赏析版2011年7-12月经济学人文章(英汉双语对照)汇(15)

卫生福利及食物局长最近提出的提高自费病人的上限，将收入纳入医保信托基金会的建议真正使我担心。我觉得重点不是经济原因：一个稳定的额外收入来源对于缺乏资金的医院来说是很有用的，尽管有些想想可能会引起国民医疗保健制度的终结。我更担心的是这将使公费病人因为医院要接收大量付费病人而更不能及时救治。

Private patients have long been treated alongside NHS ones: my own department sees a few private patients every week, and the care it offers to NHS patients does not suffer as a result. But if the proportion of private patients substantially increased, that could change.

自费病人和公费病人一直是同时治疗的：我的医科部门每周都要看几个自费病人，而这不影响公费病人的诊治。但是如果这个比例大幅提高了，那情况就会有所改变。

The basic problem is that private patients are treated differently (in every sense) to those on the NHS. It doesn‘t matter how stringent the rules are about care being assigned according to need and people not being allowed to jump the queue just because they have money, it doesn‘t work out like that.

基本的问题是自费病人（从各个方面来说）和公费病人是差别对待的。不管这些关于医疗资源按病人需要而分配，以及任何人都不允许因为有钱就插队的规定有多严格都没用，他们不按规定做事。

My department‘s official policy, for example, is simply to see patients as soon as possible, with the most clinically urgent cases given priority. There are some spare appointments to fit in anyone who needs to be seen at short notice (inpatients, for example), and if a doctor wants a private patient seen then we will squeeze them in if we can, but we won‘t bump anyone else down the list so the private patient gets seen quicker. Simple, relatively efficient and fair.

例如，我的部门的办公政策非常简单，看病尽量快，同时优先临床紧急病例。剩下还有一些预约，任何短期需要照看的病人都可以预约（如住院病人）。如果一个医生想看自费病人，我们就会挤压其他病人的时间。但是我们不会裁掉看病名单上的任何人来让自费病人看得更快。很简单，这是效率和公平的相对平衡。

At least, that is the theory. And most of the time, that is what we actually do as well. But when they are treating a private patient doctors are more pushy than they are when treating an NHS patient. I would estimate that consultants are perhaps two or three times more likely to chase up whether a private patient has been given an appointment than if the patient is being treated on the NHS.

起码，那是原则。而且大部分时间里，我们实际上也是按它做的。但是当医生在治疗自费病人时会比治疗公费病人时更有干劲。我可以估计出会诊医生追求是否有自费病人预约的积极性比追求公费病人是否被医治的积极性高两到三倍。

Sometimes, if my department is busy and the waiting time is longer than normal, a consultant will pop into the office and casually mention that they believe we might have a private patient of theirs on our list and they would appreciate it ever so much if we could find a way to get them seen promptly. Only rarely will a doctor overtly say they want a patient to be seen faster because he is a paying customer, but that is the direction I am being nudged in.

有时候，如果我的部门很忙，候诊时间比平时要长，一个会诊医生就会突然进入办公室并且不经意地提到他们相信我们的名单里可能有一个他们的自费病人，如果我们能想办法帮他们得到及时治疗，他们会感激不尽。虽然几乎没有医生会公然地说他们想让自费病人能快点诊治因为他们付了钱，但我一直在被鼓动着朝那个趋势去做。