phpinfo()
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PHP Version 5.6.40

System Windows NT iZ4r4b31413jd2Z 10.0 build 14393 (Windows Server 2016) AMD64
Build Date Jan 9 2019 15:05:36
Compiler MSVC11 (Visual C++ 2012)
Architecture x64
Configure Command cscript /nologo configure.js "--enable-snapshot-build" "--enable-debug-pack" "--disable-zts" "--disable-isapi" "--disable-nsapi" "--without-mssql" "--without-pdo-mssql" "--without-pi3web" "--with-pdo-oci=c:\php-sdk\oracle\x64\instantclient_12_1\sdk,shared" "--with-oci8-12c=c:\php-sdk\oracle\x64\instantclient_12_1\sdk,shared" "--with-enchant=shared" "--enable-object-out-dir=../obj/" "--enable-com-dotnet=shared" "--with-mcrypt=static" "--without-analyzer" "--with-pgo"
Server API CGI/FastCGI
Virtual Directory Support disabled
Configuration File (php.ini) Path C:\Windows
Loaded Configuration File D:\PHPWEB\php\php.ini
Scan this dir for additional .ini files (none)
Additional .ini files parsed (none)
PHP API 20131106
PHP Extension 20131226
Zend Extension 220131226
Zend Extension Build API220131226,NTS,VC11
PHP Extension Build API20131226,NTS,VC11
Debug Build no
Thread Safety disabled
Zend Signal Handling disabled
Zend Memory Manager enabled
Zend Multibyte Support provided by mbstring
IPv6 Support enabled
DTrace Support disabled
Registered PHP Streamsphp, file, glob, data, http, ftp, zip, compress.zlib, compress.bzip2, https, ftps, phar
Registered Stream Socket Transportstcp, udp, ssl, sslv3, tls, tlsv1.0, tlsv1.1, tlsv1.2
Registered Stream Filtersconvert.iconv.*, mcrypt.*, mdecrypt.*, string.rot13, string.toupper, string.tolower, string.strip_tags, convert.*, consumed, dechunk, zlib.*, bzip2.*
Zend logo This program makes use of the Zend Scripting Language Engine:
Zend Engine v2.6.0, Copyright (c) 1998-2016 Zend Technologies

Configuration

bcmath

BCMath support enabled
DirectiveLocal ValueMaster Value
bcmath.scale00

bz2

BZip2 Support Enabled
Stream Wrapper support compress.bzip2://
Stream Filter support bzip2.decompress, bzip2.compress
BZip2 Version 1.0.6, 6-Sept-2010

calendar

Calendar support enabled

cgi-fcgi

DirectiveLocal ValueMaster Value
cgi.check_shebang_line11
cgi.discard_path00
cgi.fix_pathinfo11
cgi.force_redirect00
cgi.nph00
cgi.redirect_status_envno valueno value
cgi.rfc2616_headers00
fastcgi.impersonate11
fastcgi.logging11

Core

PHP Version 5.6.40
DirectiveLocal ValueMaster Value
allow_url_fopenOnOn
allow_url_includeOffOff
always_populate_raw_post_data00
arg_separator.input&&
arg_separator.output&&
asp_tagsOffOff
auto_append_fileno valueno value
auto_globals_jitOnOn
auto_prepend_fileno valueno value
browscapno valueno value
default_charsetUTF-8UTF-8
default_mimetypetext/htmltext/html
disable_classesno valueno value
disable_functionsexec,system,passthru,popen,pclose,shell_exec,proc_open,dl,chmodexec,system,passthru,popen,pclose,shell_exec,proc_open,dl,chmod
display_errorsOffOff
display_startup_errorsOffOff
doc_rootno valueno value
docref_extno valueno value
docref_rootno valueno value
enable_dlOffOff
enable_post_data_readingOnOn
error_append_stringno valueno value
error_logsyslogsyslog
error_prepend_stringno valueno value
error_reporting022527
exit_on_timeoutOffOff
expose_phpOnOn
extension_dir./ext./ext
file_uploadsOnOn
highlight.comment#FF8000#FF8000
highlight.default#0000BB#0000BB
highlight.html#000000#000000
highlight.keyword#007700#007700
highlight.string#DD0000#DD0000
html_errorsOnOn
ignore_repeated_errorsOffOff
ignore_repeated_sourceOffOff
ignore_user_abortOffOff
implicit_flushOffOff
include_path.;C:\php\pear;D:\wwwroot\yyjg.net\wwwroot\core/Extend/Vendor/.;C:\php\pear
input_encodingno valueno value
internal_encodingno valueno value
log_errorsOnOn
log_errors_max_len10241024
mail.add_x_headerOnOn
mail.force_extra_parametersno valueno value
mail.logno valueno value
max_execution_time180180
max_file_uploads200200
max_input_nesting_level6464
max_input_time6060
max_input_vars10001000
memory_limit128M128M
open_basedirno valueno value
output_buffering40964096
output_encodingno valueno value
output_handlerno valueno value
post_max_size200M200M
precision1414
realpath_cache_size16K16K
realpath_cache_ttl120120
register_argc_argvOffOff
report_memleaksOnOn
report_zend_debugOnOn
request_orderCGPCGP
sendmail_fromno valueno value
sendmail_pathno valueno value
serialize_precision1717
short_open_tagOnOn
SMTPlocalhostlocalhost
smtp_port2525
sql.safe_modeOffOff
sys_temp_dirno valueno value
track_errorsOffOff
unserialize_callback_funcno valueno value
upload_max_filesize200M200M
upload_tmp_dirD:\PHPWEB\php\temp\D:\PHPWEB\php\temp\
user_dirno valueno value
user_ini.cache_ttl300300
user_ini.filename.user.ini.user.ini
variables_orderGPCSGPCS
windows.show_crt_warningOffOff
xmlrpc_error_number00
xmlrpc_errorsOffOff
zend.detect_unicodeOnOn
zend.enable_gcOnOn
zend.multibyteOffOff
zend.script_encodingno valueno value

ctype

ctype functions enabled

curl

cURL support enabled
cURL Information 7.59.0
Age 4
Features
AsynchDNS Yes
CharConv No
Debug No
GSS-Negotiate No
IDN Yes
IPv6 Yes
krb4 No
Largefile Yes
libz Yes
NTLM Yes
NTLMWB No
SPNEGO Yes
SSL Yes
SSPI Yes
TLS-SRP No
Protocols dict, file, ftp, ftps, gopher, http, https, imap, imaps, ldap, pop3, pop3s, rtsp, scp, sftp, smb, smbs, smtp, smtps, telnet, tftp
Host x86_64-pc-win32
SSL Version OpenSSL/1.0.2q
ZLib Version 1.2.7.3
libSSH Version libssh2/1.8.0

date

date/time support enabled
"Olson" Timezone Database Version 2016.10
Timezone Database internal
Default timezone PRC
DirectiveLocal ValueMaster Value
date.default_latitude31.766731.7667
date.default_longitude35.233335.2333
date.sunrise_zenith90.58333390.583333
date.sunset_zenith90.58333390.583333
date.timezonePRCPRC

dom

DOM/XML enabled
DOM/XML API Version 20031129
libxml Version 2.9.4
HTML Support enabled
XPath Support enabled
XPointer Support enabled
Schema Support enabled
RelaxNG Support enabled

ereg

Regex Library Bundled library enabled

exif

EXIF Support enabled
EXIF Version 1.4 $Id: cad29b729548e4206f0697710cc9e177f26fdff3 $
Supported EXIF Version 0220
Supported filetypes JPEG,TIFF
DirectiveLocal ValueMaster Value
exif.decode_jis_intelJISJIS
exif.decode_jis_motorolaJISJIS
exif.decode_unicode_intelUCS-2LEUCS-2LE
exif.decode_unicode_motorolaUCS-2BEUCS-2BE
exif.encode_jisno valueno value
exif.encode_unicodeISO-8859-15ISO-8859-15

filter

Input Validation and Filtering enabled
Revision $Id: 5b79667bd9a68977a9b4f7505223a8e216e04908 $
DirectiveLocal ValueMaster Value
filter.defaultunsafe_rawunsafe_raw
filter.default_flagsno valueno value

ftp

FTP support enabled

gd

GD Support enabled
GD Version bundled (2.1.0 compatible)
FreeType Support enabled
FreeType Linkage with freetype
FreeType Version 2.7.0
GIF Read Support enabled
GIF Create Support enabled
JPEG Support enabled
libJPEG Version 9 compatible
PNG Support enabled
libPNG Version 1.5.26
WBMP Support enabled
XPM Support enabled
libXpm Version 30512
XBM Support enabled
WebP Support enabled
DirectiveLocal ValueMaster Value
gd.jpeg_ignore_warning00

hash

hash support enabled
Hashing Engines md2 md4 md5 sha1 sha224 sha256 sha384 sha512 ripemd128 ripemd160 ripemd256 ripemd320 whirlpool tiger128,3 tiger160,3 tiger192,3 tiger128,4 tiger160,4 tiger192,4 snefru snefru256 gost gost-crypto adler32 crc32 crc32b fnv132 fnv1a32 fnv164 fnv1a64 joaat haval128,3 haval160,3 haval192,3 haval224,3 haval256,3 haval128,4 haval160,4 haval192,4 haval224,4 haval256,4 haval128,5 haval160,5 haval192,5 haval224,5 haval256,5

iconv

iconv support enabled
iconv implementation "libiconv"
iconv library version 1.14
DirectiveLocal ValueMaster Value
iconv.input_encodingno valueno value
iconv.internal_encodingno valueno value
iconv.output_encodingno valueno value

json

json support enabled
json version 1.2.1

libxml

libXML support active
libXML Compiled Version 2.9.4
libXML Loaded Version 20904
libXML streams enabled

mbstring

Multibyte Support enabled
Multibyte string engine libmbfl
HTTP input encoding translation disabled
libmbfl version 1.3.2
mbstring extension makes use of "streamable kanji code filter and converter", which is distributed under the GNU Lesser General Public License version 2.1.
Multibyte (japanese) regex support enabled
Multibyte regex (oniguruma) version 5.9.5
DirectiveLocal ValueMaster Value
mbstring.detect_orderno valueno value
mbstring.encoding_translationOffOff
mbstring.func_overload00
mbstring.http_inputno valueno value
mbstring.http_outputno valueno value
mbstring.http_output_conv_mimetypes^(text/|application/xhtml\+xml)^(text/|application/xhtml\+xml)
mbstring.internal_encodingno valueno value
mbstring.languageneutralneutral
mbstring.strict_detectionOffOff
mbstring.substitute_characterno valueno value

mcrypt

mcrypt supportenabled
mcrypt_filter supportenabled
Version 2.5.8
Api No 20021217
Supported ciphers cast-128 gost rijndael-128 twofish cast-256 loki97 rijndael-192 saferplus wake blowfish-compat des rijndael-256 serpent xtea blowfish enigma rc2 tripledes arcfour
Supported modes cbc cfb ctr ecb ncfb nofb ofb stream
DirectiveLocal ValueMaster Value
mcrypt.algorithms_dirno valueno value
mcrypt.modes_dirno valueno value

mhash

MHASH support Enabled
MHASH API Version Emulated Support

mysql

MySQL Supportenabled
Active Persistent Links 0
Active Links 1
Client API version mysqlnd 5.0.11-dev - 20120503 - $Id: 76b08b24596e12d4553bd41fc93cccd5bac2fe7a $
DirectiveLocal ValueMaster Value
mysql.allow_local_infileOnOn
mysql.allow_persistentOnOn
mysql.connect_timeout6060
mysql.default_hostno valueno value
mysql.default_passwordno valueno value
mysql.default_portno valueno value
mysql.default_socketno valueno value
mysql.default_userno valueno value
mysql.max_linksUnlimitedUnlimited
mysql.max_persistentUnlimitedUnlimited
mysql.trace_modeOffOff

mysqli

MysqlI Supportenabled
Client API library version mysqlnd 5.0.11-dev - 20120503 - $Id: 76b08b24596e12d4553bd41fc93cccd5bac2fe7a $
Active Persistent Links 0
Inactive Persistent Links 0
Active Links 0
DirectiveLocal ValueMaster Value
mysqli.allow_local_infileOnOn
mysqli.allow_persistentOnOn
mysqli.default_hostno valueno value
mysqli.default_port33063306
mysqli.default_pwno valueno value
mysqli.default_socketno valueno value
mysqli.default_userno valueno value
mysqli.max_linksUnlimitedUnlimited
mysqli.max_persistentUnlimitedUnlimited
mysqli.reconnectOffOff
mysqli.rollback_on_cached_plinkOffOff

mysqlnd

mysqlndenabled
Version mysqlnd 5.0.11-dev - 20120503 - $Id: 76b08b24596e12d4553bd41fc93cccd5bac2fe7a $
Compression supported
core SSL supported
extended SSL not supported
Command buffer size 4096
Read buffer size 32768
Read timeout 31536000
Collecting statistics Yes
Collecting memory statistics No
Tracing n/a
Loaded plugins mysqlnd,debug_trace,auth_plugin_mysql_native_password,auth_plugin_mysql_clear_password
API Extensions mysql,mysqli,pdo_mysql
mysqlnd statistics
bytes_sent 131529
bytes_received 2704565
packets_sent 2640
packets_received 20624
protocol_overhead_in 82496
protocol_overhead_out 10560
bytes_received_ok_packet 0
bytes_received_eof_packet 0
bytes_received_rset_header_packet 10008
bytes_received_rset_field_meta_packet 0
bytes_received_rset_row_packet 7582
bytes_received_prepare_response_packet 1006061
bytes_received_change_user_packet 1671064
packets_sent_command 1260
packets_received_ok 0
packets_received_eof 0
packets_received_rset_header 1112
packets_received_rset_field_meta 0
packets_received_rset_row 1171
packets_received_prepare_response 14621
packets_received_change_user 3600
result_set_queries 1082
non_result_set_queries 87
no_index_used 631
bad_index_used 0
slow_queries 0
buffered_sets 1082
unbuffered_sets 0
ps_buffered_sets 0
ps_unbuffered_sets 0
flushed_normal_sets 0
flushed_ps_sets 0
ps_prepared_never_executed 0
ps_prepared_once_executed 0
rows_fetched_from_server_normal 2518
rows_fetched_from_server_ps 0
rows_buffered_from_client_normal 2518
rows_buffered_from_client_ps 0
rows_fetched_from_client_normal_buffered 2518
rows_fetched_from_client_normal_unbuffered 0
rows_fetched_from_client_ps_buffered 0
rows_fetched_from_client_ps_unbuffered 0
rows_fetched_from_client_ps_cursor 0
rows_affected_normal 20
rows_affected_ps 0
rows_skipped_normal 2518
rows_skipped_ps 0
copy_on_write_saved 6208
copy_on_write_performed 43409
command_buffer_too_small 0
connect_success 30
connect_failure 0
connection_reused 0
reconnect 0
pconnect_success 0
active_connections 18446744073709551588
active_persistent_connections 0
explicit_close 29
implicit_close 0
disconnect_close 0
in_middle_of_command_close 0
explicit_free_result 1081
implicit_free_result 0
explicit_stmt_close 0
implicit_stmt_close 0
mem_emalloc_count 0
mem_emalloc_amount 0
mem_ecalloc_count 0
mem_ecalloc_amount 0
mem_erealloc_count 0
mem_erealloc_amount 0
mem_efree_count 0
mem_efree_amount 0
mem_malloc_count 0
mem_malloc_amount 0
mem_calloc_count 0
mem_calloc_amount 0
mem_realloc_count 0
mem_realloc_amount 0
mem_free_count 0
mem_free_amount 0
mem_estrndup_count 0
mem_strndup_count 0
mem_estndup_count 0
mem_strdup_count 0
proto_text_fetched_null 0
proto_text_fetched_bit 0
proto_text_fetched_tinyint 4346
proto_text_fetched_short 14987
proto_text_fetched_int24 1667
proto_text_fetched_int 1900
proto_text_fetched_bigint 12
proto_text_fetched_decimal 0
proto_text_fetched_float 0
proto_text_fetched_double 0
proto_text_fetched_date 0
proto_text_fetched_year 0
proto_text_fetched_time 0
proto_text_fetched_datetime 0
proto_text_fetched_timestamp 0
proto_text_fetched_string 22985
proto_text_fetched_blob 0
proto_text_fetched_enum 132
proto_text_fetched_set 0
proto_text_fetched_geometry 0
proto_text_fetched_other 0
proto_binary_fetched_null 0
proto_binary_fetched_bit 0
proto_binary_fetched_tinyint 0
proto_binary_fetched_short 0
proto_binary_fetched_int24 0
proto_binary_fetched_int 0
proto_binary_fetched_bigint 0
proto_binary_fetched_decimal 0
proto_binary_fetched_float 0
proto_binary_fetched_double 0
proto_binary_fetched_date 0
proto_binary_fetched_year 0
proto_binary_fetched_time 0
proto_binary_fetched_datetime 0
proto_binary_fetched_timestamp 0
proto_binary_fetched_string 0
proto_binary_fetched_json 0
proto_binary_fetched_blob 0
proto_binary_fetched_enum 0
proto_binary_fetched_set 0
proto_binary_fetched_geometry 0
proto_binary_fetched_other 0
init_command_executed_count 0
init_command_failed_count 0
com_quit 29
com_init_db 30
com_query 1171
com_field_list 0
com_create_db 0
com_drop_db 0
com_refresh 0
com_shutdown 0
com_statistics 0
com_process_info 0
com_connect 0
com_process_kill 0
com_debug 0
com_ping 0
com_time 0
com_delayed_insert 0
com_change_user 0
com_binlog_dump 0
com_table_dump 0
com_connect_out 0
com_register_slave 0
com_stmt_prepare 0
com_stmt_execute 0
com_stmt_send_long_data 0
com_stmt_close 0
com_stmt_reset 0
com_stmt_set_option 30
com_stmt_fetch 0
com_deamon 0
bytes_received_real_data_normal 1606780
bytes_received_real_data_ps 0

odbc

ODBC Supportenabled
Active Persistent Links 0
Active Links 0
ODBC library Win32
DirectiveLocal ValueMaster Value
odbc.allow_persistentOnOn
odbc.check_persistentOnOn
odbc.default_cursortypeStatic cursorStatic cursor
odbc.default_dbno valueno value
odbc.default_pwno valueno value
odbc.default_userno valueno value
odbc.defaultbinmodereturn as isreturn as is
odbc.defaultlrlreturn up to 4096 bytesreturn up to 4096 bytes
odbc.max_linksUnlimitedUnlimited
odbc.max_persistentUnlimitedUnlimited

openssl

OpenSSL support enabled
OpenSSL Library Version OpenSSL 1.0.2q 20 Nov 2018
OpenSSL Header Version OpenSSL 1.0.2q 20 Nov 2018
Openssl default config c:/usr/local/ssl/openssl.cnf
DirectiveLocal ValueMaster Value
openssl.cafileno valueno value
openssl.capathno valueno value

pcre

PCRE (Perl Compatible Regular Expressions) Support enabled
PCRE Library Version 8.38 2015-11-23
DirectiveLocal ValueMaster Value
pcre.backtrack_limit10000001000000
pcre.recursion_limit100000100000

PDO

PDO supportenabled
PDO drivers mysql, odbc, pgsql, sqlite

pdo_mysql

PDO Driver for MySQLenabled
Client API version mysqlnd 5.0.11-dev - 20120503 - $Id: 76b08b24596e12d4553bd41fc93cccd5bac2fe7a $

PDO_ODBC

PDO Driver for ODBC (Win32)enabled
ODBC Connection Pooling Enabled, strict matching

pdo_pgsql

PDO Driver for PostgreSQLenabled
PostgreSQL(libpq) Version 9.6.2
Module version 1.0.2
Revision $Id: 0e858dd2051ca8c2fd3c781909a0670ab5fecd36 $

pdo_sqlite

PDO Driver for SQLite 3.xenabled
SQLite Library 3.8.10.2

pgsql

PostgreSQL Supportenabled
PostgreSQL(libpq) Version 9.6.2
PostgreSQL(libpq) PostgreSQL 9.6.2 (win32)
Multibyte character support enabled
SSL support enabled
Active Persistent Links 0
Active Links 0
DirectiveLocal ValueMaster Value
pgsql.allow_persistentOnOn
pgsql.auto_reset_persistentOffOff
pgsql.ignore_noticeOffOff
pgsql.log_noticeOffOff
pgsql.max_linksUnlimitedUnlimited
pgsql.max_persistentUnlimitedUnlimited

Phar

Phar: PHP Archive supportenabled
Phar EXT version 2.0.2
Phar API version 1.1.1
SVN revision $Id: 6e5cec2462a6ded53d4379ea9a69487a60d5c43c $
Phar-based phar archives enabled
Tar-based phar archives enabled
ZIP-based phar archives enabled
gzip compression enabled
bzip2 compression enabled
OpenSSL support enabled
Phar based on pear/PHP_Archive, original concept by Davey Shafik.
Phar fully realized by Gregory Beaver and Marcus Boerger.
Portions of tar implementation Copyright (c) 2003-2009 Tim Kientzle.
DirectiveLocal ValueMaster Value
phar.cache_listno valueno value
phar.readonlyOnOn
phar.require_hashOnOn

Reflection

Reflectionenabled
Version $Id: 5f15287237d5f78d75b19c26915aa7bd83dee8b8 $

session

Session Support enabled
Registered save handlers files user
Registered serializer handlers php_serialize php php_binary wddx
DirectiveLocal ValueMaster Value
session.auto_startOffOff
session.cache_expire180180
session.cache_limiternocachenocache
session.cookie_domainno valueno value
session.cookie_httponlyOffOff
session.cookie_lifetime00
session.cookie_path//
session.cookie_secureOffOff
session.entropy_fileno valueno value
session.entropy_length00
session.gc_divisor10001000
session.gc_maxlifetime14401440
session.gc_probability11
session.hash_bits_per_character55
session.hash_function00
session.namePHPSESSIDPHPSESSID
session.referer_checkno valueno value
session.save_handlerfilesfiles
session.save_pathD:\PHPWEB\php\temp\D:\PHPWEB\php\temp\
session.serialize_handlerphpphp
session.upload_progress.cleanupOnOn
session.upload_progress.enabledOnOn
session.upload_progress.freq1%1%
session.upload_progress.min_freq11
session.upload_progress.namePHP_SESSION_UPLOAD_PROGRESSPHP_SESSION_UPLOAD_PROGRESS
session.upload_progress.prefixupload_progress_upload_progress_
session.use_cookiesOnOn
session.use_only_cookiesOnOn
session.use_strict_modeOffOff
session.use_trans_sid00

SimpleXML

Simplexml supportenabled
Revision $Id: d7077fc935154236afb4fe70814ba358efdbdca4 $
Schema support enabled

SPL

SPL supportenabled
Interfaces Countable, OuterIterator, RecursiveIterator, SeekableIterator, SplObserver, SplSubject
Classes AppendIterator, ArrayIterator, ArrayObject, BadFunctionCallException, BadMethodCallException, CachingIterator, CallbackFilterIterator, DirectoryIterator, DomainException, EmptyIterator, FilesystemIterator, FilterIterator, GlobIterator, InfiniteIterator, InvalidArgumentException, IteratorIterator, LengthException, LimitIterator, LogicException, MultipleIterator, NoRewindIterator, OutOfBoundsException, OutOfRangeException, OverflowException, ParentIterator, RangeException, RecursiveArrayIterator, RecursiveCachingIterator, RecursiveCallbackFilterIterator, RecursiveDirectoryIterator, RecursiveFilterIterator, RecursiveIteratorIterator, RecursiveRegexIterator, RecursiveTreeIterator, RegexIterator, RuntimeException, SplDoublyLinkedList, SplFileInfo, SplFileObject, SplFixedArray, SplHeap, SplMinHeap, SplMaxHeap, SplObjectStorage, SplPriorityQueue, SplQueue, SplStack, SplTempFileObject, UnderflowException, UnexpectedValueException

sqlite3

SQLite3 supportenabled
SQLite3 module version 0.7-dev
SQLite Library 3.8.10.2
DirectiveLocal ValueMaster Value
sqlite3.extension_dirno valueno value

standard

Dynamic Library Support enabled
Internal Sendmail Support for Windows enabled
DirectiveLocal ValueMaster Value
assert.active11
assert.bail00
assert.callbackno valueno value
assert.quiet_eval00
assert.warning11
auto_detect_line_endings00
default_socket_timeout6060
fromno valueno value
url_rewriter.tagsa=href,area=href,frame=src,input=src,form=fakeentrya=href,area=href,frame=src,input=src,form=fakeentry
user_agentno valueno value

tokenizer

Tokenizer Support enabled

wddx

WDDX Supportenabled
WDDX Session Serializer enabled

xml

XML Support active
XML Namespace Support active
libxml2 Version 2.9.4

xmlreader

XMLReader enabled

xmlwriter

XMLWriter enabled

zip

Zip enabled
Zip version 1.12.5
Libzip version 0.11.2

zlib

ZLib Supportenabled
Stream Wrapper compress.zlib://
Stream Filter zlib.inflate, zlib.deflate
Compiled Version 1.2.7.3
Linked Version 1.2.7.3
DirectiveLocal ValueMaster Value
zlib.output_compressionOffOff
zlib.output_compression_level-1-1
zlib.output_handlerno valueno value

Additional Modules

Module Name

Environment

VariableValue
_FCGI_X_PIPE_ \\.\pipe\IISFCGI-18362ba8-2200-4918-8a6e-ff6b1bee8407
PHP_FCGI_MAX_REQUESTS 10000
ALLUSERSPROFILE C:\ProgramData
APPDATA C:\Windows\system32\config\systemprofile\AppData\Roaming
APP_POOL_CONFIG C:\inetpub\temp\apppools\wwwroot\wwwroot.config
APP_POOL_ID wwwroot
CommonProgramFiles C:\Program Files\Common Files
CommonProgramFiles(x86) C:\Program Files (x86)\Common Files
CommonProgramW6432 C:\Program Files\Common Files
COMPUTERNAME iZ4r4b31413jd2Z
ComSpec C:\Windows\system32\cmd.exe
LOCALAPPDATA C:\Windows\system32\config\systemprofile\AppData\Local
NUMBER_OF_PROCESSORS 2
OS Windows_NT
Path C:\Windows\system32;C:\Windows;C:\Windows\System32\Wbem;C:\Windows\System32\WindowsPowerShell\v1.0\;D:\Program Files\Microsoft SQL Server\110\DTS\Binn\;D:\Program Files (x86)\Microsoft SQL Server\110\Tools\Binn\;D:\Program Files\Microsoft SQL Server\110\Tools\Binn\;D:\Program Files (x86)\Microsoft SQL Server\110\Tools\Binn\ManagementStudio\;C:\Program Files (x86)\Microsoft Visual Studio 10.0\Common7\IDE\PrivateAssemblies\;D:\Program Files (x86)\Microsoft SQL Server\110\DTS\Binn\;C:\sslctlw;C:\Windows\system32\config\systemprofile\AppData\Local\Microsoft\WindowsApps
PATHEXT .COM;.EXE;.BAT;.CMD;.VBS;.VBE;.JS;.JSE;.WSF;.WSH;.MSC
PROCESSOR_ARCHITECTURE AMD64
PROCESSOR_IDENTIFIER Intel64 Family 6 Model 85 Stepping 4, GenuineIntel
PROCESSOR_LEVEL 6
PROCESSOR_REVISION 5504
ProgramData C:\ProgramData
ProgramFiles C:\Program Files
ProgramFiles(x86) C:\Program Files (x86)
ProgramW6432 C:\Program Files
PSModulePath C:\Program Files\WindowsPowerShell\Modules;C:\Windows\system32\WindowsPowerShell\v1.0\Modules;D:\Program Files (x86)\Microsoft SQL Server\110\Tools\PowerShell\Modules\
PUBLIC C:\Users\Public
SystemDrive C:
SystemRoot C:\Windows
TEMP C:\Windows\TEMP
TMP C:\Windows\TEMP
USERDOMAIN WORKGROUP
USERNAME iZ4r4b31413jd2Z$
USERPROFILE C:\Windows\system32\config\systemprofile
windir C:\Windows

PHP Variables

VariableValue
_REQUEST["aid"]13644
_REQUEST["_URL_"]
Array
(
    [0] => index
    [1] => view
    [2] => aid
    [3] => 13644
)
_GET["aid"]13644
_GET["_URL_"]
Array
(
    [0] => index
    [1] => view
    [2] => aid
    [3] => 13644
)
_SERVER["_FCGI_X_PIPE_"]\\.\pipe\IISFCGI-18362ba8-2200-4918-8a6e-ff6b1bee8407
_SERVER["PHP_FCGI_MAX_REQUESTS"]10000
_SERVER["ALLUSERSPROFILE"]C:\ProgramData
_SERVER["APPDATA"]C:\Windows\system32\config\systemprofile\AppData\Roaming
_SERVER["APP_POOL_CONFIG"]C:\inetpub\temp\apppools\wwwroot\wwwroot.config
_SERVER["APP_POOL_ID"]wwwroot
_SERVER["CommonProgramFiles"]C:\Program Files\Common Files
_SERVER["CommonProgramFiles(x86)"]C:\Program Files (x86)\Common Files
_SERVER["CommonProgramW6432"]C:\Program Files\Common Files
_SERVER["COMPUTERNAME"]iZ4r4b31413jd2Z
_SERVER["ComSpec"]C:\Windows\system32\cmd.exe
_SERVER["LOCALAPPDATA"]C:\Windows\system32\config\systemprofile\AppData\Local
_SERVER["NUMBER_OF_PROCESSORS"]2
_SERVER["OS"]Windows_NT
_SERVER["Path"]C:\Windows\system32;C:\Windows;C:\Windows\System32\Wbem;C:\Windows\System32\WindowsPowerShell\v1.0\;D:\Program Files\Microsoft SQL Server\110\DTS\Binn\;D:\Program Files (x86)\Microsoft SQL Server\110\Tools\Binn\;D:\Program Files\Microsoft SQL Server\110\Tools\Binn\;D:\Program Files (x86)\Microsoft SQL Server\110\Tools\Binn\ManagementStudio\;C:\Program Files (x86)\Microsoft Visual Studio 10.0\Common7\IDE\PrivateAssemblies\;D:\Program Files (x86)\Microsoft SQL Server\110\DTS\Binn\;C:\sslctlw;C:\Windows\system32\config\systemprofile\AppData\Local\Microsoft\WindowsApps
_SERVER["PATHEXT"].COM;.EXE;.BAT;.CMD;.VBS;.VBE;.JS;.JSE;.WSF;.WSH;.MSC
_SERVER["PROCESSOR_ARCHITECTURE"]AMD64
_SERVER["PROCESSOR_IDENTIFIER"]Intel64 Family 6 Model 85 Stepping 4, GenuineIntel
_SERVER["PROCESSOR_LEVEL"]6
_SERVER["PROCESSOR_REVISION"]5504
_SERVER["ProgramData"]C:\ProgramData
_SERVER["ProgramFiles"]C:\Program Files
_SERVER["ProgramFiles(x86)"]C:\Program Files (x86)
_SERVER["ProgramW6432"]C:\Program Files
_SERVER["PSModulePath"]C:\Program Files\WindowsPowerShell\Modules;C:\Windows\system32\WindowsPowerShell\v1.0\Modules;D:\Program Files (x86)\Microsoft SQL Server\110\Tools\PowerShell\Modules\
_SERVER["PUBLIC"]C:\Users\Public
_SERVER["SystemDrive"]C:
_SERVER["SystemRoot"]C:\Windows
_SERVER["TEMP"]C:\Windows\TEMP
_SERVER["TMP"]C:\Windows\TEMP
_SERVER["USERDOMAIN"]WORKGROUP
_SERVER["USERNAME"]iZ4r4b31413jd2Z$
_SERVER["USERPROFILE"]C:\Windows\system32\config\systemprofile
_SERVER["windir"]C:\Windows
_SERVER["ORIG_PATH_INFO"]/index.php/index-view-aid-13644.html
_SERVER["URL"]/index.php
_SERVER["SERVER_SOFTWARE"]Microsoft-IIS/10.0
_SERVER["SERVER_PROTOCOL"]HTTP/1.1
_SERVER["SERVER_PORT_SECURE"]1
_SERVER["SERVER_PORT"]443
_SERVER["SERVER_NAME"]yyjg.net
_SERVER["SCRIPT_NAME"]/index.php
_SERVER["SCRIPT_FILENAME"]D:\wwwroot\yyjg.net\wwwroot\index.php
_SERVER["REQUEST_URI"]/index.php/index-view-aid-13644.html
_SERVER["REQUEST_METHOD"]GET
_SERVER["REMOTE_USER"]no value
_SERVER["REMOTE_PORT"]7218
_SERVER["REMOTE_HOST"]216.73.216.32
_SERVER["REMOTE_ADDR"]216.73.216.32
_SERVER["QUERY_STRING"]no value
_SERVER["PATH_TRANSLATED"]D:\wwwroot\yyjg.net\wwwroot\index.php\index-view-aid-13644.html
_SERVER["PATH_INFO"]/index-view-aid-13644
_SERVER["LOGON_USER"]no value
_SERVER["LOCAL_ADDR"]172.16.121.93
_SERVER["INSTANCE_META_PATH"]/LM/W3SVC/1
_SERVER["INSTANCE_NAME"]WWWROOT
_SERVER["INSTANCE_ID"]1
_SERVER["HTTPS_SERVER_SUBJECT"]CN=www.yyjg.net
_SERVER["HTTPS_SERVER_ISSUER"]C=PL, O=Asseco Data Systems S.A., CN=Certum DV TLS G2 R39 CA
_SERVER["HTTPS_SECRETKEYSIZE"]2048
_SERVER["HTTPS_KEYSIZE"]256
_SERVER["HTTPS"]on
_SERVER["GATEWAY_INTERFACE"]CGI/1.1
_SERVER["DOCUMENT_ROOT"]D:\wwwroot\yyjg.net\wwwroot
_SERVER["CONTENT_TYPE"]no value
_SERVER["CONTENT_LENGTH"]0
_SERVER["CERT_SUBJECT"]no value
_SERVER["CERT_SERIALNUMBER"]no value
_SERVER["CERT_ISSUER"]no value
_SERVER["CERT_FLAGS"]no value
_SERVER["CERT_COOKIE"]no value
_SERVER["AUTH_USER"]no value
_SERVER["AUTH_PASSWORD"]no value
_SERVER["AUTH_TYPE"]no value
_SERVER["APPL_PHYSICAL_PATH"]D:\wwwroot\yyjg.net\wwwroot\
_SERVER["APPL_MD_PATH"]/LM/W3SVC/1/ROOT
_SERVER["IIS_UrlRewriteModule"]7.1.0871.0
_SERVER["HTTP_USER_AGENT"]Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)
_SERVER["HTTP_HOST"]yyjg.net
_SERVER["HTTP_ACCEPT_ENCODING"]gzip, br, zstd, deflate
_SERVER["HTTP_ACCEPT"]*/*
_SERVER["HTTP_CONNECTION"]close
_SERVER["FCGI_ROLE"]RESPONDER
_SERVER["PHP_SELF"]/index.php/index-view-aid-13644.html
_SERVER["REQUEST_TIME_FLOAT"]1789495302.5556
_SERVER["REQUEST_TIME"]1789495302

PHP Credits

PHP Group
Thies C. Arntzen, Stig Bakken, Shane Caraveo, Andi Gutmans, Rasmus Lerdorf, Sam Ruby, Sascha Schumann, Zeev Suraski, Jim Winstead, Andrei Zmievski
Language Design & Concept
Andi Gutmans, Rasmus Lerdorf, Zeev Suraski, Marcus Boerger
PHP Authors
ContributionAuthors
Zend Scripting Language Engine Andi Gutmans, Zeev Suraski, Stanislav Malyshev, Marcus Boerger, Dmitry Stogov, Xinchen Hui, Nikita Popov
Extension Module API Andi Gutmans, Zeev Suraski, Andrei Zmievski
UNIX Build and Modularization Stig Bakken, Sascha Schumann, Jani Taskinen
Windows Port Shane Caraveo, Zeev Suraski, Wez Furlong, Pierre-Alain Joye, Anatol Belski
Server API (SAPI) Abstraction Layer Andi Gutmans, Shane Caraveo, Zeev Suraski
Streams Abstraction Layer Wez Furlong, Sara Golemon
PHP Data Objects Layer Wez Furlong, Marcus Boerger, Sterling Hughes, George Schlossnagle, Ilia Alshanetsky
Output Handler Zeev Suraski, Thies C. Arntzen, Marcus Boerger, Michael Wallner
SAPI Modules
ContributionAuthors
AOLserver Sascha Schumann
Apache 1.3 (apache_hooks) Rasmus Lerdorf, Zeev Suraski, Stig Bakken, David Sklar, George Schlossnagle, Lukas Schroeder
Apache 1.3 Rasmus Lerdorf, Zeev Suraski, Stig Bakken, David Sklar
Apache 2.0 Filter Sascha Schumann, Aaron Bannert
Apache 2.0 Handler Ian Holsman, Justin Erenkrantz (based on Apache 2.0 Filter code)
Caudium / Roxen David Hedbor
CGI / FastCGI Rasmus Lerdorf, Stig Bakken, Shane Caraveo, Dmitry Stogov
CLI Edin Kadribasic, Marcus Boerger, Johannes Schlueter, Moriyoshi Koizumi, Xinchen Hui
Continuity Alex Leigh (based on nsapi code)
Embed Edin Kadribasic
FastCGI Process Manager Andrei Nigmatulin, dreamcat4, Antony Dovgal, Jerome Loyet
ISAPI Andi Gutmans, Zeev Suraski
litespeed George Wang
NSAPI Jayakumar Muthukumarasamy, Uwe Schindler
phpdbg Felipe Pena, Joe Watkins, Bob Weinand
phttpd Thies C. Arntzen
pi3web Holger Zimmermann
Sendmail Milter Harald Radi
thttpd Sascha Schumann
tux Sascha Schumann
WebJames Alex Waugh
Module Authors
ModuleAuthors
BC Math Andi Gutmans
Bzip2 Sterling Hughes
Calendar Shane Caraveo, Colin Viebrock, Hartmut Holzgraefe, Wez Furlong
COM and .Net Wez Furlong
ctype Hartmut Holzgraefe
cURL Sterling Hughes
Date/Time Support Derick Rethans
DB-LIB (MS SQL, Sybase) Wez Furlong, Frank M. Kromann
DBA Sascha Schumann, Marcus Boerger
DOM Christian Stocker, Rob Richards, Marcus Boerger
enchant Pierre-Alain Joye, Ilia Alshanetsky
ereg Rasmus Lerdorf, Jim Winstead, Jaakko Hyvätti
EXIF Rasmus Lerdorf, Marcus Boerger
fileinfo Ilia Alshanetsky, Pierre Alain Joye, Scott MacVicar, Derick Rethans
Firebird driver for PDO Ard Biesheuvel
FTP Stefan Esser, Andrew Skalski
GD imaging Rasmus Lerdorf, Stig Bakken, Jim Winstead, Jouni Ahto, Ilia Alshanetsky, Pierre-Alain Joye, Marcus Boerger
GetText Alex Plotnick
GNU GMP support Stanislav Malyshev
Iconv Rui Hirokawa, Stig Bakken, Moriyoshi Koizumi
IMAP Rex Logan, Mark Musone, Brian Wang, Kaj-Michael Lang, Antoni Pamies Olive, Rasmus Lerdorf, Andrew Skalski, Chuck Hagenbuch, Daniel R Kalowsky
Input Filter Rasmus Lerdorf, Derick Rethans, Pierre-Alain Joye, Ilia Alshanetsky
InterBase Jouni Ahto, Andrew Avdeev, Ard Biesheuvel
Internationalization Ed Batutis, Vladimir Iordanov, Dmitry Lakhtyuk, Stanislav Malyshev, Vadim Savchuk, Kirti Velankar
JSON Omar Kilani, Scott MacVicar
LDAP Amitay Isaacs, Eric Warnke, Rasmus Lerdorf, Gerrit Thomson, Stig Venaas
LIBXML Christian Stocker, Rob Richards, Marcus Boerger, Wez Furlong, Shane Caraveo
mcrypt Sascha Schumann, Derick Rethans
MS SQL Frank M. Kromann
Multibyte String Functions Tsukada Takuya, Rui Hirokawa
MySQL driver for PDO George Schlossnagle, Wez Furlong, Ilia Alshanetsky, Johannes Schlueter
MySQL Zeev Suraski, Zak Greant, Georg Richter, Andrey Hristov
MySQLi Zak Greant, Georg Richter, Andrey Hristov, Ulf Wendel
MySQLnd Andrey Hristov, Ulf Wendel, Georg Richter, Johannes Schlüter
OCI8 Stig Bakken, Thies C. Arntzen, Andy Sautins, David Benson, Maxim Maletsky, Harald Radi, Antony Dovgal, Andi Gutmans, Wez Furlong, Christopher Jones, Oracle Corporation
ODBC driver for PDO Wez Furlong
ODBC Stig Bakken, Andreas Karajannis, Frank M. Kromann, Daniel R. Kalowsky
OpenSSL Stig Venaas, Wez Furlong, Sascha Kettler, Scott MacVicar
Oracle (OCI) driver for PDO Wez Furlong
pcntl Jason Greene, Arnaud Le Blanc
Perl Compatible Regexps Andrei Zmievski
PHP Archive Gregory Beaver, Marcus Boerger
PHP Data Objects Wez Furlong, Marcus Boerger, Sterling Hughes, George Schlossnagle, Ilia Alshanetsky
PHP hash Sara Golemon, Rasmus Lerdorf, Stefan Esser, Michael Wallner, Scott MacVicar
Posix Kristian Koehntopp
PostgreSQL driver for PDO Edin Kadribasic, Ilia Alshanetsky
PostgreSQL Jouni Ahto, Zeev Suraski, Yasuo Ohgaki, Chris Kings-Lynne
Pspell Vlad Krupin
Readline Thies C. Arntzen
Recode Kristian Koehntopp
Reflection Marcus Boerger, Timm Friebe, George Schlossnagle, Andrei Zmievski, Johannes Schlueter
Sessions Sascha Schumann, Andrei Zmievski
Shared Memory Operations Slava Poliakov, Ilia Alshanetsky
SimpleXML Sterling Hughes, Marcus Boerger, Rob Richards
SNMP Rasmus Lerdorf, Harrie Hazewinkel, Mike Jackson, Steven Lawrance, Johann Hanne, Boris Lytochkin
SOAP Brad Lafountain, Shane Caraveo, Dmitry Stogov
Sockets Chris Vandomelen, Sterling Hughes, Daniel Beulshausen, Jason Greene
SPL Marcus Boerger, Etienne Kneuss
SQLite 3.x driver for PDO Wez Furlong
SQLite3 Scott MacVicar, Ilia Alshanetsky, Brad Dewar
Sybase-CT Zeev Suraski, Tom May, Timm Friebe
System V Message based IPC Wez Furlong
System V Semaphores Tom May
System V Shared Memory Christian Cartus
tidy John Coggeshall, Ilia Alshanetsky
tokenizer Andrei Zmievski, Johannes Schlueter
WDDX Andrei Zmievski
XML Stig Bakken, Thies C. Arntzen, Sterling Hughes
XMLReader Rob Richards
xmlrpc Dan Libby
XMLWriter Rob Richards, Pierre-Alain Joye
XSL Christian Stocker, Rob Richards
Zip Pierre-Alain Joye, Remi Collet
Zlib Rasmus Lerdorf, Stefan Roehrich, Zeev Suraski, Jade Nicoletti, Michael Wallner
PHP Documentation
Authors Mehdi Achour, Friedhelm Betz, Antony Dovgal, Nuno Lopes, Hannes Magnusson, Georg Richter, Damien Seguy, Jakub Vrana, Adam Harvey, Peter Cowburn
Editor Philip Olson
User Note Maintainers Daniel P. Brown, Thiago Henrique Pojda
Other Contributors Previously active authors, editors and other contributors are listed in the manual.
PHP Quality Assurance Team
Ilia Alshanetsky, Joerg Behrens, Antony Dovgal, Stefan Esser, Moriyoshi Koizumi, Magnus Maatta, Sebastian Nohn, Derick Rethans, Melvyn Sopacua, Jani Taskinen, Pierre-Alain Joye, Dmitry Stogov, Felipe Pena, David Soria Parra, Stanislav Malyshev, Julien Pauli, Stephen Zarkos, Anatol Belski, Remi Collet, Ferenc Kovacs
Websites and Infrastructure team
PHP Websites Team Rasmus Lerdorf, Hannes Magnusson, Philip Olson, Lukas Kahwe Smith, Pierre-Alain Joye, Kalle Sommer Nielsen, Peter Cowburn, Adam Harvey, Ferenc Kovacs, Levi Morrison
Event Maintainers Damien Seguy, Daniel P. Brown
Network Infrastructure Daniel P. Brown
Windows Infrastructure Alex Schoenmaker

PHP License

This program is free software; you can redistribute it and/or modify it under the terms of the PHP License as published by the PHP Group and included in the distribution in the file: LICENSE

This program is distributed in the hope that it will be useful, but WITHOUT ANY WARRANTY; without even the implied warranty of MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE.

If you did not receive a copy of the PHP license, or have any questions about PHP licensing, please contact license@php.net.

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首页>医管智库>境外医院
医疗服务质量参差不齐,170余年历史的美国商保遭遇滑铁卢?
提交者:凌武娟发表时间:2021-7-27点击次数:25553来源:健康界

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  《美国医学会杂志》(JAMA)6月初发表的一项新研究显示,与美国联邦医疗保险(Medicare)等公共医保计划相比,商业医疗保险计划的受保人,其医疗服务的可及性更低、满意度也更低,医疗费用却更高。
  
  该研究认为,这说明,公共医疗保险计划能提供更具成本效益的医疗服务。这似乎与美国以商业医疗保险为主所能带来的预期效果相左。
  
  根据美国国家卫生统计中心(National Center for Health Statistics)的数据,2019年,美国61.3%的人口拥有商业医疗保险,拥有公共医保的人口比例仅为37.4%。不论是从人口比例,还是保险市场的竞争情况来看,商业医疗保险下的医疗服务口碑本应更好,但为何会出现这种现象?这在美国是不是一种趋势?美国也要“主攻”公共医疗保险了吗?
  
  公共医保下的医疗服务更得民心
  
  发表在JAMA上的这项研究由旧金山退伍军人事务医学中心(San Francisco Veterans Affairs Medical Center)和加州大学旧金山分校(University of California, San Francisco)研究人员联合开展。
  
  研究人员比较了联邦医疗保险、联邦医疗补助(Medicaid)、退伍军人医疗保险、雇主商业医疗保险和个人商业医疗保险等五种保险的覆盖范围、医疗服务满意度等各方面的不同,涉及约15万来自美国17个州和华盛顿特区的成年人,其中约64%的人拥有商业医保。在商业医保受保人中,约80%有雇主购买的医保计划;在公共医保受保人中,三分之二受保于联邦医疗保险,约四分之一享受联邦医疗补助。
  
  研究结果显示,与联邦医疗保险的受保人相比,通过雇主购买医保的人拥有私人医生的可能性较小,且医保覆盖范围更不稳定,因费用问题看医生困难、不服药的情况更多,且更可能有医疗费用方面的债务。他们对医疗服务的满意度也更低。与联邦医疗补助的受保人相比,通过雇主购买医保的人同样也更可能出现医疗费用债务。


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  研究人员总结认为,与公共医保的受保人相比,商业医保的受保人更难获得护理服务,护理成本更高,护理满意度更低。这些发现表明,公共医疗保险提供的医疗服务可能更具成本效益。
  
  对于导致该研究结果的原因,约翰·霍普金斯大学布隆伯格公共卫生学院(Johns Hopkins Bloomberg School of Public Health)健康政策与管理教授杰拉德·安德森(Gerard Anderson)告诉健康界(CN-Healthcare),美国拥有商业医疗保险的个人往往倾向于经常更换保险公司,而这可能意味着他们的医生也跟着不停地变换,而政府的公共医
  
  保每年为受保人提供的医生几乎是相同的。
  
  也就是说,看病医生的不同可能导致医疗质量和患者满意度参差不齐。
  
  清华大学医院管理研究院教授杨燕绥则认为,由于政府的公共医疗保险基金比较大,有着政府公权力的支撑,因此谈判力更强。而政府可以通过定点医疗机构、集体采购、打包定价如DRG和DIP等方式,让医院之间展开竞争,以此控制成本,从而提高医疗质量。相比之下,商保公司失去了这层优势,他们更多的精力和资金都用在广告营销和保险产品上,医疗质量相对更低,医疗费用反而更高些。
  
  撇开这项研究结果,纵观美国两大主要公共医保计划——联邦医疗保险和联邦医疗补助,其覆盖人群数量呈上升趋势。
  
  越来越多人被纳入公共医保
  
  美国国家卫生统计中心的一份调查报告显示,截至2019年,美国没有医保的人口数量为3320万人,占总人口10.3%。该数字较美国人口普查局公布的2018年2750万未投保人数(占总人口8.5%)有所增加。


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  未参保人数在增加的同时,美国联邦医疗保险和联邦医疗补助的参保人数也在一直上升。
  
  根据凯撒家庭基金会(KHN)今年6月发布的一份对美国联邦数据的分析报告,由于新冠疫情引起的经济衰退,加上联邦政府要求各州在国家紧急状态结束之前,保留联邦医疗补助计划原有的受保人,在过去一年中,联邦医疗补助计划的受保人增加了900多万人(从2020年2月的7130万人上升至今年1月的8050万人)。
  
  一般情况下,联邦医疗补助受保人数激增带来的一个直接影响是州政府预算大大减少,但由于疫情,美国国会去年将联邦政府对联邦医疗补助的报销资金份额提高了6.2%。
  
  美国卫生专家预测,拜登政府至少会在今年底之前不会撤销国家的卫生紧急状态。因此,更多人在更长时间里会受益于联邦医疗补助计划。
  
  杰拉德·安德森表示,疫情期间,美国政府允许经济贫困者免费加入联邦医疗补助计划也是该计划受保人持续上升的原因。
  
  联邦医疗保险呈现同样的趋势。根据美国退休人员协会公共政策研究所(AARP Public Policy Institute)的报告,美国联邦医疗保险计划现有受保人4400万人,占美国总人口的15%,预计到2030年这一数字将上升至7900万人。
  
  安德森认为,这其中的根本原因是美国老龄化问题持续加剧。随着美国婴儿潮一代(1946年初至1964年底出生的人)逐渐达到65岁,加入美国联邦医疗保险的人自然会增加。
  
  不论是疫情原因还是自然的人口老龄化,实际上,美国民意也逐渐倾向于选择公共医保计划。
  
  根据Morning Consult/Politico今年3月的一项新调查,高达68%的民众支持公共医保计划,高于去年3月份的63%,上升了5个百分点。
  
  而美国政府也正有此意扩大公共医保计划覆盖范围,推行新公共医保计划。
  
  新公共医保计划难以落地
  
  早在《平价医疗法案》(ACA)形成过程中,其草案里就包含了一个公众医保计划,但在当时,该计划只是政策制定者的一个初步想法,且仅限于没有雇主医保计划的民众。
  
  作为ACA的“死忠粉”,美国新任总统拜登在竞选时就宣布了一系列医疗卫生计划,其中一项就是设立新的公共医保计划,期望覆盖97%的美国人。
  
  据悉,该计划面向的是全美国人,不像联邦医疗保险和联邦医疗补助对年龄、经济能力等有限制,任何人均可购买,即使是有雇主医保的人。与之相比,该新计划向医疗机构支付的服务费率不仅高于其他公共医保计划,也高于典型的商保计划。
  
  该计划一宣布,既有支持声,也有反对声。
  
  凯撒家庭基金会副总裁辛西娅·考克斯(Cynthia Cox)表示,该医保计划是规范美国医疗价格更直接的方法,
  
  可能会从根本上改变美国医疗的定价方式。
  
  反对者则认为,新冠疫情仍在美国肆虐,在这种时候推行该计划显然不合适。商业保险公司和部分医疗机构等利益有损方也反对该计划落地。
  
  外媒评论称,这仅是一个选择性的公共医保计划,不是全民医保计划,后者将为民众提供一种单一的医保计划,随着时间的推移可能挤压商保市场,将商保挤出主市场。
  
  安德森认为,这是个关于选择可用性的辩论题。
  
  “美国崇尚个人主义和自由文化,因此,美国人喜欢有选择,有些人甚至愿意为获得更多选择而付出更多。正因为这样,提供多种医保计划的商保往往更被民众接受,如果是单一的公共医保计划反而限制了他们的选择。就目前而言,商保公司每年的参保人数比例仍相同,未出现下降现象,而政府的公共医保计划尚未有实质性的动作。”
  
  杨燕绥表示,美国的商保发展得比较早,已经有170多年的历史了,而美国政府公共医保计划是1964年各方妥协下的产物。“所以商保在在美国发展的时间比较长,当达成共识要建立社会医疗保险的时候,你能让商业保险退出吗?这是不太可能的。”
  
  杨燕绥同时也提到,商保公司竞争力大,其更多费用都投入到产品营销和招募客户上,加上商保公司不能掌握病案信息,谈判能力较弱,其下的医疗服务质量实则不如公共医保。也就是说从控费和医疗质量角度而言,显然公共医保更有优势。
  
  所以,美国全面实行公共医保或只是时间问题?
  
  武汉九鼎顾问是一家集医院绩效、战略、文化、人力资源为一体的医院管理咨询公司,如有咨询需求请拨打热点:027-82444583,或扫描以下二维码添加客服微信。
  

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