卫生保健花费数据背后的问题

Behind the Health Spending Data
9 @, [* h7 Q# `2 tSpending on health care in the United States grew in 2007 at the lowest rate in nine years, according to government analysts — a sliver of good news for those worried about the relentless rise in health care costs. But buried within the overall statistics was sobering evidence that health costs continue to be a pressing concern that can only be remedied through deep-seated reform in the delivery of health services.
& F2 y, v$ T8 ]9 @' uThe Centers for Medicare and Medicaid Services reported this week that total health care spending rose 6.1 percent in 2007, slightly less than the growth of 6.7 percent in 2006. Even so, it continued to expand faster than the overall economy, reaching a total of $2.2 trillion in 2007, or 16.2 percent of the gross domestic product, a record.
The chief reason for the overall slowdown was much slower growth in spending on prescription drugs. Retail spending on prescription drugs rose only 4.9 percent in 2007. That was the lowest rate in more than four decades, well below the 8.6 percent growth the previous year and the average of 9.4 percent a year from 2001 to 2006.
Government analysts attributed the deceleration to increased use of generic drugs as many brand-name blockbusters lost patent protection, as well as to slower growth in prescription drug prices and safety concerns that depressed sales of some drugs. The big uncertainty is whether the slowdown will continue or is a temporary phenomenon.
. b1 z+ G- k9 k4 AIn contrast to prescription drugs, spending for most other health care services, including payments to hospitals, clinics, nursing homes and home health services, grew at about the same rate or faster in 2007 as in 2006. Only the growth rate in spending for physician services declined, partly because Congress reduced Medicare payments to doctors for imaging services that many experts believe are widely overused.
Given that prescription drugs make up a relatively small slice of total spending on health care — some 10 percent — it will be imperative to reduce the growth rates in spending on hospital care, nursing care and other medical services if health care is to become more affordable.

: k$ Z3 r" i3 _( J/ whttp://www.nytimes.com/2009/01/08/opinion/08thu3.html

Behind the Health Spending Data

卫生支出数据背后
7 v3 H: b& I! W: V根据政府分析人士透露，美国医疗保健支出在07年以近9年最低速增长，这对担心医疗费用不断增加的人士来讲无疑是条好消息，但是隐藏在整个统计清醒的证据表明，医疗费用仍然是一个紧迫的问题，唯有通过提供卫生服务的深层次改革来补救。
2 F4 N3 g4 Y' c& ?1 r" x: n# x6 {3 [医疗保险和医疗补助中心在这周的报道称全部卫生保健支出在07年增长6.1%，略低于06年的6.7%的涨幅。既便如此，支出的持续增长速度仍快于整个经济增长速度，07年达到2.2万亿美元，占到国民生产总值的16.2%，也创造了一个记录。
整体放缓的主要原因是处方药消费的增速大大减慢，零售处方药开支07年仅增长4.9%，这是近40多年的最低增速，远远低于前一年8.6%和01到06年平均每年9.4的增速。
- g' P. S' f: m. w/ A政府分析人士把该放缓归因于大牌公司失去专利保护而引发的非专利药使用增加，以及由于处方药价格和安全担忧致使某些药销售不景气带来的增长减慢。最大的不确定因素是，这种放缓是继续下去还只是暂时现象。
相比处方药而言，大多其他卫生保健花费，包括支付给医院，诊所，疗养院和家庭保健服务，增速在07年比06年相当或略快，只有医生服务支出增长率下降，部分原因是美国国会削减医疗保险支付给医生的影像服务，这曾经被专家认为被广泛滥用。鉴于处方药费用在整个医疗保健支出占相对较小的份额-差不多10%-当务之急是，降低医院护理、护理照料和其他医疗服务开支增长，即是卫生保健变得更加可负担得起。