时间:2018-12-16 作者:英语课 分类:VOA标准英语2012年(九月)


英语课

 



Expanding Health Insurance in Developing Countries


Rwanda will host a regional conference next week (9-11/13), with a focus on health insurance. Rwanda has been praised for moving toward universal coverage 1 for its population. But many say it’s a complicated issue that does not have a one-size-fits-all solution.


The Conference on Social Health Protection in the East African Community will consider various approaches to providing universal health coverage in Rwanda, Uganda, Kenya, Tanzania and Burundi.


Universal coverage is the subject of a new study that reviewed health systems in 12 African and Asian countries.


The World Health Organization’s Joe Kutzin says universal coverage is more of a “direction than a destination.”


“What it means you want to move towards universal coverage, which means you want to improve access. You want to improve financial protection and you want to improve quality. And in that sense, those are goals for every country in the world. So it’s relevant to every African country, every European country, the U.S. and so on, to make progress towards those goals,” he said.


Kutzin is coordinator 2 of health financing policy and analyzed 3 the study published in the Bulletin of the World Health Organization.


Dr. Ernst Spaan, one of the authors, said, “There is a lot of debate going on on how to finance health services in developing countries. In Asia and Africa there is a lot of debate on should they focus on social health insurance or community-based health insurance? And we actually looked into that and we found out there are a lot of studies, but it’s a bit patchy. So we decided 4 to do a systematic 5 review of the literature.”


Spaan is a senior researcher and lecturer in public health at the Radboud University Nijmegen Medical Center in the Netherlands.


The study looked at what he calls impact indicators 6. These include the way financial resources are collected to fund insurance plans, the amount of coverage provided to recipients 7, whether that coverage is provided to all segments of society and whether there’s been an improvement in the quality of life.


It says social and community health insurance plans “hold untapped potential” for achieving universal coverage. But Spaan says for that to happen, funding issues need to be addressed. For example, he says social plans are generally mandatory 8 and may be funded through payroll 9 deductions 10.


“That of course poses a problem in many developing countries because of the fact that the informal sector 11 is quite large. Sometimes even 60 percent of the population or higher is not in formal employment. Also because of the large agricultural sector income is dependent on harvest times, so it’s also very erratic,” said Spaan.


WHO’s Kutzin said some insurance systems may also require a user fee that’s paid at the time of medical services.


“When people have to pay a lot at the time they use services it poses a real, severe economic risk to their households. Very often you find cases where, for example, people have to sell off their assets, whether that is in cash or in animals. Whatever may be the main source of wealth, people are selling off their assets in order to raise the money to pay for care,” he said.


Spaan and his colleagues also looked at community insurance plans.


“These are organized, generally, on a smaller scale. And in many countries you find these schemes are linked to, for instance, one hospital or even to a school. So they insure school children, for instance, or they insure the people around a certain health facility. But what is more important is that it’s a certain scheme where the local population is more involved in the set-up of the scheme. And least that’s the ideal,” said Spaan.


He added that the study’s findings “back the World Health Organization’s view that pre-paid financing mechanisms 12, such as health insurance, are a key route to universal coverage.”


But Kutzin said there are many ways to provide health coverage besides those presented in the study.


“One of the best known cases we have is from Thailand, which in 2002 instituted a program called the Universal Health Coverage Scheme. It’s neither community-based nor is it contributory. It is a system where the government using general tax revenues puts all of that money into a single pool. And anyone is entitled to sign-up for the program. They don’t have to contribute anything. That pool pays for services on behalf of the entire population,” he said.


He said Rwanda uses a multiple funding approach for its mandatory health coverage, including general tax revenues and donor 13 funding. And it uses its community-based systems in a coordinated 14 way.


Universal health coverage has been a controversial topic here in the United States, but not in many other countries. Kutzin said that’s because there has not been a clear discussion about what universal coverage is trying to achieve. He says the main question is whether two people, one rich and one poor, with the same medical condition, have access to the same treatment? 




1 coverage
n.报导,保险范围,保险额,范围,覆盖
  • There's little coverage of foreign news in the newspaper.报纸上几乎没有国外新闻报道。
  • This is an insurance policy with extensive coverage.这是一项承保范围广泛的保险。
2 coordinator
n.协调人
  • The UN Office for the Coordination of Humanitarian Affairs, headed by the Emergency Relief Coordinator, coordinates all UN emergency relief. 联合国人道主义事务协调厅在紧急救济协调员领导下,负责协调联合国的所有紧急救济工作。
  • How am I supposed to find the client-relations coordinator? 我怎么才能找到客户关系协调员的办公室?
3 analyzed
v.分析( analyze的过去式和过去分词 );分解;解释;对…进行心理分析
  • The doctors analyzed the blood sample for anemia. 医生们分析了贫血的血样。 来自《简明英汉词典》
  • The young man did not analyze the process of his captivation and enrapturement, for love to him was a mystery and could not be analyzed. 这年轻人没有分析自己蛊惑著迷的过程,因为对他来说,爱是个不可分析的迷。 来自《简明英汉词典》
4 decided
adj.决定了的,坚决的;明显的,明确的
  • This gave them a decided advantage over their opponents.这使他们比对手具有明显的优势。
  • There is a decided difference between British and Chinese way of greeting.英国人和中国人打招呼的方式有很明显的区别。
5 systematic
adj.有系统的,有计划的,有方法的
  • The way he works isn't very systematic.他的工作不是很有条理。
  • The teacher made a systematic work of teaching.这个教师进行系统的教学工作。
6 indicators
(仪器上显示温度、压力、耗油量等的)指针( indicator的名词复数 ); 指示物; (车辆上的)转弯指示灯; 指示信号
  • The economic indicators are better than expected. 经济指标比预期的好。
  • It is still difficult to develop indicators for many concepts used in social science. 为社会科学领域的许多概念确立一个指标仍然很难。
7 recipients
adj.接受的;受领的;容纳的;愿意接受的n.收件人;接受者;受领者;接受器
  • The recipients of the prizes had their names printed in the paper. 获奖者的姓名登在报上。 来自《简明英汉词典》
  • The recipients of prizes had their names printed in the paper. 获奖者名单登在报上。 来自《现代英汉综合大词典》
8 mandatory
adj.命令的;强制的;义务的;n.受托者
  • It's mandatory to pay taxes.缴税是义务性的。
  • There is no mandatory paid annual leave in the U.S.美国没有强制带薪年假。
9 payroll
n.工资表,在职人员名单,工薪总额
  • His yearly payroll is $1.2 million.他的年薪是120万美元。
  • I can't wait to get my payroll check.我真等不及拿到我的工资单了。
10 deductions
扣除( deduction的名词复数 ); 结论; 扣除的量; 推演
  • Many of the older officers trusted agents sightings more than cryptanalysts'deductions. 许多年纪比较大的军官往往相信特务的发现,而不怎么相信密码分析员的推断。
  • You know how you rush at things,jump to conclusions without proper deductions. 你知道你处理问题是多么仓促,毫无合适的演绎就仓促下结论。
11 sector
n.部门,部分;防御地段,防区;扇形
  • The export sector will aid the economic recovery. 出口产业将促进经济复苏。
  • The enemy have attacked the British sector.敌人已进攻英国防区。
12 mechanisms
n.机械( mechanism的名词复数 );机械装置;[生物学] 机制;机械作用
  • The research will provide direct insight into molecular mechanisms. 这项研究将使人能够直接地了解分子的机理。 来自《简明英汉词典》
  • He explained how the two mechanisms worked. 他解释这两台机械装置是如何工作的。 来自《简明英汉词典》
13 donor
n.捐献者;赠送人;(组织、器官等的)供体
  • In these cases,the recipient usually takes care of the donor afterwards.在这类情况下,接受捐献者以后通常会照顾捐赠者。
  • The Doctor transplanted the donor's heart to Mike's chest cavity.医生将捐赠者的心脏移植进麦克的胸腔。
14 coordinated
adj.协调的
  • The sound has to be coordinated with the picture. 声音必须和画面协调一致。
  • The numerous existing statutes are complicated and poorly coordinated. 目前繁多的法令既十分复杂又缺乏快调。 来自英汉非文学 - 环境法 - 环境法
学英语单词
actuating lever
ageing hardening
air launched cruise missile
Amphicoelia
approximation by operator
Atherolipin
athletic communication psychology
back out
baggage-rooms
beef-witted
bimorphic male
bottle track
brachyeardia
catch ratline
central tegmental tract
climatic stability theory
communication modem
counterguerilla
couplets on pillar
cylindruria
derne
design-construction team
dirty Sanchezes
Edlitz
electrolytic gravimetry
electronic inductivity
enterocardiovirus
Every bean has its black
exit jewel
fast loading
fault tolerant routing algorithm
feature-based design
fenestellae
filicanes
fluid state
full circle girder erecting crane
future light cone
grieve
histrionic
i-wived
identification of immature infant
Insiza
integrated trajectory system
issue in
kilogal meter
left internal spermatic vein
lifoes
low pump suction pressure
low-voltage capacitor discharge
make your bread
Mankayan
Mexican stand-off
National Association of Precancel Collectors
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nickums
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North Fareham
octonare
Olorani
Oseen force
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paciest
padbolt
panoptically
pinest
plane bed
plusia agnata staudinger
polytropic expansion
promotion and transfer
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protanabol
quarter moon
radiatio
radio environment
regular epitaxy
road level
rotating contactor
sales representatives
sell't
shifting shaft
slugginess
soil bearing value
spice mixture
stinking rich
stitch line
subdermal vascular plexus free skin graft
subintrance
technically strong market
temperature expansion of pipes
terminal interchange
thyroid hormone evaluation
tongbok (dongbog)
trigyric
upbar
verbal creation
Vilna Gaon
vitamin b12 monocarboxylic acid
wako
Wiesentheid
wound heart wood
yahe (papua new guinea)
yoy