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新加坡的医疗成本不断上涨，究竟是什么导致的？_我的网站

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A | British Prime Minister Boris Johnson is fighting for his political life but his opponents have few options for replacing him — so say two senior academics.,Calls for Johnson to go have reached fever pitch since Chris Pincher, the Conservative MP he appointed as deputy chief whip in February, was sacked for drunkenly groping two men at a posh private members' club in London.,This week it emerged that Johnson had been informed of earlier sexual assault claims against Pincher before he promoted him — leaving cabinet colleagues were embarrassed at having to defend the ever-changing official line.,Laura McAllister, professor of public policy at the Wales Governance Centre, told Sputnik nobody should take Johnson's political demise for granted.,"He survived so much in a way that few other politicians have ever managed to, particularly those in senior public office and prime minister," McAllister says. "He operates by a completely different set of rules and principles and ethics, which we would assume would be his undoing, but actually in reality he seems to have been able to ride the storm".,The academic points to Johnson's survival of the scandals around his advisor Dominic Cummings, 'Partygate', his handling of the COVID-19 pandemic before the Pincher affair. But she conceded that the spate of ministerial resignations led by Sajid Javid as health secretary and Rishi Sunak as chancellor of the exchequer were "hugely significant.","Two Cabinet members who sat in Cabinet yesterday morning had resigned without warning by the evening," the professor stresses "I think it's also fair to say that both of those individuals are thinking about their own potential bids to stand as the next leader of the Conservative Party and therefore timing is very much predicated on that.",McAllister says things have changed since the days of Margaret Thatcher, who resigned in 1990 after failing to win a leadership challenge by an overwhelming margin.,"[T]here was a much stronger Cabinet code, a ministerial code that was upheld broadly, or if it wasn't upheld, then there were consequences," she says "That's not the case now, and it seems very likely that Johnson will not resign of his own accord.","He still has a base of support, of course, even though that’s dwindling away now," she adds.,The academic also doubts that a general election would break the political deadlock.,"Whilst Labour are a few percentage points ahead, they clearly aren’t making sufficient headway to be confident of winning a majority," McAllister says. "The best they could hope for in the current polling would be a minority government and potentially having to seek coalition partners".,Those could include the Liberal Democrats and the Scottish National Party (SNP), who would demand a repeat of the 2014 independence referendum as the price of their support. Ironically, independence for Scotland and its 59 parliamentary seats would shore up the Conservative majority in Westminster and make Labour nigh on unelectable.,"[Labour leader] Keir Starmer has already ruled out any deals with the SNP for obvious constitutional reasons, and therefore with Plaid Cymru in Wales," she points out, "So it seems unlikely that that route to power is open".,McAllister believes a new Tory leader would at least enjoy a "honeymoon period" bounce in the polls.,"And who knows, were Johnson to be defenestrated, it might be that a new leader might choose to capitalize on the honeymoon period and call an earlier election," she speculates.,Beleaguered BoJo Battles With Opposition at Weekly PM's Questions12:52 GMT,No 'Coup', But Then Who?,Mark Garnett, a politics professor at Lancaster University and author of the books "The British Prime Minister in an Age of Upheaval" and "From Anger to Apathy: The British Experience" thinks Johnson has no hope of survival. But he does not see how the party can push the PM out if he refuses to jump.,He says Javid and Sunak's resignations are "serious blows" to Johnson, but they are only "symptoms of a more general crisis of leadership".,"Johnson has been involved in too many incidents which raise questions about his personal integrity," Garnett says, with ministers told to defend the PM against allegations that turned out to be true. "In effect, they have been asked to lie in public on his behalf. Their patience has finally snapped.",But the professor does not see the near simultaneous resignations as a "coup", stressing: "The most surprising thing is that ministers have tolerated Johnson for so long".,While Sunak was seen as the favorite to succeed Johnson just six months ago "he is being held at least partly responsible for the country's economic problems and his chances of becoming prime minister are now very remote," Garnett says. "Sajid Javid's chances are greater, but Conservative members (who make the final decision) seem more attracted to the Defence Secretary, Ben Wallace, who has not resigned.",The academic believes MPs are worried that Johnson is now an "electoral liability" who could cost them their seats at the next general election. "The party has just lost two by-elections in crucial seats, and the main reason given by those who voted against them was Boris Johnson's leadership," he stresses.,But the problem of how to remove Johnson from office if he will not quit remains.,"Currently the party's rules make it impossible to hold a vote of confidence for another year," Garnett points out. "It is very likely that those rules will be changed within the next ten days". But he believes if a vote could be held now, "Johnson would certainly lose and be forced to resign".。新加坡的医疗成本不断上涨，引发了广泛的社会关注。而背后潜藏的主要问题——健康保险中的“按收费”模式，正逐渐成为国家金融灾难的潜在威胁。1. “按收费”计划的起源与问题2005年，新加坡健康保险领域的新秀Aviva引入了“按收费”计划，打破了健康保险市场的格局。该计划允许保险公司为医生和医院批准的任何治疗买单，导致医疗成本迅速上涨。这种模式让医生和医院可以选择最昂贵的治疗方案，而患者则因相信“最好的治疗”而积极参与。

B | 结果，医疗费用激增，公共医疗支出大幅攀升，最终负担转嫁给了消费者。数据显示，自2009年以来，政府在医疗保健方面的支出已增加了四倍，这种不可持续的增长趋势引发了社会的广泛担忧。来源：clema risk solutions2. 成本上升的背后：谁在为“按收费”买单随着“按收费”计划的普及，私立医院的医疗费用远远超过了公立医院，导致整体医疗成本的大幅上涨。

C | 研究表明，有“按收费”保险的患者，其医疗支出比没有此类保险的患者高出25%。

D | 这一问题引发了政府的关注。李显龙资政呼吁遏制过度治疗和过度开药，以控制医疗成本的攀升。然而，政治意愿的不足使得问题迟迟未得到根本解决。

E | 在这一背景下，政府近年来尝试了一些零碎的措施，例如限制医生选择，但这些措施效果有限，未能真正解决成本上升的核心问题。

F | 来源：联合早报3. 变革迫在眉睫：如何解决“按收费”问题要解决医疗成本上升的问题，必须从根本上改革“按收费”保险计划。我的建议是，取消在综合盾计划中使用MediSave资金的“按收费”覆盖范围，转而采用更具成本效益的计划。

G | 此外，保险计划的可移植性问题也需要得到解决。

H | 新加坡精算协会的研究表明，提升保险的可移植性将有助于增强市场竞争，允许新加坡人选择更适合的保险产品。总之，取消“按收费”计划和提升保险的可移植性，将是解决新加坡医疗成本问题的关键举措。这是一场必须进行的改革，为了全社会的利益，迫切需要采取行动。来源：联合早报面对日益严峻的医疗成本问题，新加坡亟需对现有的健康保险体系进行全面改革。只有通过各方的共同努力，才能为全体居民提供可持续的、负担得起的医疗保障。