本科毕业设计(论文) 外文翻译 原文 The American Health Care System — Managed Care America's private and public third-party payers, squeezed by health care costs that continue to soar at rates well above inflation, are persuaded that "managed care" plans will produce demonstrable savings pared with the current cost trends of traditional fee-for-service medicine. They are accelerating their efforts to promote plans that integrate the delivery and financing of care and that apply new constraints on encounters between physicians and patients. The key constraint for doctors is the limitation placed on the autonomy of their clinical decisions. The constraint for patients is the requirement that they see only physicians who are members of a plan's closed or partially open panel or who are selected as "preferred" practitioners. In general, these doctors have agreed to deliver only "necessary" medical services in return for prescribed fees. Most definitions characterize managed care as a system that integrates the financing and delivery of appropriate medical care by means of the following features: contracts with selected physicians and hospitals that furnish prehensive set of health care services to enrolled members, usually for a predetermined monthly premium; utilization and quality controls that contracting providers agree to accept; financial incentives for patients to use the providers and
