奥巴马对抗奥巴马医改

奥巴马总统推行的标志性2010年医改,美国患者保护与平价医疗法案已经将本来无法享受医保的数以百万计的美国人成功纳入到医保范畴。而且,医改并没有像批评者警告的那样推高医疗费用;事实上,医改甚至有望使成本曲线向下掉头。

但“奥巴马医改”能否成功遏制过高的医疗保健费用依然存在变数。这取决于奥巴马政府其他政策是否配合,尤其是美印知识产权这一看似无关领域的谈判结果。但这次,奥巴马似乎屈从于来自美国制药公司的强大游说压力,决意要破坏自己的标志性改革。

药品费用在美国医疗开支中所占的比重越来越大。事实上,处方药支出占GDP的比重在短短20年内已增长近两倍。因此要靠推动制药行业竞争来降低医疗费用——也就是说要允许仿制药的生产和销售。相反,奥巴马政府与印度谈判的贸易协议将削弱仿制药竞争,从而导致印度和其他国家数十亿人负担不起救命的药物。而且这并非原本善意政策的意外后果;而是美国贸易政策的明确目标。

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