最近的民意调查表明美国公众对医疗保健系统的现状大为不满,多数调查对象赞赏加拿大的医疗保健模式。尽管批评的呼声很高,但改革的步骤却极缓慢而且效果很差。改革为何如此缓慢?其答案首先是应明白措施和效果是不平行的。过去20年来,政府和公众都面临着减少医疗费用增长的压力。联邦政府的一系列措施如下:控制联邦政府的医疗补贴、减少维持医疗卫生系统运行的联邦津贴;采用预付费用方式,以便降低服务直接付费;减少医院不必要仪器设备; Recent public opinion polls show that the American public is greatly dissatisfied with the status quo of the health care system, and most respondents appreciate Canada’s health care model. Although the cries of criticism are high, the steps to reform have been extremely slow and have had poor results. Why is the reform so slow? The answer, first of all, is to understand that measures and effects are not parallel. Over the past 20 years, the government and the public are facing pressure to reduce the growth of medical expenses. The federal government has a series of measures as follows: control of the federal government’s medical subsidies, reduction of federal subsidies to maintain the operation of the health system; use of pre-payment methods to reduce the direct payment of services; reduce hospital unnecessary equipment and equipment;