時(shí)差N小時(shí):醫(yī)療法案 Medicare Act

By the early 1950s, it was becoming apparent thata growing number of elderly Americans had noeconomic protection from the increasing cost ofhealth care. Most people over 65 had very lowincomes and few owned private health insurance ofany kind.

早在19世紀(jì)50年代，醫(yī)療保險(xiǎn)成本日益高漲的同時(shí)，越來越多的美國老人卻沒有受到經(jīng)濟(jì)保護(hù)，這一現(xiàn)象日益突出。大多數(shù)年齡超過65歲的老人收入微薄，只有少數(shù)人參保了各種名目的私人醫(yī)療保險(xiǎn)。

Congress began a years–long debate on this issue of national health insurance for the elderly.Critics in Congress feared Medicare would lead to substandard and overpriced care, and felt thatit should serve only the indigent. They also predicted that, with growing numbersparticipating, it would eventually bankrupt the federal Treasury.

國會(huì)就老年人國家醫(yī)療保險(xiǎn)這個(gè)問題進(jìn)行了長達(dá)幾年的爭論。國會(huì)的批評(píng)人士擔(dān)心醫(yī)療保險(xiǎn)會(huì)衍生出各種低劣、超價(jià)收費(fèi)的保險(xiǎn)，并認(rèn)為醫(yī)療保險(xiǎn)只能為窮人服務(wù)。他們估計(jì)，隨著參保的人數(shù)不斷增長，最終會(huì)導(dǎo)致聯(lián)邦財(cái)政部門破產(chǎn)。

The legislative compromise that became the final Medicare Act—officially known as the"Social Security Amendments of 1965”—was part of President Lyndon Johnson's "Great Society"program. Today it protects more than 40 million Americans from the high cost of hospital care.

立法上的妥協(xié)成就了最終的醫(yī)療法案——官方稱作“1965年社會(huì)保障修正案”，這也是林肯·約翰遜總統(tǒng)“大社會(huì)”計(jì)劃的組成部分。而今在住院花費(fèi)高昂的美國，它讓四千多萬人民受益。

Much of the program's costs are covered by payroll taxes paid by workers. Yet costs quicklystarted to exceed expectations, and as Americans' life expectancy increased over the years, theMedicare program became even more expensive.

這項(xiàng)計(jì)劃的大部分開銷來源于工薪階層的工資稅。然而，開支很快開始超出預(yù)算。而且多年來美國人口壽命也在不斷增加，這使得醫(yī)療保險(xiǎn)計(jì)劃變得更加入不敷出。

It has become a matter of national debate and a financial issue for every Congress andPresident since. Today it is still one of the fastest growing items in the federal budget.Nonetheless, Medicare remains a popular program, and a well-established part of the federalgovernment's role in our society.

自此，醫(yī)療保險(xiǎn)就變成歷任總統(tǒng)，歷屆國會(huì)上永恒不變的國家性話題和財(cái)政大事。如今，它仍然是聯(lián)邦預(yù)算中增長最快的一項(xiàng)。無論如何，醫(yī)療保險(xiǎn)仍深受人民歡迎，也是聯(lián)邦政府社會(huì)職能的良好體現(xiàn)。