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
关于医疗改革的争论仍在继续
(几星期以前由《拿骚卫报》发起的有关医疗改革的公众辩论目前正处在一个有趣的阶段。)
看来政府所谓的特别委员会还未曾征询公众的意见，就已经决定了要向政府建议实行哪一项医疗改革计划。现在，他们只需要搞一场公关活动，说服我们相信他们的决定就行了。
然而，对我们而言，这样的做法似乎有点搞颠倒了。医疗改革关系到我们的钱和我们的健康，难道不应该首先问问我们想怎么改吗?
医疗改革的模式有好几种，并不是每种模式都需要我们投入更多的钱，好让那些政府官僚舒舒服服地坐在宽敞的办公室里。医疗卫生完全私有化也许会有大问题，但是委员会所推荐的公费医疗制也一样问题重重。
例如，加拿大的全民公费医疗体制现正通过缩小公费医疗项目的范围以及限制保险等方式尽可能地将公费医疗的费用转移到私人承担部分。
该国医疗*公开宣布，为了解决资金问题，患者住院的时间正逐步缩短，将来甚至还会完全取消住院这一项。
当我们巴哈马群岛还在引用全民“免费”医疗体制作为我们医疗改革的方向时，加拿大的公共体制关于降低、抵消不断上升的医疗成本的争论早已此起彼伏了，更不用说那些满腹牢骚的患者了，他们苦苦等来的只是劣质的医疗服务。
不过我们最关心的问题还是，特选委员会虽然已经投票赞成公费医疗保险制度，可他们并没有搞清楚这种改革方案或是其它方案到底需要多少资金。
而且他们似乎也没有考虑过这样的计划将会对国家的财政赤字或是我们个人的腰包产生什么样的影响。显而易见，现在的情况就是，无论要花多少钱，提交给国会的方案就是这个了。
像这样一个影响范围如此之广，而且可能对我国经济造成巨大损失的提案，应该由公众对它及其它可供选择的方案进行更为谨慎的评估。解决问题的办法从来都不只一个。我们可不认为一小撮顾问的意见就可以代表“公众”的意见。
