为什么大家不去追究医疗费用如此昂贵的根本原因，而是只要求全民医保，直接解决问题呢？

Joshua Light
Hospitals and doctors hire more peoplle for paperwork to minimize their liability - lawyers are always in the wings
Health insurance is siloed in the states. Open it to a national market, increase competition, lower costs, sll that
It isn’t greed driving it - it’s liability. Put a cap on settlements for medical liability
 
医院和医生雇佣更多人来处理文书工作，以减少他们的责任——律师总是在背后支持。
美国的健康保险在各州是独立的。开放到全国市场，增加竞争，降低成本，等等。
这不是贪婪推动的——是责任问题。对医疗责任赔偿设定上限。
 
Margot Conard
Your desire is one of the intensions of having universal health care, I think. In the United States, we treat healthcare as a weird combination of being insurance supported and as such, seeing little market forces and so not responding to market forces, and those without health insurance who see full market forces.
Most Americans get health insurance through the employer of at least one head of household. Mothers with little support and the disabled and /or elderly mostly get health insurance through Medicaid and /or Medicare.
 
我认为你想要的其实就是全民医保的目标之一。在美国，我们将医疗保健视为一个奇怪的组合，既是由保险支持的，但却缺乏市场力量，因此没有响应市场力量，那些没有医保的人则完全受到市场力量的影响。
大多数美国人通过至少一位家庭成员的雇主获得健康保险。那些缺乏支持的母亲、残疾人和/或老年人主要通过医疗补助和/或医疗保险获得健康保险。
 
Elliot Easton
Why not just follow what all other economic competitors have long known and follow their example since they spend far less on their healthcare systems and have far better outcomes and customer satisfaction?
17% of our total healthcare costs are in administrative fees. That’s a minimum amount. Administrative costs for Social Security and for Medicare are 3–4%. Those are two socialized programs.
 
为什么不按照所有其他经济竞争者早已知道的做法，效仿他们的例子呢？他们在医疗保健系统上的支出远低于我们，且结果和客户满意度要好得多。
我们医疗保健总成本的17%是行政费用。这是最低金额。社会保障和医疗保险的行政费用是3-4%。这两个是社会化项目。
 
We spend almost 20% of our GDP on healthcare. The next most expensive system is the Netherlands at 14%. The rest of our competitors are between 10–14%. What do they all have in common but don’t share with the US? They don’t have profit-driven systems. We do.
In a nutshell, those are the reasons why our system is so expensive in comparison to all our healthcare systems in the economically developed world. The only solution is a government-funded universal healthcare system.
 
我们将接近20%的GDP花在医疗保健上。下一个最贵的系统是荷兰，为14%。其他竞争者的医疗保健系统费用在10-14%之间。它们有什么共同点，却没有与美国分享？它们没有以盈利为驱动的系统。我们有。
简而言之，这些就是为什么我们的系统相比经济发达国家的所有医疗保健系统如此昂贵的原因。唯一的解决方案是政府资助的全民医保系统。
 
Cameron Fraser
Because people know the cause and the demand for universal healthcare is a demand to get rid of what makes health care so expensive. What you need to get rid of is the two key for profit elements… for profit hospitals, and for profit health insurance.
 
因为人们知道原因，而要求全民医保的诉求就是要摆脱那些让医疗如此昂贵的因素。你需要去除的两个关键的盈利元素是……盈利性医院和盈利性健康保险。
 
Kim Wegenke
What do you suppose will happen when you just get rid of those insurance companies that are adding 25 to 30% to your healthcare expenses? You will have to get another group to handle those payments. The government is doing that job for a 3% fee for 15% of the population now. Maybe you could offer that service to the rest of us and see which offer the customers prefer in a capitalistic manner, rather than use government sanctioned monopolies that don't have any incentive to lower prices.
 
你认为当你去掉那些让你医疗支出增加25%到30%的保险公司时，会发生什么呢？你将不得不找另一个团体来处理这些支付。现在政府为15%的人口以3%的费用做这项工作。也许你可以为我们其他人提供这个服务，看看在资本主义方式下，顾客更喜欢哪种选择，而不是使用政府批准的垄断机构，这些机构没有任何激励去降低价格。
 
Blair Blakely
Well, you see, we already know why health care in the U.S. is so expensive. It’s health insurance companies.
Get rid of the thing that makes healthcare so expensive in the U.S.? That's what Universal Healthcare would do.
 
你看，我们已经知道为什么美国的医疗保健这么贵了。那就是健康保险公司。
去掉那些让医疗保健如此昂贵的东西？这就是全民医保将会做的事情。
 
Pawel Spoon
somewhere i did read last week that the actual problem with humanity is not the greed but to envy, sorry for my bad english.
and the whole discussion in us about universal healthcare proves that right.
you are so busy with no-to-have-to-pay-for-somebody that you miss the whole point
you are a society of loners, so no society at all.
 
我上周确实读到，问题不在于贪婪，而是嫉妒，抱歉我的英语不好。
美国关于全民医保的讨论证明了这一点。
你们如此忙于不想为别人付钱，结果错过了整个重点。
你们是一个孤独者的社会，根本没有社会。
 
Alan Moore
Because the cause of the high price of healthcare is that it is not a “single-payer” system. In consequence, in addition to paying for healthcare, we have to pay dividends to shareholders in insurance companies, we have to pay wages and salaries to their employees, we have to pay for their office space, utilities, and advertising. We have to pay for the billing and collections departments of healthcare providers, and their office space and utility use — all expenses that contribute nothing whatsoever to healthcare.
 
因为医疗费用高昂的原因是它不是一个“单一支付者”系统。因此，除了支付医疗费用外，我们还必须为保险公司的股东支付分红，必须为他们的员工支付工资和薪水，必须为他们的办公空间、公共设施和广告支付费用。我们还必须为医疗提供者的账单和催收部门支付费用，以及他们的办公空间和公用事业费用——所有这些费用对医疗保健毫无贡献。
 
Jeremy Schoenhaar
That’s basically what universal healthcare does. It removes the middleman. The middleman is the insurance company. There’s only one way to keep the middleman and reduce costs. Force the insurance companies to become non-profits. Have fun explaining that to shareholders.
 
这基本上就是全民医保的作用。它去除了中介。中介就是保险公司。只有一种方法可以保留中介并降低成本，那就是强迫保险公司变成非营利机构。祝你好运，向股东解释这一点。
 
Alessandro Ricci
I'll tell you why.
They did. And found out the cause.
The cause is for profit care demanded to small companies whose primary obxtive is producing revenue for shareholders, and grant cheap care to patients.
To get rid of it, you need to have a big payer with the mission to provide the best care possible, that is not obligated to maximize profit for shareholders.
In other words, universal healthcare.
 
我告诉你为什么。
他们已经做过了，并找到了原因。
原因是为了盈利的医疗服务被小公司要求提供，这些公司的主要目标是为股东创造收入，同时为病人提供廉价的护理。
要摆脱这一点，你需要有一个大的支付方，任务是提供最好的护理，而不需要最大化股东的利润。
换句话说，就是全民医保。
 
Adam Maass
Because… the core issue of expensive healthcare (and poor health outcomes despite the expense) is multiple insurers and the army of clerks necessary to file the claims and deny payments.
Get rid of those, and the system becomes cheaper and more effective. How to do that? Universal healthcare.
 
因为……医疗费用昂贵的核心问题（尽管费用高昂但健康结果差）是多个保险公司和需要大量职员来处理索赔和拒绝支付的行政人员。
去掉这些，系统就变得更便宜、更有效。如何做到这一点？全民医保。
 
Marissa-Anneke Collins
The cause has already been found… healthcare as a for-profit enterprise rather than as a service. Guess what the end result of getting rid of that would be?
 
原因已经找到了……医疗作为一个盈利性企业，而不是作为一种服务。猜猜去掉这一点后的最终结果会是什么？
 
Chuck Karish
We know why health care is so expensive in the US. It’s manage by insurance companies that add more bureaucratic overhead than they do value. Their incentives drive them to pursue profits in preference to better patient outcomes. Because the incentives are perverse socialized medicine would do a better job at lower cost.
 
我们知道为什么美国的医疗保健如此昂贵。它由保险公司管理，增加了比它们带来的价值更多的官僚开销。它们的激励机制驱使它们追求利润，而不是更好的病人结果。因为激励机制是扭曲的，社会化医疗会以更低的成本做得更好。
 
Victor Croasdale
The reason US healthcare is so expensive is the medical insurance companies. They abstract money and provide nothing of value. Get rid of them and healthcare becomes affordable of course you also get universal healthcare.
 
美国医疗保健如此昂贵的原因是医疗保险公司。它们抽取资金，却什么有价值的东西也不提供。去掉它们，医疗保健当然变得负担得起，你也会得到全民医保。
 
Rik Elswit
You seem to think that how to achieve universal health care is a mystery. The US is the only nominally first world nation that hasn’t been able to accomplish this. The reason is that it would cost the few obscenely wealthy men who own our government, money. And they won’t stand for it.
 
你似乎认为实现全民医保是一个谜。美国是唯一一个名义上属于发达国家，却没有能够做到这一点的国家。原因是，它会让那些拥有我们政府的少数极度富有的人损失钱财。而他们是不会接受的。
 
Leah
Because when you do that, you find the cause is privatized, for- profit insurance is the reason.
When the insurance organism isn't looking to profit off of ill health, the prices go down.
When the insurance organism has a whole country under them, they have much more leverage when negotiating prices with pharmaceutical companies.
Also, in most countries with a universal health coverage, advertising drugs to the public is illegal (doctors choose treatment, not patients) so the cost of advertising is not their burden. They don't need to take into account that part of the pharma company’s costs.
 
因为当你这么做时，你会发现原因在于私有化的、以盈利为目的的保险。
当保险机构不再以病态为盈利来源时，价格就会下降。
当保险机构控制了整个国家时，他们在与制药公司谈判价格时会有更多的杠杆作用。
此外，在大多数实行全民医保的国家，向公众广告药品是非法的（医生选择治疗，而不是患者），所以广告费用不再是他们的负担。制药公司的费用中不需要考虑这一部分。
 
Anthony Atkielski
Health care is expensive in the USA because it is a greed-driven, for-profit industry, just like everything else in the country. The obxtive is not to make people well, it is to enrich institutional and insurance shareholders as much as possible, and it works well because patients have to either pay or die.
 
美国的医疗保健之所以昂贵，是因为它是一个由贪婪驱动、以盈利为目的的行业，就像美国的其他一切一样。其目标不是让人们恢复健康，而是尽可能多地让机构和保险股东致富，而这种运作模式非常成功，因为患者要么付钱，要么死掉。
 
In countries with universal health care, the industry is seen as a public service and is driven by the public interest, not the greed of a handful of anonymous investors. It can therefore be provided at cost, which is much, much less expensive than the prices—with 95% margins built in—practiced in the US.
It is almost inconceivable that this will ever change. There are too many influential people making too much money from health care.
 
在实行全民医保的国家，医疗行业被视为公共服务，驱动它的是公众利益，而不是少数匿名投资者的贪婪。因此，它可以按成本提供，这比美国的定价要便宜得多，因为美国的价格中内嵌了95%的利润。
几乎不可想象这种情况会有任何改变。因为有太多有影响力的人从医疗保健中赚取了太多的钱。
 
Tom S
Healthcare in the US is expensive because the politicians are in the pockets of the insurance companies. The insurance company contracts include provisions that they will pay a fixed percentage (usually in the neighborhood of 20%–40%) of the fee charged to uninsured patients. So, for the healthcare provider to obtain the amount that they require for performing the services, they have to charge 2–3 times more than they would would otherwise. Then, should a provider fail to pursue and enforce the full billing amount to the uninsured patient, the healthcare provider can be criminally charged with fraud.
 
美国的医疗保健之所以昂贵，是因为政客们被保险公司收买了。保险公司合同中包括规定，它们将支付未投保患者费用的一定百分比（通常在20%到40%之间）。因此，为了让医疗服务提供者获得他们所需的费用，他们不得不收取比正常情况下高出2到3倍的费用。然后，如果提供者没有追讨并强制执行对未投保患者的全部账单金额，医疗服务提供者可能会面临欺诈的刑事指控。
 
If I had a chance, I would replace Obamacare with a one page law that would state that no healthcare provider can charge more than 50% more than the minimum that they will accept from an insurance carrier, e.g. if they will accept $3000 from an insurance carrier then they can’t charge an uninsured patient more than $4500. The law would give healthcare providers 1 year to renegotiate their contracts with insurance carriers.
Of course, no such law will be written because the politicians value the donations they receive from the insurance companies more than they value the lives and livelihood of their constituents.
 
如果我有机会，我会用一条简短的法律取代奥巴马医保，规定任何医疗提供者不得收取比他们从保险公司接受的最低费用多出50%的费用。例如，如果他们从保险公司接受3000美元，那么他们不能向未投保患者收取超过4500美元的费用。法律将给医疗提供者一年时间与保险公司重新谈判合同。
当然，不会有这样的法律被写出来，因为政客们更看重从保险公司收到的捐款，而不是选民的生命和生计。
 
John Zuijdveld
Did you forget momentarily that YOU live in a Capitalist nation? That EVERY industry and business is run by ppl. who's whole reason for living is to serve the company or the corporation? If they don't they lose their job instantly and no-one higher up cares if there is hunger or sickness down the track.
 
你难道一时忘记了你生活在一个资本主义国家吗？每一个行业和企业都由那些生活的唯一目的就是为公司或企业服务的人所管理。如果他们不这样做，他们会立刻失业，而且高层根本不在乎未来的饥饿或疾病。
 
In the USA every hospital and every medical practice are owned by billionaires, and so are the health insurance companies and I'd bet that many of these billionaires own all of these services. They most probably are also heavily invested into the pharmaceutical industry and even vise-versa!
So there's an obvious monopolistic system operating here. BTW the principles of Capitalism don't confine themselves soley to the health industry or the insurance companies involved here, the principals remain the same for every enterprise within the USA.
 
在美国，每一家医院和每一个医疗机构都是亿万富翁拥有的，健康保险公司也是，而且我敢打赌，这些亿万富翁可能拥有所有这些服务。他们很可能也在制药行业有重大的投资，甚至可能是相互投资的！
所以这里显然存在一个垄断系统。顺便提一下，资本主义的原则不仅限于医疗行业或涉及的保险公司，这些原则在美国的每一个企业中都是一样的。
 
The insurance companies charge you towards poverty as do the hospitals who won't even admit you if you're not insured, and if you can't afford the price of the medications you need to keep you alive then you mightn't even get to the hospitals’ front door!
So . . . In the Capitalist nation that YOU and all the racist Republicans and rightwing gun infused neo-nazi nationslists support are you REALLY brave enough to challenge the rulers/system that's ruled you for so long?
 
保险公司把你推向贫困，医院也是如此，如果你没有保险，他们甚至不会接收你，如果你负担不起你需要的药物来维持生命，你甚至可能无法到达医院的门口！
所以……在你和所有支持种族主义的共和党人以及充满武器的右翼新纳粹民族主义者所支持的资本主义国家里，你真的有足够的勇气挑战长久以来一直统治你的统治者/系统吗？
 
xiao Wen
In the United States, health insurance is a money laundering scam.
American businessmen have entangled massive costs into health insurance, which is clearly a social service that developed countries should have, by manipulating the government. Through this channel, people's income and taxes are funneled back into the pockets of interest groups and big corporate entities in various forms of additional fees.
 
在美国，健康保险是一个洗钱骗局。
美国商人通过操控政府，将巨额费用卷入健康保险，这显然是发达国家应当拥有的社会服务。通过这一渠道，人们的收入和税收以各种额外费用的形式流回到利益集团和大企业的口袋中。
 
Even though many fundamental medical research and scientific breakthroughs are expensive, when spread across each citizen, they should not be as costly as they are now. However, by marketizing and monopolizing various aspects within the entire pharmaceutical and insurance industries, excessive profits have been added to the final costs, disguised as necessary expenses for the welfare of ordinary people and scientific progress. However, in the performance uations of these large conglomerates, profit is the only criterion.
 
尽管许多基础医学研究和科学突破是昂贵的，但当这些成本分摊到每个公民身上时，它们本不应如此昂贵。然而，通过市场化和垄断整个制药和保险行业的各个方面，过度的利润被加到最终的成本上，这些成本被伪装成普通人福祉和科学进步所需的开支。然而，在这些大企业的绩效评估中，利润是唯一的标准。
 
You can imagine a river, where taxes, finances, and insurance are the water sources, factories and laboratories are the water users upstream, and the public are the water users downstream. To stimulate market competition and mechanisms, we introduced private companies into the river. They either inject water into the river or divert water, changing the entire structure of the cash flow. In the United States, these companies have such great power that they have greatly altered the river structure, enabling them to save more money before the public, while also tricking the public to invest more taxes and insurance funds into the water sources. In fact, for every dollar of benefit the public eventually gains, the upstream insurance companies, pharmaceutical companies, and various law firms save ten dollars. This country has been destroyed by such parasites. So that no one believes public service can be an act of kindness.
 
你可以想象一条河流，税收、财政和保险是水源，工厂和实验室是上游的用水者，公众是下游的用水者。为了激发市场竞争和机制，我们引入了私人公司进入这条河流。它们要么向河中注水，要么引水，从而改变了现金流的整个结构。在美国，这些公司拥有如此巨大的权力，它们极大地改变了河流结构，使它们能在公众之前节省更多的钱，同时也愚弄公众，让他们向水源投资更多的税收和保险资金。事实上，对于公众最终获得的每一美元利益，上游的保险公司、制药公司和各种律师事务所节省了十美元。这个国家已经被这样的寄生虫摧毁了。所以，没有人再相信公共服务可以是出于善意的行为。
 
Tauonic Lightning
We know what the cause is: unrestricted profit motive in a market where you can charge as much as you want, because people will go into as much debt as they have to in order to not die. We can get rid of that by switching to universal healthcare, which has worked for the rest of the developed world for many decades now.
 
我们知道原因是什么：在一个你可以随意收费的市场中，利润动机没有限制，因为人们会为了不死而背负尽可能多的债务。我们可以通过转向全民医保来消除这一点，这在其他发达国家已经行之多年，效果显著。