Silverman Morton W
College of Optometry, Nova Southeastern University, Ft. Lauderdale, Florida 33328-2018, USA.
Optometry. 2006 Apr;77(4):180-6. doi: 10.1016/j.optm.2006.01.012.
The number of uninsured and underinsured Americans continues to rise. Many large U.S. corporations are finding the burden of providing health insurance for their retirees, as well as their workers, seriously affecting their ability to compete globally. Many smaller companies are eliminating their health insurance entirely, or requiring greater contributions on the part of the insured worker. The problems encountered by industry have resulted in a new form of health insurance called Consumer-Driven Health Plans, which require greater outlays by covered workers. The changes in our health care delivery system in the past 42 years have dramatically changed the practice of optometry as well as medicine. The rapid growth in health care costs, particularly for our citizens who pay for their own health insurance, has outpaced wages by nearly 4 times. The number of citizens who qualify for Medicaid continues to increase. This presents a particular problem for optometry, as vision care is not a mandated service of Medicaid under federal guidelines. In addition, many managed care plans may have to eliminate eye care benefits, which are often a carve-out of a major plan in order to stay competitive. There is also evidence to suggest that many of our citizens who can least afford the present cost of health care will attempt to receive their care from community clinics and charitable programs, including vision care programs.
未参保和参保不足的美国人数量持续上升。许多美国大公司发现，为退休人员以及员工提供医疗保险的负担严重影响了它们在全球竞争的能力。许多小公司则完全取消了医疗保险，或者要求参保员工缴纳更多费用。行业所面临的这些问题催生了一种新型医疗保险，即消费者驱动型健康计划，该计划要求参保员工支付更多费用。在过去42年里，我们医疗保健提供系统的变革极大地改变了验光配镜行业以及医学实践。医疗保健成本的快速增长，尤其是对于那些自行购买医疗保险的公民来说，其增长速度几乎是工资增长速度的4倍。符合医疗补助资格的公民数量持续增加。这给验光配镜行业带来了一个特殊问题，因为根据联邦指导方针，视力保健并非医疗补助的法定服务项目。此外，许多管理式医疗计划可能不得不取消眼部护理福利，而眼部护理福利通常是从主要计划中剥离出来的，以便保持竞争力。还有证据表明，我们许多最无力承担当前医疗保健费用的公民将试图从社区诊所和慈善项目获得医疗服务，包括视力保健项目。
