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By the early 1950s, it was becoming apparent that a growing number of elderly Americans had no economic protection from the increasing cost of health care. Most people over 65 had very low incomes and few owned private health insurance of any kind.
早在19世紀(jì)50年代，醫(yī)療保險成本日益高漲的同時，越來越多的美國老人卻沒有受到經(jīng)濟(jì)保護(hù)，這一現(xiàn)象日益突出。大多數(shù)年齡超過65歲的老人收入微薄，只有少數(shù)人參保了各種名目的私人醫(yī)療保險。
Congress began a years–long debate on this issue of national health insurance for the elderly. Critics in Congress feared Medicare would lead to substandard and overpriced care, and felt that it should serve only the indigent. They also predicted that, with growing numbers participating, it would eventually bankrupt the federal Treasury.
國會就老年人國家醫(yī)療保險這個問題進(jìn)行了長達(dá)幾年的爭論。國會的批評人士擔(dān)心醫(yī)療保險會衍生出各種低劣、超價收費(fèi)的保險，并認(rèn)為醫(yī)療保險只能為窮人服務(wù)。他們估計，隨著參保的人數(shù)不斷增長，最終會導(dǎo)致聯(lián)邦財政部門破產(chǎn)。
The legislative compromise that became the final Medicare Act—officially known as the "Social Security Amendments of 1965”—was part of President Lyndon Johnson's "Great Society" program. Today it protects more than 40 million Americans from the high cost of hospital care.
立法上的妥協(xié)成就了最終的醫(yī)療法案——官方稱作“1965年社會保障修正案”，這也是林肯·約翰遜總統(tǒng)“大社會”計劃的組成部分。而今在住院花費(fèi)高昂的美國，它讓四千多萬人民受益。
Much of the program's costs are covered by payroll taxes paid by workers. Yet costs quickly started to exceed expectations, and as Americans' life expectancy increased over the years, the Medicare program became even more expensive.
這項計劃的大部分開銷來源于工薪階層的工資稅。然而，開支很快開始超出預(yù)算。而且多年來美國人口壽命也在不斷增加，這使得醫(yī)療保險計劃變得更加入不敷出。
It has become a matter of national debate and a financial issue for every Congress and President since. Today it is still one of the fastest growing items in the federal budget. Nonetheless, Medicare remains a popular program, and a well-established part of the federal government's role in our society.
自此，醫(yī)療保險就變成歷任總統(tǒng)，歷屆國會上永恒不變的國家性話題和財政大事。如今，它仍然是聯(lián)邦預(yù)算中增長最快的一項。無論如何，醫(yī)療保險仍深受人民歡迎，也是聯(lián)邦政府社會職能的良好體現(xiàn)。
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