奧巴馬醫改就要成功了：借錢去打仗，不如借錢搞醫保。

眾議院就要通過參議院的醫改版本了。眾議院宣稱目前已有足夠的票數，〉 = 216 的票數通過醫改法案 。眾議院通過參議院的法案後，奧巴馬會發布一項總統命令， 不許用聯邦經費幫助買含有人工流產的保險，以滿足部分保守的眾議院民主黨人的要求。之後，根據議會條例，參議院應眾議院的要求修改醫改法案中隻和預算有關的條款，符合國會的和解程序。修改後的醫改法案 ，隻需要51 票就可通過參議院，參議院民主黨有59 票，通過法案毫無懸念。修改後的參議院法案，經奧巴馬簽署後，馬上就可成為法律。

我的許多朋友都有過失業後買不起保險的經曆，有綠卡的父母無法在美看病，醫療保險費在過去十年內增加了 600% 。這一切都將改變！

有了全民醫保（參議院醫改法案覆蓋94-95%在美國的人，這是一個巨大的進步）的美國，才是老農理想的美國。借錢去打仗，不如借錢搞醫保。祝賀奧巴馬！祝賀在美的“華工”們！

	參議院醫改法案 Senate (Patient Protection and Affordable Care Act)	眾議院醫改法案 House (Affordable Health Care for America Act)
WHO'S COVERED: 兩院版本都尋求讓醫療保險覆蓋百分之 94 到百分之 96 之間的美國人，目前的覆蓋率隻有百分之 83 ，這意味著多覆蓋大約 3 千萬人。	About 94 percent of legal residents under age 65 — compared with 83 percent now. Government subsidies to help buy coverage start in 2014. Of the remaining 24 million people under age 65 left uninsured, about one-third would be illegal immigrants. 健康保險覆蓋麵將達到 94% 。政府補貼從 2014 年開始，不資助非法移民。	About 96 percent of legal residents under age 65 — compared with 83 percent now. Government subsidies to help buy coverage start in 2013. About one-third of the remaining 18 million people under age 65 left uninsured would be illegal immigrants. 健康保險覆蓋麵將達到 96% 。 政府補貼從 2013 年開始，不資助非法移民。
COST: 參眾兩院醫改立法耗資都在 8 千億美元以上	Coverage provisions cost $871 billion over 10 years. 參議院醫改法案 10 年將耗資 8,710 億美元。	The Congressional Budget Office says the bill's cost of expanding insurance coverage over 10 years is $1.055 trillion. The net cost is $894 billion, factoring in penalties on individuals and employers who don't comply with new requirements. That's under President Barack Obama's $900 billion goal. However, those figures leave out a variety of new costs in the bill, including increased prescription drug coverage for seniors under Medicare, so the measure may be around $1.2 trillion 眾議院版本 10 年的花費投入超過 1 萬億美元，突破奧巴馬醫改議案支出上限 9000 億美元。
HOW IT'S PAID FOR: 兩院版本都將采取向高收入美國人增稅，征收其它各種稅種，降低向得到政府聯邦醫療保險和州醫療輔助項目支持的醫療服務提供者支出的費用，來彌補增加的保險費用的開支。	Fees on insurance companies, drugmakers, medical device manufacturers. Medicare payroll tax increased to 2.35 percent on income over $200,000 a year for individuals, $250,000 for couples. A 10 percent sales tax on tanning salons, to be paid by the person soaking up the rays. Cuts to Medicare and Medicaid. Forty percent excise tax on insurance companies, keyed to premiums paid on health care plans costing more than $8,500 annually for individuals and $23,000 for families. Fees for employers whose workers receive government subsidies to help them pay premiums. Fines on people who fail to purchase coverage. 參議院醫改法案中，首先對醫保公司，製藥商，醫醫保器材公司收費，二是對年收入超過 20 萬美元的單身人士、超過 25 萬美元的夫婦，其老年醫保工薪稅將提高至 2.35% ；三是對於每年醫保保費超過 8500 元的單身人士、超過 2.3 萬美元的夫婦，就其高額保單征收 40% 的消費稅；四是對有超過 50 個員工並使用政府健康保險補貼的企業收取罰金。	$460 billion over the next decade from new income taxes on single people making more than $500,000 a year and couples making more than $1 million. There are also more than $400 billion in cuts to Medicare and Medicaid; a new $20 billion fee on medical device makers; $13 billion from limiting contributions to flexible spending accounts; sizable penalties paid by individuals and employers who don't obtain coverage; and a mix of other corporate taxes and fees. 眾議院醫改法案對最富有的人收稅，對於收入超過 500,000 元的單身人士、收入超過一百萬美元的夫婦，依照他們的收入的一部分收稅。
REQUIREMENTS FOR INDIVIDUALS: 絕大多數美國人將被要求獲得某種形式的保險，否則將麵臨罰金。	Almost everyone must get coverage through an employer, on their own or through a government plan. Exemptions for economic hardship. Those who are obligated to buy coverage and refuse to do so would pay a fine starting at $95 in 2014 and rising to $750. 參議院醫改法案要求大多數人參加健康保險否則交罰金，罰金金額從 2014 年的 95 美元開始，在 2016 年將增加到 750 美元。	Individuals must have insurance, enforced through a tax penalty of 2.5 percent of income. People can apply for hardship waivers if coverage is unaffordable. 眾議院醫改法案要求大多數人參加健康保險否則交罰金，罰金金額是個人收入的 2.5% 。
REQUIREMENTS FOR EMPLOYERS: 對雇主的要求	Not required to offer coverage, but companies with more than 50 employees would pay a fee of $750 per employee if the government ends up subsidizing employees' coverage. 參議院醫改法案沒有要求雇主提供健康保險，對有超過 50 個員工並使用政府健康保險補貼的企業收取罰金。	Employers must provide insurance to their employees or pay a penalty of 8 percent of payroll. Companies with payrolls under $500,000 annually are exempt. Small businesses — those with 10 or fewer workers — get tax credits to help them provide coverage. 眾議院醫改法案要求雇主提供健康保險，但公司總工資支出低於 500,000 美元的企業被除外。
SUBSIDIES: 補貼	Tax credits for individuals and families likely making up to 400 percent of the federal poverty level, which computes to $88,200 for a family of four. Tax credits for small employers. 參議院醫改法案的健康保險補貼範圍包括了在聯邦貧困線收入的 4 倍（對一個四口的家庭現在是年收入 88,000 美元）。擴展了醫療補助項目聯邦貧困線收入的 133% 標準。	Individuals and families with annual income up to 400 percent of poverty level, or $88,000 for a family of four, would get sliding-scale subsidies to help them buy coverage. The subsidies would begin in 2013. 眾議院醫改法案的健康保險補貼範圍也包括了在聯邦貧困線收入的 4 倍（對一個四口的家庭現在是年收入 88,000 美元）。它將幫助醫療補助項目低收入個人和家庭支付預防費用和體檢費用。
BENEFITS PACKAGE: 保險產品基本標準	All plans sold to individuals and small businesses would have to cover basic benefits. The government would set four levels of coverage. The least generous would pay an estimated 60 percent of health care costs per year; the most generous would cover an estimated 90 percent 保險產品必須涵蓋最基本的保險標準，政府製訂四個保險支付水平（支付 60% 到 90% 不等）。保險公司出保險產品。	A committee would recommend a so-called essential benefits package including preventive services. Out-of-pocket costs would be capped. The new benefit package would be the basic benefit package offered in the exchange. 特別委員會推薦基本保險標準，公共交換市場上的保險為基本保險。
INSURANCE INDUSTRY RESTRICTIONS: 對保險公司的限製	Starting in 2014: no denial of coverage based on pre-existing conditions. No higher premiums allowed for pre-existing conditions or gender. Limits on higher premiums based on age and family size. Starting upon enactment of legislation: children up to age 26 can stay on parents insurance; no lifetime limits on coverage. 參議院版本將於 2014 年開始完全禁止私人保險公司基於已患病或者性別的原因拒絕向客戶提供保險，或者提高保險費用。對基於年齡提高保險費用進行限製。 26 歲以下的子女可留在父母的計劃裏得到醫療保險的覆蓋。	Starting in 2013, no denial of coverage based on pre-existing conditions. No higher premiums allowed for pre-existing conditions or gender. Limits on higher premiums based on age. 眾議院版本將於 2013 年開始完全禁止私人保險公司基於已患病或性別的原因拒絕向客戶提供保險，或者提高保險費用。對基於年齡提高保險費用進行限製。
GOVERNMENT-RUN PLAN: 兩院法案版本都包含運用新的公共交換或者市場的特色內容，而眾議院議員們在法案中包含了一個政府經營的選項，政府經營保險的費率將由政府協商製定	In place of a government-run insurance option, the estimated 26 million Americans purchasing coverage through new insurance exchanges would have the option of signing up for national plans overseen by the same office that manages health coverage for federal employees and members of Congress. Those plans would be privately owned, but one of them would have to be operated on a nonprofit basis, as many Blue Cross Blue Shield plans are now. 參議院醫改法案中沒有公共選擇計劃，卻讓政府出資提供聯邦補貼、美國人事管理局監管來幫助那些中低收入的人支付保險交易市場上的保費。	A new public plan available through the insurance exchanges would be set up and run by the health and human services secretary. Democrats originally designed the plan to pay Medicare rates plus 5 percent to doctors. But the final version — preferred by moderate lawmakers — would let the HHS secretary negotiate rates with providers. 眾議院醫改法案設置了公共選擇計劃，提供保險計劃與私營保險公司競爭，政府與醫療服務提供部門協商醫療費用。
HOW YOU CHOOSE YOUR HEALTH INSURANCE:	Self-employed people, uninsured individuals and small businesses could pick a plan offered through new state-based purchasing pools. Would generally encourage employees to keep work-provided coverage.	Beginning in 2013, through a new Health Insurance Exchange open to individuals and, initially, small employers. It could be expanded to large employers over time. States could opt to operate their own exchanges in place of the national exchange if they follow federal rules.
DRUGS:	Grants 12 years of market protection to high-tech drugs used to combat cancer, Parkinson's and other deadly diseases. Drug companies contribute $80 billion over 10 years with the majority of the money used to limit the prescription coverage gap in Medicare.	Grants 12 years of market protection to high-tech drugs used to combat cancer, Parkinson's and other deadly diseases. Phases out the gap in Medicare prescription drug coverage by 2019. Requires the HHS secretary to negotiate drug prices on behalf of Medicare beneficiaries.
CHANGES TO MEDICAID:	Income eligibility levels likely to be standardized to 133 percent of poverty — $29,327 a year for a family of four — for parents, children and pregnant women. Federal government would pick up the full cost of the expansion during the first three years. States could negotiate with insurers to arrange coverage for people with incomes slightly higher than the cutoff for Medicaid.	The federal-state insurance program for the poor would be expanded to cover all individuals under age 65 with incomes up to 150 percent of the federal poverty level, which is $33,075 per year for a family of four. The federal government would pick up the full cost of the expansion in 2013 and 2014; thereafter the federal government would pay 91 percent and states would pay 9 percent
LONG-TERM CARE:	New voluntary long-term care insurance program would provide a basic benefit designed to help seniors and disabled people avoid going into nursing homes.	New voluntary long-term care insurance program would provide a basic benefit designed to help seniors and disabled people avoid going into nursing homes.
ANTITRUST:	Maintains the health insurance industry's decades-old antitrust exemption. 醫療保險業繼續不受反壟斷法製約。	Would strip the health insurance industry of a long-standing exemption from antitrust laws covering market allocation, price-fixing and bid rigging. The bill also would give the Federal Trade Commission authority to look into the health insurance industry at its own initiative. 醫療保險業要受反壟斷法製約。
ILLEGAL IMMIGRANTS: 非法移民	Would be barred from receiving government subsidies or using their own money to buy coverage offered by private companies in the exchanges. 非法移民不能得到政府補貼和買政府扶植的交易市場上的健康保險。	Would be barred from receiving government subsidies but permitted to use their own money to buy coverage offered by private companies in the exchange. 非法移民非法移民不能得到政府補貼，但可以買政府扶植的交易市場上的健康保險。
ABORTION: 墮胎	The bill tries to maintain a strict separation between taxpayer funds and private premiums that would pay for abortion coverage. No health plan would be required to offer coverage for the procedure. In plans that do cover abortion, beneficiaries would have to pay for it separately, and those funds would have to be kept in a separate account from taxpayer money. Moreover, individual states would be able to prohibit abortion coverage in plans offered through the exchange, after passing specific legislation to that effect. Exceptions would be made for cases of rape, incest and danger to the life of the mother. 醫保如果要覆蓋墮胎費用，那麽受益人要單獨付款，且這些資金需要在一個分開的賬戶上。眾議院指責參議院的墮胎限製有漏洞。	Private companies in the exchange could not offer plans covering abortion if those plans received federal subsidy money. Most plans in the exchange would be affected, because most consumers in the exchange would be using federal subsidy money to buy coverage. The new government plan could not offer abortion coverage. Insurance companies would be permitted to offer supplemental abortion coverage in separate plans that people could buy with their own money. Use of federal money for abortion coverage would be limited to cases of rape, incest or danger to the woman's life. 眾議院醫改法案禁止支出經費來支付墮胎手術，除非墮胎手術與強奸、亂倫或者孕婦的健康問題有關。

[雨辰26]

回複llbyw的評論:
回得太好了！切中要害！

[雨辰26]

北美老農：你寫得好！完全讚成！！！

[llbyw]

放心，沒有醫改子孫後代一樣也要付比現在高的多的稅， 美國的過渡消費已經好幾代人，子孫後代得替好幾代人還債已經是不爭的事實。

現在即使大家都為醫改付出一些(這個不好說)，給子孫後代一個相對有保障的醫療係統，是很值的。尤其是我們這些中國人，身在他鄉，本來就無所依靠，有個大病小災的又沒人幫襯，現在至少你不會因為沒保險付不起醫療費等死，你還不支持，之隻能說一句，are you out of your mind?

回複lapis的評論:
這是自己借債讓子孫還錢的缺德事。
社會主義大鍋飯肯定不能持久。這事大夥心裏都有數。
你難道不是從大陸出來的？如果美國和大陸一樣，你還出國幹啥？

[safying]

抽全球的血去謀自己的戰爭利益是聰明壞人，借錢去滿足部分內需是笨好人。
下一步，不是搞星際競賽就是再發動場戰爭。。。

[mamamia99]

回複lapis的評論:

美國現在的醫療保險已經淪為第三世界水平了，還要怎樣？

千千萬萬中國普通百姓多希望有醫保，但中國政府沒有這個條件，也沒有這個良心 - 你也跟著瞎嚷嚷啥呢？你感謝奧巴馬還來不及呢！你難道變成了美國南方農民，一聽社會主義就要抄來福槍？？？

美國醫療保險支出比任何一個實行醫保的國家都要高，還有3200完沒有醫療保險。。。改革勢在必行，共和黨執政也要改，現在因為是民主黨執政，共和黨就開始用共產主義和社會主義忽悠百姓 - 您不幸也是個沒頭腦。。。

[lapis]

這是自己借債讓子孫還錢的缺德事。
社會主義大鍋飯肯定不能持久。這事大夥心裏都有數。
你難道不是從大陸出來的？如果美國和大陸一樣，你還出國幹啥？

[buzz]

跟老農一起開心！