美国国家公共电台 NPR Health Insurers Try Paying More Up Front To Pay Less Later

 

ARI SHAPIRO, HOST:

Diabetes¹, high blood pressure and other chronic² conditions account for the vast majority of health spending in the U.S. Some health plans are beginning to offer free maintenance care for people with chronic health problems. The hope is spending a little more on keeping them healthy early on will save a lot of money in the long run. Mark Zdechlik from Minnesota Public Radio reports.

MARK ZDECHLIK, BYLINE³: Ten years ago, Michael McBrayer of St. Paul learned he had Type 1 diabetes.

MICHAEL MCBRAYER: I give myself shots multiple times a day.

ZDECHLIK: McBrayer faces dire⁴ consequences if he fails to control his blood sugar.

MCBRAYER: Kidney failure, blindness, heart disease - all those things are looming⁵ out there.

ZDECHLIK: For the past several years, McBrayer's health insurance has paid for everything he needs to keep his diabetes in check. He doesn't spend a dime⁶ on supplies.

MCBRAYER: I need to test my blood upward to ten times a day. And every time I have a strip to test my blood, that's a dollar a strip.

ZDECHLIK: There are also syringes, insulin and other prescriptions⁷ as well as consultations⁸ every several weeks with a pharmacy⁹ specialist. McBrayer has health insurance through his wife's employer, the state of Minnesota. It's a HealthPartners plan that charges the state extra to cover diabetes care. The sales pitch for this hybridized insurance is that employers who spend a little more upfront helping¹⁰ people manage chronic conditions stand to save a lot in the future. University of Michigan professor and physician Mark Fendrick is a pioneer in this emerging approach to health insurance.

MARK FENDRICK: We've been trying to change the health care conversation in the United States from how much we spend to how well we spend.

ZDECHLIK: Fendrick says it makes both medical and economic sense to make it affordable¹¹ to properly manage chronic conditions like asthma¹² and diabetes.

FENDRICK: I want the health insurance plan my patients have to charge my patients the least for the services that are going to make them healthier.

ZDECHLIK: That may seem like common sense, but health plans have been running hard in the opposite direction. Consumers are on the hook for a rapidly growing, not shrinking, amount of their health costs. But Mike Thompson, who heads an industry group that advises some 12,000 companies, says businesses are beginning to realize that might not be the best approach.

MIKE THOMPSON: We're getting smarter as the evidence comes in as to how to be more surgical¹³ in how we apply those cost sharing so that people are more prudent¹⁴ on discretionary care but are more compliant¹⁵ certainly with the care they need to stay healthy.

ZDECHLIK: The enhanced insurance benefit that pays for all of Michael McBrayer's Type 1 diabetes maintenance is paying off for his wife's employer, too, according to HealthPartners executive Dan Rehrauer. He says the diabetes program has saved the state of Minnesota about $1 million on medical services since its inception¹⁶ almost 10 years ago.

THOMPSON: We've reduced hospitalizations and emergency department utilization¹⁷, which is exactly what we want to see. You've got a healthy employee and saving money.

ZDECHLIK: HealthPartners says the program McBrayer is a part of has helped quadruple the number of diabetes patients with optimal¹⁸ care. For NPR News, I'm Mark Zdechlik in St. Paul.

SHAPIRO: And this story is part of a reporting partnership¹⁹ with NPR, Minnesota Public Radio and Kaiser Health News.

(SOUNDBITE OF ROYKSOPP'S "EPLE")

1 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。

2 chronic   

adj.(疾病)长期未愈的，慢性的；极坏的

参考例句：

• Famine differs from chronic malnutrition.饥荒不同于慢性营养不良。
• Chronic poisoning may lead to death from inanition.慢性中毒也可能由虚弱导致死亡。

3 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。

4 dire   

adj.可怕的，悲惨的，阴惨的，极端的

参考例句：

• There were dire warnings about the dangers of watching too much TV.曾经有人就看电视太多的危害性提出严重警告。
• We were indeed in dire straits.But we pulled through.那时我们的困难真是大极了，但是我们渡过了困难。

5 looming   

n.上现蜃景（光通过低层大气发生异常折射形成的一种海市蜃楼）v.隐约出现，阴森地逼近( loom的现在分词 )；隐约出现，阴森地逼近

参考例句：

• The foothills were looming ahead through the haze. 丘陵地带透过薄雾朦胧地出现在眼前。 来自《简明英汉词典》
• Then they looked up. Looming above them was Mount Proteome. 接着他们往上看，在其上隐约看到的是蛋白质组山。 来自英汉非文学 - 生命科学 - 回顾与展望

6 dime   

n.（指美国、加拿大的钱币）一角

参考例句：

• A dime is a tenth of a dollar.一角银币是十分之一美元。
• The liberty torch is on the back of the dime.自由火炬在一角硬币的反面。

7 prescriptions   

药( prescription的名词复数 )； 处方； 开处方； 计划

参考例句：

• The hospital of traditional Chinese medicine installed a computer to fill prescriptions. 中医医院装上了电子计算机来抓药。
• Her main job was filling the doctor's prescriptions. 她的主要工作就是给大夫开的药方配药。

8 consultations   

n.磋商（会议）( consultation的名词复数 )；商讨会；协商会；查找

参考例句：

• Consultations can be arranged at other times by appointment. 磋商可以通过预约安排在其他时间。 来自《现代汉英综合大词典》
• Consultations are under way. 正在进行磋商。 来自《现代汉英综合大词典》

9 pharmacy   

n.药房，药剂学，制药业，配药业，一批备用药品

参考例句：

• She works at the pharmacy.她在药房工作。
• Modern pharmacy has solved the problem of sleeplessness.现代制药学已经解决了失眠问题。

10 helping   

n.食物的一份&adj.帮助人的，辅助的

参考例句：

• The poor children regularly pony up for a second helping of my hamburger. 那些可怜的孩子们总是要求我把我的汉堡包再给他们一份。
• By doing this, they may at times be helping to restore competition. 这样一来, 他在某些时候,有助于竞争的加强。

11 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。

12 asthma   

n.气喘病，哮喘病

参考例句：

• I think he's having an asthma attack.我想他现在是哮喘病发作了。
• Its presence in allergic asthma is well known.它在过敏性气喘中的存在是大家很熟悉的。

13 surgical   

adj.外科的，外科医生的，手术上的

参考例句：

• He performs the surgical operations at the Red Cross Hospital.他在红十字会医院做外科手术。
• All surgical instruments must be sterilised before use.所有的外科手术器械在使用之前，必须消毒。

14 prudent   

adj.谨慎的，有远见的，精打细算的

参考例句：

• A prudent traveller never disparages his own country.聪明的旅行者从不贬低自己的国家。
• You must school yourself to be modest and prudent.你要学会谦虚谨慎。

15 compliant   

adj.服从的，顺从的

参考例句：

• I don't respect people who are too compliant.我看不起那种唯命是从，唯唯诺诺的人。
• For years I had tried to be a compliant and dutiful wife.几年来，我努力做一名顺从和尽职尽职的妻子。

16 inception   

n.开端，开始，取得学位

参考例句：

• The programme has been successful since its inception.这个方案自开始实施以来一直卓有成效。
• Julia's worked for that company from its inception.自从那家公司开办以来，朱莉娅一直在那儿工作。

17 utilization   

n.利用，效用

参考例句：

• Computer has found an increasingly wide utilization in all fields.电子计算机已越来越广泛地在各个领域得到应用。
• Modern forms of agricultural utilization,have completely refuted this assumption.现代农业利用形式，完全驳倒了这种想象。

18 optimal   

adj.最适宜的；最理想的；最令人满意的

参考例句：

• What is the optimal mix of private and public property rights in natural resources?私人和国家的自然资源产权的最适宜的组合是什么？
• Optimal path planning is a key link for the sailing contest.帆船最优行驶路径规划是帆船比赛取胜的关键环节。

19 partnership   

n.合作关系，伙伴关系

参考例句：

• The company has gone into partnership with Swiss Bank Corporation.这家公司已经和瑞士银行公司建立合作关系。
• Martin has taken him into general partnership in his company.马丁已让他成为公司的普通合伙人。