Himmelstein J, Rest K
Public Health Rep. 1996 Jan-Feb;111(1):12-24; discussion 25.
The medical component of workers' compensation programs-now costing over $24 billion annually-and the rest of the nation's medical care system are linked. They share the same patients and providers. They provide similar benefits and services. And they struggle over who should pay for what. Clearly, health care reform and restructuring will have a major impact on the operation and expenditures of the workers' compensation system. For a brief period, during the 1994 national health care reform debate, these two systems were part of the same federal policy development and legislative process. With comprehensive health care reform no longer on the horizon, states now are tackling both workers' compensation and medical system reforms on their own. This paper reviews the major issues federal and state policy makers face as they consider reforms affecting the relationship between workers' compensation and traditional health insurance. What is the relationship of the workers' compensation cost crisis to that in general health care? What strategies are being considered by states involved in reforming the medical component of workers compensation? What are the major policy implications of these strategies?
工人赔偿计划的医疗部分——目前每年花费超过240亿美元——与美国其他医疗体系相互关联。它们拥有相同的患者和医疗服务提供者。它们提供类似的福利和服务。而且它们在应由谁来支付何种费用的问题上存在争议。显然，医疗保健改革和重组将对工人赔偿体系的运作和支出产生重大影响。在1994年全国医疗保健改革辩论的短暂时期内，这两个体系成为了同一联邦政策制定和立法进程的一部分。随着全面医疗保健改革不再提上日程，各州现在正在自行应对工人赔偿和医疗体系改革。本文回顾了联邦和州政策制定者在考虑影响工人赔偿与传统医疗保险之间关系的改革时所面临的主要问题。工人赔偿成本危机与一般医疗保健成本危机之间的关系是怎样的？参与改革工人赔偿医疗部分的各州正在考虑哪些策略？这些策略的主要政策影响是什么？
