1、奧巴馬醫(yī)改(中英版)Made by 402The reformation of the medical treatment faces lots of obstacles.The reformation of the medical treatment faces lots of obstacles.How did Obama succeed in breaking out of the crisis ?How did Obama succeed in breaking out of the crisis ? 第一頁，共二十頁。奧巴馬醫(yī)改(中英版)2數(shù)十年來美國歷任總統(tǒng)推行醫(yī)改都鎩數(shù)十年來美國

2、歷任總統(tǒng)推行醫(yī)改都鎩羽而歸，皆因反對聲四起。奧氏也遇羽而歸，皆因反對聲四起。奧氏也遇到到(y do)同樣難題。旨在讓全民都同樣難題。旨在讓全民都得到醫(yī)保的醫(yī)改計(jì)劃為何遭遇重重阻得到醫(yī)保的醫(yī)改計(jì)劃為何遭遇重重阻撓？既然攔阻甚多，這次怎么又能順撓？既然攔阻甚多，這次怎么又能順利過關(guān)利過關(guān) ?American former presidents had tried to carry out health reforms in the past years but they failed. So many people at all levels reject the health reforms.

3、Obama faced the same difficulties. Why did the health reforms were obstructed heavily even it is good to American? Why Obama got approval this time with solid opposition?第二頁，共二十頁。奧巴馬醫(yī)改(中英版)3The difficulty of the health care reform in U.Sis encountering with opposition美國醫(yī)改難美國醫(yī)改難 難在遭遇重重反對難在遭遇重重反對 Obam

4、a strategy is properly to avoid making the same mistakes奧巴馬策略得當(dāng)奧巴馬策略得當(dāng) 避免重蹈覆轍避免重蹈覆轍 United Democratic Party attack Republican Party by using procedures smartly團(tuán)結(jié)民主黨團(tuán)結(jié)民主黨 巧用程序狙擊共和黨巧用程序狙擊共和黨 第三頁，共二十頁。奧巴馬醫(yī)改(中英版)4醫(yī)改與美國傳統(tǒng)價值觀相悖醫(yī)改與美國傳統(tǒng)價值觀相悖Healthcare reform contradicts with the Americans traditional values

5、 多數(shù)人反對建立公共保險(xiǎn)機(jī)構(gòu)多數(shù)人反對建立公共保險(xiǎn)機(jī)構(gòu)Most people object to establish the public insurance organization 共和黨極力阻撓醫(yī)改共和黨極力阻撓醫(yī)改 The Republican Party obstructs the healthcare reform vigorously. 保險(xiǎn)業(yè)堅(jiān)決抵制醫(yī)改保險(xiǎn)業(yè)堅(jiān)決抵制醫(yī)改The insurance business firm resisting medicine changes醫(yī)藥行業(yè)反對醫(yī)改醫(yī)藥行業(yè)反對醫(yī)改 The medicine opposethe Healthcare

6、reform中產(chǎn)階級、富人憂心忡忡中產(chǎn)階級、富人憂心忡忡The middle class and the rich person are heavy-hearted 第四頁，共二十頁。奧巴馬醫(yī)改(中英版)醫(yī)改與美國傳統(tǒng)價值觀相悖醫(yī)改與美國傳統(tǒng)價值觀相悖Healthcare reform contradicts with the Americans traditional values 民調(diào)顯示民調(diào)顯示48%的美國人反對醫(yī)改。反對根本原因的美國人反對醫(yī)改。反對根本原因在于，醫(yī)改與美國傳統(tǒng)價值觀相悖。美國人對政在于，醫(yī)改與美國傳統(tǒng)價值觀相悖。美國人對政府干預(yù)府干預(yù)(gny)市場、國家控制社會的戒心

7、根深市場、國家控制社會的戒心根深蒂固，對政府主導(dǎo)醫(yī)療和國家控制醫(yī)保的措施保蒂固，對政府主導(dǎo)醫(yī)療和國家控制醫(yī)保的措施保持高度警惕性持高度警惕性 .Polls show 48% of Americans opposed to medical reform. Against the fundamental reason is that health care reform with the United States, contrary to traditional values. U.S. government intervention in the market, state-controlle

8、d deep-rooted wariness of society, on the government-led control of health care and national health insurance policy to maintain the high degree of vigilance 第五頁，共二十頁。奧巴馬醫(yī)改(中英版)奧巴馬原想建立奧巴馬原想建立(jinl)非營利公共保險(xiǎn)機(jī)構(gòu)，通過與私營保險(xiǎn)機(jī)構(gòu)展非營利公共保險(xiǎn)機(jī)構(gòu)，通過與私營保險(xiǎn)機(jī)構(gòu)展開競爭有效降低保險(xiǎn)費(fèi)。但大多數(shù)人堅(jiān)決反對，他們認(rèn)為這是在破壞開競爭有效降低保險(xiǎn)費(fèi)。但大多數(shù)人堅(jiān)決反對，他們認(rèn)為這是在破壞美國的

9、自由價值觀念，他們青睞市場主導(dǎo)的醫(yī)保，要美國的自由價值觀念，他們青睞市場主導(dǎo)的醫(yī)保，要把政府的手拿把政府的手拿開開。多數(shù)人反對建立公共保險(xiǎn)機(jī)構(gòu)多數(shù)人反對建立公共保險(xiǎn)機(jī)構(gòu)Most people object to establish the public insurance organization Obama originally wanted to build non-profit public insurance institutions, by means of competing with the private insurance sector to reduce insurance

10、 premiums more effectively. But most people firmly opposed, they think this is undermining the American values of freedom, they favor a market-driven health care, to put the governments hand away.第六頁，共二十頁。奧巴馬醫(yī)改(中英版)共和黨極力共和黨極力(jl)阻阻撓醫(yī)改，有黨派撓醫(yī)改，有黨派思維作祟，但更思維作祟，但更因執(zhí)政理念不同。因執(zhí)政理念不同。共和黨人一直主共和黨人一直主張張小政府大市場小政府

11、大市場，而醫(yī)改將形成，而醫(yī)改將形成強(qiáng)勢政府，對社強(qiáng)勢政府，對社會生活和經(jīng)濟(jì)產(chǎn)會生活和經(jīng)濟(jì)產(chǎn)生過分干涉，違生過分干涉，違背資本主義自由背資本主義自由市場經(jīng)濟(jì)的原則市場經(jīng)濟(jì)的原則 共和黨極力阻撓醫(yī)改共和黨極力阻撓醫(yī)改 The Republican Party obstructs the healthcare reform vigorously. Republicans obstruct medical reform with the thought of party mischief, but more because of the ruling idea is different. Republ

12、icans have been advocating small government, big market, while the medical reform will form a strong government, social life and the economy too much interference, which is contrary to the principles of capitalist free market economy第七頁，共二十頁。奧巴馬醫(yī)改(中英版)保險(xiǎn)業(yè)堅(jiān)決抵制醫(yī)改保險(xiǎn)業(yè)堅(jiān)決抵制醫(yī)改The insurance business firm re

13、sisting medicine changes受醫(yī)改沖擊最大的將是保險(xiǎn)業(yè)。在美國醫(yī)保體系中，保險(xiǎn)受醫(yī)改沖擊最大的將是保險(xiǎn)業(yè)。在美國醫(yī)保體系中，保險(xiǎn)企業(yè)是既得利益者，對醫(yī)改持抵制態(tài)度。投票前，保險(xiǎn)利企業(yè)是既得利益者，對醫(yī)改持抵制態(tài)度。投票前，保險(xiǎn)利益集團(tuán)游說議員，斥巨資投放廣告益集團(tuán)游說議員，斥巨資投放廣告(gunggo)號召反對號召反對醫(yī)改。醫(yī)改。Hardest hit by medical reform will be the insurance industry. In the United States medical insurance system, insurance compa

14、nies who have vested interests resisted on medical reform. Before the vote, the insurance interest groups lobby the members and cost lots of money in advertising, called against the medical reform.第八頁，共二十頁。奧巴馬醫(yī)改(中英版)醫(yī)藥行業(yè)反對醫(yī)改醫(yī)藥行業(yè)反對醫(yī)改 The medicine oppose the Healthcare reformsome medeine enterprises r

15、efuse health reform, for the reforms increase costs. it will use cheap effective medeine and technology, which will cut down the profits of medicine enterprise heavily.what is more, doctor association worry about the reforms may course damage to doctors interests.藥品企業(yè)也反對醫(yī)改，因?yàn)獒t(yī)改要控制藥品企業(yè)也反對醫(yī)改，因?yàn)獒t(yī)改要控制成本

16、，必然將更多地使用成本，必然將更多地使用(shyng)便宜便宜而有效的適宜藥品、適宜技術(shù)，醫(yī)藥企而有效的適宜藥品、適宜技術(shù)，醫(yī)藥企業(yè)的盈利空間將會大大縮小；三是醫(yī)生業(yè)的盈利空間將會大大縮小；三是醫(yī)生協(xié)會，也擔(dān)心醫(yī)改會損害醫(yī)生的利益。協(xié)會，也擔(dān)心醫(yī)改會損害醫(yī)生的利益。第九頁，共二十頁。奧巴馬醫(yī)改(中英版)除不得不繳納更多稅收來為窮人享受醫(yī)保除不得不繳納更多稅收來為窮人享受醫(yī)保“埋單埋單”外，中產(chǎn)階級外，中產(chǎn)階級(zhngchnjij)、富裕階層還擔(dān)心，大量窮人在獲保后涌入醫(yī)療服務(wù)市、富裕階層還擔(dān)心，大量窮人在獲保后涌入醫(yī)療服務(wù)市場，而醫(yī)療資源相對有限，富人們曾經(jīng)享受的場，而醫(yī)療資源相對有限，富人

17、們曾經(jīng)享受的VIP式服務(wù)將可能不復(fù)存在式服務(wù)將可能不復(fù)存在 In addition to have to pay more taxes to enjoy medical insurance for the poor, pays the bill, the middle class and wealthy class is also concerned that a large number of poor by the influx of medical services after the insurance market, while relatively limited medical

18、resources, the rich people who enjoy the VIP-style services may no longer exist中產(chǎn)階級、富人憂心忡忡中產(chǎn)階級、富人憂心忡忡The middle class and the rich person are heavy-hearted 第十頁，共二十頁。奧巴馬醫(yī)改(中英版)11雷厲風(fēng)行雷厲風(fēng)行(li l fng xng)動用動用輿論壓力輿論壓力Vigorous and resolute use of public pressure 先易后難先易后難 逐個逐個(zhg)擊破擊破The easier one by one

19、break搶在中期選舉前推動改革搶在中期選舉前推動改革 Rush to promote the revolution before the mid-term elections頂住壓力頂住壓力 堅(jiān)持信念堅(jiān)持信念Withstand the pressure of its convictions 吸取教訓(xùn)吸取教訓(xùn) 只提綱領(lǐng)只提綱領(lǐng)Lessons provided only program 懂得妥協(xié)和放棄懂得妥協(xié)和放棄Know how to compromise and give up 第十一頁，共二十頁。奧巴馬醫(yī)改(中英版)奧巴馬在奧巴馬在6月月9日民主黨參議院公布醫(yī)改方案之后，次日即在全國動員全

20、美日民主黨參議院公布醫(yī)改方案之后，次日即在全國動員全美200萬草萬草根支持者在根支持者在50個州展開宣傳，掀起一場全國性的大討論。這實(shí)際上也是借助公眾個州展開宣傳，掀起一場全國性的大討論。這實(shí)際上也是借助公眾輿論的力量迫使輿論的力量迫使(psh)既得利益集團(tuán)低頭。既得利益集團(tuán)低頭。On June 9 , Obama announced the Senate Democratic health care reform proposal, the next day in national grassroots mobilization of the nations two million supp

21、orters in 50 states to have a publicity, which set off a big national discussion. This is actually using the power of public opinion forced the bow of vested interests.雷厲風(fēng)行雷厲風(fēng)行(li l fng xng)動用動用輿論壓力輿論壓力Vigorous and resolute use of public pressure 第十二頁，共二十頁。奧巴馬醫(yī)改(中英版)Obama has the full support of hig

22、h-profile medical reform program,and then he faced the problems from the interference of Congress and interest groups, and even many voters began to waver on his support. But Obama has not manipulated by them, instead of taking a more active engagement situation to face it , even if such contact is

23、not happy.頂住壓力頂住壓力 堅(jiān)持堅(jiān)持(jinch)信念信念Withstand the pressure of its convictions 奧巴馬高調(diào)全面支持奧巴馬高調(diào)全面支持(zhch)醫(yī)改方案之后，面臨了醫(yī)改方案之后，面臨了來自國會和利益集團(tuán)的干擾，甚至眾多選民也開始來自國會和利益集團(tuán)的干擾，甚至眾多選民也開始動搖對他的支持動搖對他的支持(zhch)。但奧巴馬并未因此受制于。但奧巴馬并未因此受制于人，而是采取了更積極的接觸態(tài)勢，哪怕這樣的接人，而是采取了更積極的接觸態(tài)勢，哪怕這樣的接觸并不愉快觸并不愉快第十三頁，共二十頁。奧巴馬醫(yī)改(中英版)先易后難先易后難 逐個逐個(zhg)

24、擊破擊破The easier one by one to break奧巴馬針對各個利益集團(tuán)，按難易程度采取分別談判、各個擊奧巴馬針對各個利益集團(tuán)，按難易程度采取分別談判、各個擊破的戰(zhàn)略。奧巴馬積極游說此前一直被稱為破的戰(zhàn)略。奧巴馬積極游說此前一直被稱為“醫(yī)改禁區(qū)醫(yī)改禁區(qū)”的美的美國醫(yī)學(xué)協(xié)會，與全美醫(yī)院體系達(dá)成國醫(yī)學(xué)協(xié)會，與全美醫(yī)院體系達(dá)成(dchng)共識，并得到了全共識，并得到了全美護(hù)士協(xié)會的支持美護(hù)士協(xié)會的支持 Obama have a active lobby with the American Medical Association ,which is referred to as r

25、estricted medical reform . Then reach a consensus with the nations hospital system and has been supported by the National Nurses Association.第十四頁，共二十頁。奧巴馬醫(yī)改(中英版)吸取教訓(xùn)吸取教訓(xùn) 只提綱領(lǐng)只提綱領(lǐng)(gnglng)Lessons provided only program 克林頓也曾力推醫(yī)改，拿出長達(dá)數(shù)百頁的報(bào)告，卻連克林頓也曾力推醫(yī)改，拿出長達(dá)數(shù)百頁的報(bào)告，卻連國會投票也沒爭取到。有了前車之鑒，奧巴馬沒有國會投票也沒爭取到。有了前車之鑒

26、，奧巴馬沒有(mi yu)推出幾百頁方案，讓議員在看懂之前就失去推出幾百頁方案，讓議員在看懂之前就失去耐心，而是推出一些綱領(lǐng)和方針，交由國會自行擬訂耐心，而是推出一些綱領(lǐng)和方針，交由國會自行擬訂方案。方案。Clinton has pressed for medical reform with hundreds of pages of reports but it failed to get any votes from the Congress. With this lesson, Obama did not release hundreds of pages of the program w

27、hich will make the Members lose patience before understand, but to introduce programs and policies which is drafted by Congress.第十五頁，共二十頁。奧巴馬醫(yī)改(中英版)搶在中期選舉前推動搶在中期選舉前推動(tu dng)改革改革 Rush to promote the revolution before the mid-term elections奧巴馬他在上任后第一年就開始奧巴馬他在上任后第一年就開始大刀闊斧推行這一改革大刀闊斧推行這一改革(gig)，爭取在中期選舉

28、季節(jié)到來之前取爭取在中期選舉季節(jié)到來之前取得成果，以免因改革得成果，以免因改革(gig)努力努力受到政治需求限制受到政治需求限制 懂得懂得(dng de)妥協(xié)和放棄妥協(xié)和放棄Know how to compromise and give up 奧巴馬作出了讓步，有關(guān)設(shè)立公共奧巴馬作出了讓步，有關(guān)設(shè)立公共保險(xiǎn)機(jī)構(gòu)的構(gòu)想在參議院的最終版保險(xiǎn)機(jī)構(gòu)的構(gòu)想在參議院的最終版本醫(yī)改議案中消失了。這不僅平息本醫(yī)改議案中消失了。這不僅平息了巨大爭議，也將大大降低政府開了巨大爭議，也將大大降低政府開支。支。Obama made a concession that the relevant idea of setting up public insurance institutions was die out in the final Medical reform