美国底层：当你穷到连你的血都一文不值时……

K_A_irony
Please check out all of your local food resources. I am very worried about your nutrition. If you don't know where all the food banks are and the little free pantries, call 211.

请查看你当地所有的食物援助资源。我非常担心你的营养状况。如果你不知道所有的食品银行和免费小食品储藏室在哪里，请拨打 211 查询。

[dexed]
Thanks so much. I wasn’t familiar with that number.

非常感谢。我之前不知道这个号码。

Desolationism
We’ve had to lean on food assistance for us and our kids a few times. It has been a life saver when pay was nonexistent in my business. There are a lot of food resources are out there, you just have to know where to look. A simple google search of “food banks near me” is a great start.

我们家和孩子有好几次都不得不依靠食品援助度日。当我的生意完全没有收入时，这真是救命稻草。其实有很多食物资源可以利用，只是需要知道去哪里找。简单的谷歌搜索"附近的食品银行"就是个很好的开始。

DragonBorn76
Yes what the previous poster said. Are you using local resources like food banks, or maybe even on Facebook there are groups with names called "No Buy" groups or even food for all projects. Here on Reddit there are communities too like r/Food_Pantry , r/freemeal . I'm so sorry you are going through all this.

楼上说得对。你有没有利用本地资源比如食品银行？Facebook 上也有叫"无消费交换"小组或者"全民食物计划"之类的群组。Reddit 上也有像 r/Food_Pantry 和 r/freemeal 这样的互助社区。真抱歉你正在经历这些困难。

Few_Library3961
as much as it sucks, them checking for total protien is in place to be sure the process of donating isnt going to cause harm to you. if that goes too low, you can and likely will suffer much more expensive health issues while still not being able to donate. Take a break from it, maybe try again in a few weeks.

虽然很糟糕，但他们检测总蛋白含量是为了确保献血过程不会对你造成伤害。如果这个指标太低，你可能会面临更严重的健康问题，医疗费用反而更高，而且依然无法捐献。建议你先休息几周，过段时间再来试试。

[dexed]
Yeah unfortunately at this plasma center I think you have to wait 6 months unless you bring in a doctor note…

唉，这个血浆中心要求得等六个月，除非你能拿出医生证明...

zayn2123
Former phlebotomist here, most places have a 1 week deferral for low protein.

我是前采血师，大多数机构对低蛋白情况会暂缓一周采血。

If it happens multiple times they will ask for a "protein sample only" blood draw (usually not paid) to test just for protein and that usually requires a passable result and the center's physician's approval to continue donating.

如果多次出现这种情况，他们会要求单独采集"蛋白质检验样本"（通常没有报酬），仅检测蛋白质指标，这通常需要检验结果达标并获得中心医师批准后才能继续捐献。

attempt_no23
Former phlebotomist, could I ask you a question? I wanted to donate blood and plasma as it was recently noted how doing such can also help clear some PFAS out of our system but more for the greater good of donating as a whole. I am anemic so does that rule me full stop no go to donate at all? I debated going to a center this week and OP's post opened a new outlook I was not aware of in terms of what specifications need to be met for proper donation. Thanks in advance if you have the moment to reply. :)

前辈采血师，能请教个问题吗？最近看到研究说捐献血液和血浆有助于清除体内的 PFAS 化学物质，不过主要还是想行善举。我本身贫血，这是否意味着完全不能捐献？本打算这周去献血中心的，结果看到 OP 的帖子才意识到原来捐献还有这么多指标要求。如有空回复，提前感谢啦 :)

Lost-platypus8271
Donating plasma is ok for a few bucks, but do you have a medical center in your area? You can join medical studies that pay MUCH better. It’s how I made it through grad school back in the day. That and the $0.35 day-old bagels from the local cafeteria.

捐血浆挣点小钱还行，但你们那儿有医疗中心吗？参加付费医学研究项目报酬高得多。我当年读研就靠这个活下来的，再加上食堂里 0.35 美元的隔夜贝果。

Pro tip: grocery stores change their weekly sales Tuesday after hours, so if you shop late on Tuesday or early Wednesday you’ll get all the marked-down-for-quick-sale items. I got 18-count organic brown eggs for $3.38 yesterday at my local QFC. I get much of my dairy and meat this way - it’s not expired, just fewer days to the sell-by than the fresher stuff they will get in the week’s new delivery.

专业建议：超市每周促销活动通常在周二下班后更新，所以周二晚上或周三早上去购物能抢到所有打折清仓商品。昨天我在当地 QFC 超市用 3.38 美元买了 18 枚装的有机褐壳鸡蛋。我的乳制品和肉类很多都这么买——不是过期食品，只是保质期比本周新到货的商品短几天。

thingstopraise
Pro tip: grocery stores change their weekly sales Tuesday after hours

专业建议：超市每周特惠商品通常在周二下班后更换

I think that this is really location-dependent and can't be stated definitively for every place in the country. Where I live, every chain flips over to the new sales Thursday AM.

我觉得这事儿很看地区，不能一刀切地说全美都这样。我这儿所有连锁店都是周四上午才换促销商品。

BMP4
How do you go about finding these as a relatively healthy and normal grad student?

作为一个相对健康又普通的在读研究生，该怎么找到这些有偿体检机会呢？

UntoNuggan
clinicaltrials.gov is where I (a disabled person) look, you can sort by location and currently recruiting. Idk if there's a filter for healthy volunteers, but they definitely need healthy people as controls.

身为残障人士，我通常关注clinicaltrials.gov这个平台，可以按地域和正在招募的项目筛选。不确定是否有专门筛选健康志愿者的选项，但他们确实需要健康人群作为对照组。

ETA: there's a way to expand the filters ("more filters") to check "accepts healthy volunteers? YES"

补充说明：在"更多筛选条件"里可以勾选"接受健康志愿者？是"来进一步筛选

Not all studies offer financial compensation. This is from the FAQ:

并非所有研究都提供金钱补偿。根据常见问题解答：

"Do participants have to pay any costs or do they get paid for taking part in clinical research?

参与临床试验需要自费还是可以获得报酬？

The informed consent form describes the study’s payment and costs. Some studies pay participants who take part, but the amount varies based on the study."

知情同意书中会详细说明研究的报酬及相关费用。部分研究会向参与者支付报酬，但具体金额因研究项目而异。

SO when you're looking at studies in your area that accepted healthy volunteers, there's two main sections to read through:

所以当你筛选所在地接受健康志愿者参与的研究时，有两个关键部分需要仔细阅读：

Eligibility criteria: what's their definition of a "healthy volunteer," and do you meet that definition. (eg some studies exclude you if you have had a recent infection, etc)

入选标准：明确研究对"健康志愿者"的定义，并确认自身是否符合条件（例如部分研究会排除近期感染过疾病的受试者等）

Informed consent: this provides BOTH info about potential compensation, AND very important info about possible medical risks to participating in the study. What are you actually signing up for? Etc. Sometimes it's to see if a medication has any side effects. Sometimes it's just medical imaging, like getting an fMRI or whatever.

知情同意书：这份文件既提供了关于潜在报酬的信息，也包含了参与研究可能面临的医疗风险等重要内容。你实际上在签署什么？等等。有时是为了观察药物是否会产生副作用。有时只是进行功能性磁共振成像（fMRI）之类的医学影像检查。

Note that for any new vaccine/medication/etc to be tested on humans, there are safety + ethical standards in place now. This includes an "institutional review board" to decide whether to allow the study. Test tube + animal trials are also done before testing a new vaccine/medicine on humans.

需注意，任何要在人体上测试的新疫苗/药物等都需符合现行的安全与伦理标准。这包括由"机构审查委员会"来决定是否批准研究。在人体试验前，还需完成试管和动物试验环节。

HOWEVER: You are effectively signing up to be a guinea pig, so it is definitely important to know what the potential risks are (and if you're comfortable taking those risks).

不过：你实际上就是自愿当小白鼠，所以了解潜在风险（以及你是否愿意承担这些风险）绝对很重要。

sultrykitten90
Try to stock up on eggs, tuna, hotdogs, and possibly sausage to up protein levels. I'm sorry this income stream has taken a pause ❤️‍

尽量囤些鸡蛋、金枪鱼、热狗和香肠来提高蛋白质摄入。很遗憾你的收入来源暂时中断了 ❤️‍

[dexed]
Thanks   

谢谢

Leosis0820
I know it may not be feasible but protein shakes help. I use to drink them the day before and day of when I was donating. Buying a protein powder in bulk generally is cheaper, if you have an Aldi near they tend to be cheapest.

我知道这可能不现实，但蛋白质奶昔确实有帮助。我以前献血前一天和当天都会喝。批量购买蛋白粉通常更便宜，如果你附近有奥乐齐超市，那里的价格往往最优惠。

lezemt
Carnation powder goes in water and it’s like 4.00 for a thing of 12 servings. It’s pretty good 2.

康乃馨粉剂兑水喝就行，12 份装才 4 美元左右。味道还不错。

NumerousLow5
They also sell protein shakes at dollar tree as well. However eggs maybe be more cost efficient!

Dollar Tree 也卖蛋白奶昔，不过鸡蛋可能更划算！

thisnameisuniquenow
Single serve shakes are a very poor $per gram, they are sold at a convenience premium. Powder is pretty cheap and can just be mixed with water. Powder would be cheaper then eggs if you just need protein but the eggs will have more vitamins and fats so are probably a better purchase and don't sleep on cartons of liquid eggs whites, about the same cost as eggs but most of the protein is in the whites and you aren't getting bogged down with having to eat yolks, r/gainit loves egg whites.

单份包装奶昔的性价比极低（按克计价），它们卖的是便捷性带来的溢价。蛋白粉相当便宜，加水冲泡即可。若只看重蛋白质摄入，蛋白粉确实比鸡蛋便宜，但鸡蛋还富含更多维生素和脂肪，整体营养价值更高。另外千万别忽略盒装液体蛋清——价格与整蛋相当，绝大部分蛋白质集中在蛋清里，还不用硬着头皮吃蛋黄，r/gainit 健身板块的用户就超爱用蛋清。

sauroden
Also switch all your bread, rice, etc to whole grain “Brown” varieties. You will have a small hit on the bread costing a bit more but you can offset that by buying rice, beans etc in bulk. You can load in sufficient protein for health just with whole grains and beans and lentils. Also, peanut butter is huge for struggle meals- cheap and actually filling.

另外把所有面包、米饭等主食都换成全谷物的"褐色"版本。虽然面包价格会小涨，但你可以通过大宗购买米、豆类来抵消差价。仅靠全谷物、豆类和扁豆就足以摄入健康所需的蛋白质。还有个穷吃法宝——花生酱，既便宜又有饱腹感。

Intrepid-Sky8123
Lentils are a cheap protein source. If you can’t afford much else, there’s always lentils. I believe they also contain iron, which helps your blood.

扁豆是种便宜的蛋白质来源。如果实在买不起别的东西，至少还能买扁豆。我记得扁豆里还含铁，能改善血液健康。

dikicker
Bummer to have to scroll this far down the thread to find the best comment

倒霉透了，居然要翻到评论区这么下面才找到最佳回复

Lentils for all!

人人有扁豆吃！

E: garlic powder though

编辑补充：不过别忘了加蒜粉

Icy_Thanks_4424
Black beans are also really good for protein and fiber and cheap if you buy the dry kind!

黑豆也是很好的蛋白质和纤维来源，买干货的话特别便宜！

Traegs_
I don't know if all Kroger owned grocery stores do this, but I get the discount "repacked" eggs they put together from cartons that had broken ones in them. Right now they're only $1.49 per dozen. I eat 2 eggs most mornings and haven't paid full price for eggs in like two months.

不知道所有克罗格旗下的超市是不是都这样，但我一直买他们"重新包装"的特价鸡蛋——就是把包装盒里破了壳的鸡蛋重新组装出售。现在一打只要 1.49 美元。我每天早上吃两个鸡蛋，已经将近两个月没买过原价鸡蛋了。

Don't be afraid or ashamed to go to a food bank either. Your situation is what they're for.

别害怕或羞于去食物银行求助。它们存在的意义就是帮助处于你这样困境的人。

Yung_Oldfag
Turkey and ham are about to be dirt cheap at every grocery store in a day or two

再过一两天，所有超市里的火鸡和火腿就要便宜得跟不要钱似的了

ButtBread98
Sardines are good protein too. And cheap

沙丁鱼也是不错的蛋白质来源，而且很便宜

Coconutmigration69
I was just about to say, sardines in water is like my go to breakfast nowadays. It’s so efficient

我刚想说，水浸沙丁鱼现在成了我的早餐标配。实在是太有效了 

Lost-platypus8271
Sausage has surprisingly little protein, especially for the price. Beans are where it’s at. Rice and beans, great nutrition for the price. Rice is more energy dense than wheat.

香肠的蛋白质含量出奇地低，特别是考虑到价格。豆类才是王道。米饭配豆子，性价比超高的营养组合。大米的能量密度比小麦更高

ikilledholofernes
Tofu and vital wheat gluten are also really good, cheap options. You can make a bunch of seitan for just a couple dollars, plus it’s so easy to cook, and you can make it taste pretty good with basic spices. And a block of tofu is only like $2.

豆腐和面筋也是既便宜又优质的选择。几美元就能做出一大堆面筋，而且烹饪超简单，用基础调料就能做出不错的口感。一块豆腐也才 2 美元左右。

Just to mix things up, since eggs and meat are getting so expensive, and tuna can be high in mercury. 

只是换个花样，毕竟现在鸡蛋和肉类这么贵，而金枪鱼又可能汞含量超标。

kemarti1
As someone whose child relies on plasma, your blood is not worthless. You are keeping my child from lifelong brain damage. You are doing a very selfless thing, but please take care of yourself. If your protein is too low, it’s too low and you need to take care of yourself before you can help others. I don’t pretend to know your situation, or how hard this is, but know that your donations mean the world to families like mine. THANK YOU!

作为一个孩子依赖血浆制品的家长，你的血液绝非一文不值。你正在保护我的孩子免受终身性脑损伤。你在做一件非常无私的事，但请照顾好自己。如果蛋白质水平太低就是真的不够，你需要先照顾好自己才能帮助他人。我无意揣测你的处境有多艰难，但请知道你的捐赠对象我们这样的家庭而言意味着全世界。谢谢你！

[dexed]
Wow that is so kind of you. I admit when I first started donating plasma it was just out of financial need. But having learned more about it, I am very moved to hear stories like this. As a parent of three kids myself, I really hope my donations have helped someone out there. Really hope I can donate again someday.

哇，这真是太好了。我承认刚开始捐献血浆时纯粹是出于经济需要。但了解得越多，听到这样的故事就越是感动。作为有三个孩子的家长，我真心希望我的捐献能帮到有需要的人。真的很希望有朝一日还能再次捐献。

buttneymarie
This is the kindest thing I have read on the internet in a while .

这是我在网上最近读到的最暖心的事情了。

FaustAndFriends
Alright fine, this comment has convinced me to donate plasma. (I’ve been scared of possible malfunctions with the machines or something) 

好吧，这番评论成功说服我去捐献血浆了。（我一直挺害怕机器会出故障什么的）

mjk67
I donated for years. Tuna is cheap protein.

我多年来一直在献血。金枪鱼是廉价的蛋白质来源。

sem-nexus
Sardines too if you want some variety

沙丁鱼也可以，如果你想换换口味的话……

one-two-time
I love sardines now that I’m an adult. Some Worcestershire sauce, hot sauce, throw some spices on soo good!

成年后我突然爱上沙丁鱼了！加点伍斯特酱、辣酱，再撒些香料——简直绝了！

Wings_of_Pastrami_91
Yeah, canned tuna's legit cheap protein

确实，金枪鱼罐头是货真价实的便宜蛋白质来源

itsforathing
Walmart great value brand 5oz canned tuna is $1 in my area. I used to suggest spam a lot but honestly it’s gotten more expensive as of late. Hard to suggest a 12oz can of spam for $4-5 when an entire Walmart rotisserie chicken is $6 hot and $4 nfzchilled.

在我所在的地区，沃尔玛惠宜品牌 5 盎司罐头金枪鱼售价 1 美元。过去我常推荐斯帕姆午餐肉，但近期它确实涨价了。当 12 盎司的斯帕姆罐头要 4-5 美元时，实在很难推荐它，毕竟沃尔玛一整只烤鸡热乎的才 6 美元，冷藏的只要 4 美元。

1.5-2lb of chicken for the week plus a couple jars of stock from boiling the bones and scraps.

这样一周能有 1.5-2 磅鸡肉，煮骨头和边角料还能得到几罐高汤。

ayannauriel
Visit a food bank, they usually have something with protein. I hope things get better for you.

去食物银行看看，他们通常能提供含蛋白质的食物。希望你的情况能好转起来。

[dexed]
Thanks   

谢谢

KittyinaSock
1 in 7 Americans use resources like food pantries. They are there because everyone deserves food. You deserve to eat.

7 个美国人中就有 1 个会使用食品银行等救助资源。这些资源存在的原因很简单——每个人都该吃饱饭。你也该有饭吃。

[dexed]
Thanks. It can be embarrassing going in since I live in a small town so will likely see someone I know working or volunteering there. But I guess I shouldn’t be worried about that.

谢谢。在小镇上生活确实会有点尴尬，因为去那里很可能会碰到认识的人在当工作人员或志愿者。不过我想自己也没必要太在意这个。

Andi23765
If you do see someone working or volunteering there that you know, they know what it takes for you to come in. Don't be pressed--be fed.

如果你在那儿看到你认识的人在打工或做志愿者，他们明白你来这儿需要多大的勇气。别觉得难为情——先填饱肚子要紧。

Desolationism
Those people aren’t the ones that will shame you. They are the ones that may lend some help.

那些人不会羞辱你。他们反而可能会伸出援手。

eatsumsketti
Yep. I worked in plasma for years but I have a heart murmur, so can't donate.

确实。我在血浆中心工作多年，但因为心脏有杂音，没法捐献血浆。

Canned fish, eggs, beans, and tofu are great to help boost numbers but I'm gonna be honest with you, it takes a bit for that TP to be corrected.

罐头鱼、鸡蛋、豆类和豆腐对提升指标很有帮助，但说实话，血小板数值的恢复需要时间。

Same with hematocrit. 

红细胞压积数值的提升同样需要过程。

Focus on hitting your protein hard as you can for at least a week. I know it's not ideal, but they are doing this for your safety as well.

至少坚持一周全力以赴补充蛋白质。虽然不理想，但这确实是出于对你安全的考虑。

InsuranceDapper5731
If you have a friend with a Costco membership, ask them to get you a gift card that will allow you to enter without needing a membership. Their rotisserie chickens are 4.95.

如果有朋友持有 Costco 会员卡，可以请他们帮你买张礼品卡，这样无需会员资格也能进场。他们的烤鸡只卖 4.95 美元。

howabouthere
This. Old group of friends pooled their money once a month and the one with the membership buys the rotisserie chicken. They break their own chickens down, then boil the bones all together to make a huge thing of stock. They split the stock for freezing. Freeze meat too.

这就是生活。一帮老朋友每个月凑一次钱，有会员卡的那个人负责买烤鸡。大家各自分解自己的鸡肉，然后把所有鸡骨头一起熬成一大锅高汤。分装高汤冷冻起来，肉也冻上。

They also pool to buy the biggest bags of lentils, rice, and beans. Other meat and staples too. Gives a lot of purchasing power online or in-store.They separate out to portions paid for. $5 goes a lot further when it's $1 or less per pound of whatever. They'd rotate which items got bulked based on needs.

他们还集资买大包装的扁豆、大米和豆类，包括其他肉类和主食。这样无论线上还是线下都能获得更强的购买力。大家按出资比例分配物资——当每磅食物均价低于 1 美元时，5 美元就能买更多东西。他们会根据需求轮换囤购的品类。

Queasy_Strike_4655
That sucks. I used to donate plasma all the time when I was homeless and I’d see people donating that did not look healthy enough. Luckily I stopped when I got a job and place to live, long term it can have permanent consequences if you donate twice a week consistently but I understand being that poor. I hope things get better for you my friend.

真难受。我以前无家可归时也经常去献血浆，经常看到有些捐献者看起来根本不够健康。幸好我找到工作和住处后就停下来了——长期坚持每周献两次血浆可能会造成永久性伤害，但我完全理解那种穷到走投无路的感觉。朋友，希望你的境况能好起来。

Thorathecrazy
Twice a wwek is crazy, that should not beallowed, tey are so cold taking advantage of desperate people. Amd no one should have to starve, I really hope they find better options than risking tgeir health.

一周抽两次血也太疯狂了，这根本不该被允许。他们简直冷血到在剥削走投无路的人。任何人都不该挨饿，真心希望他们能找到不损害健康的更好选择。

Queasy_Strike_4655
Yeah the second donation of the week is usually the big money!

一周第二次捐献通常能拿到大钱！

Poly_Olly_Oxen_Free
At the place near me, the sign out front says it's $45 if you donate once a week, and $130 if you go twice a week. So the second one is worth almost double the first one. And they give a $50 bonus if you hit 8 donations in a month.

我附近的地方，门口告示写着每周捐献一次给 45 美元，每周去两次则给 130 美元。所以第二次几乎比第一次多一倍。而且如果你一个月内完成 8 次捐献，还能额外获得 50 美元奖励。

ruritto
Damn that sucks. Have you tried checking if there's any free clinics near you? Some will write notes without charging much. Also food banks might help with the protein situation.

真糟心。你试过查查附近有没有免费诊所吗？有些诊所开证明收费很低。食物银行也许还能帮你解决蛋白质摄入的问题。

Agitated-Lettuce5289
Not only this, but if your income and debt ratio is high enough, a lot of non-profit hospitals have a grant that will wipe your debt if you call the financial department. I’ve done this in the past and they wiped my debt AND even offered the grant for the following 6 months so no bills came out of pocket for that period of time.

不仅如此，如果你的收入与债务比率足够高，许多非营利医院都设有援助金项目——只要联系财务部门就能免除债务。我以前就这么操作过，他们不仅免了我的债，还提供了后续六个月的补助金，那段时间完全不用自掏腰包支付账单。

I hope this helps.

希望能帮到你。

Glopez1223
I donate plasma too and am perpetually too low on hematocrit. It's been a nightmare because I can't afford to feed myself red meats, nor do I care for it much. The days before I go I eat about 4 bowls of cereal with the highest iron count I can find but it has to be soggy cereal because my teeth are destroyed and I can't afford to get them fixed. I contemplate plenty about just not going but I can't afford to feed my son if I don't donate. My food bank just came out with a once a month only instead of every 2 weeks policy so I lost that source of food. I cannot understand how this whole thing has not collapsed yet because it's so unsustainable for 60% of us to be living like this. I just want to go to sleep at night not stressed to insomnia over how my next bill is going to get paid. I'm so so tired.

我也在捐血浆，而且血细胞比容一直偏低。这简直是噩梦，因为我既买不起红肉来补充营养，也不太喜欢吃红肉。每次捐献前几天，我都要吃掉差不多四碗我能找到的铁含量最高的麦片粥——必须是泡软的麦片，因为我的牙齿全坏了又没钱治。我经常想着干脆别去了，可如果不捐血浆就养不起儿子。食品救济站刚改成每月一次（原本是两周一次），我又少了个食物来源。实在想不通这个体系怎么还没崩溃，60%的人都活成这样根本不可持续啊。我只想晚上能安心睡觉，不用为下张账单怎么付愁到失眠。真的太累了。

[dexed]
Believe me I understand…

相信我，我懂…

Afraid-Way1203
sorry my friend. i am sorry you have to go through this .

抱歉，朋友。真为你经历的这些感到难过。

Undyingpatriot13
America is dying   

美国正在走向衰亡

JesusStarbox
My local plasma center gave me food when I hadn't eaten. It was just a can of ravioli heated in the microwave but still...

我常去的血浆中心在我没吃饭的时候给了我食物。虽然只是微波炉加热的一罐意大利馄饨，但依然...

[dexed]
Wow that was really nice of them.

真是太暖心了。

StanktheGreat
I used to donate plasma to stay afloat while I was unemployed for two years. What helped me if I forgot to eat or couldn't right away for some reason was stop by a local gym or vitamin center for a protein shake. Muscle milk or one of the cheap ones, usually around $5-$7 bucks.

我曾经失业两年，靠捐献血浆勉强维生。如果忘记吃饭或一时无法进食时，我会去附近的健身房或保健品店买杯蛋白粉饮料——肌肉牛奶之类的平价产品，通常 5-7 美元就能搞定。

That would usually (7/10 times) put my protein over the acceptable limit to donate and get that sweet, sweet money that kept food on my table

这招十有七八能让我的蛋白质含量超过捐献标准，换回那些维持生计的救命钱。

Yuukiko_
they do it so you don't harm yourself. long term it's just going to cost yourself especially if you live in a country like the united states with poor healthcare options

这是为了保障捐献者健康。长期来看得不偿失，尤其在美国这种医疗体系糟糕的国家。