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导读：奥巴马就一个四十五年前的承诺每个年老公民都会获得应有的医疗保健，而展开的一次讲话。  

Forty-five years ago, we made a solemn compact as a nation that senior citizens would not go without the health care they need. This is the promise we made when Medicare was born. And it’s the responsibility of each generation to keep that promise.

四十五年前，我们郑重许诺要让我们国家的每一个年老公民获得应有的医疗保健。这是医疗保险诞生之初我们许下的诺言。也是每代人信守承诺的责任。

That’s why a report issued this week by the Trustees who oversee Medicare was such good news. According to this report, the steps we took this year to reform the health care system have put Medicare on a sounder financial footing. Reform has actually added at least a dozen years to the solvency of Medicare – the single longest extension in history – while helping to preserve Medicare for generations to come.

这也是为什么本周由医保监管第三方发布的报告是个好消息的原因。根据这份报告，今年以来我们在医疗保险系统所采取的一系列改革措施使得医疗保险获得了更加坚实的财政基础。改革实际增加了至少12年的医保偿付能力——这是历史上最长的单次延长——将为即将到来的数代人提供医疗保险。

We’ve made Medicare more solvent by going after waste, fraud, and abuse – not by changing seniors’ guaranteed benefits. In fact, seniors are starting to see that because of health reform, their benefits are getting better all the time.

在经历了浪费，欺诈和滥用之后，我们使得医保更有偿付能力——不是通过调整老人们已有的利益。实际上，通过医疗改革，一直以来，老人们获得了越来越好的医疗保健。

Seniors who fall into the “doughnut hole” – the gap in Medicare Part D drug coverage – are eligible right now for a $250 rebate to help cover the cost of their prescriptions. Now, I know for people facing drug costs far higher than that, they need more help. That’s why we negotiated a better deal with the pharmaceutical companies for seniors. So starting next year, if you fall in the doughnut hole, you’ll get a 50-percent discount on the brand-name medicine you need. And in the coming years, this law will close the doughnut hole completely once and for all.

陷入“甜甜圈漏洞”——联邦医疗保险制度第四部分的处方药保险缺口——的老人们现在将有资格获得250美元的贴现以补偿他们在处方药上的支出。现在，我知道人民面对着远比这高的药物支出，他们需要更多的帮助。这也是为什么我们为了老人们而与制药公司谈判以获得更好交易的原因。因此，从明年开始，如果你陷入甜甜圈漏洞，你将在你所需要的品牌药品上获得50%的折扣。在未来几年，该法律将一劳永逸的完全堵上这个甜甜圈漏洞。

Already, we have put insurance companies on notice that we have the authority to review and reject unreasonable rate increases for Medicare Advantage plans. And we’ve made it clear to the insurers that we won’t hesitate to use this authority to protect seniors.   

我们已经告诫保险公司，我们有权审查和否决针对老人医疗保险优惠计划的不合理的费率调整。而且我们明确的告诉保险公司我们在保护老年人行使该项权力上绝不会犹豫。

Beginning next year, preventive care – including annual physicals, wellness exams, and tests like mammograms – will be free for seniors as well. That will make it easier for folks to stay healthy. But it will also mean that doctors can catch things earlier, so treatment may be less invasive and less expensive.

从明年开始，预防保健——包括年度体检，身体检查，以及像乳房X射线检查之类的测试——也将对老年人免费。这将让人们更容易保持身体健康。但这同时也意味着医生们能更早发现苗头，而治疗也将具有更小的危害性花费也更便宜。

And as reform ramps up in the coming years, we expect seniors to save an average of $200 per year in premiums and more than $200 each year in out of pocket costs, too.

在未来数年，随着改革的进一步推进，我们希望老人们每人每年能节省200美元的保险支出和200美元的自掏腰包支出。

This is possible in part through reforms that target waste and abuse and redirect those resources to where they’re supposed to go: our seniors. We’re already on track to cut improper payments in half – including money that goes to criminals who steal taxpayer dollars by setting up insurance scams and other frauds. And we won’t stop there. Because by preventing the loss of these tax dollars, we can both address the runaway costs of Medicare and improve the quality of care seniors receive – and we can crack down on those who prey on seniors and take advantage of people.

通过针对浪费和滥用以及重现配置这些资源到应该使用的地方：面向我们的老人，这是可以实现的。我们已经走上正轨，砍掉了一半的不合理支出——包括流向罪犯的钱，他们通过设计保险骗局和其他欺诈手段窃取纳税人钱财。我们不会在此止步。因为通过阻止这类的税金损失，我们不仅可以控制医疗保险的成本失控，而且可以改善老人们获得的保险的质量——我们将严厉打击那些掠食老人利益和占人民小便宜的人。

So we are no longer accepting business as usual. We’re making tough decisions to meet the challenges of our time. And as a result, Medicare is stronger and more secure. That’s important. Because Medicare isn’t just a program. It’s a commitment to America’s seniors – that after working your whole life, you’ve earned the security of quality health care you can afford. As long as I am President, that’s a commitment this country is going to keep.

因此我们再也不会像往常一样接受现状。我们将做出艰难的决定来面对我们的挑战。作为结局，医疗保险制度将变得更加坚实更加安全。这很重要。因为医疗保险不仅仅是一项计划。这是对美国老年人的承诺——在你一生的努力工作之后，你应该享有你所能负担的安宁和高质量的医疗保健。只要我还是总统，国家将继续践行这项诺言。

Thank you.

谢谢大家！

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