美國用於健保的費用,佔GDP 16%,堪稱世界第一。
還在惡化(保費不斷升高)。
儘管政府通過了健保改革的立法,形勢不容樂觀。
Bad Medicine: A Guide to the Real Costs and Consequences of the New Health Care Law
要點:
By 2019, roughly 21 million Americans will still be uninsured.
cost far more than advertised, more than $2.7 trillion over 10 years of full implementation.
will add $352 billion to the national debt over that period.
......
While the law contains few direct provisions for rationing care, it nonetheless sets the stage for government rationing and interference with how doctors practice medicine.
Millions of Americans who are happy with their current health insurance will not be able to keep it.
究其原因,巨大的經濟利益使得醫藥界主宰了美國的健保現狀。
管窺一
精神病醫生 Daniel Carlat 寫了本書,Unhinged: The Trouble With Psychiatry [Unhinged: The Trouble With Psychiatry. ]. 書中介紹了(西)藥廠的市場營銷,他是怎樣為藥廠服務,在醫生群中推廣抗抑鬱葯(Effexor )的。
這裡有對 Daniel Carlat 37分鐘的採訪,裡面有藥廠如何買文章,登載於主要的醫學雜誌上。及藥物盲試的報告是怎樣做出來的。
藥廠還建有醫生開處方的資料庫,誰開了那種葯,開了多少,都一清二楚。
http://www.npr.org/templates/story/story.php?storyId=128107547
管窺二
N個月前,我去參加了國內某醫科大學在美的年度餐會。參加者多數是黑頭髮的醫生,但還有些黃頭髮的白人。當然後來明白了,他們是大藥廠來贊助的。
(待續)