Buck J A, Koyanagi C
Office of Policy and Planning, Center for Mental Health Services, Rockville, Maryland 20857.
Hosp Community Psychiatry. 1994 Sep;45(9):883-7. doi: 10.1176/ps.45.9.883.
This paper reviews problems that the Medicaid program poses for health care reformers and how the Clinton plan would deal with them. The Clinton plan represents a compromise between preserving or expanding the Medicaid program and eliminating. The plan would seek to extend services to those without insurance and reduce health care costs, partly by limiting services and increasing out-of-pocket costs for Medicaid beneficiaries. All Medicaid beneficiaries would be included in the same basic system of health care that the plan proposes for other Americans. All current beneficiaries would remain eligible for Medicaid, but services would be reduced for many of them. However, services that are important for persons with severe mental illness would be maintained. The plan also would increase out-of-pocket costs for premiums and services, and these increases could be significant for some beneficiaries.
本文回顾了医疗补助计划给医疗改革者带来的问题，以及克林顿计划将如何应对这些问题。克林顿计划代表了在保留或扩大医疗补助计划与取消该计划之间的一种妥协。该计划试图将服务扩展到没有保险的人群，并降低医疗成本，部分方式是限制服务并增加医疗补助受益人的自付费用。所有医疗补助受益人都将被纳入该计划为其他美国人提议的同一基本医疗体系。所有现有受益人仍有资格享受医疗补助，但他们中许多人的服务将被削减。然而，对重症精神疾病患者重要的服务将得以维持。该计划还将增加保费和服务的自付费用，而这些增加对一些受益人可能相当可观。
