医疗改革演讲稿

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奥巴马医疗改革演讲稿

Good evening, everybody.Tonight, after nearly 100 years of talk and frustration, after decades of trying, and a year of sustained effort and debate, the United States Congre finally declared that America’s workers and America’s families and

America’s small businees deserve the security of knowing that here, in this country, neither illne nor accident should endanger the dreams they’ve worked a lifetime to achieve.

Tonight, at a time when the pundits said it was no longer poible, we rose above the weight of our politics.We pushed back on the undue influence of special interests.We didn’t give in to mistrust or to cynicism or to fear.Instead, we proved that we are still a people capable of doing big things and tackling our biggest challenges.We proved that this government — a government of the people and by the people — still works for the people.

I want to thank every member of Congre who stood up tonight with courage and conviction to make health care reform a reality.And I know this wasn’t an easy vote for a lot of people.But it was the right vote.I want to thank Speaker Nancy Pelosi for her extraordinary leadership, and Majority Leader Steny Hoyer and

Majority Whip Jim Clyburn for their commitment to getting the job done.I want to thank my outstanding Vice President, Joe Biden, and my wonderful Secretary of

Health and Human Services, Kathleen Sebelius, for their fantastic work on this iue.I want to thank the many staffers in Congre, and my own incredible staff in the White House, who have worked tirelely over the past year with Americans of all walks of life to forge a reform package finally worthy of the people we were sent here to serve.

Today’s vote answers the dreams of so many who have fought for this reform.To every unsung American who took the time to sit down and write a letter or type out an e-mail hoping your voice would be heard — it has been heard tonight.To the untold numbers who knocked on doors and made phone calls, who organized and mobilized out of a firm conviction that change in this country comes not from the top

down, but from the bottom up — let me reaffirm that conviction:This moment is poible because of you.

Most importantly, today’s vote answers the prayers of every American who has hoped deeply for something to be done about a health care system that works for insurance companies, but not for ordinary people.For most Americans, this debate has never been about abstractions, the fight between right and left, Republican and Democrat — it’s always been about something far more personal.It’s about every American who knows the shock of opening an envelope to see that their premiums just shot up again when times are already tough enough.It’s about every parent who knows the desperation of trying to cover a child with a chronic illne only to be told “no” again and again and again.It’s about every small busine owner forced to choose between insuring employees and staying open for busine.They are why we committed ourselves to this cause.

Tonight’s vote is not a victory for any one party — it’s a victory for them.It’s a victory for the American people.And it’s a victory for common sense.

Now, it probably goes without saying that tonight’s vote will give rise to a frenzy of instant analysis.There will be tallies of Washington winners and losers,

predictions about what it means for Democrats and Republicans, for my poll numbers, for my administration.But long after the debate fades away and the prognostication fades away and the dust settles, what will remain standing is not the government-run system some feared, or the status quo that serves the interests of the insurance industry, but a health care system that incorporates ideas from both parties — a system that works better for the American people.

If you have health insurance, this reform just gave you more control by reining in the worst excees and abuses of the insurance industry with some of the toughest consumer protections this country has ever known — so that you are actually getting what you pay for.

If you don’t have insurance, this reform gives you a chance to be a part of a big purchasing pool that will give you choice and competition and cheaper prices for insurance.And it includes the largest health care tax cut for working families and

small businees in history — so that if you lose your job and you change jobs, start that new busine, you’ll finally be able to purchase quality, affordable care and the security and peace of mind that comes with it.

This reform is the right thing to do for our seniors.It makes Medicare stronger and more solvent, extending its life by almost a decade.And it’s the right thing to do for our future.It will reduce our deficit by more than $100 billion over the next decade, and more than $1 trillion in the decade after that.

So this isn’t radical reform.But it is major reform.This legislation will not fix everything that ails our health care system.But it moves us decisively in the right direction.This is what change looks like.

Now as momentous as this day is, it’s not the end of this journey.On Tuesday, the Senate will take up revisions to this legislation that the House has embraced, and these are revisions that have strengthened this law and removed provisions that had no place in it.Some have predicted another siege of parliamentary maneuvering in order to delay adoption of these improvements.I hope that’s not the case.It’s time to bring this debate to a close and begin the hard work of implementing this reform properly on behalf of the American people.This year, and in years to come, we have a solemn responsibility to do it right.

Nor does this day represent the end of the work that faces our country.The work of revitalizing our economy goes on.The work of promoting private sector job creation goes on.The work of putting American families’ dreams back within reach goes on.And we march on, with renewed confidence, energized by this victory on their behalf.

In the end, what this day represents is another stone firmly laid in the foundation of the American Dream.Tonight, we answered the call of history as so many

generations of Americans have before us.When faced with crisis, we did not shrink from our challenge — we overcame it.We did not avoid our responsibility — we embraced it.We did not fear our future — we shaped it.

Thank you, God ble you, and may God ble the United States of America.奥巴马政府医改的主要内容

（一）奥巴马的政策主张

奥巴马主张，对于那些已有保险并且感到满意的民众，这部分人的保险不必作任何改动；而是为那些对现有的制度不满意或者没有保险的人提供帮助。同时，奥巴马还极力主张加强由雇主来承担的医疗保健计划。

在医保覆盖方面，奥巴马明确提出要确保所有美国公民都能获得适当的医保覆盖，让医疗保健成为每个美国人都负担得起、享受得到的服务，但保留患者的选择权；并且要建立一项全美健康保险交换制度和一项新的公共卫生计划，提供一定程度的私人保险，比如没有提供医疗保险的小型公司员工，未受雇佣的个人可以通过美国联邦政府的这一制度获得保费合理的医疗保险。政府设立一个医疗保险计划市场，各个家庭可以在私人计划或是美国联邦医疗保险（Medicare）等政府新推出的计划中选择。

在医疗保险的可及性与公平性方面，奥巴马主张向低收入家庭提供补贴用于保险成本，向重病患者提供补贴帮助投保。家长必须为孩子投保，大公司必须提供保险，或是成立基金用于支付保险费。消除癌症患者和癌症幸存者之间的医疗保险差异，确保所有的人能够公平地购买到合理保费的私人保险。在医疗保健方面，奥巴马主张通过扩大贷款还款资助力度，提供适当的赔偿，保证培训课程开展，加强医疗保健工作队伍，加强基础建设以改善工作环境。奥巴马还承诺5年内支持癌症研究的预算将翻倍，有必要扭转近年来对该领域资助的停滞状态。

（二）医疗改革的目标

2009年9月9日，奥巴马在国会两院联席会议上发表讲话，阐述其医疗保健政策改革计划，呼吁推动这项改革措施，以拯救已经陷入危机多年的美国医保体系。奥巴马宣布，他的医疗改革计划要达到3个目标：一是给已有保险的人提供更多安全保障, 病人自费的额度将受到限制，这将通过对保险公司的严格立法实现。因为在新的改革方案下,保险公司因为投保人有既往病史而拒绝赔付,或因投保人生病而取消其保险计划或限制他们的保险范围均是违法行为。二是给没有保险的人提供在他们经济支付能力范围内的选择，新的医保计划要求每个人都有保险,这是权利,也是责任。如果个人和小企业负担不起现有的最低价格保险,政府将按照所需数额提供税收抵免。三是缓解医疗保健体系给美国家庭、企业和政府带来的开支增长。

（三）医改资金来源

2009年6月，奥巴马宣布了一项进一步投资3130亿美元的计划，以推动美国的医疗改革。这笔资金来自于削减现行的联邦针对老人和贫困人口的医疗照顾计划开支，而遭受这一变革冲击最大的是美国医院。而在此之前，还曾在递交给国会的财政预算中制定了总额为6350亿美元的医疗改革计划。这笔从联邦医保系统中削减出来的资金将用于老年人和穷人的医疗保健。

医疗改革实施后，在第一个十年内预计耗资9000亿美元，主要通过减少现有医疗保健体系资金浪费或滥用来筹集，其他费用则来自医药和保险公司的税收，不会增加纳税人的经济负担。

（四）政府在医疗服务市场的作用

奥巴马政府医保改革的焦点是要建立由政府主导的公共保险公司,奥巴马认为这是引进竞争、降低医保费用的关键。提供一个不以营利为目的的公共保险公司,主要是为了防止私营保险公司的滥权行为,其服务对象只针对那些没有保险的人。

（五）舆论评价

奥巴马虽然承诺扩大医疗覆盖面，改善医疗服务。但美国布鲁金斯学会的经济和医疗政策高级学者亨利.埃龙认为：虽然奥巴马政府的医疗改革目标明确，但也是困难重重。当前美国健康保健体系最大的问题是，很多人还没有健康保险， 以及在这方面花费太多。以目前的情况看，这两大问题的解决很难取得进展。