美国国家公共电台 NPR Hospitals Worry Repeal Of Obamacare Would Jeopardize Innovations In Care

 

STEVE INSKEEP, HOST: 

Now we report on the big effect that the repeal¹ of the Affordable² Care Act would have on hospitals. Exactly what effect depends on whether and how Congress makes good on a promise to replace the law. Here's what is known - the current law helps people pay hospital bills, since many more have insurance, and the law also gives hospitals incentives³ to give better care to patients. Here's Kristin Gourlay from Rhode Island Public Radio.

KRISTIN GOURLAY, BYLINE⁴: Here's one thing hospitals could lose - patients who can pay. Hospitals like this one take care of anyone who walks or rolls through the emergency room doors. This is the busy ER at Rhode Island Hospital in Providence⁵ on a Friday night. Whether you have insurance or not, the ER will take care of you. If the Affordable Care Act is repealed⁶, more people could come through those doors without insurance, people got covered, for example, in states that expanded Medicaid. And those Medicaid funds were a big deal, says Rachel Garfield with the Kaiser Family Foundation.

RACHEL GARFIELD: It is fair to say that if the Medicaid expansion goes away wholesale⁷ and things go back to the way they were before this expansion was in place that a lot of those hospitals would see an increase in their uncompensated care costs.

GOURLAY: Or unpaid⁸ medical bills. There's still a gap, says Garfield, because Medicaid doesn't always cover the complete cost of care, but it's been better than nothing. Now, if that Medicaid coverage⁹ goes away, hospitals could lose more than $160 billion nationwide according to an American Hospital Association estimate. And there's another concern.

TIMOTHY FERRIS: Well, personally I'm worried that the progress we've made over the past five years would be threatened.

GOURLAY: Dr. Timothy Ferris with Massachusetts General Hospital in Boston says the ACA encouraged hospitals with financial incentives to experiment with how to take care of patients and save money.

FERRIS: We have now more than 20 different programs - video visits, electronic consultation¹⁰ with specialists, programs for patients with diabetes¹¹ and heart disease - and I would be worried that a repeal of the ACA would undermine our ability to invest in services for our patients that we are now investing in.

GOURLAY: Ferris' hospital has signed agreements to create accountable care organizations, or ACOs, with physicians and insurers in hopes of saving money. This is how they work - insurers pay doctors for making sure the patient is getting the best and most appropriate care, not for every test and procedure a doctor does like the typical system. Ferris knows most of those experiments haven't paid off yet, but he says they need time to work out the kinks.

FERRIS: One of the things that is difficult for people outside of health care to appreciate, particularly politicians, is how long it takes to make significant improvements in the delivery of care. Because, you know, delivering care to patients, you have to be very careful when you make changes.

GOURLAY: Or risk harming patients. Many other hospitals across the country have invested in these new networks, often overhauling¹² medical records systems, hiring staff, creating new services. Dennis Keefe, head of a large hospital chain called Care New England in Rhode Island, says he worries about the future of his ACO - Integra.

DENNIS KEEFE: I think if there is a real change in direction away from these alternative payment models, we will be assuming risk to care for a population. We have invested enormously to really be successful in this area. We have gone from zero premium¹³ dollars flowing through Integra to a billion dollars.

GOURLAY: These are seismic¹⁴ changes in the way hospitals do business, and most want the government to keep supporting these innovations.

For NPR News, I'm Kristin Gourlay in Providence.

(SOUNDBITE OF KONTAKTE SONG, "MOTORIK")

INSKEEP: That story's part of a reporting partnership with NPR News, Rhode Island Public Radio and Kaiser Health News

1 repeal   

n.废止，撤消；v.废止，撤消

参考例句：

• He plans to repeal a number of current policies.他计划废除一些当前的政策。
• He has made out a strong case for the repeal of the law.他提出强有力的理由，赞成废除该法令。

2 affordable   

adj.支付得起的，不太昂贵的

参考例句：

• The rent for the four-roomed house is affordable.四居室房屋的房租付得起。
• There are few affordable apartments in big cities.在大城市中没有几所公寓是便宜的。

3 incentives   

激励某人做某事的事物( incentive的名词复数 )； 刺激； 诱因； 动机

参考例句：

• tax incentives to encourage savings 鼓励储蓄的税收措施
• Furthermore, subsidies provide incentives only for investments in equipment. 更有甚者，提供津贴仅是为鼓励增添设备的投资。 来自英汉非文学 - 环境法 - 环境法

4 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

5 providence   

n.深谋远虑，天道，天意；远见；节约；上帝

参考例句：

• It is tempting Providence to go in that old boat.乘那艘旧船前往是冒大险。
• To act as you have done is to fly in the face of Providence.照你的所作所为那样去行事，是违背上帝的意志的。

6 repealed   

撤销，废除( repeal的过去式和过去分词 )

参考例句：

• The Labour Party repealed the Act. 工党废除了那项法令。
• The legislature repealed the unpopular Rent Act. 立法机关废除了不得人心的租借法案。

7 wholesale   

n.批发；adv.以批发方式；vt.批发，成批出售

参考例句：

• The retail dealer buys at wholesale and sells at retail.零售商批发购进货物，以零售价卖出。
• Such shoes usually wholesale for much less.这种鞋批发出售通常要便宜得多。

8 unpaid   

adj.未付款的，无报酬的

参考例句：

• Doctors work excessive unpaid overtime.医生过度加班却无报酬。
• He's doing a month's unpaid work experience with an engineering firm.他正在一家工程公司无偿工作一个月以获得工作经验。

9 coverage   

n.报导，保险范围，保险额，范围，覆盖

参考例句：

• There's little coverage of foreign news in the newspaper.报纸上几乎没有国外新闻报道。
• This is an insurance policy with extensive coverage.这是一项承保范围广泛的保险。

10 consultation   

n.咨询；商量；商议；会议

参考例句：

• The company has promised wide consultation on its expansion plans.该公司允诺就其扩展计划广泛征求意见。
• The scheme was developed in close consultation with the local community.该计划是在同当地社区密切磋商中逐渐形成的。

11 diabetes   

n.糖尿病

参考例句：

• In case of diabetes, physicians advise against the use of sugar.对于糖尿病患者，医生告诫他们不要吃糖。
• Diabetes is caused by a fault in the insulin production of the body.糖尿病是由体內胰岛素分泌失调引起的。

12 overhauling   

n.大修；拆修；卸修；翻修v.彻底检查( overhaul的现在分词 )；大修；赶上；超越

参考例句：

• I had no chance of overhauling him. 我没有赶上他的可能。 来自辞典例句
• Some sites need little alterations but some need total overhauling. 有些网站需要做出细微修改，而有些网站就需要整体改版。 来自互联网

13 premium   

n.加付款；赠品；adj.高级的；售价高的

参考例句：

• You have to pay a premium for express delivery.寄快递你得付额外费用。
• Fresh water was at a premium after the reservoir was contaminated.在水库被污染之后，清水便因稀而贵了。

14 seismic   

a.地震的，地震强度的

参考例句：

• Earthquakes produce two types of seismic waves.地震产生两种地震波。
• The latest seismic activity was also felt in northern Kenya.肯尼亚北部也感觉到了最近的地震活动。