考博英语翻译---为贫穷者新开的处方

1、考博英语翻译考博英语翻译-为贫穷者新开的处方为贫穷者新开的处方Health careA new prescription for the poor为贫穷者新开的处方America is developing a two-tier health system, one for those with private insurance, the other for the less well-off美国正在发展一个双重的健康系统，一重是为那些有个人保险的人群，而另一重则是为那些不那么富裕的人群Oct 8th 2011 | NEW YORK | from the print edition“ITS time for Dancing with the Stars!”, a woman announces enthusiastically. At this New York health centre, wedged between housing projects to the east and Chinatown to the west, “dancing with the stars” m

2、eans dancing with a physical therapist. An old man stands up with a nurse and begins a determined samba.“是时候和明星一起跳舞了！”一位女士满怀热情地宣告。在这个坐落于房屋工程的西面，唐人街东面的纽约健康中心， “和明星起舞”的意思是和一位物理治疗师跳舞。一位老者和一个护士站起来，开始跳事先确定好的桑巴舞。Comprehensive Care Management (CCM), which runs this centre, tries to keep old people active. To do so, explains Joseph Healy, the chief operating officer, is in the companys best interest. The government pays CCM a capped rate for the care of its members. If someone gets sick, his health cost

3、s rise and the companys margin shrinks. Mr Healy argues that the system is the best way to provide good care at a low cost. Increasingly others seem to agree.经营这个中心的综合护理管理部门（CCM）努力保持老人们的活力。约瑟夫-海莉，首席运营官解释说，这样做符合公司的最佳利益。政府给这个部门一个封顶的津贴来让他们照顾这些人。如果有人生病了，他的健康成本就会上升，公司的利润就会萎缩。海莉先生确定说这个系统能够在一个低成本上提供最佳的护理。其他人也逐渐同意这个观点。Medicaid, Americas health programme for the poor, is in the process of being transformed. Over the next three years, New York will move its entire Medicaid population into “managed care”,

4、paying companies a set rate to tend to the poor, rather than paying a fee for each service. New York is not alone. States from California to Mississippi are expanding managed care. It is the culmination of a steady shift in the way most poor Americans receive their health-care treatment.公共医疗补助，即美国的穷人健康计划，正在被改造的过程中。在接下来的 三年内，纽约将把整个接受穷人健康计划的人群纳入“管理关怀”之中，付给公司们一个事先定好的费用来照顾那些穷人，而不是按照项目来付费。纽约不是唯一这样做的州。加州，密西西比州正在拓展管理关怀计划。这代表一种正在进行中的稳步转变，即大部分贫穷美国人接受健康关怀方式的转变。Medicaid is Americas single biggest health pr

5、ogramme. This year roughly one in five Americans will be covered by Medicaid for a month or more. It gobbles more federal and local money than any state programme, other than education. Costs will rise even more when Barack Obamas health-care reform expands the programme by easing eligibility rules in 2014. Congresss “supercommittee” is already considering cuts. However, there are more immediate pressures behind the present drive for change.公共医疗补助是美国最大的单一健康计划。今年，五个美国人中的一个就会被纳入该计划一个月或更长时间。除了教育之外，

6、它比其他任何州的财政计划耗去更多联邦和地方的经费。当 2014 年奥巴马的健康保险改革放宽适用人群而使整个计划更加庞大的时候，成本将会进一步上升。众议院的“超级委员会”已经在考虑削减经费。然而，选择这种变化，将会有更多即刻的压力存在。Enrolment in Medicaid jumped during the downturn, from 42.7m in December 2007 to 50.3m in June 2010. Mr Obamas stimulus bill helped to pay for some of this, but that money has dried up. Faced with gaping deficits, some desperate governors slashed payments to hospitals and doctors, or refused to pay for trips to the dentist or oculist. But much the most important result has been st

7、ructural: the expansion of managed care.公共医疗补助计划的参与人数在经济滑坡期间从 2007 年 12 月的 4270 万人跳到了 2010 年 6 月的 5030 万人。奥巴马先生的经济刺激经费能够帮助付掉其中的一部分，但是钱已经被用光。面对资金短缺，一些绝望的州长砍掉了给医院和医生的补助，或是拒绝支付牙医和眼科医生的旅行费用。但是，更多地，最重要的结果是结构上的：管理关怀的拓展。States have dabbled in managed care for decades. The trend accelerated in the 1990s, with the share of Medicaid patients under this form of care reaching 72% by 2009. Now, however, there is a strong push for the remainder. States that did not have managed care, such as Louisiana, are in

8、troducing it. Other states are extending it to people previously deemed off limits: California and New York, for example, are moving the elderly and disabled into that system of care. Texas is targeting more than 400,000 Medicaid beneficiaries in the Rio Grande Valley. Local politicians had resisted the move, nervous that care might deteriorate. But the yawning deficit meant that they were overruled.各个州涉足管理关怀已经有几十年的历史了。这个趋势在 90 年代得到加速发展，在 2009 年前使用这种护理方式的公共医疗补助病人占到了 72%。现在，对于剩下的人，这也是很强的推动力。像路易斯安

9、那州这样没有管理关怀的州正在引进管理关怀。其他州也把这个拓展到原先被认为不适用的人群：举例说像加州和纽约州，正在把老人和残障人士纳入这个系统中，德州的目标是在格兰德河谷超过400000 公共医疗补助收益人群。地方政治家反对这个举动，他们担心这个护理系统将会变质。但是巨大的赤字意味着他们的观点注定要被批驳。The result is a country with two distinct tiers of health care. Most Americans with private insurance are still horrified by thoughts of health-management organisations and prefer to pay fees for each medical service. For the poor, managed care is becoming the norm.结果就是一个国家有两套截然不同的健康保险系统。大多数有个人保险的美国人仍旧害怕那些健康管理组织的想法而宁愿为单独的医疗服务付费。对于穷人来说，管理关怀已经成为一种常规。Advocates of managed care have high expectations. First, they hope that it will make costs more predictable. Second, they believe that the change will improve patients health. In managed care, a patient has a network of doctors and specialists. If the programme works properly, doctors can monitor all aspects of care, in contrast to the fragmented fee-for-service system. The contracts that states have with firms can set standards for quality. Texas, for instance, will cut 5% from

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