为什么美国消费者要为处方药支付如此高的价格

Democratic lawmakers in the U.S. Congress have proposed an addition to President Joe Biden's climate and social spending legislation. The addition would permit Medicare to negotiate with drug companies over the cost of some prescription medications.
美国国会的民主党议员提议在乔·拜登总统的气候和社会支出法案中增加一项。该增项将允许老年医保与药企就一些处方药费用进行谈判。

Medicare is the federal government's health care program for Americans over 65 years old.
老年医保是联邦政府为65岁以上美国人提供的医保项目。

Americans pay higher prices for prescription medications than people in almost any other developed country. For many years, politicians and health care representatives have struggled without success to change the system. If passed, the proposal would bring a small improvement to the situation for older Americans.
美国人要支付的处方药价格几乎比其它任何发达国家人民都要更高。多年来，政客和医保代表一直在努力改变这一体系，但是没有成功。如果获得通过，该提案将对美国老年人的状况带来小幅改善。

The plan in discussion would permit Medicare officials to negotiate pricing on a small number of the thousands of prescription medications for sale in the United States. It would begin with about 10 drugs and end at 20. Some members of Congress at first had hoped to permit Medicare officials to negotiate the prices of up to 250 costly drugs every year.
这项正在讨论的方案将会允许老年医保官员就美国销售的数千种处方药中一小部分药价进行谈判。它将从大约10种药物开始，到20种药物结束。一些国会议员起初希望老年医保官员每年对多达250种高价药的价格进行谈判。

Although the number is small, the drugs that would be covered by the proposal make up a large amount of the money Medicare patients spend each year.
尽管数量很少，但是提案将要覆盖的药物占据老年医保患者每年支付的大量资金。

A study by the Kaiser Family Foundation released this year found that the 10 top-selling drugs covered under Medicare made up 16 percent of spending in 2019. The top 50 drugs made up 80 percent of spending.
凯撒家庭基金会今年发布的一项研究发现，老年医保覆盖的前10种畅销药占到了2019年支出的16%。前50种畅销药占到了支出的80%。

Complex system
复杂体系

In many other countries, governments are able to negotiate drug prices and bring down the cost for a single national health care system. In the United States, however, people under 65 are mostly covered by for-profit health insurance companies.
在其它许多国家，政府能够就药价进行谈判，并降低单一国家医保系统的成本。然而在美国65岁以下人士大多由营利性医疗保险公司承保。

Americans 65 years and older can received Medicare, which takes the place of private insurance. But for many years, Medicare did not offer prescription drug coverage. Older Americans had to pay for medication or get additional private insurance to pay for it.
65岁及以上美国人都可以获得老年医保，它取代了私营保险。但是多年来，老年保险不提供处方药承保。美国老年人不得不支付药费，或是购买额外的私营保险来支付费用。

In 2003, Congress created a new Medicare drug plan, which was meant to help older Americans pay for their medication. Many believe it was poorly designed. The plan asks each insurance company to negotiate with each drug company, rather than using the power of Medicare to force drug companies to lower their prices.
2003年，国会制定了一项新的医保药品方案，旨在帮助美国老年人支付药费。许多人认为它设计很差。该方案要求每家保险公司与每家药企协商，而不是利用老年医保的权力迫使药企降价。

‘Subsidizing R&D for the world'
“为世界研发提供补贴”

For years, critics of drug companies have pointed out that they set prices in the U.S. far above those in other countries where they sell the same drugs. A study by the research organization Rand Corporation compared the U.S. with 32 other countries. It found that drugs cost about 256 percent more in the U.S.
药企的批评者指出，多年来，药企在美国的定价远远高于其它国家。研究机构兰德公司的一项研究将美国同其它32个国家进行了比较。它发现美国的药品费用高出大约256%。

"Americans are paying for "R&D for the world," said Lovisa Gustafsson. She is vice president of the Controlling Health Care Costs program at the Commonwealth Fund, a research organization in Washington, D.C.
洛维萨·古斯塔夫森表示：“美国人正在为世界研发掏腰包。”她是民福基金医保成本控制项目的副总裁，这是华盛顿特区的一家研究机构。

R&D stands for Research and Development, or the science behind finding new drugs and bringing them to the market. R&D is very costly. Many drug companies include R&D cost in the prices of their products sold in the United States.
研发代表研究与开发，即寻找新药并将其推向市场背后的科学。研发成本非常高。许多制药公司在美国销售的产品价格中包含了研发成本。

"Patients in the U.S. face far higher cost-sharing than in a lot of other countries," Gustafsson said. She added that even Americans with insurance do not always have the money to buy their needed medications. She also says there are many studies that show about 25 percent of Americans have difficulty paying for their medications, even with insurance.
古斯塔夫森说：“与许多其他国家相比，美国患者要分摊的费用要高得多。”她补充说，即使有保险的美国人也不是总能买得起他们所需的药物。她还表示，许多研究表明，即使有保险，仍有约 25% 的美国人难以支付药物费用。

Putting a lid on costs
限制费用

The proposal being considered in Congress calls for a limit on the yearly amount Medicare patients can be asked to pay for their medication.
国会正在考虑的提案要求限制医保患者每年要支付的药费。

Jo Ann Jenkins is the head of the AARP, a powerful Washington organization that represents older Americans.
乔·安·詹金斯是美国退休人士协会的负责人，这是华盛顿一家代表美国老年人的强大组织。

"Allowing Medicare to finally negotiate drug prices is a big win for seniors," she said. She called the proposed change a "real relief for seniors."
她表示：“允许老年医保最终协商药价对老年人来说是一次巨大的胜利。”她称该提案改变了老年人真实焦虑。

Drug firms unhappy
药企不爽

PhRMA is a powerful trade organization that represents the drug industry. It reacted unhappily to news of the proposal.
美国药物研究和制造商协会是一家代表制药业的强大贸易组织。它对该提案消息颇感不爽。

The head of PhRMA, Stephen J. Ubl, said in a statement that the proposal would harm the environment that "brought us lifesaving vaccines and therapies to combat COVID-19,"
美国药物研究和制造商协会负责人斯蒂芬·J·乌布勒在一份声明中表示，该提案将会损害为我们带来新冠肺炎救命疫苗和疗法的客观环境。

"It gives the government the power to dictate how much a medicine is worth and leaves many patients facing a future with less access to medicines and fewer new treatments," Ubl added.
乌布勒还说：“它赋予政府权力来决定一种药物的价值，并使许多患者面临更难获得药物和新疗法的未来。”

Industry claims exaggerated?
行业说法夸大其词？

Many supporters of permitting the government to negotiate drug prices say that the drug companies are exaggerating the effects of the proposal on their industry.
许多允许政府谈判药价的支持者表示，制药公司夸大了该提案对其行业的影响。

In August, the Congressional Budget Office released the results of a study that looked at what would happen if drug companies were forced to accept lower profits. The study found it would decrease the number of new drugs on the market by .05 percent.
今年8月，国会预算办公室公布了一项研究结果，该研究着眼于如果药企被迫接受较低的利润会发生什么。研究发现，它将使市场上的新药数量减少0.05%。

I'm Susan Shand.
我是苏珊·尚德。