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加拿大医疗保险制度单一,管理简单、管理成本低;美国医疗保险制度多元化、管理复杂、管理成本高。美国医疗管理成本远超加拿大。对比1999年美国和加拿大有关医疗保险、雇主医疗福利、医院、诊所、疗养院及家庭医疗等公布的医疗管理费用,1999年美国的总管理费用2943亿美元;人均1059美元;加拿大分别为94亿美元和307美元。美国的管理费占医疗费总开支的31%,加拿大占16.7%。加拿大医疗保险方案的一般管理费占1.3%,但是加拿大私立保险公司管理费与美国相比则较高。加拿大供方的管理费远为节俭。1969—1999年美国医疗管理所花人力费由18.2%上升为27.3%,加拿大从1971年的16.0%增加为1991年的19.1%。如能将美国管理费降到加拿大水平,每年可节省管理费2090亿美元,足够医疗保险基金的全民覆盖。
Canada has a single medical insurance system, simple management, and low management costs; the United States has a diversified medical insurance system, complex management, and high management costs. The cost of medical management in the United States far exceeds that of Canada. Comparing the US and Canada’s 1999 medical and administrative expenses related to medical insurance, employer’s medical benefits, hospitals, clinics, nursing homes, and home medical services, the total U.S. administration cost was US$ 294.3 billion in 1999; the per capita figure was US$ 1059; Canada was US$ 9.4 billion respectively. And 307 US dollars. Management fees in the United States accounted for 31% of total medical expenses, and Canada accounted for 16.7%. The general management fee of the Canadian health insurance scheme accounted for 1.3%, but the management fee of the Canadian private insurance company was higher than that of the United States. Canadian suppliers’ management fees are far more frugal. From 1969 to 1999, the labor cost of the United States medical administration rose from 18.2% to 27.3%, and Canada increased from 16.0% in 1971 to 19.1% in 1991. If we can reduce the U.S. management fee to Canada, we can save 290 billion U.S. dollars in management fees each year, which is enough for universal coverage of medical insurance funds.