医学专题一奥巴马医改(中英版).ppt

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1、Made by 402The reformation of the medical treatment faces lots of obstacles.The reformation of the medical treatment faces lots of obstacles.How did Obama succeed in breaking out of the crisis?How did Obama succeed in breaking out of the crisis?第一页，共二十页。2数十年来美国历任总统推行医改都铩数十年来美国历任总统推行医改都铩羽而归，皆因反对声四起。奥

2、氏也遇羽而归，皆因反对声四起。奥氏也遇到到(y do)同样难题。旨在让全民都同样难题。旨在让全民都得到医保的医改计划为何遭遇重重阻得到医保的医改计划为何遭遇重重阻挠？既然拦阻甚多，这次怎么又能顺挠？既然拦阻甚多，这次怎么又能顺利过关利过关?American former presidents had tried to carry out health reforms in the past years but they failed.So many people at all levels reject the health reforms.Obama faced the same diffi

3、culties.Why did the health reforms were obstructed heavily even it is good to American?Why Obama got approval this time with solid opposition?第二页，共二十页。3The difficulty of the health care reform in U.Sis encountering with opposition美国医改难美国医改难 难在遭遇重重反对难在遭遇重重反对 团结团结(tunji)民主党民主党 巧用程序阻击共和党巧用程序阻击共和党 Obama

4、 strategy is properly to avoid making the same mistakes奥巴马策略得当奥巴马策略得当 避免重蹈覆辙避免重蹈覆辙 United Democratic Party attack Republican Party by using procedures smartly团结民主党团结民主党 巧用程序狙击共和党巧用程序狙击共和党 第三页，共二十页。4医改与美国传统价值观相悖医改与美国传统价值观相悖Healthcare reform contradicts with the Americans traditional values 多数人反对建立公共保

5、险机构多数人反对建立公共保险机构Most people object to establish the public insurance organization 共和党极力阻挠医改共和党极力阻挠医改 The Republican Party obstructs the healthcare reform vigorously.保险业坚决抵制医改保险业坚决抵制医改The insurance business firm resisting medicine changes医药行业反对医改医药行业反对医改 The medicine opposethe Healthcare reform中产阶级、富

6、人忧心忡忡中产阶级、富人忧心忡忡The middle class and the rich person are heavy-hearted 第四页，共二十页。医改与美国传统价值观相悖医改与美国传统价值观相悖Healthcare reform contradicts with the Americans traditional values 民调显示民调显示48%的美国人反对医改。反对根本原因的美国人反对医改。反对根本原因在于，医改与美国传统价值观相悖。美国人对政在于，医改与美国传统价值观相悖。美国人对政府干预府干预(gny)市场、国家控制社会的戒心根深市场、国家控制社会的戒心根深蒂固，对政府

7、主导医疗和国家控制医保的措施保蒂固，对政府主导医疗和国家控制医保的措施保持高度警惕性持高度警惕性.Polls show 48%of Americans opposed to medical reform.Against the fundamental reason is that health care reform with the United States,contrary to traditional values.U.S.government intervention in the market,state-controlled deep-rooted wariness of soc

8、iety,on the government-led control of health care and national health insurance policy to maintain the high degree of vigilance 第五页，共二十页。奥巴马原想建立奥巴马原想建立(jinl)非营利公共保险机构，通过与私营保险机构非营利公共保险机构，通过与私营保险机构展开竞争有效降低保险费。但大多数人坚决反对，他们认为这是在破展开竞争有效降低保险费。但大多数人坚决反对，他们认为这是在破坏美国的自由价值观念，他们青睐市场主导的医保，要坏美国的自由价值观念，他们青睐市场主导的医

9、保，要把政府的手把政府的手拿开拿开。多数人反对建立公共保险机构多数人反对建立公共保险机构Most people object to establish the public insurance organization Obama originally wanted to build non-profit public insurance institutions,by means of competing with the private insurance sector to reduce insurance premiums more effectively.But most peopl

10、e firmly opposed,they think this is undermining the American values of freedom,they favor a market-driven health care,to put the governments hand away.第六页，共二十页。共和党极力共和党极力(jl)阻挠医改，有党阻挠医改，有党派思维作祟，但派思维作祟，但更因执政理念不更因执政理念不同。共和党人一同。共和党人一直主张直主张小政府大小政府大市场市场，而医改将，而医改将形成强势政府，形成强势政府，对社会生活和经对社会生活和经济产生过分干涉，济产生过分干

11、涉，违背资本主义自违背资本主义自由市场经济的原由市场经济的原则则 共和党极力阻挠医改共和党极力阻挠医改 The Republican Party obstructs the healthcare reform vigorously.Republicans obstruct medical reform with the thought of party mischief,but more because of the ruling idea is different.Republicans have been advocating small government,big market,whi

12、le the medical reform will form a strong government,social life and the economy too much interference,which is contrary to the principles of capitalist free market economy第七页，共二十页。保险业坚决抵制医改保险业坚决抵制医改The insurance business firm resisting medicine changes受医改冲击最大的将是保险业。在美国医保体系中，保险受医改冲击最大的将是保险业。在美国医保体系中，

13、保险企业是既得利益者，对医改持抵制态度。投票前，保险利企业是既得利益者，对医改持抵制态度。投票前，保险利益集团游说议员，斥巨资投放广告益集团游说议员，斥巨资投放广告(gunggo)号召反对医号召反对医改。改。Hardest hit by medical reform will be the insurance industry.In the United States medical insurance system,insurance companies who have vested interests resisted on medical reform.Before the vote,

14、the insurance interest groups lobby the members and cost lots of money in advertising,called against the medical reform.第八页，共二十页。医药行业反对医改医药行业反对医改 The medicine oppose the Healthcare reformsome medeine enterprises refuse health reform,for the reforms increase costs.it will use cheap effective medeine

15、and technology,which will cut down the profits of medicine enterprise heavily.what is more,doctor association worry about the reforms may course damage to doctors interests.药品企业也反对医改，因为医改要控制药品企业也反对医改，因为医改要控制成本，必然将更多地使用成本，必然将更多地使用(shyng)便宜便宜而有效的适宜药品、适宜技术，医药企而有效的适宜药品、适宜技术，医药企业的盈利空间将会大大缩小；三是医生业的盈利空间将会大

16、大缩小；三是医生协会，也担心医改会损害医生的利益。协会，也担心医改会损害医生的利益。第九页，共二十页。除不得不缴纳更多税收来为穷人享受医保除不得不缴纳更多税收来为穷人享受医保“埋单埋单”外，中产阶级外，中产阶级(zhngchnjij)、富裕阶层还担心，大量穷人在获保后涌入医疗服务市、富裕阶层还担心，大量穷人在获保后涌入医疗服务市场，而医疗资源相对有限，富人们曾经享受的场，而医疗资源相对有限，富人们曾经享受的VIP式服务将可能不复存式服务将可能不复存在在 In addition to have to pay more taxes to enjoy medical insurance for th

17、e poor,pays the bill,the middle class and wealthy class is also concerned that a large number of poor by the influx of medical services after the insurance market,while relatively limited medical resources,the rich people who enjoy the VIP-style services may no longer exist中产阶级、富人忧心忡忡中产阶级、富人忧心忡忡The

18、middle class and the rich person are heavy-hearted 第十页，共二十页。11雷厉风行雷厉风行(li l fng xng)动用动用舆论压力舆论压力Vigorous and resolute use of public pressure 先易后难先易后难 逐个逐个(zhg)击破击破The easier one by one break抢在中期选举前推动改革抢在中期选举前推动改革 Rush to promote the revolution before the mid-term elections顶住压力顶住压力 坚持信念坚持信念Withstand

19、the pressure of its convictions 吸取教训吸取教训 只提纲领只提纲领Lessons provided only program 懂得妥协和放弃懂得妥协和放弃Know how to compromise and give up 第十一页，共二十页。奥巴马在奥巴马在6月月9日民主党参议院公布医改方案之后，次日即在全国动员全美日民主党参议院公布医改方案之后，次日即在全国动员全美200万万草根支持者在草根支持者在50个州展开宣传，掀起一场全国性的大讨论。这实际上也是借助公个州展开宣传，掀起一场全国性的大讨论。这实际上也是借助公众舆论的力量迫使众舆论的力量迫使(psh)既得

20、利益集团低头。既得利益集团低头。On June 9,Obama announced the Senate Democratic health care reform proposal,the next day in national grassroots mobilization of the nations two million supporters in 50 states to have a publicity,which set off a big national discussion.This is actually using the power of public opini

21、on forced the bow of vested interests.雷厉风行雷厉风行(li l fng xng)动用动用舆论压力舆论压力Vigorous and resolute use of public pressure 第十二页，共二十页。Obama has the full support of high-profile medical reform program,and then he faced the problems from the interference of Congress and interest groups,and even many voters b

22、egan to waver on his support.But Obama has not manipulated by them,instead of taking a more active engagement situation to face it,even if such contact is not happy.顶住压力顶住压力 坚持坚持(jinch)信念信念Withstand the pressure of its convictions 奥巴马高调全面支持奥巴马高调全面支持(zhch)医改方案之后，面临了医改方案之后，面临了来自国会和利益集团的干扰，甚至众多选民也开始来自国

23、会和利益集团的干扰，甚至众多选民也开始动摇对他的支持动摇对他的支持(zhch)。但奥巴马并未因此受制于。但奥巴马并未因此受制于人，而是采取了更积极的接触态势，哪怕这样的接人，而是采取了更积极的接触态势，哪怕这样的接触并不愉快触并不愉快第十三页，共二十页。先易后难先易后难 逐个逐个(zhg)击破击破The easier one by one to break奥巴马针对各个利益集团，按难易程度采取分别谈判、各个击奥巴马针对各个利益集团，按难易程度采取分别谈判、各个击破的战略。奥巴马积极游说此前一直被称为破的战略。奥巴马积极游说此前一直被称为“医改禁区医改禁区”的美的美国医学协会，与全美医院体系达成

24、国医学协会，与全美医院体系达成(dchng)共识，并得到了全共识，并得到了全美护士协会的支持美护士协会的支持 Obama have a active lobby with the American Medical Association,which is referred to as restricted medical reform.Then reach a consensus with the nations hospital system and has been supported by the National Nurses Association.第十四页，共二十页。吸取教训吸取教

25、训 只提纲领只提纲领(gnglng)Lessons provided only program 克林顿也曾力推医改，拿出长达数百页的报告，却连克林顿也曾力推医改，拿出长达数百页的报告，却连国会投票也没争取到。有了前车之鉴，奥巴马没有国会投票也没争取到。有了前车之鉴，奥巴马没有(mi yu)推出几百页方案，让议员在看懂之前就失去推出几百页方案，让议员在看懂之前就失去耐心，而是推出一些纲领和方针，交由国会自行拟订耐心，而是推出一些纲领和方针，交由国会自行拟订方案。方案。Clinton has pressed for medical reform with hundreds of pages of

26、reports but it failed to get any votes from the Congress.With this lesson,Obama did not release hundreds of pages of the program which will make the Members lose patience before understand,but to introduce programs and policies which is drafted by Congress.第十五页，共二十页。抢在中期选举前推动抢在中期选举前推动(tu dng)改革改革 Ru

27、sh to promote the revolution before the mid-term elections奥巴马他在上任后第一年就开始奥巴马他在上任后第一年就开始大刀阔斧推行这一改革大刀阔斧推行这一改革(gig)，争取在中期选举季节到来之前取争取在中期选举季节到来之前取得成果，以免因改革得成果，以免因改革(gig)努力努力受到政治需求限制受到政治需求限制 懂得懂得(dng de)妥协和放弃妥协和放弃Know how to compromise and give up 奥巴马作出了让步，有关设立公共奥巴马作出了让步，有关设立公共保险机构的构想在参议院的最终版保险机构的构想在参议院的最终

28、版本医改议案中消失了。这不仅平息本医改议案中消失了。这不仅平息了巨大争议，也将大大降低政府开了巨大争议，也将大大降低政府开支。支。Obama made a concession that the relevant idea of setting up public insurance institutions was die out in the final Medical reform.This not only put down a huge controversy,but also will greatly reduce government expenditure.To avoide

29、the reforms will be limited by political demand第十六页，共二十页。17 共和党想用共和党想用“阻碍议事程序阻碍议事程序”拖延改法案拖延改法案Republicans want to impede the proceedings in order to delay healthcare reform bill民主党人用民主党人用“预算协调预算协调”程序迂回推进程序迂回推进Democrats use the“budget coordination”program advance roundabout奥巴马和佩洛西紧盯摇摆议员奥巴马和佩洛西紧盯摇摆议员M

30、r.Obama and Pelosi keep a close eye on the hesitative US Congressman强化堕胎限制强化堕胎限制 奥巴马凑足票数奥巴马凑足票数Obama gather votes to strengthen restrictions on abortions投票进行时，大约300名反对者聚集在国会大厦附近一处草坪，高举自制标牌及美国国旗。其中一条标语写道：“扼杀法案！”第十七页，共二十页。3月月23日，在美国首都华盛顿白宫，美国总统奥巴马签署医疗保险改日，在美国首都华盛顿白宫，美国总统奥巴马签署医疗保险改革法案，美国民主党人努力多年的全面革法案，美国民主党人努力多年的全面(qunmin)医改目标终将实现医改目标终将实现 Moment of the great success第十八页，共二十页。19第十九页，共二十页。内容(nirng)总结Made by 402。美国医改难 难在遭遇重重反对。奥巴马原想建立非营利公共保险机构，通过与私营保险机构展开竞争(jngzhng)有效降低保险费。Thank you第二十页，共二十页。