各州应允许医疗补助受益人根据自己的选择购买健康计划，并提供随收入提高逐渐减少的风险校正医疗补助拨款。

States should then allow Medicaid recipients to purchase a health plan of their choosing with a risk-adjusted Medicaid grant that phases out as income rises.

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几年来纽约州一直通过提供高额的公共医疗补助系统津贴来维护那些医疗水平欠佳的医院和疗养院，该系统一直在提供一些没有必要的服务。

For years New York has subsidised inefficient hospitals and nursing homes through high Medicaid reimbursement rates, providing an incentive to provide unnecessary services.

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未来三年，纽约市将会转移全部的公共医疗补助人群至“管理型医疗保健”体系，即支付其他公司一定费委托其为贫困者提供医疗保障，而不是为贫困者的每一项医疗开销逐一买单。

Over the next three years, New York will move its entire Medicaid population into "managed care", paying companies a set rate to tend to the poor, rather than paying a fee for each service.

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