Vogel R J
School of Public Administration and Policy, College of Business and Public Administration, The University of Arizona, Tucson 85721, USA.
Clin Ther. 1998 Nov-Dec;20(6):1250-62. doi: 10.1016/s0149-2918(98)80120-3.
The Medicare program is in precarious financial condition because of underfunding and structural defects in the way it pays providers of medical care. Given the prevailing anti-tax sentiment, the more promising route for attaining Medicare fiscal solvency would seem to lie on the expenditure side of the equation. This paper proposes a managed care model for reform that relies on an efficient and already-tested form of competitive bidding for the provision of medical care. It concludes with a discussion of short-run, intermediate-run, and long-run budgetary and tax implications for the Medicare program.
医疗保险计划处于不稳定的财务状况，原因在于资金不足以及支付医疗服务提供者方式上的结构缺陷。鉴于当前普遍存在的反税情绪，实现医疗保险财政偿付能力更有前景的途径似乎在于等式的支出方面。本文提出了一种改革的管理式医疗模式，该模式依赖于一种高效且已经过检验的竞争性投标形式来提供医疗服务。文章最后讨论了医疗保险计划在短期、中期和长期的预算及税收影响。
