Soumerai S B, Ross-Degnan D
Harvard Medical School, Boston, MA 02115, USA.
N Engl J Med. 1999 Mar 4;340(9):722-8. doi: 10.1056/NEJM199903043400909.
In summary, most low-income elderly and disabled persons lack coverage for important medications, resulting in avoidable deterioration of health among those with chronic illnesses and use of expensive institutional services. Rapidly escalating drug costs, more restrictive drug-coverage policies, and a dramatic increase in the population of elderly and disabled persons will exacerbate these problems. With the current budget surplus, as well as bipartisan concern about health care needs and public concern about drug costs and coverage, it is time to act responsibly and aggressively. We recommend a national replication of the best features of state pharmacy-assistance programs in a federal-state insurance program for low-income Medicare enrollees, either alone or in combination with expanded Medicare coverage. Such a program will reduce the current inequitable situation in which the most vulnerable patients have the least access to medications, with serious medical and economic consequences.
总之，大多数低收入老年人和残疾人缺乏重要药物的保险覆盖，导致慢性病患者健康状况出现可避免的恶化，并使用昂贵的机构服务。药品成本迅速上升、药品保险政策更加严格，以及老年人和残疾人数量急剧增加，将使这些问题更加严重。鉴于目前的预算盈余，以及两党对医疗保健需求的关注和公众对药品成本及保险覆盖的关注，现在是采取负责任且积极行动的时候了。我们建议在联邦-州保险计划中，单独或与扩大的医疗保险覆盖相结合，对低收入医疗保险参保者全国推广州药房援助计划的最佳特色。这样一个计划将减少当前最脆弱患者获得药物机会最少的不公平状况，带来严重的医疗和经济后果。
