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2016-02-10 18:17:05




Health reform


Medicare, the opera


Another election, another nonsensical fight over theelderly


APRIL has been a cheerful month for the Affordable Care Act, better known as Obamacare.More than 7m Americans have signed up for private coverage through the law's exchanges and,by the end of February, more than 3m people had enrolled in Medicaid, the health programmefor the poor. According to the latest Gallup poll, America's share of uninsured has fallen to itslowest level since 2008. These figures are good news for anyone keen to expand healthcoverage. They may not be so helpful for the Democrats' election prospects.


To understand why, consider another set of figures. More than 40m older Americans areenrolled in Medicare, the public-health programme for those aged 65 and older, with more than15m of them in private Medicare plans. These are reliable voters in elections. And Republicansare singing them the same aria again and again: Democrats are raiding their benefits to pay forObamacare.


Democratic politicians are desperate to convince them otherwise. On April 7th health officialsprovided some help: after proposing in February to cut payments to private Medicare plans by1.9%, the Centres for Medicare and Medicaid Services (CMS) said they would rise slightlyinstead. This will not quiet Republicans.


Obamacare does indeed lower Medicare spending by $716 billion from 2013 to 2022. Of this, $156 billion comes from Medicare Advantage, which lets the elderly use public money to buyprivate health plans. For years the government has paid more for these private plans, perperson, than for traditional Medicare. Private insurers passed along the extra subsidy toconsumers in the form of additional benefits or lower fees. Obamacare sought to bring privatepayments in line with traditional Medicare.

奥巴马医改确实会在2013至2022年间降低医疗开支约7160亿美元。其中,1560亿美元来自医疗照顾优先计划(Medicare Advantage),该计划允许老年人使用公共资金购买个人健康计划。多年来,政府为每个人在个人健康计划上的花费要高于传统医保。私人保险公司以给予额外好处或降低保费的形式,对消费者提供额外补贴。奥巴马医改试图将个人支付带回传统医保的正轨上来。

This was not a radical idea, but it is politically controversial nevertheless. MedicareAdvantage is increasingly popular—about three in ten Medicare beneficiaries are enrolled in aprivate plan. Insurers argue that Obamacare's cuts, combined with other measures, will forcethem to raise prices or cut benefits.


Last month's special election in Florida was a cautionary tale for Democrats. “To pay forObamacare, Washington is forcing seniors to endure deep cuts to Medicare Advantage,” purredan advertisement. “Sadly, Alex Sink supports these cuts.” Ms Sink lost her campaign. Notsurprisingly, Republicans as well as many anxious Democrats implored CMS not to lowerpayments. In February 40 senators wrote to CMS to ask as much. On April 3rd 29congressional Democrats and Republicans sent their own letter.

上月佛罗里达的补选一事,值得民主党警惕。一则竞选标语这样写道:“为了支付奥巴马医改,华盛顿正迫使老年人忍受医疗照顾优先计划的削减。不幸的是,Alex Sink支持这项削减政策。”随后Sink失掉了竞选。不出意料,共和党人以及许多焦虑的民主党人恳求医疗保险和医疗补助服务中心(CMS)不要削减这项支出。2月,40名参议员致函医疗保险和医疗补助服务中心(CMS)提出同样的要求。4月3日,国会中29名民主党人和共和党人致函医疗保险和医疗补助服务中心(CMS)。

In the end CMS said it would raise payments by 0.4%. The true effect on Medicare Advantage ismore complex. America's Health Insurance Plans, the industry group that had lobbied againstcuts, maintains that CMS's changes still amount to lower payments. Ana Gupte of LeerinkSwann, an investment bank, points out that delaying cuts now may mean a bigger cut nextyear.

最后,医疗保险和医疗补助服务中心(CMS)表示将支付金额提高0.4个百分点。医疗照顾优先计划的真正影响比这更加复杂。美国健康保险计划是一个反对削减支出的行业组织,他们认为,医疗保险和医疗补助服务中心(CMS)的承诺仍旧意味着降低支付。来自Leerink Swann投行的Ana Gupte指出,现在的推迟可能意味着明年更大幅度的削减。

The ruckus belies a simple fact. Both Democrats and Republicans agree that Medicare spendingmust be contained. The budget proposed by congressional Republicans, written by Paul Ryan,would preserve all Obamacare's cuts to Medicare, including those to Medicare Advantage. Justdon't expect Republicans to mention that on the campaign trail.


1.sign up 报名参加;签约雇用

例句:And it remains to be seen whether largenumbers of younger, healthier Americans will sign upfor coverage.


2.more than 超过

例句:He had notched up more than 25 victories worldwide.


3.keen to 热衷于

例句:He is keen to point out the benefits which the family network can provide.


4.pay for 支付

例句:In a 27-page order released Friday, judge Lucy KOH vacated$ 450 million of the originalaward and ordered a new trial to sort out how much Samsung should pay for 13 devices wherethe jury 's math is in dispute.





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