安省各党派如何看待医疗保健系统存在的弊病？

为人民服务 · 发表于 2011-11-10 19:04

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根据加拿大健康资讯学会的数据，2010年安省医疗保健系统的开支占其GDP的12.2%，即每人$5,641元。安省的钱怎么花无疑将成为即将进行的竞选中的一个主要议题。
　　According to the Canadian Institute for Health Information, Ontario’s health care system cost 12.2 percent of its GDP, or $5,641 per person, in 2010. The province’s use of that money is sure to become a major issue in the upcoming election.

　　加拿大纳税人联盟的全国调研总监Fildebrandt对大中报说：“没人谈论关于如何能更加合理分配资源的问题。开支每年都以超过6%的速度增加，但我认为，服务质量却没有以同样的速度上升。”
　　“Nobody’s talking about how to better allocate resources,” Derek Fildebrandt, the Canadian Taxpayers Federation’s national research director, told Chinese News. “Spending goes up more than six percent every year, but I don’t think our quality’s going up six percent every year.”

　　安省进步保守党卫生保健方面的评论员Elliott指出，保守党认识到合理分配医疗保健开支的重要性。
　　Christine Elliott, the Progressive Conservative critic of health and long-term care, said her party recognizes the need to wisely allocate health care spending.

　　因为他们一直听到关于目前的系统是如何如何无法持续等。我们希望把重点放在建立一个以病人为中心的系统。该系统不涉及哪家独立的机构，把重点放在人们如何利用这个系统，以及如何按部就班地接受治疗。”
　　“I think that people have a general anxiety about health care, because they keep hearing about how our present system is unsustainable,” she said. “We want to focus on a patient-centered system that isn’t about the individual institutions, but how people move through the system and get treated every step along the line.”

　　Elliott举了一个她认为安省需要改变的例子——目前缺乏对安省老年人的长期护理。
　　As an example of something she believes the province needs to change, Elliott cited the current lack of long-term care for much of Ontario’s aging population.

　　“安省许多地方根本没有提供住家护理服务，而即便在提供住家护理服务的地方，服务也不周全。我认为，这导致了我们所见到的大量急诊室病人积压的状况，因为病人们根本没地方可去。”

　　“Home care services simply aren’t available in many parts of the province, and certainly if there is home care it’s still not adequate for the needs of the patient,” she said. “I think it commits to a lot of the emergency room backlogs that we see, because there simply isn’t anywhere for people to go.”

　　安省新民主党卫生保健方面的评论家Gélinas则指出，新民主党担心安省医疗保健服务分布不均的问题。
　　France Gélinas, the provincial NDP critic for health and long-term care, said her party is concerned with Ontario’s unequal distribution of health care services.

　　Gélinas表示，从2005年4月开始，安省卫生保健厅就建立了200间家庭卫生小组——由包括机构医师、护师、注册护士、社会工作者、营养学家及其他卫生保健专业人士所组成的组织。她说：“这些都集中在一些称得上是较富裕的街区。”
　　Gélinas表示，从2005年4月开始，安省卫生保健厅就建立了200间家庭卫生小组——由包括医生、护理人员、注册护士、社工、营养学家及其他卫生保健专业人士组成。她说：“但这些小组都集中在一些称得上是较富裕的街区。”
　　Since April 2005, Gélinas said, the province’s Ministry of Health and Long-Term Care has established 200 family health teams, organizations that include physicians, nurse practitioners, registered nurses, social workers, dietitians and other health care professionals. These have been “concentrated in what I would call well-off neighbourhoods,” she said.

　　Gélinas 继续说：“所有人都知道，最需要帮助的人群——那些生病更频繁且更久的人都是生活在社会阶梯最下层的人们。新民主党将确保新的医疗服务能面向那些最需要服务的人，而且能让他们方便看病。”
　　“Everybody knows that the people with the greatest need, that will get sick more often for longer periods of time, are people at the bottom end of the social ladder,” Gélinas continued. The NDP would like to “make sure that when new health services are rolled out, they are rolled out where people need them, in a way that is accessible to them.”

　　Gélinas指出，安省的移民社区也面临一系列特别的问题，包括为时3个月的OHIP等待期,以及“难以找到说自己母语的医疗服务”。
　　Ontario’s immigrant community also faces a number of unique problems, Gélinas said, including a three-month wait time for OHIP coverage, and a lack of “access to care in their language of choice.”

　　她说：“安省需要尊重这个事实：当你有语言障碍时，坦白地说，你就很难获得医疗保健系统的服务了。”
　　The province needs to be “respectful of the fact that if you have a language barrier, then frankly, the health care system is not accessible to you,” she said.

　　在被问到语言障碍的问题时，一位安省卫生厅发言人回答大中报说：“家庭医疗小组是由面向社区的”。该发言人举了耆晖家庭医疗中心为例。
　　Asked about the language barrier, an office spokesperson with the provincial Ministry of Health told Chinese News that many “family health teams are designed to be community-driven,” citing the Carefirst Family Health Team as an example.

　　这名发言人在电子邮件中说：“耆晖会为列治文山及多伦多北部大约6,000名患者提供服务，特别针对亚洲及南亚社区。”耆晖会的多元文化小组与安居服务中介机构和“特定文化”社区代理机构通力合作。
　　Carefirst serves “approximately 6,000 patients in the Richmond Hill and north Toronto areas, with a specific focus on the Asian and southeast Asian communities,” the spokesperson wrote via e-mail. The centre’s multicultural team collaborates with settlement service agencies and “culturally specific” community agencies.

　　在谈到为时3个月的OHIP等候期时，该位发言人在电子邮件中表示，移民可以到社区医疗中心看病，因为这些中心受省府有关部门委托，为抵达安省但没有医疗保险的人士服务。
　　As for the three-month OHIP waiting period, the spokesperson wrote that immigrants can visit community health centres, which “are mandated to service non-insured people residing in Ontario who do not have health insurance.”

　　该名发言人还说：“需要注意的是，医院和医生都有义务在必要的时候提供急诊治疗。”
　　“It is also important to note that hospitals and doctors have an obligation to provide emergency care when necessary,” the spokesperson continued.

　　安省卫生厅长马修斯对大中报说：“毫无疑问，我们需要医疗保健拨款花得更加物有所值。”
　　Deb Matthews, Ontario’s minister of health and long-term care, told Chinese News “there is no question we need to get better value for health care dollars.”

　　按照安省2010年《全民优化医疗法》，医疗保健机构必须开展大众服务“质量改善计划”，并且医保机构管理层的薪资水平应与该机构能否实现其质量改善计划挂钩。
　　Under the province’s 2010 Excellent Care for All Act, health care organizations must develop public “quality improvement plans,” and executive compensation is linked to an organization’s ability to meet them.

　　安省自由党也建立了新的安省医护质量委员会，利用病人和住家看护人员进行问卷调查来监督这一行业的进程。
　　The provincial Liberals also created a new organization, Health Quality Ontario, that monitors the industry’s progress by conducting patient and caregiver surveys.

　　马修斯说：“我们已经有很多机会来得到社区的进一步支持，比如病人安置以及家庭护理，以便更多人能摆脱对医院和长期护理中心的依赖。”
　　“We’ve got a great opportunity to build more community support, like supportive housing, like home care, to keep more people out of hospitals and out of long-term care,” Matthews said.

　　当被问到许多移民社区的成员都面临的语言障碍问题时，马修斯表示，安省正在加紧对国外培训的医疗专业人士的资格认证，因为他们具备文化上的竞争力。
　　When asked about the language barriers faced by many members of the immigrant community, Matthews said the province is working on speeding up credential recognition for internationally educated medical professionals, “because they bring that cultural competency with them.”

　　她说：“人们在能与他们用同一种语言的医护人员交流时，他们将得到最好的护理。”
　　“People will get the best care when they can get care from a provider who speaks their language,” she said.

　　马修斯不同意新民主党评论人士Gélinas所说的，安省家庭医疗小组主要为富裕的民众所设。
　　Matthews disagreed with NDP critic Gélinas’ assertion that the province’s family health teams have been mainly established in affluent neighbourhoods.

　　她说：“安省居民中有94%的人都有家庭医生，但我们的目标是100%。我们可以很清楚地看到哪些地方还存在不足，而在以后我们做出决定时，我们将在最需要的地方投资。”
　　“We’ve now got 94 percent of Ontarians with family doctors, and our goal is 100 percent,” she said. “We can see very clearly where there is still a shortage, and as we make future decisions, we will be making those investments where their need is the greatest.”

　　以上各党派中没有任何一位能具体说出他们将如何执行他们的想法，或如何为这些想法来分配拨款。
　　None of the party representatives specified exactly how they would implement their ideas, or allocate funding for them.

　　纳税人联盟的Fildebrandt 说：“很过改进服务的办法并不需要大手术。比如拨款跟着病人走，而不是你只要是医院，拨款就自动送上门。那就意味着医院间将竞争，看谁能给病人提供更好的服务。”
　　“There are a lot of different forms of correction that are not even that radical,” said the Taxpayers Federation’s Fildebrandt. “One would be just allowing money to follow patients instead of block funding to hospitals. That would mean hospitals would have to actually compete with one another for who can provide the best services.”

　　虽然是否采用使用费存在争议，但它也不失为一个办法。Fildebrandt说：“它可以鼓励人在适当的时候使用该系统。”
　　User fees, while controversial, are another idea. “It would provide an incentive to use the system when appropriate,” Fildebrandt said.

　　他继续说：“可以建立相关机制，来确保最贫困的人群不会因为穷而影响看病。”但是，它可以帮助安省居民认识到“我们的系统并不是免费的。”
　　“You could build mechanisms into that to ensure the poorest aren’t as proportionally affected,” he continued. But it would help Ontario residents recognize that “our system is not free.”

　

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