Taricco A
Aetna Casualty and Surety, Hartford, CT.
Physician Exec. 1990 Jul-Aug;16(4):28-30.
While cost controls applied by Medicare and indemnity insurance programs initially helped curtail abusive medical billing practices, creative billing techniques have since resulted in runaway medical costs and rising insurance premiums. Employers have been forced to increase employee's contributions to health care by increasing deductibles, copayments, and coinsurance or by simply dropping health care benefits. If National Health Insurance comes to pass, and that is a cry now coming from major employers, it will be followed in time by federalization of all health care delivery systems, including Workers' Compensation. It is the providers who shift their fees into Workers' Compensation, which pays from the first dollar, who will cause the business community to petition Washington for relief. It will claim the need for cost controls in Workers' Compensation to keep American business competitive in world markets.
虽然医疗保险和赔偿保险计划实施的成本控制措施最初有助于遏制滥用医疗计费行为，但此后创新的计费技巧导致了医疗成本失控和保险费上涨。雇主们被迫通过提高免赔额、共付额和 coinsurance（此处 coinsurance 未翻译，可能是特定保险术语，需根据具体背景确定准确译法，暂保留原文），或者干脆取消医疗福利来增加员工对医疗保健的缴费。如果国家医疗保险得以通过，而这正是主要雇主们目前所呼吁的，那么包括工伤赔偿在内的所有医疗保健提供系统将迟早实现联邦化。正是那些将费用转嫁给工伤赔偿（工伤赔偿从第一笔费用就开始支付）的医疗服务提供者，将促使商界向华盛顿请愿寻求救济。商界会声称需要对工伤赔偿进行成本控制，以使美国企业在世界市场上保持竞争力。
