International Circulation: What are the leading differences between United States and China for medicare system， especially for the prevention aspect?

《国际循环》：请您简单评价一下美国与中国医疗卫生体统，尤其是预防医学方面有何不同?

Prof. Weaver: In the United States， everyone at age 65 and older is eligible for government help insurance. Before that age， most people get their help insurance from their employers. Now I know in china that some of the rural help is delivered to the government. But a lot of the cost of medical care is depending on the patient or the family. Now the problem with the united states is that we still have about forty seven million people out of three hundred million people - that will be about one in seven people - have no insurance， none at all. Moreover another thirty million have inadequate insurance. So they have huge financial burdens， in our health care system. The other deficiency in the US health care system is that very little expense to reward physicians for prevention. It is still based on procedures done and number of patient visits， but very little expend on prevention.Thus， one thing that both countries could be doing of best job possible will be trying to maximize the prevention.

Weaver教授：在美国，每名65岁或以上的老年人都有资格获得政府保险，小于这个年龄的人大部分是从雇主那里获得保险。现在我知道在中国，农村地区的保险是政府给的，但是大部分医疗保险的费用还是要患者及其家庭来承担，支付医疗保险。现在美国的问题是我们在3亿人口里面还有大概四千七百万的人没有保险，也就是七个人里面有一人没有保险，完全没有。另外还有三千万的人的保险额度不足。因此在我们的医疗体系里面，他们的经济负担是非常重的。美国医疗体系还有另一个不足是医师做预防工作的报酬很少，医师主要的酬劳还是来自治疗、患者数，但是做预防工作几乎就没有什么报酬。所以，两国的共同之处就是都应该尽可能提高预防工作的重要性。

International Circulation: For example， Dr. HuDayi is urging Chinese doctors to quit smoking， to have a better life style and he is also collaborating with the media to lead both the doctors and patients to a healthier life.

《国际循环》：举例来说，胡大一教授正在中国致力于使医师戒烟和改善生活方式的研究，并且他还与媒体通力合作以引导医师和患者过更健康的生活。

Prof. Weaver: That is important because physicians can be leader and set an example for their patients. Right? If doctors don not smoke， then it sends a good message to patients that smoking is bad.

Weaver教授：这很重要，因为医生对患者起到引导和树立模范的作用，如果医生不吸烟，那无形中就传递给患者一种信息：吸烟有害健康。

International Circulation: In your opinion， what is the ideal medicare system and how to build it? Is there anything that China could learn from other existing medicare systems such as US or UK?

《国际循环》：您认为理想的医疗体系是什么样的?如何构建呢？中国有哪些可以借鉴之处?

Prof. Weaver: I don not know. We do not have a perfect system in the United States by any means. One thing is that you would like to have access to medical care for every body. Our system does not provide access to everybody in fact because as I said forty seven million people have no insurance whatsoever.

Weaver教授：我不清楚。美国的医疗体系称不上是完美的医疗体系。你应该让所有人都能够获得医疗保健，但是我们的医疗体系不能让每个人都获得医疗，如前文我说的还有四千七百万人没有医疗保险。

International Circulation: So， what aspects do you think are the most urgent to change?

《国际循环》：那么，您认为这一系统中哪些部分是最需要进行改进的？

Prof. Weaver: I think it is important to provide health care for children so that many preventable diseases as well as immunizations can occur for children. Also，that it is important to provide adequate funding for prevention because if the government does not incentivize or improve prevention ultimately they will pay the cost for those patients and their diseases which will be far more expensive.

Weaver教授：我认为儿童的医疗保健是一个重要方面，儿童有许多可预防的疾病，还有免疫接种等。还有，为预防工作提供适当的资金也是很重要的，因为如果政府不激励或者改善预防工作，政府最终就要给这些患者花钱治病，治病的钱最终要比预防多得多。

International Circulation: Looking to the future， do you think what is the biggest threatens for human beings’ health? And does it have any directional function for our clinical practice?  

《国际循环》：展望未来，您认为对人类健康威胁最大的问题是什么?对我们临床工作有什么指导意义?

Prof. Weaver: One of the things that we in the United States are very concerned about and I know that concern is here in china as well. It is increasing rates of obesity and being overweight. As a country becomes richer， it appears that people eat more sugars， more refined food and higher calories， so the incidence of obesity increases. When obesity increases it brings hypertension， high blood pressure， diabetes and many other diseases that are chronic and disabling people in long term.

Weaver教授：现在美国有一个很大的问题，我知道在中国也有，就是肥胖和超重的人数越来越多。当一个国家越来越富裕时，人们似乎就会吃越来越多甜食、精炼食品，摄入更高的热量，从而使肥胖的发生率增加。肥胖发病率提高，就会导致高血压、糖尿病以及很多其他疾病，慢性病，长期致残的疾病。

International Circulation: Last month on the ESC congress EUROPA III’s results were published. It showed that though the medicine therapy such as statins is increasing， the diabetes and obesity prevalences are still increasing in Europe， so what is your opinion of this result?

《国际循环》：上个月ESC年会公布了EUROPA III研究的结果，表明尽管药物治疗如他汀等的应用比例上升，但是糖尿病和肥胖的患病率仍然有所升高，您对此结果有何看法？

Prof. Weaver: Maybe it is the same in the US. In the US women， twenty two percent suffer from high blood pressure; sixty percent overweight or obese， thirty three percent very obese; sixteen percent physically inactive; and sixteen percent of women are users of cigarettes. You are fortunately in china that only one or two percent of women use cigarettes.

Weaver教授：美国的情况也与此相似。在美国妇女有22%患高血压病，60%超重或肥胖，33%非常肥胖，16%不锻炼，还有16%的妇女吸烟。而在中国只有1%或2%的妇女吸烟。

International Circulation: But the data is increasing now in China. Some young women think it fashionable to smoking.

《国际循环》：然而中国的这一数据也有所升高。一些年轻女性认为吸烟很时尚。

Prof. Weaver: That is what happens in the United States too. One of the increasing groups of smokers is young women. Teenagers at twenty years old and twenty or thirty year olds think it is fashionable to smoke. Men actually is decreasing or giving up smoking. But women have found it fashionable to smoke which is not a good plan. But it sounds like the same thing is happening in china， right? Some women are thinking it is fashionable to smoke. One thing we have found is that