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Saturday, March 29, 2014

癌症中心被健保计划拒之门外 - 大纪元

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2014-03-29 22:53:07
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【大纪元2014年03月29日讯】(大纪元记者林燕综合报导)有了承诺,他们以为没有人会被拒,以为春天已经来临、自己变得幸运。但是新的健保法案可能还会让他们失望,因为全美最好的肿瘤(癌症)医院至今未开启大门。

据美联社(AP)调查报导,全美各州的健保计划中顶级癌症治疗中心缺失,癌症患者可能无法顺利获得顶级癌症中心的治疗。

本次调查揽括全美23家综合性癌症中心,均隶属美国国家综合癌症网络,仅获得四家中心的肯定答覆 州健保交易平台出售的全部健保计划中含有他们。

癌症治疗服务的网络成员都是一些顶级医院,有最新的临床研究和走在学术前沿,能为病人提供多学科的治疗方法。这些医院的癌症病人存活率均高于平均数。在红蓝卡的覆盖项目中,癌症中心的作用更是举足轻重。

  

仅17%的癌症中心参保

四家综合性癌症中心作出答覆的,约占总数的17%,分别是位于巴尔的摩的金梅尔(Kimmel)综合癌症中心、费城福克斯蔡斯(Fox Chase)癌症中心、北卡罗来纳州的杜克(Duke)癌症研究所,以及田纳西州的范德比尔特-英格拉姆(Vanderbilt-Ingram)癌症中心。

除了参保比例低之外,癌症中心的地区间差距也非常明显。纽约水牛城共有七家健保公司,其中有五家健保公司覆盖罗斯威尔公园(Roswell Park)癌症中心;但整个纽约州的16家健保公司中,却有11家的医疗服务商名单上没有罗斯威尔公园癌症中心。

还有两家癌症中心表示会特殊对待,如田纳西州的圣犹大儿童研究医院表示,只要孩子有转诊单,就可享受住院治疗。

此外,要注意一点:有些低成本的健保计划也是不包括这些指定的癌症中心。"一些计划提供的医生、医院选择更少,"根据美国癌症协会抗癌行动联盟发言人(American Cancer Society Cancer Action Network)史蒂夫 魏斯(Steve Weiss)说。"但也算是走过了很长的路,正在弥补数十年来存在严重问题的医疗体系。"

  

掘地三尺 挖计划累

癌症患者处于窘境,面对的新问题是:在线选购计划并不容易,要分清哪些顶级医疗机构已加入或未加入(计划)确实不是易事。那需要消费者花更多的时间去挖才能知道。

"这样做的问题马上就会显现出来,癌症治疗首当其冲,"西雅图癌症护理联盟的执行副总裁诺曼 哈伯德(Norman Hubbard)说。

"对已签约的人群来说,这些癌症中心的进入选择是个福利恶化的表现,"市场研究公司阿瓦利尔(Avalere)的CEO丹 门德尔松(Dan Mendelson)说。这些患者可能无法获得最先进的治疗,包括新药物的临床试验。

在健保法案之前,一经诊断出癌症,就意味着癌症患者无法续保。但现在,健保公司不得以预先条件为由拒绝任何人投保,或收取更多保费。意味着癌症患者需要个人掏腰包的费用有了上限,那么以往担忧的 不断付治疗费 癌症患者的金融暗门将被彻底关闭。

癌症病人的投保问题一直是健保计划中的焦点之一。不光是健保交易平台上出售的健保计划,还有扩展的红蓝卡、白卡覆盖项目中,癌症中心作为医疗提供商的缺失,无疑会引起大家更多的关注。

新障碍更加微妙

与圣路易斯市的塞特(Siteman)癌症中心合作,属于管理式医疗组织的副主任梅拉妮 拉皮德斯(Melanie Lapidus),认为患者并没有意识到健保平台其实提供了一种更严格的个人保险。

比如在圣路易斯市,蓝盾公司的许多健保平台外计划都有包括塞特癌症中心,但在健保交易平台内的计划中却没有包括。

"有很多人对我们说,'我选择蓝盾是因为你们(医院)总在他们的服务商名单上,所以我以为你们也会在他们的州健保计划中,'"拉皮德斯说。"现在还很难说谁是在医疗网络内,而谁不在。"

同样的情况还出现在:八家在华府健保交易平台登记的健保公司中,有五家将西雅图癌症照护联盟排除在外;休斯敦地区只有不到一半的计划包含MD安德森癌症中心;纽约市的九家健保公司中只有两家包括纪念斯隆-凯特琳癌症中心、另有两家只参与交易平台之外的计划。

健保公司 为成本忙

不久前,健保公司争先恐后地争抢揽括癌症研究中心在内,但现在他们的重点已转向医疗成本。为了保持低保费,健保公司收窄了医院和医生的服务网络。政府补贴的私人计划通常比联邦医疗保险(红蓝卡)或雇主计划的选择更少一些。

如果不包括顶级癌症中心,健保公司可以降低成本。同时也可以规避风险,并给癌症幸存者或有癌症家属史的人士一个暗示,他们应该看看其它地方(其它健保计划)。

就如同蓝盾公司在声明中提到的,"我们了解到的是,人们愿意做出取舍,以便有机会获得负担得起的医疗保健,"该公司表示。"而我们的供应商能正好能反映这种情况。"

出于控制成本的目的,少数几个癌症中心被免除在支付系统之外。现在,这个问题似乎仅限于新的健保计划。如果雇主进一步缩小网络,这个问题将会成为工作保险人群的新担忧。

政府表示持续关注

医护以及管理人员说,他们很关心这个问题。一些州的保险监管机构也在关注此问题。"总体来说,健保法案提高了癌症治疗的可选择途径。但当它到达健保交易平台,我们有些担心。"外科肿瘤学教学医院的副教授威利 安德伍德(Willie Underwood)说,"有一些事情应该在成为问题之前谈谈。"

"我希望保险公司能够创新,拿出新的产品设计,"华盛顿州的保险专员迈克 库磊德勒(Mike Kreidler)委员说。"与此同时,也要求监管机构象我一样提高警惕,以确保不会有不合理的妥协。"

奥巴马政府说,它已通知保险公司,会对36个州的医疗网络在明年进行细查。"癌症治疗将是一个优先事项。"

(责任编辑:丽莎)


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