
 
我上周確實讀到，問題不在于貪婪，而是嫉妒，抱歉我的英語不好。
美國關(guān)于全民醫(yī)保的討論證明了這一點。
你們?nèi)绱嗣τ诓幌霝閯e人付錢，結(jié)果錯過了整個重點。
你們是一個孤獨者的社會，根本沒有社會。
 
Alan Moore
Because the cause of the high price of healthcare is that it is not a “single-payer” system. In consequence, in addition to paying for healthcare, we have to pay dividends to shareholders in insurance companies, we have to pay wages and salaries to their employees, we have to pay for their office space, utilities, and advertising. We have to pay for the billing and collections departments of healthcare providers, and their office space and utility use — all expenses that contribute nothing whatsoever to healthcare.
 
因為醫(yī)療費用高昂的原因是它不是一個“單一支付者”系統(tǒng)。因此，除了支付醫(yī)療費用外，我們還必須為保險公司的股東支付分紅，必須為他們的員工支付工資和薪水，必須為他們的辦公空間、公共設(shè)施和廣告支付費用。我們還必須為醫(yī)療提供者的賬單和催收部門支付費用，以及他們的辦公空間和公用事業(yè)費用——所有這些費用對醫(yī)療保健毫無貢獻。
 
Jeremy Schoenhaar
That’s basically what universal healthcare does. It removes the middleman. The middleman is the insurance company. There’s only one way to keep the middleman and reduce costs. Force the insurance companies to become non-profits. Have fun explaining that to shareholders.
 
這基本上就是全民醫(yī)保的作用。它去除了中介。中介就是保險公司。只有一種方法可以保留中介并降低成本，那就是強迫保險公司變成非營利機構(gòu)。祝你好運，向股東解釋這一點。
 
Alessandro Ricci
I'll tell you why.
They did. And found out the cause.
The cause is for profit care demanded to small companies whose primary obxtive is producing revenue for shareholders, and grant cheap care to patients.
To get rid of it, you need to have a big payer with the mission to provide the best care possible, that is not obligated to maximize profit for shareholders.
In other words, universal healthcare.
 
我告訴你為什么。
他們已經(jīng)做過了，并找到了原因。
原因是為了盈利的醫(yī)療服務(wù)被小公司要求提供，這些公司的主要目標是為股東創(chuàng)造收入，同時為病人提供廉價的護理。
要擺脫這一點，你需要有一個大的支付方，任務(wù)是提供最好的護理，而不需要最大化股東的利潤。
換句話說，就是全民醫(yī)保。
 
Adam Maass
Because… the core issue of expensive healthcare (and poor health outcomes despite the expense) is multiple insurers and the army of clerks necessary to file the claims and deny payments.
Get rid of those, and the system becomes cheaper and more effective. How to do that? Universal healthcare.
 
因為……醫(yī)療費用昂貴的核心問題（盡管費用高昂但健康結(jié)果差）是多個保險公司和需要大量職員來處理索賠和拒絕支付的行政人員。
去掉這些，系統(tǒng)就變得更便宜、更有效。如何做到這一點？全民醫(yī)保。
 
Marissa-Anneke Collins
The cause has already been found… healthcare as a for-profit enterprise rather than as a service. Guess what the end result of getting rid of that would be?
 
原因已經(jīng)找到了……醫(yī)療作為一個盈利性企業(yè)，而不是作為一種服務(wù)。猜猜去掉這一點后的最終結(jié)果會是什么？
 
Chuck Karish
We know why health care is so expensive in the US. It’s manage by insurance companies that add more bureaucratic overhead than they do value. Their incentives drive them to pursue profits in preference to better patient outcomes. Because the incentives are perverse socialized medicine would do a better job at lower cost.
 
我們知道為什么美國的醫(yī)療保健如此昂貴。它由保險公司管理，增加了比它們帶來的價值更多的官僚開銷。它們的激勵機制驅(qū)使它們追求利潤，而不是更好的病人結(jié)果。因為激勵機制是扭曲的，社會化醫(yī)療會以更低的成本做得更好。
 
Victor Croasdale
The reason US healthcare is so expensive is the medical insurance companies. They abstract money and provide nothing of value. Get rid of them and healthcare becomes affordable of course you also get universal healthcare.
 
美國醫(yī)療保健如此昂貴的原因是醫(yī)療保險公司。它們抽取資金，卻什么有價值的東西也不提供。去掉它們，醫(yī)療保健當然變得負擔得起，你也會得到全民醫(yī)保。
 
Rik Elswit
You seem to think that how to achieve universal health care is a mystery. The US is the only nominally first world nation that hasn’t been able to accomplish this. The reason is that it would cost the few obscenely wealthy men who own our government, money. And they won’t stand for it.
 
你似乎認為實現(xiàn)全民醫(yī)保是一個謎。美國是唯一一個名義上屬于發(fā)達國家，卻沒有能夠做到這一點的國家。原因是，它會讓那些擁有我們政府的少數(shù)極度富有的人損失錢財。而他們是不會接受的。
 
Leah
Because when you do that, you find the cause is privatized, for- profit insurance is the reason.
When the insurance organism isn't looking to profit off of ill health, the prices go down.
When the insurance organism has a whole country under them, they have much more leverage when negotiating prices with pharmaceutical companies.
Also, in most countries with a universal health coverage, advertising drugs to the public is illegal (doctors choose treatment, not patients) so the cost of advertising is not their burden. They don't need to take into account that part of the pharma company’s costs.
 
因為當你這么做時，你會發(fā)現(xiàn)原因在于私有化的、以盈利為目的的保險。
當保險機構(gòu)不再以病態(tài)為盈利來源時，價格就會下降。
當保險機構(gòu)控制了整個國家時，他們在與制藥公司談判價格時會有更多的杠桿作用。
此外，在大多數(shù)實行全民醫(yī)保的國家，向公眾廣告藥品是非法的（醫(yī)生選擇治療，而不是患者），所以廣告費用不再是他們的負擔。制藥公司的費用中不需要考慮這一部分。
 
Anthony Atkielski
Health care is expensive in the USA because it is a greed-driven, for-profit industry, just like everything else in the country. The obxtive is not to make people well, it is to enrich institutional and insurance shareholders as much as possible, and it works well because patients have to either pay or die.
 
美國的醫(yī)療保健之所以昂貴，是因為它是一個由貪婪驅(qū)動、以盈利為目的的行業(yè)，就像美國的其他一切一樣。其目標不是讓人們恢復(fù)健康，而是盡可能多地讓機構(gòu)和保險股東致富，而這種運作模式非常成功，因為患者要么付錢，要么死掉。
 
In countries with universal health care, the industry is seen as a public service and is driven by the public interest, not the greed of a handful of anonymous investors. It can therefore be provided at cost, which is much, much less expensive than the prices—with 95% margins built in—practiced in the US.
It is almost inconceivable that this will ever change. There are too many influential people making too much money from health care.
 
在實行全民醫(yī)保的國家，醫(yī)療行業(yè)被視為公共服務(wù)，驅(qū)動它的是公眾利益，而不是少數(shù)匿名投資者的貪婪。因此，它可以按成本提供，這比美國的定價要便宜得多，因為美國的價格中內(nèi)嵌了95%的利潤。
幾乎不可想象這種情況會有任何改變。因為有太多有影響力的人從醫(yī)療保健中賺取了太多的錢。
 
Tom S
Healthcare in the US is expensive because the politicians are in the pockets of the insurance companies. The insurance company contracts include provisions that they will pay a fixed percentage (usually in the neighborhood of 20%–40%) of the fee charged to uninsured patients. So, for the healthcare provider to obtain the amount that they require for performing the services, they have to charge 2–3 times more than they would would otherwise. Then, should a provider fail to pursue and enforce the full billing amount to the uninsured patient, the healthcare provider can be criminally charged with fraud.
 
美國的醫(yī)療保健之所以昂貴，是因為政客們被保險公司收買了。保險公司合同中包括規(guī)定，它們將支付未投?；颊哔M用的一定百分比（通常在20%到40%之間）。因此，為了讓醫(yī)療服務(wù)提供者獲得他們所需的費用，他們不得不收取比正常情況下高出2到3倍的費用。然后，如果提供者沒有追討并強制執(zhí)行對未投?；颊叩娜抠~單金額，醫(yī)療服務(wù)提供者可能會面臨欺詐的刑事指控。
 
If I had a chance, I would replace Obamacare with a one page law that would state that no healthcare provider can charge more than 50% more than the minimum that they will accept from an insurance carrier, e.g. if they will accept $3000 from an insurance carrier then they can’t charge an uninsured patient more than $4500. The law would give healthcare providers 1 year to renegotiate their contracts with insurance carriers.
Of course, no such law will be written because the politicians value the donations they receive from the insurance companies more than they value the lives and livelihood of their constituents.
 
如果我有機會，我會用一條簡短的法律取代奧巴馬醫(yī)保，規(guī)定任何醫(yī)療提供者不得收取比他們從保險公司接受的最低費用多出50%的費用。例如，如果他們從保險公司接受3000美元，那么他們不能向未投保患者收取超過4500美元的費用。法律將給醫(yī)療提供者一年時間與保險公司重新談判合同。
當然，不會有這樣的法律被寫出來，因為政客們更看重從保險公司收到的捐款，而不是選民的生命和生計。
 
John Zuijdveld
Did you forget momentarily that YOU live in a Capitalist nation? That EVERY industry and business is run by ppl. who's whole reason for living is to serve the company or the corporation? If they don't they lose their job instantly and no-one higher up cares if there is hunger or sickness down the track.
 
你難道一時忘記了你生活在一個資本主義國家嗎？每一個行業(yè)和企業(yè)都由那些生活的唯一目的就是為公司或企業(yè)服務(wù)的人所管理。如果他們不這樣做，他們會立刻失業(yè)，而且高層根本不在乎未來的饑餓或疾病。
 
In the USA every hospital and every medical practice are owned by billionaires, and so are the health insurance companies and I'd bet that many of these billionaires own all of these services. They most probably are also heavily invested into the pharmaceutical industry and even vise-versa!
So there's an obvious monopolistic system operating here. BTW the principles of Capitalism don't confine themselves soley to the health industry or the insurance companies involved here, the principals remain the same for every enterprise within the USA.
 
在美國，每一家醫(yī)院和每一個醫(yī)療機構(gòu)都是億萬富翁擁有的，健康保險公司也是，而且我敢打賭，這些億萬富翁可能擁有所有這些服務(wù)。他們很可能也在制藥行業(yè)有重大的投資，甚至可能是相互投資的！
所以這里顯然存在一個壟斷系統(tǒng)。順便提一下，資本主義的原則不僅限于醫(yī)療行業(yè)或涉及的保險公司，這些原則在美國的每一個企業(yè)中都是一樣的。
 
The insurance companies charge you towards poverty as do the hospitals who won't even admit you if you're not insured, and if you can't afford the price of the medications you need to keep you alive then you mightn't even get to the hospitals’ front door!
So . . . In the Capitalist nation that YOU and all the racist Republicans and rightwing gun infused neo-nazi nationslists support are you REALLY brave enough to challenge the rulers/system that's ruled you for so long?
 
保險公司把你推向貧困，醫(yī)院也是如此，如果你沒有保險，他們甚至不會接收你，如果你負擔不起你需要的藥物來維持生命，你甚至可能無法到達醫(yī)院的門口！
所以……在你和所有支持種族主義的共和黨人以及充滿武器的右翼新納粹民族主義者所支持的資本主義國家里，你真的有足夠的勇氣挑戰(zhàn)長久以來一直統(tǒng)治你的統(tǒng)治者/系統(tǒng)嗎？
 
xiao Wen
In the United States, health insurance is a money laundering scam.
American businessmen have entangled massive costs into health insurance, which is clearly a social service that developed countries should have, by manipulating the government. Through this channel, people's income and taxes are funneled back into the pockets of interest groups and big corporate entities in various forms of additional fees.
 
在美國，健康保險是一個洗錢騙局。
美國商人通過操控政府，將巨額費用卷入健康保險，這顯然是發(fā)達國家應(yīng)當擁有的社會服務(wù)。通過這一渠道，人們的收入和稅收以各種額外費用的形式流回到利益集團和大企業(yè)的口袋中。
 
Even though many fundamental medical research and scientific breakthroughs are expensive, when spread across each citizen, they should not be as costly as they are now. However, by marketizing and monopolizing various aspects within the entire pharmaceutical and insurance industries, excessive profits have been added to the final costs, disguised as necessary expenses for the welfare of ordinary people and scientific progress. However, in the performance uations of these large conglomerates, profit is the only criterion.
 
盡管許多基礎(chǔ)醫(yī)學(xué)研究和科學(xué)突破是昂貴的，但當這些成本分攤到每個公民身上時，它們本不應(yīng)如此昂貴。然而，通過市場化和壟斷整個制藥和保險行業(yè)的各個方面，過度的利潤被加到最終的成本上，這些成本被偽裝成普通人福祉和科學(xué)進步所需的開支。然而，在這些大企業(yè)的績效評估中，利潤是唯一的標準。
 
You can imagine a river, where taxes, finances, and insurance are the water sources, factories and laboratories are the water users upstream, and the public are the water users downstream. To stimulate market competition and mechanisms, we introduced private companies into the river. They either inject water into the river or divert water, changing the entire structure of the cash flow. In the United States, these companies have such great power that they have greatly altered the river structure, enabling them to save more money before the public, while also tricking the public to invest more taxes and insurance funds into the water sources. In fact, for every dollar of benefit the public eventually gains, the upstream insurance companies, pharmaceutical companies, and various law firms save ten dollars. This country has been destroyed by such parasites. So that no one believes public service can be an act of kindness.
 
你可以想象一條河流，稅收、財政和保險是水源，工廠和實驗室是上游的用水者，公眾是下游的用水者。為了激發(fā)市場競爭和機制，我們引入了私人公司進入這條河流。它們要么向河中注水，要么引水，從而改變了現(xiàn)金流的整個結(jié)構(gòu)。在美國，這些公司擁有如此巨大的權(quán)力，它們極大地改變了河流結(jié)構(gòu)，使它們能在公眾之前節(jié)省更多的錢，同時也愚弄公眾，讓他們向水源投資更多的稅收和保險資金。事實上，對于公眾最終獲得的每一美元利益，上游的保險公司、制藥公司和各種律師事務(wù)所節(jié)省了十美元。這個國家已經(jīng)被這樣的寄生蟲摧毀了。所以，沒有人再相信公共服務(wù)可以是出于善意的行為。
 
Tauonic Lightning
We know what the cause is: unrestricted profit motive in a market where you can charge as much as you want, because people will go into as much debt as they have to in order to not die. We can get rid of that by switching to universal healthcare, which has worked for the rest of the developed world for many decades now.
 
我們知道原因是什么：在一個你可以隨意收費的市場中，利潤動機沒有限制，因為人們會為了不死而背負盡可能多的債務(wù)。我們可以通過轉(zhuǎn)向全民醫(yī)保來消除這一點，這在其他發(fā)達國家已經(jīng)行之多年，效果顯著。