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美国和瑞典的私人医疗保险:比较综述。

Private health insurance in the United States and Sweden: A comparative review.

作者信息

Dave Udit, Lewis Emma G, Patel Jenilkumar H, Godbole Nikhil

机构信息

Tulane University School of Medicine New Orleans Louisiana USA.

出版信息

Health Sci Rep. 2024 Mar 14;7(3):e1979. doi: 10.1002/hsr2.1979. eCollection 2024 Mar.

Abstract

BACKGROUND AND AIMS

The United States of America and Sweden both contain a public and private component to their healthcare systems. While both countries spend a similar amount per capita on public healthcare expenditures, the United States spends significantly more in the private healthcare sector. Sweden has a social democratic model of health care, and given its identity as a welfare state, private health insurance providers have a small and nuanced role.

METHODS

This paper was completed after searches were queried for "Sweden," "United States," and variants of the words "insurance," "public," "private," "Medicare," "Medicaid," "public," and "costs." A preliminary search in May 2022, yielded 78 articles, of which 45 were ultimately considered relevant for this review. Inclusion criteria consisted of English language articles, topic relevance, and verification of MEDLINE-indexed journals. These searches were performed in PubMed, Google Scholar, Embase, and Cochrane. Summary findings of these searches are compiled in this review.

RESULTS

Sweden guarantees low-cost appropriate care to all citizens with equitable access; however, drawbacks of its system include high financial burden, lack of primary care infrastructure, as well as geographical and socioeconomic inequities. On the other hand, the United States' healthcare system is built around the private sector with public health insurance reserved only for the most vulnerable patient populations.

CONCLUSION

Our goal is to provide an overview, compare the role of private health insurance in both countries, and highlight policies that have had beneficial effects in each nation. Possible solutions to the drawbacks of each nation's health insurance policies could be addressed by additional support to Sweden's vulnerable population by developing a program similar to the US' Medicare Advantage program. Conversely, the United States may benefit from increasing access to public health insurance, especially in instances where families face unemployment.

摘要

背景与目的

美国和瑞典的医疗保健系统都包含公共和私人两个部分。虽然两国在公共医疗保健支出方面的人均花费相近,但美国在私人医疗保健领域的支出要高得多。瑞典拥有社会民主主义的医疗保健模式,鉴于其福利国家的身份,私人医疗保险提供商的作用较小且细微。

方法

本文在对“瑞典”“美国”以及“保险”“公共”“私人”“医疗保险”“医疗补助”“公共”和“成本”等词的变体进行搜索后完成。2022年5月的初步搜索产生了78篇文章,其中45篇最终被认为与本综述相关。纳入标准包括英文文章、主题相关性以及对MEDLINE索引期刊的验证。这些搜索在PubMed、谷歌学术、Embase和Cochrane中进行。本综述汇编了这些搜索的总结结果。

结果

瑞典为所有公民提供低成本的适当医疗服务,且医疗服务可公平获取;然而,其系统的缺点包括高财务负担、缺乏初级保健基础设施以及地理和社会经济不平等。另一方面,美国的医疗保健系统以私营部门为核心构建,公共医疗保险仅保留给最脆弱的患者群体。

结论

我们的目标是提供一个概述,比较两国私人医疗保险的作用,并突出在每个国家产生有益影响的政策。每个国家医疗保险政策缺点的可能解决方案可以通过类似于美国医疗保险优势计划的项目为瑞典弱势群体提供额外支持来解决。相反,美国可能会从增加公共医疗保险的可及性中受益,特别是在家庭面临失业的情况下。

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