David Geffen School of Medicine, Los Angeles, CA, USA.
QJM. 2010 Sep;103(9):709-14. doi: 10.1093/qjmed/hcq072. Epub 2010 May 18.
Health care reforms are now a reality in America after a long and tortuous debate. President Obama has achieved a 'victory' unlike anything seen since the term of President Lyndon Johnson, over 40 years ago. The new law brings America closer to universal coverage and access to affordable health care for its citizens, but the cost of the program and its impact on individuals, physicians, hospitals, the pharmaceutical and device industry and insurance companies is not yet fully known. The debate preceding the enactment of health care reform brought up numerous comparisons (often invidious and falsified) between the American system of health care and other systems throughout the world, including the National Health Service in the United Kingdom and Medicare in Canada. This overview examines the issues raised in the debate, perceptions of health care systems on a global basis, provides some perspectives on the reform of health care systems and examines some of the realities underlying these changes for the future of health care in America.
在美国经历了漫长而曲折的辩论之后，医疗改革如今成为现实。总统奥巴马取得了一场“胜利”，这是自 40 多年前林登·约翰逊总统(Lyndon Johnson)以来从未有过的。新法律使美国更接近全民覆盖，并为其公民提供负担得起的医疗保健，但该计划的成本及其对个人、医生、医院、制药和设备行业以及保险公司的影响尚不完全清楚。在医疗改革法案颁布之前的辩论中，人们对美国的医疗保健系统与包括英国国民保健制度（National Health Service）和加拿大老年保健制度（Medicare）在内的全球其他医疗保健系统进行了大量比较（往往是带有恶意的和虚假的）。这篇综述考察了辩论中提出的问题，对全球范围内的医疗保健系统的看法，提供了一些关于医疗保健系统改革的观点，并探讨了这些变化背后的一些现实情况，这些情况将影响美国未来的医疗保健。
