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加州"全民免费健保"沦为笑话 州长:绝不会签署

 

  加州参议会通过「加州全民健保」法案,民主党籍的洛县县政委(电视剧)员汤玛斯认为,该法案规定由州政府担任单一支付人的健保方式,绝对行不通。(记者吴珮甄/摄影)

  川普政府新政下的「欧记健保」岌岌可危,加州上至州政府、下至地方政府,无不着手研拟对策,以防万一。所谓「加州全民健保法」的加州议案SB562,1日获加州参议会全会通过。但即使民主党为主的加州,也不是一面倒支持,法案内未详述财务来源成为最大为人诟病之处,不但被解读成是2018年期中选举的政治操作,满腹理想却「爹不疼娘不爱」的提案,更有医疗管理层与保险业者称为「天大笑话。」

  SB562被提案人与支持者宣称,这是实现加州全民健保的第一步,主要以州政府为「单一支付人」,取代保险公司,代替民众与医师、医院与其他医疗服务提供者进行交涉协商。加州居民不论移民(专题)身分都可有纳入健保。

  但这块大饼似乎画得不切实际。民主党籍的洛县县政委员汤玛斯(Mark Ridley-Thomas)表示,政府担任单一支付人的方式绝对行不通,因为背后需要的经费太高,因此SB562不可能通过。非营利的蒙地贝娄市比佛利社区医院总裁陈素娟也表示,加州全民健保是崇高理想,但实行不可能。日前加州参议会拨款委员会的分析报告指出,加州全民健保一年就要花4000亿元的天价,将近加州总预算的三倍,不太可能落实。

  此外,提案人的论点是一半经费,可从联邦政府拨款给红蓝白卡与白卡的经费出,加州政府「仅」需筹措另外的2000亿。陈素娟表示,这是很大的未知数,还需向联邦政府申请,不只川普不可能肯首,连国会是否通过还不知道,从财务预算角度「简直是天方夜谭。」另一个关卡是加税填补不足经费,但初步民调也指出,多数加州居民不会同意加税,日前分析报告说,可加徵的15%薪资税,但也不够2000亿。

  陈素娟表示,提出加州全民健保的政治宣示意味浓厚,想表达对川普的不满。尤其提案背后是由加州护理人员工会支持,和医院与给付者对立。保险公司相当于在加州没有生意做,也不会同意。虽然只是象徵意义,「但永远会製造舆论声音。」

  从医院经营角度而言,陈素娟表示,政府出面应能减少呆帐问题,但政府出的费用是否能符合成本还是一大难题。目前因政府不愿意承担风险,白卡已经交给保险公司管理,所以给付额已经被中间人层层剥削,「如此大的成本,政府怎麽经营?」通过不代表落实,州长布朗自己都表明,就算法案通过他也不会签署生效,且还要经过选民公投同意增加税收。

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