Campbell A J
Department of Medicine, University of Otago, Medical School, Dunedin.
N Z Med J. 1995 May 24;108(1000):193-5.
Asset testing of elderly people in long term care discriminates unfairly on grounds of age in two ways: only elderly people are charged for public hospital inpatient care and only for elderly people are public health system charges determined by assets not income. In this paper it is argued that the essential requirement for a public health system is that it is universally and promptly available to every person, irrespective of a person's ability to pay. This does not preclude direct charges. The costs for long term care should be met by charges for living and accommodation expenses and any charge for medical and nursing costs should be determined by income and not asset testing. There is no justification for charging for medical and nursing inpatient costs in long term care and not in other areas of public hospital care. If direct charges have to be made for inpatient care, then in the interests of equity, and to achieve adequate funding for the public health system, direct charges for such care should be for acute as well as long term care and for the young and middle aged as well as for the elderly, providing these charges do not preclude any person receiving necessary care.
只有老年人才需支付公立医院住院护理费用，且只有老年人的公共卫生系统费用是由资产而非收入决定的。本文认为，公共卫生系统的基本要求是它应普遍且及时地为每个人提供服务，无论其支付能力如何。这并不排除直接收费。长期护理费用应由生活和住宿费用收费来承担，任何医疗和护理费用收费都应由收入而非资产测试来决定。对长期护理中的医疗和护理住院费用收费而在公立医院护理的其他领域不收费是没有道理的。如果必须对住院护理收取直接费用，那么为了公平起见，并为公共卫生系统获得足够资金，此类护理的直接收费应涵盖急症护理以及长期护理，涵盖年轻人、中年人和老年人，前提是这些收费不排除任何人获得必要护理。
