2014.04.26【英译汉】What American Healthcare Can Learn From Germany 3

ydyinglluk (Erin) 译坛新秀
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发表于:2014-04-26 09:03 [只看楼主] [划词开启]

Germanyis in the middle of the pack among developed countries when it comes to healthcare spending per capita, according to a report released by the Commonwealth Fund last fall.

根据去年英联邦基金会公布的一份报告显示,德国在所有的发达国家中,人均在医疗保健方面的花销处于中等水平。


Commonwealth Fund

But of all of the countries studied, Germans were the most likely to be able to get a same-day or next-day appointment and to hear back from a doctor quickly if they had a question. They rarely use emergency rooms, and they can access doctors after-hours with ease.

但是在这一调查所涉及的所有国家中,德国是最有可能获得当天或次日就诊机会的国家,如果病人有什么问题,德国也是能最快从医生嘴里听到答复的国家。他们很少使用候诊室,而且他们在几小时内就能很容易就见到医生。

Commonwealth Fund

AndGermanymanages to put its health-care dollars to relatively good use: For each $100 it spends on healthcare, it extends life by about four months, according to a recent analysis in the American Journal of Public Health. In theU.S., one of the worst-performing nations in the ranking, each $100 spent on healthcare resulted in only a couple of extra weeks of longevity.

德国成功地将其医疗保健的资金相对合理地运用起来,根据《美国公共健康日报》最近的一场调查分析,德国每花一百美元在医疗保健上,人均寿命将延长4个月。而在美国,每一百美元的投入只能换来两个多星期的寿命延长,因而它也成为排名最次的国家之一。

Then, of course, there are the drawbacks. Since there are no provider networks inGermany, doctors don’t know what other providers patients have seen, so there are few ways to limit repeat procedures. In fact,Germanyis facing quantity-control issues similar toAmerica’s, but theU.S.is more of a vanguard in attempting to limit waste. The ACA created Accountable Care Organizations, voluntary groups of doctors and nurses that can share in the savings if they manage to treat Medicare patients more efficiently.

当然,德国模式也有缺点,因为德国没有医疗服务人员网络,医生不知道病人已经见过其它哪些医疗人员,因此程序上的重复操作不可避免。事实上,德国正在面临和美国一样的量控问题,但是英国可能在减少浪费的方面做的最好。《平价医疗法案》使得责任制医疗组织得以产生,用过医生和护士组成的志愿小组的形式,如果他们能够更有效的治愈享受医疗保险的患者,那么他们就能一起省下不少开销。

The German government is similarly trying to push more people into “family physician” programs, in which just one doctor would serve as a gatekeeper. But that’s an idea the Germans borrowed from the American HMO model of the 1980s.

同样,德国政府在试图让更多人进入“家庭医师”项目计划,这一计划意味着一户一医生。但是这个主意是德国人借鉴了二十世纪八十年代美国的HMO模式。

And like the U.S., Germany may see a shortage of primary-care doctors in the near future, both because primary-care doctors there don’t get paid as much as specialists, and because entrenched norms have prevented physician assistants from shouldering more responsibility, Schlette said. There are so few nurses available to provide geriatric care that Germans have started importing their own home health aides from Eastern Europe or thePhilippines.

而且和美国一样,德国在未来几年里可能会面对“初级保健医生荒”,一方面这是由于初级保健医生的工资和专门医师有所差距,另一方面由于人们根深蒂固的观念使得医师助理不怎么担责任,Schlette说道。能承担老年人护理工作的护士人数越来越少,德国人已经开始向东欧国家或菲律宾进口家庭护工。  

Raquel LopezLeoncarries a tray at the SenVital elderly home outsideBerlin. Facing a shortage, German institutions increasingly turn to southern European countries for nursing jobs. (Thomas Peter/Reuters)

The German government is also currently trying to lure more primary care doctors to rural areas, where staffing issues are much worse than in affluent towns and cities—just like in, well, you guessed it.

德国政府正在鼓励更多的保健医师进入农村地区,相比于富裕的市镇而言,农村地区的医师资源匮乏的问题更为严重,这一点和……额,我想你应该猜到了。

The mandatory German insurance can also get rather expensive. Sam pays 355 euros a month for her sickness fund because as a freelancer, she’s responsible for both the employer- and employee-paid portions. And in one 2010 survey, nearly as many Germans (16 percent) as Americans (17 percent) said they spent a lot of time on medical paperwork or disputes.

德国的强制医疗保险的花费也很高昂。萨姆每月要付给疾病基金会355欧元,作为一个自由职业者,她既要支付雇员缴纳的部分,也要支付雇主缴纳的部分。在2010年的一次调查中,几乎有同样多的德国人(16%)和美国人(17%)说他们会花很多时间在医疗账单和医疗纠纷上。

With limitations on how much they can charge, German doctors and hospitals instead try to pump up their earnings by performing as many procedures as possible, just like American providers do.

由于德国的医生和医院在收入上的限制,使得他们不再通过尽可能提高进行医疗检查的次数来提高收入,这一点就和美国的医疗服务人员相同。

“Is the system good?” Schlette said. “Well, maybe, but there is a lot of oversupply of care and poor care coordination.”

“这一体系真的好吗?”Schlette说道,“好吧,可能是好的,但是这一体系也太过于关注医疗服务的好坏。”

With few resource constraints, healthcare systems likeAmerica's andGermany's tend to go with the most expensive treatment option possible. An American might find himself in an MRI machine for a headache that a British doctor would have treated with an aspirin and a smile.

由于美国和德国的医疗保健体系对于医疗资源的使用上几乎没有限制,两国的医疗保健体系都倾向于使用最贵的医疗服务。同样是头疼,美国的医生可能会让你去做核磁共振,英国的医生却只会给你开点儿阿司匹林然后送给你一个微笑。

Similarly, “In Germany, it will always be an operation,” Göpffarth said. “Meanwhile,Franceand theU.K.tend to try drugs first and operations later.”

同样,“在德国,手术是非常常见的。”Göpffarth说。“在法国或者英国的话,医生们更倾向于先用药再做手术。”

***

2014.04.22【英译汉】What American Healthcare Can Learn From Germany 1

2014.04.26【英译汉】What American Healthcare Can Learn From Germany 2

2014.04.26【英译汉】What American Healthcare Can Learn From Germany 3

2014.04.26【英译汉】What American Healthcare Can Learn From Germany 4

最后编辑于:2014-04-26 09:10
分类: 英语
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