Goals for Health Care Reform

アメリカの医療保険制度は壊滅的な状態にある。
その複雑なシステムを素人の私が説明しようとするより、もっといい方法がある。
マイケル･ムーア監督の「SICKO」という映画だ。
SICKOの詳細はここをクリック
アメリカは国民健康保険が無い唯一の先進国だ。一長一短はあるが「民間」の医療保険会社は、基本的に「利益追求」という宿命から逃れられない。そして医療保険に入れない（お金が払えない）人が５０００万人もいる…というのが、何を意味するだろうか。そう！お金が無ければ病気にもなれない。
こんな逸話もある；
救急車で一命をとりとめたが保険金を申請しようとしたら「救急車の使用は事前連絡が無ければ保険は適用されない」と…
もちろん保険会社によって規定は異なるだろうが（それがまた話をややこしくする）笑い話として笑い飛ばすには、あまりにも悲しい話だ。
かつてヒラリー・クリントン女史が国民皆保険制度を導入しようとしたが、医療保険会社や製薬会社の政治的圧力のために頓挫したとも言われている。
このまま何もしなければ１０年後にはＧＤＰの２０％が医療費に費やされるとも予測されている。この問題を解決するためにはまた巨額の予算が必要とされている。しかしこのまま何も手を打たなければ、本当の窮地に陥る正念場にアメリカが直面しているといえるだろう。
Over the past few days, I’ve been traveling through the Middle East and Europe working to renew our alliances, enhance our common security, and propose a new partnership between the United States and the Muslim world.
But even as I’m abroad, I’m firmly focused on the other pressing challenges we face 窶骭€ including the urgent need to reform our health care system. Even as we speak, Congress is preparing to introduce and debate health reform legislation that is the product of many months of effort and deliberation. And if you’re like any of the Americans I’ve met across this country who know all too well that the soaring costs of health care make our current course unsustainable, I imagine you’ll be watching their progress closely.
I’m talking about the families I’ve met whose spiraling premiums and out-of-pocket expenses are pushing them into bankruptcy or forcing them to go without the check-ups or prescriptions they need. Business owners who fear they’ll be forced to choose between keeping their doors open or covering their workers. Americans who rightly worry that the ballooning costs of Medicare and Medicaid could lead to fiscal catastrophe down the road.
Simply put, the status quo is broken. We cannot continue this way. If we do nothing, everyone’s health care will be put in jeopardy. Within a decade, we’ll spend one dollar out of every five we earn on health care 窶骭€ and we’ll keep getting less for our money.
That’s why fixing what’s wrong with our health care system is no longer a luxury we hope to achieve 窶骭€ it’s a necessity we cannot postpone any longer.
The growing consensus around that reality has led an unprecedented coalition to come together for change. Unlike past attempts at reforming our health care system, everyone is at the table 窶骭€ patient’s advocates and health insurers; business and labor; Democrats and Republicans alike.
A few weeks ago, some of these improbable allies committed to cut national health care spending by two trillion dollars over the next decade. What makes this so remarkable is that it probably wouldn’t have happened just a few short years ago. But today, at this historic juncture, even old adversaries are united around the same goal: quality, affordable health care for all Americans.
Now, I know that when you bring together disparate groups with differing views, there will be lively debate. And that’s a debate I welcome. But what we can’t welcome is reform that just invests more money in the status quo 窶骭€ reform that throws good money after bad habits.
We must attack the root causes of skyrocketing health care costs. Some of these costs are the result of unwarranted profiteering that has no place in our health care system, and in too many communities, folks are paying higher costs without receiving better care in return. And yet we know, for example, that there are places like the Mayo Clinic in Minnesota, the Cleveland Clinic in Ohio, and other institutions that offer some of the highest quality of care in the nation at some of the lowest costs in the nation. We should learn from their successes and promote the best practices, not the most expensive ones. That’s how we’ll achieve reform that fixes what doesn’t work, and builds on what does.
This week, I conveyed to Congress my belief that any health care reform must be built around fundamental reforms that lower costs, improve quality and coverage, and also protect consumer choice. That means if you like the plan you have, you can keep it. If you like the doctor you have, you can keep your doctor, too. The only change you’ll see are falling costs as our reforms take hold.
I also made it very clear to Congress that we must develop a plan that doesn’t add to our budget deficit. My budget included an historic down payment on reform, and we’ll work with Congress to fully cover the costs through rigorous spending reductions and appropriate additional revenues. We’ll eliminate waste, fraud, and abuse in our health care system, but we’ll also take on key causes of rising costs 窶骭€ saving billions while providing better care to the American people.
All across America, our families are making hard choices when it comes to health care. Now, it’s time for Washington to make the right ones. It’s time to deliver. And I am absolutely convinced that if we keep working together and living up to our mutual responsibilities; if we place the American people’s interests above the special interests; we will seize this historic opportunity to finally fix what ails our broken health care system, and strengthen our economy and our country now and for decades to come.