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.
这个想法并不激进,但在政治上却引起争议。医疗照顾优先计划愈发流行,约有三成的医保受益者参加了个人计划。保险公司抱怨到,奥巴马医改中与其他措施相配合的缩减政策,会迫使他们提价或削减福利。
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 29 congressionalDemocrats 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.
骚动掩盖了一个简单的事实:民主党人和共和党人均认为,必须遏制医疗支出。国会共和党提出的预算由PaulRyan撰写,该预算保留了所有奥巴马医改中对医疗支出的削减政策,其中也包括了医疗照顾优先计划。但别指望着共和党人会在竞选中提及此事。译者:萧毛毛
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