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直至最近,卫生保健经费似乎尚未受到经济及联邦预算状况的干扰。国家卫生经费和联邦卫生费用的迅速增长每年都超过国民生产总值的增加和联邦预算,而未认真控制。但是当预算前景发生危机时,暴露了预算设计与卫生政策之间的关系。在响应1982和1983年预算决案的各项决定时,与其它年份相比,1982到1986财政年度的老年医疗保险制度和医疗困难补助制度的经费减少超过250亿美元。老年医疗保险制度的计划变化包括受益者成本负担加重和医院补偿的极度
Until recently, health care funding did not appear to have been disrupted by economic and federal budget conditions. The rapid growth of national health funds and federal health expenditures exceeds the increase in gross national product and the federal budget each year, without careful control. However, when the budget outlook is in crisis, the relationship between budget design and health policy is exposed. In responding to the decisions of the 1982 and 1983 budget decisions, the funding for the old-age medical insurance system and the medical hardship subsidy system for fiscal year 1982 to 1986 was reduced by more than US$25 billion compared to other years. The planned changes in the old-age medical insurance system include aggravated cost burden on beneficiaries and extreme hospital compensation