20世纪70年代以来,美国由于传统的医疗保险“第三方付费”(即保险公司付费)办法,对医疗服务的提供者(医院)和医疗服务的接受者(投保人)缺乏控制力,医疗成本的逐年上涨依然没有得到遏制,医疗费增长迅猛,并逐渐超过军费开支,成为第一大财政支出项目,1993年美国的医疗费用支出高达10000亿美元,1997年更是占到国民生产总值的14%,人均达2500美元,居世界第一位,美国政府不堪重负。因此,70年代中期以来,美 Since the 1970s, the United States has no control over providers of medical services (hospitals) and recipients of medical services (policyholders) due to the traditional “third-party payment” (payment by insurance companies) Medical costs have not been checked year by year. Medical expenses have risen rapidly and gradually surpassed military expenditures to become the first major expenditure item. In 1993, the United States spent as much as one trillion U.S. dollars in medical expenses and in 1997, The value of 14%, up to 2,500 US dollars per capita, ranking first in the world, the U.S. government overwhelmed. Therefore, since the mid-1970s, the United States