《NEJM Interviews听写》第十二期(2)开始讨论参考答案！

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《NEJM Interiews听写》第十二期(2) ： Senator Chuck Grassley and Congressman Pete Stark on President Bush’s tax-based health care proposals.
相关链接：http://content.nejm.org/cgi/content/full/356/14/1393/DC1，
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From the eidence of not fair, I suppose I can argue. I argue the opposite that the existing system isn’t fair, because you're encouraging people that can deduct something to hae, maybe more expensie plans and what they hae to hae and consequently, a lot of people hae cartelized plans. I think the best way to answer is hae a policy that fits indiiduals as opposed to masses, so you hae indiidual choice if you do it as the way the president wants to do it. I think the more indiidual choices you hae, the more fair it is and you take care of a lot of these problems. if Pete's right that it only helps three million people, there are other benefits to it than the number of people it helps, in the sense, that it is gonna moderate medical cost and reducing inflation of healthcare.

How would this Bush's proposal actually reduce healthcare cost?

For instance, when you hae plans and negotiate it, we'll say between Union and workers, they probably hae a lot more prepays in them, a lot more extra things that are inoled in them; they would probably incorporate all the thousands state mandates, such as you hae among the 50 states for health insurance. And they all drie you up the cost of health insurance. And if you hae indiidual policies, they can buy different ones and we think an economic thing that for indiiduals who are making a choice, there are gonna be a little more discretion and maybe buying expensie parts of health insurance as opposed to less expensie, what they just kind of need to get buy.

Congressman, do you respond to that?

Two things, and indiidual choice I subscribe to, but in my state California, and as far as I know in the state of Iowa, many people would hae trouble buying a policy because it's not aailable. I don't think that president wants us to go down the path of beginning to regulate state insurance policy programs to make sure that indiidual policies are aailable to eery person. I would support that.

He is right that right now the indiidual market is a weaker from the group insurance. We think this will strengthen the market and people are gonna hae more choice, I would expect maybe a little bit long lines where we ended up with part D, pharmaceutical for medicare. We actually ended up with many more plans than all we anticipate and there are much more competetion than we anticipate.

I think what we're coming through here is a philosophic difference that the senator and I hae. I am not as confident as he is that the kind-hearted insurance executies are going to come after a market and include and stop sharing picking so that you own the best risk. I don't think that the same free market, economic incenties that can exist in the retail market or in the stock market applying necessarily to buying medical care.

What do you think about this idea of this quoted affordable choice where the Bush plan would gie states more freedom to take medicate money that might go with the hospitals and help insured poor people with that. First, Senator Grassley?

I learned something from goernors about those who don't hae any insurance. Fie republican and fie democrat goernors came to me two year ago. And when I was the chairman of the finance committee, they says,"senator Grassley, we can sae the federal taxpayers' dollars and the state taxpayers' dollars and actually sere more people if you would gie us more flexibility in how we administer the medicate program". And we did that, and not only those ten goernors come to me, they got all fifty goernors to sign a letter to congress urging that point of iew and so what we were doing here in this program. The affordable choice initiatie is to gie the states more flexibility and een more resources to do what we did on medicate. And do you trust state goernment, do you trust goernors, or does the Washington DC hae all the ideas and all the brain power, and should we make all the decisions?

Well, giing goernors the opportunity to decide how to spend funds, the goernors are subjected to the same kind of lobbying pressures as we are. And what will happen in states where medicate funds can be moed is that the old promargins like me are gonna lobby the deil out of goernor Schwarzenegger to put all the money he can in long-term care and programs for the elderly. And there are just as many lobbyists and much political pressure to help poor children and low-income younger people. So the tendency in eery state would be to go with the will of squeakest lobbyist. So I do feel that some minimum federal standards in how we spend the federal tax dollars that we send to the states is necessary.

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simon81, thank you for your continous efforts in keeping this acitiity rolling. I made the comparison the time right after you posted the reference script, but failed to find out any mistakes, so did this second try. I think there might be some mistakes in it, but just don't know what the correct words or phrases are, due to my poor listening comprehension. So I hae to admit that you did an excellent job.

From the eidence of not fair, I suppose I got to argue. I argue the opposite that the existing system isn’t fair, because you're encouraging people that can deduct something to hae, maybe more expensie plans than what they hae to hae and

1. I argue the opposite that the existing system isn’t fair,
I argue the opposite that the existing system is fair.

Attention:
Congress Stark在part1里面发表了自己的态度(First of all, I don’t think it is fair.)，而Senator Grassley接下来的讲话中摆出了自己的态度，即（I argue the opposite, the existing system is fair.）两者的对话很有意思，大家可以连着听听看。

2. because you're encouraging people that can deduct something to hae, maybe more expensie plans and what they hae to hae
Because you are encouraging people that can deduct something to hae, maybe more expensie plans and more than they hae to hae.

3. a lot of people hae cartelized plans.
a lot of people hae catalyzed plans.

此句取决于两词的含义，且看词典中的解释
cartel [kɑ:'tel]
n. 卡特尔, 企业联合, 俘虏交换条约, 决斗挑战书
[经] 同业联合, 联合贩卖, 卡特尔

catalyze ['kætәlaiz]
t. 催化, 促进, 刺激
[医] 催化

本人认为此句中用后者似乎更为合适，因为前句中提及“Because you are encouraging people that can deduct something to hae, maybe more expensie plans and more than they hae to hae.”，即“刺激消费计划”

4.Two things, and indiidual choice I subscribe to,
To detect the indiidual choice, I hae tried to.

5.I don't think that president wants us to go down the path of beginning to regulate state insurance policy programs to make sure that indiidual policies are aailable to eery person.
I don't think that president wants us to go down the path of beginning to regulate state insurance policy programs to make sure that indiidual policie is aailable to eery person.

6.Fie republican and fie democrat goernors came to me two year ago. And when I was the chairman of the finance committee
Fie republican and 5 democrat goernors came to me 2 years ago when I was the chairman of the finance committee.

7. And there are just as many lobbyists and much political pressure to help poor children and low-income younger people. So the tendency in eery state would be to go with the will of squeakest lobbyist.
这句话的确很难懂，我听了好多次还是米抓住主要意思。
建议大家都来多听听，我觉得意思好像不大对，brain storm下咯