Blumenthal D S, Lukomnik J E, Hawkins D R
Dept. of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA 30310.
J Health Care Poor Underserved. 1993;4(3):272-9; discussion 280-6. doi: 10.1353/hpu.2010.0330.
While a national health insurance plan is needed, this alone will not provide access for approximately 30 million persons who face geographic, cultural, language, or health care system barriers, or who live in areas with provider shortages. These barriers often coexist with lack of insurance coverage, but they also affect millions who have public, or even private, coverage. Moreover, large segments of this population suffer from health problems not adequately addressed by the traditional medical model: teenage pregnancy, AIDS, injury, substance abuse, and the like. To provide appropriate care for these underserved persons, we propose to expand the existing network of community health centers over the next 10 years to a total of approximately 3,000. Such an expansion would provide a cost-effective approach to improving provider distribution, increasing consumer input, combining personal health services with health promotion, and removing both financial and nonfinancial barriers to care. This model can be implemented either independent of or in conjunction with other health care system reform efforts.
虽然需要一项全国性的医疗保险计划，但仅靠这一点并不能为大约3000万人提供就医机会，这些人面临地理、文化、语言或医疗保健系统方面的障碍，或者生活在医疗服务提供者短缺的地区。这些障碍往往与缺乏保险覆盖同时存在，但它们也影响着数百万拥有公共甚至私人保险的人。此外，这一人群中的很大一部分人患有传统医疗模式未能充分解决的健康问题：青少年怀孕、艾滋病、伤害、药物滥用等等。为了为这些服务不足的人群提供适当的护理，我们建议在未来10年内将现有的社区卫生中心网络扩大到总共约3000个。这样的扩展将提供一种具有成本效益的方法，以改善医疗服务提供者的分布、增加消费者的参与、将个人健康服务与健康促进相结合，并消除医疗护理的财务和非财务障碍。这种模式可以独立实施，也可以与其他医疗保健系统改革努力相结合实施。
