The On-going Debate over Healthcare Reform

　　The public debate over healthcare reform which the Nassau Guardian alone stirred up several weeks ago is at a curious point.

　　It seems that the government's so-called Blue Ribbon Commission has already decided what plan it will propose without undertaking any public consultation and is now merely engaged in a PR campaign to convince us they have the answer.

　　This seems a little head over heels to us. Since it is our money and our health that is in question, shouldn't we have been consulted at the break about which way we want to go? There are several models to achieve healthcare reform, and not all of them require us to hand more money over to keep government bureaucrats in big offices. Purely private healthcare may have big problems - but so does the socialised medicine the commission is recommending.

　　For example, Canada's universal system of socialised medicine is now busily engaged in transferring costs from the public to the private sector... by reducing covered expenses, by de- insuring some expenses and so on.

　　Medical authorities are on record as saying that in an effort to manage costs, hospital stays are being shortened (or even dispensed with altogether).

　　So while we in the Bahamas are citing universal & free' health care as the answer to our problems, in Canada there is an uncoordinated scramble by the public system to reduce and offload the effects of rising health care costs. And we won't even mention the litany of complaints from users who have to wait for poor service.

　　But what mostly concerns us about the Blue Ribbon Commission is that they have plumped for social health insurance without determining the cost of their recommended programme, or of the alternatives.

　　And they do not seem to have taken into account the impact this plan will have on the fiscal deficit or on our individual pockets. Apparently, the position is that whatever the cost, this is the plan that will be presented to parliament.

　　An initiative so far-reaching and so potentially damaging to our economy, should require more careful assessment of the alternatives in public. There is always more than one way to skin a cat. And we do not believe that a small group of consultants constitutes 'the public'.

　　 答案

　　關(guān)于醫(yī)療改革的爭(zhēng)論仍在繼續(xù)

　　(幾星期以前由《拿騷衛(wèi)報(bào)》發(fā)起的有關(guān)醫(yī)療改革的公眾辯論目前正處在一個(gè)有趣的階段。)

　　看來政府所謂的特別委員會(huì)還未曾征詢公眾的意見，就已經(jīng)決定了要向政府建議實(shí)行哪一項(xiàng)醫(yī)療改革計(jì)劃�，F(xiàn)在，他們只需要搞一場(chǎng)公關(guān)活動(dòng)，說服我們相信他們的決定就行了。

　　然而，對(duì)我們而言，這樣的做法似乎有點(diǎn)搞顛倒了。醫(yī)療改革關(guān)系到我們的錢和我們的健康，難道不應(yīng)該首先問問我們想怎么改嗎?

　　醫(yī)療改革的模式有好幾種，并不是每種模式都需要我們投入更多的錢，好讓那些政府官僚舒舒服服地坐在寬敞的辦公室里。醫(yī)療衛(wèi)生完全私有化也許會(huì)有大問題，但是委員會(huì)所推薦的公費(fèi)醫(yī)療制也一樣問題重重。

　　例如，加拿大的全民公費(fèi)醫(yī)療體制現(xiàn)正通過縮小公費(fèi)醫(yī)療項(xiàng)目的范圍以及限制保險(xiǎn)等方式盡可能地將公費(fèi)醫(yī)療的費(fèi)用轉(zhuǎn)移到私人承擔(dān)部分。

　　該國(guó)醫(yī)療當(dāng)局公開宣布，為了解決資金問題，患者住院的時(shí)間正逐步縮短，將來甚至還會(huì)完全取消住院這一項(xiàng)。

　　當(dāng)我們巴哈馬群島還在引用全民“免費(fèi)”醫(yī)療體制作為我們醫(yī)療改革的方向時(shí)，加拿大的公共體制關(guān)于降低、抵消不斷上升的醫(yī)療成本的爭(zhēng)論早已此起彼伏了，更不用說那些滿腹牢騷的患者了，他們苦苦等來的只是劣質(zhì)的醫(yī)療服務(wù)。

　　不過我們最關(guān)心的問題還是，特選委員會(huì)雖然已經(jīng)投票贊成公費(fèi)醫(yī)療保險(xiǎn)制度，可他們并沒有搞清楚這種改革方案或是其它方案到底需要多少資金。

　　而且他們似乎也沒有考慮過這樣的計(jì)劃將會(huì)對(duì)國(guó)家的財(cái)政赤字或是我們個(gè)人的腰包產(chǎn)生什么樣的影響。顯而易見，現(xiàn)在的情況就是，無論要花多少錢，，提交給國(guó)會(huì)的方案就是這個(gè)了。

　　像這樣一個(gè)影響范圍如此之廣，而且可能對(duì)我國(guó)經(jīng)濟(jì)造成巨大損失的提案，應(yīng)該由公眾對(duì)它及其它可供選擇的方案進(jìn)行更為謹(jǐn)慎的評(píng)估。解決問題的辦法從來都不只一個(gè)。我們可不認(rèn)為一小撮顧問的意見就可以代表“公眾”的意見。

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