你对美国医疗体系有什么看法？我觉得在美国，你能得到及时的医疗服务，质量很棒

In early June I tried to make an appointment with a specialist I had seen in the past for a similar problem. The earliest appointment available was in mid-October. I asked about seeing another doctor at the practice and the earliest slot was early October. I called around to other offices and hospitals and they all said the earliest slot was October, except one that said the last week of September, but that I would have to get a referral from my primary care doctor before they would schedule the appointment. This, despite me having PPO specifically so I do not need referrals from my primary care doctor to see specialists.

六月初，我尝试预约一位过去曾为我治疗类似问题的专科医生。最早的预约时间在十月中旬。我询问了该诊所的其他医生，最早的预约时间在十月初。我打电话给其他诊所和医院，他们都说最早的预约时间在十月，只有一家诊所表示可以在九月的最后一周预约，但前提是我必须从我的初级保健医生那里获得转诊。尽管我拥有PPO保险，这意味着我不需要初级保健医生的转诊就可以看专科医生。

Meanwhile, mid-July my symptoms suddenly get much worse. I missed a concert I wanted to go to, losing out on $550 for the tickets because the cancellation insurance insisted on a doctor’s note, despite the fact by this time I was so much worse that I could leave my house at all I and was in no condition to drive. And when I was still not better after 2 weeks, the lady who had been going to go to the concert with me drove to my house and took me to the emergency room. 13 hours there, only to be told that I will need to see the specialist.

与此同时，七月中旬我的症状突然恶化。我错过了一场想去的音乐会，损失了550美元的票钱，因为取消保险坚持要医生证明，尽管当时我已经病得无法离开家，也无法开车。两周后，我仍然没有好转，原本要和我一起去音乐会的那位女士开车到我家，把我送到了急诊室。在那里待了13个小时，结果被告知我需要去看专科医生。

Years ago when I needed to see an OB-GYN specialist for a problem, I had to schedule my appointments 3 months in advance. Then he’d get mad at me if I was on my period when I had the appointment, although one of my complaints was that I had absolutely no way to predict when I would get my period because it was so erratic. If I had 2 periods that were up to 28 days apart,that was a miracle; I had times when one ended and the next one started the very next day.

几年前，当我因为一个问题需要看妇科专家时，我不得不提前三个月预约。然后，如果我在预约时来月经，他会对我生气，尽管我的抱怨之一是我根本无法预测我什么时候会来月经，因为它非常不规律。如果我有两次月经间隔长达28天，那简直是个奇迹；我有过刚结束一次月经，第二天就开始下一次月经的时候。

So I’ve spent the last few weekends sleeping for all but 5 or 6 hours the whole weekend while running to the bathroom every half hour when I am awake and waking up several times though the night to run to the bathroom. I am in pain; I cannot visit my good friends who are moving halfway across the state this weekend; I cannot attend a mandatory in-office meeting for work. (Luckily I am able to work from home, but our director wants to see us all in person this week and I will have to decline.)

所以，过去几个周末，我几乎整个周末都在睡觉，除了五六个小时外，我每半小时就要跑一次厕所，而且晚上还会醒来好几次去厕所。我很痛苦；这周末我无法去看望即将搬到州另一边的我的好朋友；我也无法参加工作的强制性办公室会议。（幸运的是，我可以在家工作，但我们的主管希望这周能见到我们所有人，我不得不拒绝。）

And, before you say that this must be because I have lousy insurance or live in an area with few medical resources, NO and NO. I live in the middle of a large metropolitan area . I live 5 minutes from one major hospital, 8 minutes from a large campus of several major hospitals, and within 20 minutes of at least half a dozen more hospitals. We have so many large hospitals in this city, it is incredible. As for my insurance, my plan is far better than most people’s. I have the best plan offered by my company, which happens to be one of the largest health insurance companies in the country!

而且，在你说这一定是因为我的保险很差或者我住在一个医疗资源匮乏的地区之前，不，都不是。我住在一个大都市的中心。我离一家大医院只有5分钟的路程，离一个由几家大医院组成的大型医疗园区有8分钟的路程，在20分钟内至少还有六家医院。我们这座城市有这么多大医院，真是令人难以置信。至于我的保险，我的计划比大多数人的要好得多。我有公司提供的最好的计划，而这家公司恰好是全国最大的健康保险公司之一！

Meanwhile the emergency room told me they believe I have one of 2 conditions. I read up on them and they are both supposed to be treated right away, otherwise they can get much worse and cause serious damage.

与此同时，急诊室告诉我他们认为我有两种可能的病症之一。我查阅了相关资料，发现这两种病症都应该立即治疗，否则可能会恶化并造成严重损害。

We have a lousy healthcare system in the U.S..

美国的医疗系统很糟糕。

Claire Jordan
The wife of a friend of mine in the US had a benign brain tumour about 25 years ago. The surgeons weren’t able to get it all out so she had to have a scan every year to make sure it stayed quiescent. So far so good, and normal.

我在美国的一位朋友的妻子大约25年前患有一个良性脑瘤。外科医生未能完全切除，因此她每年都需要进行一次扫描以确保肿瘤保持静止。到目前为止，一切正常。

Three or four years ago the radiographers doing her head scan noticed a small lump on her breast - but they didn’t bother to tell her, or her regular doctors, until it was still there a year later. These are people with good insurance, mind you.

三四年前，为她进行头部扫描的放射技师注意到她的乳房上有一个小肿块——但他们直到一年后肿块仍然存在时才告诉她或她的常规医生。请注意，这些人是有很好的保险的。

By that point, she had an aggressive breast cancer. There was a new treatment available for the type of cancer she had, which was both cheap and effective, but because it was new her insurers didn’t have a tick-box for it, so they insisted that she be treated with an older, more expensive and less effective drug. The hospital were by this point so unused to using that obsolete drug that they overdosed her and temporarily blinded her.

那时，她患上了侵袭性乳腺癌。有一种针对她所患癌症类型的新疗法，既便宜又有效，但由于它是新的，她的保险公司没有相应的选项，因此他们坚持让她使用一种更老、更昂贵且效果较差的药物。到了那时，医院已经很少使用那种过时的药物，以至于他们给她过量用药，导致她暂时失明。

Her doctors couldn’t really assess how well this vintage treatment was working, because the insurer wouldn’t authorise regular scans. Now she’s developed a new and even more aggressive type of tumour: one which cannot be cured, but only managed.

她的医生们无法真正评估这种古老的治疗方法的效果如何，因为保险公司不愿意授权进行定期扫描。现在，她发展出了一种新的、更具侵袭性的肿瘤类型：这种肿瘤无法治愈，只能进行管理。

I’m not saying this sort of clusterfuck could never happen here in the UK or in other countries with functioning universal healthcare - but if it did, it would be headline news and a national scandal, and questions would be asked about it in Parliament. In the US, it’s Tuesday.

我并不是说这种混乱的局面永远不会发生在英国或其他拥有全民医保的国家——但如果真的发生了，那将会成为头条新闻和全国性的丑闻，议会也会对此提出质询。而在美国，这只是平常的一天。

Meanwhile, here in the UK it’s not uncommon for somebody to visit their GP with a suspicious lump in the morning, and be recovering from surgery by 6pm the same day, with a course of preventative chemotherapy scheduled to begin within the next two weeks.

与此同时，在英国，一个人早上带着可疑的肿块去看全科医生，到下午6点就已经从手术中恢复，并且在接下来的两周内安排开始预防性化疗的情况并不罕见。

T Hall
Scan at 2–30. consultnt phones at 4–30 to say I will be seeing different specialist as the scan didn’t show what they were expecting. A couple of hours later a different specialist phones me at home, tells me what they’ve seen and that I should go in next morning for an operation. I went in and had the operation

在2点到3点之间进行了扫描。顾问在4点30分打电话说，我将要去看不同的专家，因为扫描结果没有显示出他们预期的内容。几个小时后，另一位专家打电话到我家，告诉我他们看到的情况，并建议我第二天早上进行手术。我去了医院并进行了手术。

Is that immediate enough?

这够快吗？

My mother had a stroke at home. She was taken by ambulance, which arrived within minutes, to a specialist stroke unit at the hospital.

我母亲在家中风了。救护车在几分钟内到达，并将她送往医院的专科中风病房。

I walked through a glass door. I really did - with particular nasty consequences. The ambulance arrived in minutes and took me to hospital where I was patched up

我走过了一扇玻璃门。我真的这么做了——结果特别糟糕。救护车几分钟内就到了，并把我送到了医院，在那里我被包扎好了。

One ‘minor’ point. None of the above; doctor consultations, operation, aftercare, ambulance, casualty care etc. cost me a single penny. That’s our NHS at work.

一个小细节。以上所有项目，包括医生咨询、手术、术后护理、救护车、急诊护理等，都没有花费我一分钱。这就是我们的NHS在发挥作用。

Frank Lucrezi
Your funny immediate care. Go visit any emergency room in the US. One of the guys i worked with his 6 year old broke his arm. He went to a hospital in the area they wanted to send him to one of their other hospitals for a child's orthopedic surgent. The insurance company wouldn't pay for a 40000 ambulance ride of less than 30 miles.

你的紧急情况真有趣。去美国的任何急诊室看看。我的一位同事，他6岁的孩子摔断了胳膊。他去了当地的一家医院，他们想把他转到他们另一家医院的儿童骨科医生那里。保险公司不愿意支付不到30英里的40000美元的救护车费用。

My wife's doctor wanted her to have a vascular doctor for a check up right away. She called the number and never got an answer. She drove to the office there were no hours posted or people there just a drop box for paperwork. She even tried calling everyday. Finally after 3 months she got a bunch of paperwork to fill out to send back. She drove over to the office no one was there and dropped it in the box, after another two months she got a call with an appointment in another 3 months.

我妻子的医生希望她立即去看血管科医生进行检查。她拨打了电话，但一直无人接听。她开车去了办公室，那里没有营业时间，也没有人，只有一个投递文件的箱子。她甚至每天都尝试打电话。最终，在三个月后，她收到了一堆需要填写的文件，并寄回。她再次开车去了办公室，依然没有人，于是她把文件投进了箱子。又过了两个月，她接到电话，预约了另外三个月后的检查。

We have 2 hospitals in our county if you have a heart attack your getting life flighted or an ambulance ride to the leigh valley to have it done. Neither one has a kids ward. There are other services that neither one offers. The original one use to have those services.

我们县有两家医院，如果你心脏病发作，你会被直升机或救护车送到利哈伊谷进行治疗。这两家医院都没有儿科病房。还有一些服务是这两家医院都不提供的。原来的那家医院曾经提供这些服务。

My dad had chemo for cancer when he was done and he kept asking the doctor if they got it. The doctor wouldn't answer it but wanted him to do another round of chemo. When he said no iam done, The doctor said we got it the first time. When I was working we went through a period where the insurance company wouldn't pay the bills. No real reason they just refused. My son in law the insurance company refused the treatment he needed for limes disease.

我父亲在完成癌症化疗后，一直问医生是否治好了。医生没有直接回答，而是希望他再做一轮化疗。当他拒绝并说‘我完成了’时，医生才说第一次治疗就成功了。在我工作时，我们经历了一段时间，保险公司无缘无故拒绝支付账单。我的女婿也遇到了保险公司拒绝支付他治疗莱姆病所需的费用。

Since the 80s i paid through the nose for heath insurance for what so some parasite can make millions. On top of that end up with co pays and deductibles for what? I guess its protecting my right to get robbed by an insurance company.

自80年代以来，我为健康保险支付了高昂的费用，结果却让一些寄生虫赚得盆满钵满。除此之外，还要支付共付额和免赔额，为了什么？我想这是在保护我被保险公司抢劫的权利。

Ann Smith
About 10 years ago i was very sick and had to spend 3 weeks in a top notch teaching hospital. The care was excellent, and I healed well but even with very good health insurance through my job I ended up with over 75 thousand (yes THOUSAND) dollars in medical debt. No one should EVER be in danger of losing their home, and be in debt for the rest of their life for a medical emergency they didn't choose to have. That is, in my mind, criminally negligent and hostile treatment of human beings needing medical care. No one should ever be faced with a choice of death or debt.

大约十年前，我病得很重，不得不在一家顶尖的教学医院住了三周。那里的护理非常出色，我也康复得很好，但即使通过工作拥有非常好的医疗保险，我最终还是背负了超过7万5千美元（是的，千）的医疗债务。任何人都不应该因为一场他们没有选择的医疗紧急情况而面临失去家园的危险，并终生负债。在我看来，这是对需要医疗护理的人类的刑事疏忽和敌对待遇。任何人都不应该面临死亡或债务的选择。

Anthony Armstrong
After suffering chest pains, I came to my local hospita
l for an echocardiogram. They decided I was either having a heart attack right then or was close to having one and moved me, there and then, to the emergency department.

在经历了胸痛之后，我来到当地医院进行超声心动图检查。他们判断我当时要么正在心脏病发作，要么即将发作，并立即将我转到了急诊科。

The very next day, I was moved to a specialist heart hospital where I am waiting for a triple bypass. The only reason it hasn’t gone ahead yet is they need to conduct more tests.

就在第二天，我被转到了一家专门的心脏医院，在那里等待进行三重搭桥手术。唯一尚未进行手术的原因是还需要进行更多的检查。

The care was immediate. I was told I would need to go straight to a bed and I did. I didn’t even get a chance to go home and get some things together. My wife was with me and did that, but they said they had the basics if she couldn’t get them.

护理是立即进行的。我被告知需要直接去病床，我照做了。我甚至没有机会回家收拾一些东西。我的妻子和我在一起，她去做了这件事，但他们说如果她无法拿到，他们有基本的东西。

The cost of keeping me in hospital is £1800 per day, without factoring in tests and the upcoming surgery. As a citizen of the U.K., I won’t be expected to pay a penny towards it. And the only difference between me and the ‘private ward’ is that they’re on the first floor (I’m on ground) and they drink bottled water, whereas I get a jug of tap water.

让我住院的费用是每天1800英镑，这还不包括检查和即将进行的手术。作为英国公民，我不需要为此支付一分钱。而我和‘私人病房’的唯一区别是他们在第一层（我在底层），他们喝瓶装水，而我则喝一壶自来水。

Big Mike
My sister in law went for a head CT scan at which time they found a tumour. She was immediately admitted into hospital more tests were ran. Met oncologist and agreed upon game plan. Brain surgery done few days later, went home after week in hospital following the surgery. Total time in hospital about 2 weeks. Cost $0.00

我的嫂子去做了一次头部CT扫描，当时发现了一个肿瘤。她立即被送入医院，进行了更多的检查。会见了肿瘤科医生，并商定了治疗方案。几天后进行了脑部手术，手术后住院一周后回家。总共住院时间大约两周。费用为$0.00。

If she was in the us, she'd be looking at min $95,000 for the same care. Basically enough to pay off 1/3 of a brand new house.

如果她在美国，同样的护理费用至少需要95,000美元。基本上足够支付一套全新房子的三分之一。

See here's the difference between us and countries with universal healthcare. In us, the quality of care is determined how rich you are. In countries with universal healthcare, how much money you make: has no bearing on your quality care. Everyone gets the same quality of care regardless of your rich or homeless. Focus in my country is healthcare and keeping people healthy. In us, it's how much money you can make off the patient.

看看我们和拥有全民医保的国家之间的区别。在美国，医疗质量取决于你有多富有。在拥有全民医保的国家，你赚多少钱：对你的医疗质量没有影响。无论你是富人还是无家可归者，每个人都能获得相同的医疗质量。在我的国家，重点是医疗保健和保持人们的健康。在美国，重点是你能从病人身上赚多少钱。

Josh
Did you know that in 2024 an estimated 1.5 million Americans traveled to Mexico to get healthcare? Medical tourism is so prent in Mexico from Americans that there are entire companies dedicated to the practice.

你知道吗，在2024年，估计有150万美国人前往墨西哥接受医疗保健？医疗旅游在墨西哥非常普遍，以至于有专门的公司致力于这一业务。

I really want that to sink in: Medical care in the US is so bad that every year over a million Americans go to a developing country to get treatment. That’s not the sign of a functioning system; that’s a national embarrassment.

我真的希望这一点能被深刻理解：美国的医疗状况非常糟糕，以至于每年有超过一百万美国人前往发展中国家接受治疗。这不是一个正常运转的系统的标志；这是一个国家的耻辱。

As far as quality goes, the US isn’t great either. By most metrics, we’re dead last among developed countries, and actually below several developing countries.

就质量而言，美国也不怎么样。根据大多数指标，我们在发达国家中排名垫底，实际上还低于几个发展中国家。

Rob Crossgrove
I’m in the UK. I had a heart attack 10 years ago. As soon as I realised I was having it, I phoned 999. The operator was very nice and kept reassuring me. It took about 10 minutes for the ambulance to get here. They gave me morphine and did an ECG. Then they gave me some more of that very nice Morphine, that makes you slightly woozy, and they took me to hospital. I don’t know how long or what day it was that I was operated on, must have been the day after because I had to sign the consent forms. They wanted to shave me, but I took one look at the fierce expression on the nurses face and the cheap razor she was holding and declined  I had a bypass, (and now have a metallic heart valve in situ), and was in hospital for 2 weeks, (cost to me £0.00).

我在英国。十年前我心脏病发作。我一意识到自己心脏病发作，就拨打了999。接线员非常友好，一直安慰我。救护车大约花了10分钟到达。他们给我注射了吗啡并做了心电图。然后他们又给我注射了一些那种让人有点晕乎乎的吗啡，然后把我送到了医院。我不知道手术进行了多长时间，也不知道是哪一天，可能是第二天，因为我必须签署同意书。他们想给我剃毛，但当我看到护士脸上严厉的表情和她手里廉价的剃须刀时，我拒绝了。我做了搭桥手术（现在体内有一个金属心脏瓣膜），并在医院住了两周（费用为0.00英镑）。

Whenever I need to see my GP, depending on the time of day I ring, I always get an appointment the same day or next day.

每当我需要看家庭医生时，根据我打电话的时间，我总是能在当天或第二天预约到。

Danielle
Sure if you are rich. But for average people the service is lousy. Do not try to blow smoke up our asses. Enough Canadians including myself have lived in the USA. I was in California for 10 years. I have had US medical insurance. For myself and my kid.

当然，如果你有钱的话。但对于普通人来说，服务很糟糕。不要试图欺骗我们。包括我在内的许多加拿大人都曾在美国生活过。我在加利福尼亚待了10年。我和我的孩子都有过美国的医疗保险。

So please stop thinking Canadisns need to take your word for how good average US healthcare is. We get ALL the U.S. News here. We know about the USA better than most Americans. Better still than most Trump supporters. Most things American think are normal about their health care horrify most Canadians.

所以请不要再认为加拿大人需要听你讲述美国普通医疗有多好。我们这里能收到所有的美国新闻。我们比大多数美国人更了解美国。甚至比大多数特朗普支持者更了解。大多数美国人认为他们的医疗保健是正常的，这让大多数加拿大人感到震惊。

Remember while most Americans are beneficially ignorant about Canada, almost all Canadians are malevolently well informed about the USA.

记住，虽然大多数美国人对加拿大有益地无知，但几乎所有加拿大人都对美国怀有恶意地了解。
 
Lisa Silverman
You might think that people get immediate care in the USA, but you’re wrong. Sometimes immediate care is available; often it’s not. I struggle more and more to get a timely checkup and treatment for my ongoing complicated medical issues. Right now I’ve been trying for awhile to get an appointment for my regular six month checkup at the Mayo Clinic. They open up slots three months in advance but they’re filled within moments. I can’t be seen within the six months at this point; I’ll be lucky to get an appointment within seven months. My sister’s had to wait months for a colonoscopy in Boston. Another sister with terrible RA is on a waiting list to see her doctor in fewer than the two months till the next opening. She’s in constant pain. I know many people in a similar boat and it’s borne out by statistics.

你可能会认为人们在美国可以立即得到医疗护理，但事实并非如此。有时可以立即得到护理，但通常不行。我越来越难以及时获得对我持续复杂的医疗问题的检查和治疗。目前，我已经尝试了一段时间，想在梅奥诊所预约我的常规六个月检查。他们提前三个月开放预约，但预约位置在瞬间就被填满。我现在无法在六个月内得到检查；如果能在七个月内预约到，我就算幸运了。我的姐姐在波士顿不得不等待几个月才能进行结肠镜检查。另一个患有严重类风湿性关节炎的姐姐在等待名单上，希望能在少于两个月的时间内见到她的医生。她一直在疼痛中。我知道许多人也处于类似的境地，统计数据也证实了这一点。

The quality of US health care actually falls near the bottom for developed countries, as measured by life expectancy (death rates), infant mortality, and preventable deaths. I don’t consider that amazing.

美国的医疗质量在发达国家中实际上接近垫底，这是通过预期寿命（死亡率）、婴儿死亡率和可预防死亡来衡量的。我不认为这有什么了不起的。

What I like about the American health system is that for now, those who meet the age criterion and can afford it can choose a comprehensive type of Medicare. It’s expensive, but at least it’s possible. I can’t say I prefer it to other countries’ systems, but at least for now I’m not required to use an HMO (aka Medicare Advantage).

我喜欢美国医疗体系的地方在于，目前，那些符合年龄标准并且负担得起的人可以选择一种全面的医疗保险类型。虽然昂贵，但至少是可能的。我不能说我更喜欢它胜过其他国家的体系，但至少目前我不必使用HMO（即Medicare Advantage）。

Bill Shine
Please tell me where in the USA I can go to get new prescxtions for existing conditions, and have them filled, immediately. It seems to take several weeks in the U.S., between scheduling appointments, going to the lab, waiting for results, and finally getting the prescxtions. In Mexico, I can do this in a morning. What the hell is wrong with the USA? When will you get your act together?

请告诉我，在美国哪里可以立即为现有病情开具新处方并配药。在美国，这似乎需要几周时间，包括预约、去实验室、等待结果，最后才能拿到处方。在墨西哥，我可以在一个上午完成。美国到底出了什么问题？你们什么时候才能把事情办好？

Derek Mathias
My own experience runs counter to most of the comments here. A few years ago, I moved from California to Germany. In the US I was with Kaiser Permanente, and they always gave me excellent treatment. They would call me up to remind me of scheduled appointments and when to schedule new appointments. My specialists would call periodically to check up on my health status. And when one department discovered a potential health problem that might relate to another health issue, they didn’t just schedule me for a new appointment with a specialist, they summoned a specialist from down the hall who was able to check me out right then and make a diagnosis. That’s because their huge facility had everything in one place. And I never had to wait more than a week or two for an appointment.

我自己的经历与这里的大多数评论相反。几年前，我从加利福尼亚搬到了德国。在美国时，我加入了凯撒永久医疗集团，他们总是给我提供极好的治疗。他们会打电话提醒我预约的时间以及何时安排新的预约。我的专科医生会定期打电话来检查我的健康状况。当一个部门发现可能与另一个健康问题相关的潜在健康问题时，他们不只是安排我与专科医生的新预约，而是从走廊里叫来一位专科医生，当时就能给我检查并做出诊断。这是因为他们的大型设施将所有东西都集中在一个地方。而且我从来不需要等待超过一两周就能预约上。

OTOH, coverage for my wife and me was $1,800 per month, each office visit cost $60, and I always ended up paying at least a few hundred dollars for most treatments. At least those expenses were capped at $12,000 per year, if I recall correctly.

另一方面，我和我妻子的保险费用是每月1800美元，每次门诊费用为60美元，而且大多数治疗我最终至少要支付几百美元。至少我记得那些费用每年上限为12000美元。

In Germany, I had a real hassle getting public health insurance, and I ended up not being able to get on my wife’s insurance because the insurance company was extremely unhelpful and withheld important information. So I ended up on private health insurance. Between the two of us, we are paying around $1,000 equivalent. Cheaper, yes, but the coverage is second-rate, and I have a large deductible. Regular doctor appointments never require waiting for more than a couple weeks, but seeing a specialist can easily take six months or more! My GP does not inspire confidence, since she confidently asserted that eating eggs raises cholesterol and that all the cholesterol is located in the albumin, not the yolk. The doctors here also never follow up.

在德国，我在获取公共医疗保险时遇到了真正的麻烦，最终无法加入我妻子的保险，因为保险公司极其不合作，并且隐瞒了重要信息。所以我最终选择了私人医疗保险。我们两个人每月支付的费用大约相当于1000美元。是的，更便宜，但保险覆盖范围是二流的，而且我有很高的免赔额。普通医生的预约通常不需要等待超过几周，但看专科医生可能轻易就要等上六个月或更久！我的全科医生并没有给我带来信心，因为她自信地断言吃鸡蛋会提高胆固醇，而且所有的胆固醇都存在于蛋白中，而不是蛋黄里。这里的医生也从不跟进。

To be fair, my less-than-satisfactory experience with the German healthcare system may be regional. I live south of Trier, close to the border with Luxembourg, and our area is underserved. I hear that the larger cities have much better healthcare.

公平地说，我对德国医疗系统不太满意的经历可能是地区性的。我住在特里尔以南，靠近卢森堡边境，我们地区的医疗服务不足。我听说大城市的医疗条件要好得多。

So take from that what you will. I know I definitely miss Kaiser Permanente, since I felt I was getting proper healthcare…but I do not miss those huge expenses.

所以你可以从中得出自己的结论。我确实非常怀念凯撒医疗集团，因为我觉得在那里我得到了适当的医疗照顾……但我不怀念那些巨额的开销。

Bob Troxell
I like being able to see the doctors I want to see and not waiting behind a massive number of people to do so. I receive the care I need, in a timely manner, and at a reasonable cost to me. I like that.

我喜欢能够看到我想看的医生，而不需要在大量人群后面等待。我能够及时获得我所需的护理，并且费用对我来说是合理的。我喜欢这样。

I worked for 37 years as a social worker, did not make a lot of money, but my employer supplied my health coverage. After I retired, I received Medicare Part A (thanks ex-wifey!) and paid for Medicare Part B. I then pay premiums for a Medicare Advantage plan that covers what Medicare does not, including my prescxtion drugs. I seldom get any charge to see my primary physician, and I pay $35 “co-pay” per visit to see a specialist. If I am hospitalized, I pay more, but there is a limit of several thousand dollars that I would pay out of pocket per year, and then my insurance pays 100%. Not bad — I can afford that.

我作为一名社会工作者工作了37年，虽然没赚到很多钱，但我的雇主提供了我的健康保险。退休后，我获得了Medicare Part A（感谢前妻！）并自费购买了Medicare Part B。然后，我支付了Medicare Advantage计划的保费，该计划涵盖了Medicare不覆盖的部分，包括我的处方药。我很少需要支付看家庭医生的费用，每次看专科医生时支付35美元的“共付额”。如果我住院，我需要支付更多，但每年自费支付的金额有几千美元的上限，之后我的保险会支付100%。还不错——我能负担得起。

I have never been to Europe or Canada, but from my readings it seems that there are some differences between their circumstances and US that might allow their systems to work in their countries but not in U.S. First, U.S. has a LOT OF PEOPLE that don’t work or won’t work much. Most of my health insurance coverage is the result of having worked for decades. If I had not worked (and my spouse had not worked), I wouldn’t have my retirement pension for income, I wouldn’t receive Medicare Part A, and I would struggle to pay for Part B and Medicare Advantage coverage. I would then be eligible, as a destitute person, to receive taxpayer-funded Medicaid.

我从未去过欧洲或加拿大，但从我的阅读中了解到，它们的情况与美国有一些不同，这些差异可能使得它们的系统在它们国家行得通，但在美国却不行。首先，美国有很多人不工作或不愿意多工作。我的大部分医疗保险覆盖是多年工作的结果。如果我没有工作（我的配偶也没有工作），我就不会有退休金作为收入，我也不会获得医疗保险A部分，我将难以支付B部分和医疗保险优势计划的费用。那样的话，作为一个贫困的人，我将有资格获得纳税人资助的医疗补助。