财富杂志 新加坡如何做到超低价优质医疗服务?(3)

The Singaporean government does supply subsidies¹ for the indigent² or if someone suffers some catastrophe³,

新加坡政府确实为贫困人群或遭遇一些大灾难的人提供补助，

but unlike in the U.S., these are not budget-busters because free-market competition keeps prices eminently⁴ reasonable.

但和美国不同，这些并不是大预算，因为自由市场竞争使价格非常合理。

Competition also slashes⁵ administrative⁶ costs. Flynn explains how these costs rocket upward in the U.S., thanks to our third-party system.

竞争也大大降低了管理成本。弗林解释了在美国，这些成本是如何飙升的，这都是由于我们的三方体系。

He cites the example of a specialist he once visited.

他引用了他曾拜访过的一位专业医师的例子。

The doctor was a solo practitioner⁷ who had one person to do the scheduling and other routine office chores,

这名医生是一位个体执业医师，他安排一个人来处理日程安排和其他例行的办公室杂务，

and two other people to file those complicated insurance claims and fight with insurance bureaucrats⁸ over any contested reimbursements⁹.

另外两个人申请那些复杂的保险索赔，并就任何有争议的赔偿问题与保险官员进行谈判。

His insight: Those two people also mean at least two more people on the other side. Five people for a single physician.

他发现：那两个人也意味着另一方至少还有两个人。一个医生要五个人。

No wonder administrative costs always balloon. Worse, insurance company profits depend on the volume of claims.

难怪管理成本总是激增。更糟糕的是，保险公司的利润取决于索赔量。

That's not a great incentive¹⁰ to control expenses, the way a real consumer market would.

这并不是控制支出的一个好动机，一个真正的消费者市场会这么做。

Singapore also teaches a sobering lesson regarding drug approvals. Any medication or device is generally okay,

在药物审批方面，新加坡也给我们上了发人深省的一课。任何药物或设备通常都是可以的，

as long as it has been approved by any of the major foreign drug-regulatory agencies, such as the FDA,

只要它通过了主要外国药品监管机构的批准，如FDA、

the European Medicines Agency, Australia's Therapeutic¹¹ Goods Administration, Health Canada and Japan's Pharmaceuticals¹² & Medical Devices Agency.

欧洲医药管理局、澳大利亚药物管理局、加拿大健康局以及日本药品和医疗器械管理局。

But here's the kicker: Unlike the FDA, Singapore asks only that a drug be proven to be safe, not whether it is actually efficacious.

但有一个问题：和FDA不同，新加坡只要求证明药物的安全性，而不管其真实的有效性。

Singapore demonstrates that a medicine that doesn't work as advertised will quickly fail in the marketplace.

新加坡证明，达不到广告宣传疗效的药物，很快会在市场上失败。

That was also true in the U.S. until FDA protocols¹³ were drastically changed decades ago.

美国的情况也是如此，直到几十年前FDA的协议被彻底改变。

Amazingly, and counterintuitively, experience demonstrates that the do-no-harm approach adopted by those non-FDA agencies

令人惊讶的是，经验证明，那些非FDA机构采取的不伤害方法

is as effective and far less costly¹⁴ than what we've been doing since the 1960s. The FDA's immensely rigid¹⁵, costly,

和我们自20世纪60年代以来所采取的方法效果一样，而且成本更低。FDA极其严格、成本高昂、

elaborate and time-consuming methods have sent drug prices through the stratosphere, with no overall positive benefit.

复杂且耗时的方法让药价飞涨，且总体上没有带来任何积极的益处。

In fact, they've cost the lives of countless¹⁶ thousands of patients desperately¹⁷ waiting for life-saving medicines stuck in the FDA's bureaucratic¹⁸ maw.

实际上，他们夺走了无数病人的性命，这些病人绝望等待着的救命药卡在了FDA官僚体系里。

1 subsidies   

n.补贴，津贴，补助金( subsidy的名词复数 )

参考例句：

• European agriculture ministers failed to break the deadlock over farm subsidies. 欧洲各国农业部长在农业补贴问题上未能打破僵局。
• Agricultural subsidies absorb about half the EU's income. 农业补贴占去了欧盟收入的大约一半。 来自《简明英汉词典》

2 indigent   

adj.贫穷的，贫困的

参考例句：

• The town government is responsible for assistance to indigent people.镇政府负责给穷人提供帮助。
• A judge normally appoints the attorney for an indigent defendant at the defendant's first court appearence.法官通常会在贫穷被告人第一次出庭时，为其指派一名辩护律师。

3 catastrophe   

n.大灾难，大祸

参考例句：

• I owe it to you that I survived the catastrophe.亏得你我才大难不死。
• This is a catastrophe beyond human control.这是一场人类无法控制的灾难。

4 eminently   

adv.突出地；显著地；不寻常地

参考例句：

• She seems eminently suitable for the job. 她看来非常适合这个工作。
• It was an eminently respectable boarding school. 这是所非常好的寄宿学校。 来自《简明英汉词典》

5 slashes   

n.（用刀等）砍( slash的名词复数 )；（长而窄的）伤口；斜杠；撒尿v.挥砍( slash的第三人称单数 )；鞭打；割破；削减

参考例句：

• They report substantial slashes in this year's defense outlays. 他们报道今年度国防经费的大量削减。 来自辞典例句
• Inmates suffered injuries ranging from stab wounds and slashes to head trauma. 囚犯们有的被刺伤，有的被砍伤，而有的头部首创，伤势不一而足。 来自互联网

6 administrative   

adj.行政的，管理的

参考例句：

• The administrative burden must be lifted from local government.必须解除地方政府的行政负担。
• He regarded all these administrative details as beneath his notice.他认为行政管理上的这些琐事都不值一顾。

7 practitioner   

n.实践者，从事者；(医生或律师等)开业者

参考例句：

• He is an unqualified practitioner of law.他是个无资格的律师。
• She was a medical practitioner before she entered politics.从政前她是个开业医生。

8 bureaucrats   

n.官僚( bureaucrat的名词复数 )；官僚主义；官僚主义者；官僚语言

参考例句：

• That is the fate of the bureaucrats, not the inspiration of statesmen. 那是官僚主义者的命运，而不是政治家的灵感。 来自辞典例句
• Big business and dozens of anonymous bureaucrats have as much power as Japan's top elected leaders. 大企业和许多不知名的官僚同日本选举出来的最高层领导者们的权力一样大。 来自辞典例句

9 reimbursements   

n.偿还( reimbursement的名词复数 )；退款；补偿；赔偿

参考例句：

• We had to put in for the food reimbursements again. 我们不得不再次申请食物赔偿。 来自互联网
• Have you figured up the total of the reimbursements I gave you? 你有没有把我给你的报销账目全部加总了呢？ 来自互联网

10 incentive   

n.刺激；动力；鼓励；诱因；动机

参考例句：

• Money is still a major incentive in most occupations.在许多职业中，钱仍是主要的鼓励因素。
• He hasn't much incentive to work hard.他没有努力工作的动机。

11 therapeutic   

adj.治疗的，起治疗作用的；对身心健康有益的

参考例句：

• Therapeutic measures were selected to fit the patient.选择治疗措施以适应病人的需要。
• When I was sad,music had a therapeutic effect.我悲伤的时候，音乐有治疗效力。

12 pharmaceuticals   

n.医药品；药物( pharmaceutical的名词复数 )

参考例句：

• the development of new pharmaceuticals 新药的开发
• The companies are pouring trillions of yen into biotechnology research,especially for pharmaceuticals and new seeds. 这些公司将大量资金投入生物工艺学研究，尤其是药品和新种子方面。 来自《简明英汉词典》

13 protocols   

n.礼仪( protocol的名词复数 )；（外交条约的）草案；（数据传递的）协议；科学实验报告（或计划）

参考例句：

• There are also protocols on the testing of nuclear weapons. 也有关于核武器试验的协议。 来自辞典例句
• Hardware components and software design of network transport protocols are separately introduced. 介绍系统硬件组成及网络传输协议的软件设计。 来自互联网

14 costly   

adj.昂贵的，价值高的，豪华的

参考例句：

• It must be very costly to keep up a house like this.维修这么一幢房子一定很昂贵。
• This dictionary is very useful,only it is a bit costly.这本词典很有用，左不过贵了些。

15 rigid   

adj.严格的，死板的；刚硬的，僵硬的

参考例句：

• She became as rigid as adamant.她变得如顽石般的固执。
• The examination was so rigid that nearly all aspirants were ruled out.考试很严，几乎所有的考生都被淘汰了。

16 countless   

adj.无数的，多得不计其数的

参考例句：

• In the war countless innocent people lost their lives.在这场战争中无数无辜的人丧失了性命。
• I've told you countless times.我已经告诉你无数遍了。

17 desperately   

adv.极度渴望地，绝望地，孤注一掷地

参考例句：

• He was desperately seeking a way to see her again.他正拼命想办法再见她一面。
• He longed desperately to be back at home.他非常渴望回家。

18 bureaucratic   

adj.官僚的，繁文缛节的

参考例句：

• The sweat of labour washed away his bureaucratic airs.劳动的汗水冲掉了他身上的官气。
• In this company you have to go through complex bureaucratic procedures just to get a new pencil.在这个公司里即使是领一支新铅笔，也必须通过繁琐的手续。