{"id":8208,"date":"2024-03-01T09:00:07","date_gmt":"2024-03-01T00:00:07","guid":{"rendered":"https:\/\/wp.meccari.jp\/?p=8208"},"modified":"2024-03-01T14:14:26","modified_gmt":"2024-03-01T05:14:26","slug":"menu_60","status":"publish","type":"post","link":"https:\/\/wp.meccari.jp\/eigocafe\/menu_60\/","title":{"rendered":"Menu 60\u3000\u533b\u7642\u4fdd\u967a\u306b\u95a2\u3059\u308b\u82f1\u8a9e\u8868\u73fe"},"content":{"rendered":"\"\"\r\n

\u3053\u3093\u306b\u3061\u306f\u3002\u300c\u533b\u5b66\u82f1\u8a9e\u30ab\u30d5\u30a7<\/strong><\/span>\u300d\u306b\u3088\u3046\u3053\u305d\uff01<\/span><\/p>\r\n

\u3053\u3053\u306f\u300c\u30b3\u30fc\u30d2\u30fc1\u676f\u5206\u300d\u306e\u6642\u9593\u3067\u3001\u533b\u5b66\u82f1\u8a9e\u306b\u307e\u3064\u308f\u308b\u8a71\u3092\u6c17\u8efd\u306b\u697d\u3057\u3093\u3067\u3044\u305f\u3060\u304f\u30b3\u30fc\u30ca\u30fc\u3067\u3059\u3002<\/span><\/p>\r\n

\u672c\u65e5\u306e\u30c6\u30fc\u30de\u306f\u300c\u533b\u7642\u4fdd\u967a\u306b\u95a2\u3059\u308b\u82f1\u8a9e\u8868\u73fe<\/strong><\/span>\u300d\u3067\u3059\u3002<\/span><\/p>\r\n

\u65e5\u672c\u306b\u306f\u300c\u56fd\u6c11\u5065\u5eb7\u4fdd\u967a<\/strong>\u300dNational Health Insurance<\/strong> \u3068\u3044\u3046\u533b\u7642\u4fdd\u967a\u304c\u3042\u308a\u307e\u3059\u304c\u3001\u56fd\u969b\u6bd4\u8f03\u306b\u304a\u3044\u3066\u65e5\u672c\u306e\u533b\u7642\u4fdd\u967a\u5236\u5ea6\u306f National Health Insurance model \u306b\u306f\u5206\u985e\u3055\u308c\u307e\u305b\u3093\u3002\u307e\u305f\u7c73\u56fd\u306a\u3069\u306e\u82f1\u8a9e\u570f\u3067\u533b\u7642\u4fdd\u967a\u3092\u5229\u7528\u3059\u308b\u969b\u306b\u306f\u3001 deductible<\/strong> \u3084 copay<\/strong> \u306a\u3069\u805e\u304d\u6163\u308c\u306a\u3044\u7528\u8a9e\u306b\u6238\u60d1\u3046\u65b9\u3082\u591a\u3044\u3053\u3068\u3067\u3057\u3087\u3046\u3002<\/span><\/p>\r\n

\u305d\u3053\u3067\u4eca\u6708\u306f\u3001\u300c\u533b\u7642\u4fdd\u967a\u306b\u95a2\u3059\u308b\u82f1\u8a9e\u8868\u73fe<\/strong>\u300d\u3092\u3054\u7d39\u4ecb\u3057\u305f\u3044\u3068\u601d\u3044\u307e\u3059\u3002<\/span><\/p>\r\n

\u65e5\u672c\u306e\u533b\u7642\u4fdd\u967a\u5236\u5ea6\u306f National Health Insurance model \u3058\u3083\u306a\u3044\u306e\uff1f<\/strong><\/span><\/span>
\r\n\u300c\u533b\u7642\u4fdd\u967a<\/strong>\u300d\u306f\u82f1\u8a9e\u3067\u306f health insurance<\/strong><\/span> \u3068\u306a\u308a\u307e\u3059\u3002\u305d\u3057\u3066\u3053\u306e health insurance \u306e\u5236\u5ea6\u3067\u3042\u308b\u300c\u533b\u7642\u4fdd\u967a\u5236\u5ea6<\/strong>\u300d\u306f healthcare system<\/strong> \u3084 health insurance system<\/strong> \u3068\u547c\u3070\u308c\u3001\u305d\u306e model \u306f\u56fd\u306b\u3088\u3063\u3066\u7570\u306a\u308a\u307e\u3059\u3002<\/span><\/p>\r\n

\u3053\u308c\u3089\u306e models \u3092\u8003\u3048\u308b\u4e0a\u3067\u91cd\u8981\u306a\u8981\u7d20\u304c insurers\/insurance companies\/payers<\/strong>\u300c\u4fdd\u967a\u63d0\u4f9b\u8005<\/strong>\u300d\u3068\u300c\u533b\u7642\u63d0\u4f9b\u8005<\/strong>\u300dproviders<\/strong> \u3067\u3059\u3002<\/span><\/p>\r\n

insurance companies<\/strong>\u300c\u4fdd\u967a\u4f1a\u793e<\/strong>\u300d\u306f\u300c\u4fdd\u967a\u3092\u63d0\u4f9b\u3057\u3066\u304f\u308c\u308b\u8005<\/strong>\u300d\u3068\u3057\u3066 insurers<\/strong><\/span> \u3068\u547c\u3070\u308c\u308b\u4ed6\u3001\u60a3\u8005\u306a\u3069\u306e\u300c\u88ab\u4fdd\u967a\u8005\u300d\u306e\u305f\u3081\u306b\u300c\u4fdd\u967a\u91d1\u3092\u6255\u3063\u3066\u304f\u308c\u308b\u8005<\/strong>\u300d\u3068\u3057\u3066 payers<\/strong><\/span> \u3068\u3082\u547c\u3070\u308c\u307e\u3059\u3002<\/span><\/p>\r\n

\u305d\u3057\u3066\u3001\u75c5\u9662\u3084\u533b\u7642\u5f93\u4e8b\u8005\u306f\u300c\u533b\u7642\u63d0\u4f9b\u8005<\/strong>\u300d\u3068\u3057\u3066 healthcare providers<\/strong><\/span> \u3084 providers<\/strong><\/span> \u3068\u547c\u3070\u308c\u307e\u3059\u3002<\/span><\/p>\r\n

\u4e16\u754c\u306e\u533b\u7642\u4fdd\u967a\u5236\u5ea6\u306f\u3053\u306e3\u3064\u306e\u8981\u7d20\u304b\u3089\u4e0b\u8a18\u306e4\u3064\u306b\u5927\u304d\u304f\u5206\u985e\u3055\u308c\u307e\u3059\u3002<\/span><\/p>\r\n

\u2022\u3000<\/em>Beveridge<\/span> model<\/strong><\/span>
\r\n\u2022\u3000<\/em>National Health Insurance<\/span> Model<\/strong><\/span>
\r\n\u2022\u3000<\/em>Bismarck<\/span> model<\/strong><\/span>
\r\n\u2022\u3000<\/em>Out-of-Pocket<\/span> model<\/strong><\/span><\/p>\r\n

\u3053\u308c\u3089\u306e\u5236\u5ea6\u306b\u306f\u3069\u306e\u3088\u3046\u306a\u7279\u5fb4\u304c\u3042\u308a\u3001\u65e5\u672c\u306e\u533b\u7642\u4fdd\u967a\u5236\u5ea6\u306f\u3069\u308c\u306b\u5206\u985e\u3055\u308c\u308b\u306e\u3067\u3057\u3087\u3046\u304b\uff1f1\u3064\u305a\u3064\u898b\u3066\u3044\u304d\u307e\u3057\u3087\u3046\u3002<\/span><\/p>\r\n

\u307e\u305a\u306f Beveridge model<\/strong><\/span> \u3067\u3059\u3002\u3053\u306e Beveridge \u3068\u306f\u5236\u5ea6\u3092\u63d0\u5531\u3057\u305f\u82f1\u56fd\u4eba\u306e William Beveridge<\/strong> \u304b\u3089\u3064\u3044\u305f\u540d\u79f0\u3067\u3059\u3002\u300c\u6c34\u4ee5\u5916\u306e\u98f2\u307f\u7269<\/strong>\u300d\u3067\u3042\u308b beverage<\/strong> \u3068\u306f\u30b9\u30da\u30eb\u3082\u767a\u97f3\u3082\u7570\u306a\u308b\u306e\u3067\u6ce8\u610f\u3057\u3066\u304f\u3060\u3055\u3044\u3002<\/span><\/p>\r\n

Beveridge model \u3067\u306f insurers \u3082 providers \u3082 government<\/strong>\u300c\u653f\u5e9c<\/strong>\u300d\u3068\u4e00\u4f53\u5316\u3057\u3066\u3044\u307e\u3059\u3002\u3064\u307e\u308a\u4fdd\u967a\u63d0\u4f9b\u8005\u3082\u533b\u7642\u63d0\u4f9b\u8005\u3082\u300c\u56fd\u55b6<\/strong>\u300d\u3068\u3057\u3066\u6a5f\u80fd\u3057\u3066\u3044\u308b\u306e\u3067\u3059\u3002<\/span><\/p>\r\n

\u3053\u306e Beveridge model \u306e\u4ee3\u8868\u4f8b\u304c\u82f1\u56fd<\/strong>\u3067\u3059\u3002\u30b3\u30ed\u30ca\u798d\u3067\u306f\u65e5\u672c\u3067\u3082\u82f1\u56fd\u306e National Health Service (NHS)<\/strong><\/span> \u306e\u540d\u79f0\u3092\u805e\u304f\u6a5f\u4f1a\u304c\u5897\u3048\u305f\u3068\u601d\u3044\u307e\u3059\u304c\u3001\u82f1\u56fd\u3067\u306f\u4e00\u90e8\u306e private sectors \u3092\u9664\u304d\u3001\u307b\u307c\u5168\u3066\u306e\u533b\u7642\u304c\u3053\u306e NHS \u306e\u7ba1\u8f44\u3067\u63d0\u4f9b\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/span><\/p>\r\n

National Health Insurance model<\/strong><\/span> \u306f\u3053\u306e Beveridge model \u304b\u3089 providers \u304c\u300c\u6c11\u55b6\u300d\u3068\u306a\u3063\u305f\u3082\u306e<\/strong>\u3068\u8003\u3048\u3089\u308c\u307e\u3059\u3002\u3053\u306e National Health Insurance model \u306e\u4ee3\u8868\u4f8b\u306f\u30ab\u30ca\u30c0<\/strong>\u3067\u3059\u304c\u3001\u30ab\u30ca\u30c0\u3067\u306f insurers \u306f government \u3068\u4e00\u4f53\u5316\u3057\u3066\u304a\u308a\u3001Beveridge model \u3068\u540c\u69d8\u306b single payer \u3068\u3057\u3066\u6a5f\u80fd\u3057\u3066\u3044\u308b\u305f\u3081\u306b\u3001\u3053\u308c\u30892\u3064\u306f single-payer model<\/strong> \u3068\u3082\u547c\u3070\u308c\u3066\u3044\u307e\u3059\u3002\u3069\u3061\u3089\u3067\u3082\u533b\u7642\u4fdd\u967a\u306f\u300c\u7a0e\u91d1<\/strong>\u300d\u4e3b\u4f53\u3067\u8cc4\u308f\u308c\u307e\u3059\u304c\u3001National Health Insurance model \u3067\u306f\u533b\u5e2b\u3084\u75c5\u9662\u306a\u3069\u306e providers \u306f\u300c\u6c11\u55b6<\/strong>\u300d\u3068\u3057\u3066\u6a5f\u80fd\u3057\u3066\u3044\u308b\u306e\u304c Beveridge model \u3068\u306f\u7570\u306a\u308b\u70b9\u3067\u3059\u3002<\/span><\/p>\r\n

\u3053\u308c\u3089 single-payer model \u3068\u306f\u7570\u306a\u308a\u3001\u8907\u6570\u306e insurers \u304c\u5b58\u5728\u3057\u3066 multiple-payer model \u3068\u306a\u308a\u3001\u305d\u3057\u3066 insurers \u3068 providers \u306e\u4e21\u65b9\u304c\u300c\u6c11\u55b6\u300d<\/strong>\u3068\u3057\u3066\u6a5f\u80fd\u3057\u3066\u3044\u308b\u306e\u304c Bismarck model<\/strong><\/span> \u306a\u306e\u3067\u3059\u3002\u3053\u306e Bismarck \u306f\u30c9\u30a4\u30c4\u4eba\u306e Otto Von Bismarck \u304b\u3089\u3064\u3044\u305f\u540d\u79f0\u3067\u3059\u304c\u3001\u305d\u306e\u767a\u97f3\u306f\u65e5\u672c\u8a9e\u7684\u306a\u300c\u30d3\u30b9\u30de\u30eb\u30af\u300d\u3067\u306f\u306a\u304f\u3001\u300c\u30d3\u30a3<\/strong>\u30ba\u30de\u30a5\u30af\u300d\u306e\u3088\u3046\u306b\u306a\u308b\u306e\u3067\u6ce8\u610f\u3057\u3066\u304f\u3060\u3055\u3044\u3002<\/span><\/p>\r\n

\u3053\u306e Bismarck model \u306e\u4ee3\u8868\u4f8b\u306f\u305d\u306e\u540d\u79f0\u304b\u3089\u3082\u63a8\u5bdf\u3067\u304d\u308b\u3088\u3046\u306b\u30c9\u30a4\u30c4<\/strong>\u3067\u3059\u304c\u3001\u65e5\u672c\u306e\u533b\u7642\u4fdd\u967a\u5236\u5ea6\u3082\u3053\u306e Bismarck model \u306b\u5206\u985e\u3055\u308c\u308b<\/strong><\/span>\u306e\u3067\u3059\u3002<\/span><\/p>\r\n

\u65e5\u672c\u306e\u533b\u7642\u4fdd\u967a\u5236\u5ea6\u3092 National Health Insurance model \u3068\u8aa4\u89e3\u3057\u3066\u3044\u308b\u65b9\u3082\u591a\u304f\u3044\u3089\u3063\u3057\u3083\u3044\u307e\u3059\u304c\u3001\u305d\u308c\u306f\u65e5\u672c\u306e\u300c\u56fd\u6c11\u5065\u5eb7\u4fdd\u967a<\/strong>\u300d\u306e\u82f1\u8a9e\u8a33\u304c National Health Insurance (NHI)<\/strong> \u3060\u304b\u3089\u3067\u3057\u3087\u3046\u3002\u78ba\u304b\u306b\u65e5\u672c\u306e\u533b\u7642\u306f\u653f\u5e9c\u4e3b\u4f53\u3067\u533b\u7642\u8cbb\u304c\u5b9a\u307e\u3063\u3066\u304a\u308a\u898f\u5236\u3082\u591a\u3044\u306e\u3067\u3059\u304c\u3001\u6c11\u55b6\u306e insurers \u3068 providers \u304c\u8907\u6570\u5b58\u5728\u3057\u3001\u533b\u7642\u8cbb\u306f\u300c\u7a0e\u91d1\u300d\u3067\u306f\u306a\u304f\u300c\u4fdd\u967a\u6599<\/strong>\u300d\u3068\u3057\u3066\u8cc4\u308f\u308c\u3066\u3044\u307e\u3059\u3002\u3067\u3059\u304b\u3089\u65e5\u672c\u306e\u533b\u7642\u4fdd\u967a\u5236\u5ea6\u306f Bismarck model \u306a\u306e\u3067\u3059\u3002<\/span><\/p>\r\n

\u305d\u3057\u3066 insurers \u304c\u57fa\u672c\u7684\u306b\u5b58\u5728\u305b\u305a\u3001\u6c11\u9593\u306e providers \u306b\u60a3\u8005\u672c\u4eba\u304c\u533b\u7642\u8cbb\u3092 out-of-pocket<\/strong>\u300c\u81ea\u5df1\u8ca0\u62c5<\/strong>\u300d\u3067\u652f\u6255\u3046\u3068\u3044\u3046\u5236\u5ea6\u304c Out-of-Pocket model<\/strong><\/span> \u3068\u306a\u308a\u307e\u3059\u3002<\/span><\/p>\r\n

\u3061\u306a\u307f\u306b\u300c\u56fd\u6c11\u7686\u4fdd\u967a\u5236\u5ea6<\/strong>\u300d\u306e\u3053\u3068\u3092\u82f1\u8a9e\u3067 national health insurance system \u3068\u8868\u73fe\u3059\u308b\u3068\u8aa4\u89e3\u3055\u308c\u3066\u3044\u308b\u65b9\u3082\u591a\u3044\u3088\u3046\u3067\u3059\u304c\u3001\u300c\u56fd\u6c11\u5168\u54e1\u304c\u305d\u306e\u793e\u4f1a\u7684\u80cc\u666f\u306b\u95a2\u308f\u3089\u305a\u306b\u5fc5\u8981\u306a\u533b\u7642\u3092\u53d7\u3051\u308b\u3053\u3068\u304c\u3067\u304d\u308b<\/strong>\u300d\u3068\u3044\u3046\u610f\u5473\u3067\u306f\u3001 universal health coverage (UHC)<\/strong><\/span> \u3084 universal insurance system<\/strong><\/span> \u3068\u3044\u3046\u7528\u8a9e\u304c\u4f7f\u308f\u308c\u307e\u3059\u306e\u3067\u899a\u3048\u3066\u304a\u3044\u3066\u304f\u3060\u3055\u3044\u306d\u3002<\/span><\/p>\r\n

HMO? POS? EPO? PPO? \u77e5\u3063\u3066\u304a\u304d\u305f\u3044\u7c73\u56fd\u533b\u7642\u4fdd\u967a\u306e\u7528\u8a9e<\/strong><\/span><\/span>
\r\n\u4e0a\u8a18\u306e4\u3064\u304c\u4e16\u754c\u306e\u533b\u7642\u4fdd\u967a\u5236\u5ea6\u306e\u5206\u985e\u306a\u306e\u3067\u3059\u304c\u3001GDP\u4e16\u754c1\u4f4d\u306e\u7c73\u56fd\u306f\u4e00\u4f53\u3069\u308c\u306b\u5206\u985e\u3055\u308c\u308b\u306e\u3067\u3057\u3087\u3046\u304b\uff1f<\/span><\/p>\r\n

\u7c73\u56fd\u306e\u533b\u7642\u4fdd\u967a\u5236\u5ea6\u306f\u3088\u304f hodgepodge of systems<\/strong><\/span> \u3068\u63f6\u63c4\u3055\u308c\u305f\u308a\u3057\u307e\u3059\u3002\u3053\u306e hodgepodge<\/strong> \u3068\u306f\u300c\u3054\u3061\u3083\u6df7\u305c<\/strong>\u300d\u3068\u3044\u3046\u30a4\u30e1\u30fc\u30b8\u306e\u7528\u8a9e\u3067\u3001\u7c73\u56fd\u3067\u306f\u4e0a\u8a184\u3064\u306e\u5236\u5ea6\u304c\u6df7\u5728\u3057\u3066\u3044\u307e\u3059\u3002<\/span><\/p>\r\n

\u7c73\u56fd\u306b\u306f Army<\/strong>\u300c\u9678\u8ecd<\/strong>\u300d\u3001Air Force<\/strong>\u300c\u7a7a\u8ecd<\/strong>\u300d\u3001Navy<\/strong>\u300c\u6d77\u8ecd<\/strong>\u300d\u3001Marine Corps<\/strong>\u300c\u6d77\u5175\u968a<\/strong>\u300d\u3001\u305d\u3057\u3066 Coast Guard<\/strong>\u300c\u6cbf\u5cb8\u8b66\u5099\u968a<\/strong>\u300d\u3068\u3044\u30465\u3064\u306e US Armed Forces<\/strong> \u304c\u5b58\u5728\u3057\u307e\u3059\u304c\u3001\u305d\u308c\u305e\u308c\u306e soldiers<\/strong> \u3084 veterans<\/strong>\u300c\u9000\u5f79\u8ecd\u4eba<\/strong>\u300d \u306b\u306f Beveridge model<\/strong> \u306e\u533b\u7642\u304c\u63d0\u4f9b\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/span><\/p>\r\n

\u307e\u305f\u300165\u6b73\u4ee5\u4e0a\u306e\u9ad8\u9f62\u8005\u304c\u5bfe\u8c61\uff08\u4ed6\u306b\u3082\u7279\u5b9a\u306e\u969c\u5bb3\u3084 end-stage-renal disease \u3084 amyotrophic lateral sclerosis \u304c\u3042\u308b\u4eba\u3082\u5bfe\u8c61\uff09\u3068\u306a\u308b Medicare<\/strong><\/span> \u3068\u3001\u4e00\u5b9a\u306e\u6761\u4ef6\u3092\u6e80\u305f\u3057\u305f\u4f4e\u6240\u5f97\u8005\u304c\u5bfe\u8c61\u3068\u306a\u308b Medicaid<\/strong><\/span> \u3068\u3044\u3046\u516c\u7684\u533b\u7642\u4fdd\u967a\u306f National Health Insurance model<\/strong> \u3068\u3057\u3066\u306e\u7279\u5fb4\u3092\u6301\u3061\u307e\u3059\u3002<\/span><\/p>\r\n

\u305d\u3057\u3066\u591a\u304f\u306e\u52b4\u50cd\u8005\u306f\u3001Bismarck model<\/strong> \u306e\u3088\u3046\u306b\u6c11\u9593\u306e\u533b\u7642\u4fdd\u967a\u306b\u52a0\u5165\u3057\u3066\u3044\u307e\u3059\u3002<\/span><\/p>\r\n

\u65e5\u672c\u3067\u306f fee-for-service plan<\/strong><\/span>\/indemnity plan<\/strong><\/span>\u300c\u51fa\u6765\u9ad8\u6255\u3044\u5236\u5ea6<\/strong>\u300d\u304c\u4e00\u822c\u7684\u3067\u3059\u304c\u3001\u7c73\u56fd\u306e\u533b\u7642\u4fdd\u967a\u3067\u306f\u5b9a\u984d\u306e\u81ea\u5df1\u8ca0\u62c5\u7387\u306b\u6cbf\u3063\u3066\u533b\u7642\u8cbb\u3092\u6255\u3046\u3068\u3044\u3046 managed care<\/strong><\/span> \u304c\u4e00\u822c\u7684\u3067\u3059\u3002<\/span><\/p>\r\n

\u305d\u3057\u3066\u3001\u3053\u306e managed care \u306b\u306f\u4e0b\u8a18\u306e4\u3064\u304c\u5b58\u5728\u3057\u307e\u3059\u3002<\/span><\/p>\r\n

\u2022\u3000<\/em>Health Maintenance Organization (HMO)<\/strong><\/span>
\r\n\u2022\u3000<\/em>Point of Service (POS)<\/strong><\/span>
\r\n\u2022\u3000<\/em>Exclusive Provider Organization (EPO)<\/strong><\/span>
\r\n\u2022\u3000<\/em>Preferred Provider Organization (PPO)<\/strong><\/span><\/p>\r\n

HMO<\/strong><\/span> \u3067\u306f\u3001\u305d\u306e HMO \u304c\u5b9a\u3081\u308b in-network<\/strong><\/span>\u300c\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u5185<\/strong>\u300d\u3067 primary care physician (PCP)<\/strong><\/span> \u3092\u9078\u3093\u3067\u53d7\u8a3a\u3059\u308b\u3053\u3068\u304c\u6c42\u3081\u3089\u308c\u307e\u3059\u3002\u5c02\u9580\u533b\u306b\u8a3a\u5bdf\u3057\u3066\u3082\u3089\u3046\u5fc5\u8981\u304c\u3042\u308b\u5834\u5408\u306b\u306f\u305d\u306e PCP \u304b\u3089\u306e referral<\/strong><\/span>\u300c\u7d39\u4ecb\u72b6<\/strong>\u300d\u304c\u5fc5\u8981\u3067\u3001\u305d\u306e\u5c02\u9580\u533b\u3084\u533b\u7642\u6a5f\u95a2\u3082\u5fc5\u305a in-network \u3067\u3042\u308b\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059\u3002\u307e\u305f\u7d39\u4ecb\u5148\u306f PCP \u304c\u6c7a\u5b9a\u3057\u3001\u60a3\u8005\u306b\u306f\u539f\u5247\u3068\u3057\u3066\u9078\u629e\u6a29\u306f\u3042\u308a\u307e\u305b\u3093\u3002<\/span><\/p>\r\n

POS<\/strong><\/span> \u3067\u306f\u6700\u521d\u306b in-network PCP \u306b\u53d7\u8a3a\u3059\u308b\u5fc5\u8981\u304c\u3042\u308b\u53cd\u9762\u3001\u8ffd\u52a0\u8cbb\u7528\u3092\u6255\u3048\u3070 point of service \u3068\u3057\u3066 out-of-network<\/strong><\/span>\u300c\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u5916<\/strong>\u300d\u306e\u5c02\u9580\u533b\u3084\u533b\u7642\u6a5f\u95a2\u306b\u7d39\u4ecb\u3057\u3066\u3082\u3089\u3046\u3053\u3068\u304c\u53ef\u80fd\u3067\u3059\u3002\u305f\u3060\u3057\u3001\u305d\u306e\u5834\u5408\u306b\u306f PCP \u304b\u3089\u306e referral \u304c\u5fc5\u8981\u3068\u306a\u308a\u307e\u3059\u3002<\/span><\/p>\r\n

EPO<\/strong><\/span> \u3067\u306f in-network \u3067\u3042\u308c\u3070\u6700\u521d\u304b\u3089\u533b\u5e2b\u3084\u533b\u7642\u6a5f\u95a2\u3092\u81ea\u7531\u306b\u9078\u3076\u3053\u3068\u304c\u3067\u304d\u307e\u3059\u3002\u3067\u3059\u304b\u3089 referral \u306f\u539f\u5247\u4e0d\u8981\u3068\u306a\u308a\u307e\u3059\u3002\u305f\u3060\u3057 exclusive \u3068\u3044\u3046\u540d\u79f0\u306e\u901a\u308a\u3001out-of-network \u306e\u5c02\u9580\u533b\u3084\u533b\u7642\u6a5f\u95a2\u3092\u53d7\u8a3a\u3059\u308b\u969b\u306b\u306f\u5b8c\u5168\u306a\u81ea\u5df1\u8ca0\u62c5\u3068\u306a\u308a\u307e\u3059\u3002<\/span><\/p>\r\n

PPO<\/strong><\/span> \u306f\u3053\u308c\u3089\u306e managed care \u306e\u4e2d\u3067\u6700\u3082\u81ea\u7531\u5ea6\u304c\u9ad8\u304f\u3001\u5951\u7d04\u3057\u3066\u3044\u308b\u8907\u6570\u306e providers \u304b\u3089\u81ea\u7531\u306b\u533b\u5e2b\u3084\u533b\u7642\u6a5f\u95a2\u3092\u9078\u3076\u3053\u3068\u304c\u3067\u304d\u307e\u3059\u3002\u307e\u305f\u8ffd\u52a0\u6599\u91d1\u3092\u652f\u6255\u3046\u3053\u3068\u3067\u3001 out-of-network \u306e\u5c02\u9580\u533b\u3084\u533b\u7642\u6a5f\u95a2\u3092\u53d7\u8a3a\u3059\u308b\u3053\u3068\u3082\u53ef\u80fd\u3068\u306a\u308a\u307e\u3059\u3002<\/span><\/p>\r\n

\u3053\u306e\u3088\u3046\u306b\u7c73\u56fd\u306e\u52b4\u50cd\u8005\u306f\u3001\u81ea\u5206\u3067\u3069\u306e\u533b\u7642\u4fdd\u967a\u3092\u9078\u3076\u306e\u304b\u3092\u6c7a\u3081\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u3002\u305d\u3057\u3066\u81ea\u7531\u5ea6\u304c\u9ad8\u304f\u306a\u308b\u7a0b\u306b\u9ad8\u984d\u3068\u306a\u308b<\/strong>\u306e\u304c\u7c73\u56fd\u306e\u539f\u5247\u3068\u8a00\u3048\u307e\u3059\u3002\u307e\u305f\u3053\u3046\u3044\u3063\u305f\u6c11\u9593\u306e\u533b\u7642\u4fdd\u967a\u3092\u6d3b\u7528\u3067\u304d\u306a\u3044\u4eba\u304c\u3001 uninsured<\/strong><\/span> \u3068\u3057\u3066\u6570\u591a\u304f\u5b58\u5728\u3057\u3066\u3044\u307e\u3059\u3002\u305d\u3046\u3044\u3063\u305f\u65b9\u9054\u306f\u672c\u4eba\u306e\u610f\u601d\u306b\u95a2\u308f\u3089\u305a\u3001 Out-of-Pocket model<\/strong> \u3068\u3057\u3066\u533b\u7642\u3092\u53d7\u3051\u3056\u308b\u3092\u5f97\u306a\u3044\u3068\u3044\u3046\u306e\u304c\u7c73\u56fd\u306e\u73fe\u72b6\u306a\u306e\u3067\u3059\u3002<\/span><\/p>\r\n

\u3053\u3046\u3044\u3063\u305f\u72b6\u6cc1\u3092\u6539\u5584\u3059\u3079\u304f\u5c0e\u5165\u3055\u308c\u305f Obamacare<\/strong><\/span> \u3068\u3044\u3046\u6cd5\u6848\u3067\u3059\u304c\u3001\u305d\u306e\u6b63\u5f0f\u540d\u79f0\u306f Patient Protection and Affordable Care Act (PPACA)<\/strong> \u3067\u3042\u308a\u3001\u7701\u7565\u3057\u3066 Affordable Care Act (ACA)<\/strong> \u3068\u3082\u547c\u3070\u308c\u3066\u3044\u307e\u3059\u3002<\/span><\/p>\r\n

\u3054\u5b58\u77e5\u306e\u901a\u308a\u3001\u81ea\u7531\u3092\u91cd\u3093\u3058\u308b\u7c73\u56fd\u3067\u306f\u3053\u306e Obamacare \u306b\u5bfe\u3059\u308b\u53cd\u767a\u3082\u5f37\u304f\u3001universal health coverage (UHC) \u3092 socialized medicine \u3068\u3057\u3066\u5acc\u60aa\u3059\u308b\u4eba\u305f\u3061\u304c\u4e00\u5b9a\u6570\u3044\u308b\u306e\u3067\u3059\u3002<\/span><\/p>\r\n

\u305f\u3060 Obamacare \u306e\u5185\u5bb9\u81ea\u4f53\u306f\u3001\u65e5\u672c\u3084\u30c9\u30a4\u30c4\u306e\u3088\u3046\u306a Bismarck model \u306e\u56fd\u304b\u3089\u898b\u3066\u3082\u305d\u308c\u307b\u3069\u5f37\u5236\u529b\u304c\u5f37\u3044\u3082\u306e\u3067\u306f\u306a\u304f\u3001\u7c73\u56fd\u5185\u3067\u3082\u300c\u5185\u5bb9\u81ea\u4f53\u306b\u306f\u540c\u610f\u3059\u308b\u300d\u3068\u3044\u3046\u4eba\u3082\u591a\u3044\u3088\u3046\u3067\u3059\u3002\u3053\u3061\u3089<\/span><\/a>\u306e\u30c8\u30fc\u30af\u30b7\u30e7\u30fc\u3067\u306f\u3001\u9053\u884c\u304f\u4eba\u306b\u300cObamacare \u3068 Affordable Care Act \u306e\u3069\u3061\u3089\u3092\u652f\u63f4\u3059\u308b\u304b\uff1f<\/strong>\u300d\u3068\u5c0b\u306d\u3066\u3044\u307e\u3059\u3002\uff08\u3082\u3061\u308d\u3093\u4e21\u8005\u306f\u540c\u3058\u3082\u306e\u3067\u3059\u3002\uff09\u82f1\u8a9e\u3067\u306f \u201csix of one, half a dozen of the other<\/strong>\u201d\u300c12\u500b\u5165\u308a\u306e\uff11\u30d1\u30c3\u30af\u306e\u5375\u306e\u3046\u3061\u306e6\u500b\u304b\u3001\u3082\u3046\u4e00\u65b9\u306e\u534a\u30d1\u30c3\u30af\u306e\u5375\u304b\u300d\u3068\u3044\u3046\u8868\u73fe\u304c\u3042\u308a\u307e\u3059\u3002\u3053\u308c\u306f\u300c\u53b3\u5bc6\u306b\u8a00\u3048\u3070\u9055\u3044\u306f\u3042\u308b\u306e\u3060\u308d\u3046\u304c\u3001\u307b\u3068\u3093\u3069\u540c\u3058\u306a\u306e\u3067\u3069\u3063\u3061\u3067\u3082\u3044\u3044\u3082\u306e<\/strong>\u300d\u3068\u3044\u3046\u610f\u5473\u306e\u6163\u7528\u8868\u73fe\u3067\u3001\u7701\u7565\u3057\u3066 \u201csix of one<\/strong>\u201d \u306a\u3069\u3068\u3082\u8868\u73fe\u3055\u308c\u307e\u3059\u3002\u3053\u308c\u3092\u898b\u308b\u3068 Obamacare \u306b\u53cd\u5bfe\u3057\u3066\u3044\u3066\u3082\u3001\u5b9f\u969b\u306b\u306f\u591a\u304f\u306e\u4eba\u304c ACA \u306e\u5185\u5bb9\u81ea\u4f53\u306b\u306f\u7406\u89e3\u3092\u793a\u3057\u3066\u3044\u308b\u3053\u3068\u304c\u308f\u304b\u308a\u307e\u3059\u306d\u3002<\/span><\/p>\r\n

premium? deductible? copay? coinsurance? \u77e5\u3063\u3066\u304a\u304d\u305f\u3044\u533b\u7642\u4fdd\u967a\u7528\u8a9e<\/strong><\/span><\/span>
\r\n\u3067\u306f\u3001\u3053\u3053\u304b\u3089\u533b\u7642\u4fdd\u967a\u306b\u52a0\u5165\u3057\u305f\u969b\u306b\u4f7f\u308f\u308c\u308b\u7528\u8a9e\u3092\u3044\u304f\u3064\u304b\u898b\u3066\u3044\u304d\u307e\u3057\u3087\u3046\u3002<\/span><\/p>\r\n

\u300c\u4fdd\u967a\u52a0\u5165\u8005<\/strong>\u300d\u3067\u3042\u308b enrollee<\/strong> \u304c\u300c\u6bce\u6708\u652f\u6255\u3046\u4fdd\u967a\u6599<\/strong>\u300d\u306e\u3053\u3068\u306f\u3001 monthly premium<\/strong> \u3084\u5358\u7d14\u306b premium<\/strong><\/span> \u3068\u547c\u3070\u308c\u307e\u3059\u3002\u305d\u3057\u3066\u3053\u306e premium \u306f\u4fdd\u967a\u3060\u3051\u3067\u306a\u304f\u3001\u52d5\u753b\u914d\u4fe1\u30b5\u30fc\u30d3\u30b9\u306a\u3069\u306b\u300c\u6bce\u6708\u652f\u6255\u3046\u6599\u91d1<\/strong>\u300d\u3068\u3044\u3046\u610f\u5473\u3067\u3082\u4f7f\u308f\u308c\u307e\u3059\u3002<\/span><\/p>\r\n

\u7c73\u56fd\u306e\u3088\u3046\u306a\u6c11\u9593\u306e\u533b\u7642\u4fdd\u967a\u3067\u306f\u3001 premium \u3092\u652f\u6255\u3044\u59cb\u3081\u308c\u3070\u3059\u3050\u306b insurer \u304c\u533b\u7642\u8cbb\u3092\u6255\u3063\u3066\u304f\u308c\u308b\u308f\u3051\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002enrollee \u304c\u300c\u533b\u7642\u4fdd\u967a\u3092\u6709\u52b9\u3068\u3059\u308b\u305f\u3081\u306b\u6bce\u5e74\u652f\u6255\u308f\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u4e00\u5b9a\u306e\u91d1\u984d<\/strong>\u300d\u306e\u3053\u3068\u3092 deductible<\/strong><\/span> \u3068\u8a00\u3044\u307e\u3059\u3002\u5f62\u5bb9\u8a5e\u306e\u3088\u3046\u306b\u601d\u308f\u308c\u308b\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u304c\u3001\u3053\u308c\u306f\u540d\u8a5e\u3067\u3059\u306e\u3067\u6ce8\u610f\u3057\u3066\u304f\u3060\u3055\u3044\u3002<\/span><\/p>\r\n

\u305d\u3057\u3066\u3001enrollee \u304c\u533b\u7642\u3092\u53d7\u3051\u308b\u969b\u306b\u652f\u6255\u3046\u4e00\u5b9a\u306e\u300c\u81ea\u5df1\u8ca0\u62c5\u91d1\u984d<\/strong>\u300d\u306e\u3053\u3068\u3092 copayment<\/strong><\/span>\u3001\u3082\u3057\u304f\u306f\u5358\u306b copay<\/strong><\/span> \u3068\u8a00\u3044\u307e\u3059\u3002\u4fdd\u967a\u8005\u3067\u3042\u308b insurer\/payer \u304c\u533b\u7642\u8cbb\u3092\u4e00\u7dd2\u306b\u652f\u6255\u3063\u3066\u304f\u308c\u3066\u3044\u308b\u3001\u3068\u3044\u3046\u30a4\u30e1\u30fc\u30b8\u306a\u306e\u3067\u3053\u3046\u547c\u3070\u308c\u3066\u3044\u308b\u306e\u3067\u3059\u3002\u3053\u308c\u3068\u3088\u304f\u4f3c\u305f\u8868\u73fe\u3068\u3057\u3066 coinsurance<\/strong><\/span> \u3068\u3044\u3046\u7528\u8a9e\u304c\u3042\u308a\u307e\u3059\u304c\u3001\u3053\u3061\u3089\u306f\u91d1\u984d\u3067\u306f\u306a\u304f\u300c\u81ea\u5df1\u8ca0\u62c5\u91d1\u5272\u5408<\/strong>\u300d\u3067\u3059\u306e\u3067\u3001\u5b9f\u969b\u306b\u306f %<\/strong> \u3067\u8868\u793a\u3055\u308c\u307e\u3059\u3002<\/span><\/p>\r\n

\u65e5\u672c\u306e\u516c\u7684\u533b\u7642\u4fdd\u967a\u306f\u5927\u5225\u3059\u308b\u3068\u300c\u88ab\u7528\u8005\u4fdd\u967a<\/strong>\u300dEmployee Health Insurance (EHI)<\/strong><\/span> \u3068\u5148\u8ff0\u3057\u305f\u300c\u56fd\u6c11\u5065\u5eb7\u4fdd\u967a<\/strong>\u300dNational Health Insurance (NHI)<\/strong><\/span> \u3001\u305d\u3057\u3066\u300c\u5f8c\u671f\u9ad8\u9f62\u8005\u533b\u7642\u5236\u5ea6<\/strong>\u300d\u306b\u5206\u985e\u3055\u308c\u307e\u3059\u3002\u3053\u306e\u3046\u3061 EHI \u3068 NHI \u306b\u95a2\u3057\u3066\u306f\u82f1\u8a9e\u8868\u73fe\u3082\u660e\u78ba\u3067\u308f\u304b\u308a\u3084\u3059\u3044\u306e\u3067\u3059\u304c\u3001\u300c\u5f8c\u671f\u9ad8\u9f62\u8005\u533b\u7642\u5236\u5ea6<\/strong>\u300d\u306b\u306f\u69d8\u3005\u306a\u82f1\u8a9e\u8868\u73fe\u304c\u4f7f\u308f\u308c\u3066\u3044\u307e\u3059\u3002\u500b\u4eba\u7684\u306b\u306f\u305d\u308c\u3089\u306e\u82f1\u8a9e\u8868\u73fe\u306f\u3069\u308c\u3082\u308f\u304b\u308a\u306b\u304f\u3044\u3068\u611f\u3058\u3066\u304a\u308a\u3001\u79c1\u304c\u8aac\u660e\u3059\u308b\u969b\u306b\u306f Health Insurance for Seniors Aged 75 and Over<\/strong><\/span> \u306e\u3088\u3046\u306a\u3082\u306e\u3092\u4f7f\u3046\u3088\u3046\u306b\u3057\u3066\u3044\u307e\u3059\u3002\u304a\u5f79\u6240\u306a\u3069\u3067\u306f\u305d\u308c\u305e\u308c\u4e8b\u60c5\u3082\u3042\u308b\u3068\u601d\u3044\u307e\u3059\u304c\u3001\u5b9f\u969b\u306b\u82f1\u8a9e\u570f\u306e\u65b9\u306b\u4f1d\u308f\u308a\u3084\u3059\u3044\u8868\u73fe\u3092\u304a\u63a2\u3057\u306e\u65b9\u306f\u3001\u662f\u975e\u3053\u3061\u3089\u306e\u8868\u73fe\u3092\u4f7f\u3063\u3066\u307f\u3066\u304f\u3060\u3055\u3044\u3002<\/span><\/p>\r\n

\u3055\u3066\u3001\u305d\u308d\u305d\u308d\u30ab\u30c3\u30d7\u306e\u30b3\u30fc\u30d2\u30fc\u3082\u6b8b\u308a\u308f\u305a\u304b\u3067\u3059\u3002\u6700\u5f8c\u306b\u533b\u7642\u4fdd\u967a\u306b\u95a2\u3059\u308b\u82f1\u4f1a\u8a71\u8868\u73fe\u3092\u3044\u304f\u3064\u304b\u3054\u7d39\u4ecb\u3057\u307e\u3059\u3002<\/span><\/p>\r\n

\u300c\u4eca\u65e5\u306f\u4fdd\u967a\u8a3c<\/strong>\u3068\u8a3a\u5bdf\u5238<\/strong>\u3092\u304a\u6301\u3061\u3067\u3059\u304b\uff1f\u300d
\r\nDo you happen to have your health insurance card<\/strong> and patient ID card<\/strong> with you today?
\r\n<\/span><\/p>\r\n

\u300c\u5065\u5eb7\u4fdd\u967a\u3092\u5229\u7528\u3057\u305f\u5834\u5408\u306e\u533b\u7642\u8cbb\u306e\u81ea\u5df1\u8ca0\u62c5\u5272\u5408\u306f3\u5272\u3067\u3059<\/strong>\u3002\u300d
\r\nIf you have health insurance, you\u2019ll need to cover 30% of your medical expenses out-of-pocket<\/strong>.
\r\n<\/span><\/p>\r\n

\u300c\u3053\u3061\u3089\u306f\u4fdd\u967a\u9069\u7528\u5916<\/strong>\u3068\u306a\u308a\u307e\u3059\u3002\u300d
\r\nThis service is not covered by insurance<\/strong>.
\r\n<\/span><\/p>\r\n

\u300c\u3053\u306e\u6cbb\u7642\u306f\u8ffd\u52a0\u8cbb\u7528<\/strong>\u304c\u304b\u304b\u308a\u307e\u3059\u3002\u300d
\r\nThere will be an additional charge<\/strong> for this treatment.
\r\n<\/span><\/p>\r\n

\u300c\u4fdd\u967a\u60c5\u5831\u3092\u304a\u6301\u3061\u3067\u306a\u3044\u5834\u5408\u3001\u5168\u984d\u81ea\u5df1\u8ca0\u62c5<\/strong>\u3068\u306a\u308a\u307e\u3059\u3002\u300d
\r\nIf you do not have your insurance information, you will have to pay the full amount yourself<\/strong>.
\r\n<\/span><\/p>\r\n

\u3067\u306f\u3001\u307e\u305f\u306e\u3054\u6765\u5e97\u3092\u304a\u5f85\u3061\u3057\u3066\u304a\u308a\u307e\u3059\u3002<\/span><\/p>\r\n

\u300cDr. \u62bc\u5473\u306e\u533b\u5b66\u82f1\u8a9e\u30ab\u30d5\u30a7\u300d\u3067\u306f\u7686\u3055\u3093\u304b\u3089\u6271\u3063\u3066\u6b32\u3057\u3044\u30c8\u30d4\u30c3\u30af\u3092\u52df\u96c6\u3044\u305f\u3057\u307e\u3059\u3002\u3053\u3061\u3089\u306e\u30ea\u30f3\u30af<\/strong><\/span><\/a>\u304b\u3089\u3053\u306e\u30ab\u30d5\u30a7\u3067\u6271\u3063\u3066\u6b32\u3057\u3044\u3068\u601d\u3046\u533b\u5b66\u82f1\u8a9e\u306e\u30c8\u30d4\u30c3\u30af\u3092\u3054\u81ea\u7531\u306b\u8a18\u8f09\u304f\u3060\u3055\u3044\u3002<\/span><\/p>\r\n

\u56fd\u969b\u533b\u7642\u798f\u7949\u5927\u5b66\u533b\u5b66\u90e8 \u533b\u5b66\u6559\u80b2\u7d71\u62ec\u30bb\u30f3\u30bf\u30fc \u6559\u6388\u3000\u62bc\u5473 \u8cb4\u4e4b<\/p>\r\n

\u00a0<\/div>","protected":false},"excerpt":{"rendered":"\u3053\u3093\u306b\u3061\u306f\u3002\u300c\u533b\u5b66\u82f1\u8a9e\u30ab\u30d5\u30a7\u300d\u306b\u3088\u3046\u3053\u305d\uff01 \u3053\u3053\u306f\u300c\u30b3\u30fc\u30d2\u30fc1\u676f\u5206\u300d\u306e\u6642\u9593\u3067\u3001\u533b\u5b66\u82f1\u8a9e\u306b\u307e\u3064\u308f\u308b\u8a71\u3092\u6c17\u8efd\u306b\u697d\u3057\u3093\u3067\u3044\u305f\u3060\u304f\u30b3\u30fc\u30ca\u30fc\u3067\u3059\u3002 \u672c\u65e5\u306e\u30c6\u30fc\u30de\u306f\u300c\u533b\u7642\u4fdd\u967a\u306b\u95a2\u3059\u308b\u82f1\u8a9e\u8868\u73fe\u300d\u3067\u3059\u3002 \u65e5\u672c\u306b\u306f\u300c\u56fd\u6c11\u5065\u5eb7\u4fdd\u967a\u300dNati","protected":false},"author":14,"featured_media":8228,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"onecolumn-960.php","format":"standard","meta":{"_acf_changed":false,"_jin_ogp_image_url":"","_jin_last_featured_id":0,"footnotes":""},"categories":[63],"tags":[],"class_list":["post-8208","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-eigocafe"],"acf":[],"_links":{"self":[{"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/posts\/8208","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/users\/14"}],"replies":[{"embeddable":true,"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/comments?post=8208"}],"version-history":[{"count":4,"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/posts\/8208\/revisions"}],"predecessor-version":[{"id":8231,"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/posts\/8208\/revisions\/8231"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/media\/8228"}],"wp:attachment":[{"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/media?parent=8208"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/categories?post=8208"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wp.meccari.jp\/api\/wp\/v2\/tags?post=8208"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}