由 Melia 等人写的专题报告,论述了加利福尼亚州计划通过协商的加利福尼亚州医疗困难补助制度(Medi-Cal)合同,推进保健市场的竞争,以控制螺旋上升的保健费用。将付不起医疗费的成人的医疗保健从州转到县一级,最后协商同私营保险公司的签订合同。其他减少加州医疗困难补助制度的预算的措施还包括缩小偿付范围和直接削减医疗项目,Petersderf 认为不管是 Medi-Cal 合同的协商,还是给付不起医疗费的成人 A special report by Melia et al. described California’s plans to negotiate a Medi-Cal contract to advance competition in the health care market to control spiraling health care costs. The health care of adults who cannot afford medical expenses is transferred from the state to the county level, and finally the contract with the private insurance company is negotiated. Other measures to reduce the budget of California’s medical hardship subsidy program include reducing the scope of payments and directly reducing medical items. Petersderf believes that whether Medi-Cal contracts are negotiated or if they cannot pay for medical expenses