Ngaba i-Medicaid iya kunciphisa ukhetho lweNyango?
Umlutha we-opioid ingxaki ekhulayo e-United States. Ukususela ngo-1999 ukuya ku-2015, nokuba ngaba izidakamizwa zonyango okanye kwi-opioid engafanelekanga njenge-heroine, abantu abangaphezu kwesiqingatha sezigidi bafa kwi-opioid overdose. Amaziko e-Medicare kunye neeNkonzo zeMedicaid (CMS) ingxelo yokuba abantu abayi-91 bafa imihla ngemihla ngokuxhatshazwa kwe-opioid, besifaka kwindlela yokufa kwabangu-32,400 ngo-2017.
Uxilongo ludlala indima enkulu ekwenzeni unyango. Ngomnye kwabahlanu baseMelika abathembele kwiMedicaid kwiimfuno zabo zonyango, ziphi iinkonzo iinkqubo ezinikezelayo kwaye ngaba ezo inkonzo ziya kuqhubeka xa iqela leRiphablikhi liphumelela ekutshitshweni koMthetho wokuNakekelwa ongenakuncedo , u-Obamacare?
Ukusetyenziswa kakubi kwe-Opioid Kuphi na indawo
Ukusetyenziswa kakubi kwe-opioid akuyona nje ingxaki yemoya. Ingxaki yesizwe.
Ukugqithiswa kwexesha elidlulileyo kwenyuka ukusuka kunxweme ngonxweme ngo-2014. I-Ohio neCalifornia yaxhatshazwa kakhulu ngaphezu kwe-2 000 ukufa kwe-opioid nganye, ngelixa i-New York, eFlorida, e-Illinois, eTexas, eMassachusetts, ePennsylvania, naseMichigan nganye yayinokufa kwabantu abangaphezu kwe-1 000. .
Njengoko ukusetyenziswa kakubi kwe-opioid akusiyo yommandla, i- Medicaid ayixhomeki kumazwe. I-Medicaid, ngelixa ilawulwa yizo zizwe, ixhaswa ngemali ngeedola. Urhulumente wezepolisi ubeka umgangatho omncinci wokuba ngubani ofanelekileyo kwiMedicaid kwaye yeyiphi inqaku eliyisiseko kufuneka lifakwe kule nkqubo.
UMthetho wezeMpilo waseMelika , njengoko wawuthiwa kwiNdlu yabaMameli be-US, ucetywe ukuba ulungelelaniso olukhulu kwinkqubo yeMedicaid. Umthetho osayilwayo, ngoku ubizwa ngokuba nguMthetho woNgcoliseko woLondolozo lweNtsebenzo, ulindele ivoti kwi-Senate yase-US ngaphambi kokuba ube ngumthetho. Ukuba udlulile, umthetho ungatshintshelwa ntoni na iingeniso zempilo ezibalulekileyo-kuquka iinkonzo zempilo yengqondo kunye nezokwelashwa kweziyobisi - zifunyenwe yinshuwalense yakho yempilo.
Oku kuquka iMedicaid.
UkuPhatha i-Opioid Addiction
Umthetho ojongene noNonophelo ongenakunqwenelekayo kufuneka ukuba uthathe inxaxheba kwi-Medicaid yokwandisa i-substance usetyenziso lwe-disorder. Nangona kunjalo, umthetho wanikezela ukuguquguquka kwaye wavumela elowo urhulumente ukuba anqume ukuba yeyiphi inkonzo endifuna ukuyibuyisela.
UMthetho woNxibelelwano woNxibelelwano olungcono unokuphelisa ukwandiswa kweMedicaid kwaye unqande unyango olugunyazisiweyo lokulutha.
Kukho amanqanaba amane olwahlukeneyo kunyango okumele acingisise ngawo:
- Iinkonzo zonyango (kubandakanywa unyango lwamaqela, unyango olulodwa kunye neenkonzo zenkxaso yokubuyisela)
- Iinkonzo eziphambili zonyango
- Iinkonzo zonyango ezifutshane kunye nexesha elide
- Unonophelo olunzulu lwezonyango zokuxilwa kwe-detoxification
Uphononongo lweMicimbi yezezeMpilo luhlolwe ukuxhaswa kwezinto ezibangelwa umlutha ukususela ngo-2015 ukuya ku-2016. Okuthakazelisayo kukuba, abaphandi bafumanisa ukuba ukugqithiswa akuzange kuphakanyiswe kwiindawo eziye zandisa ukwanda kweMedicaid .
IziXhumi ezilishumi elinesithathu kunye neSithili sase-Columbia zihlanganisa zonke iinkonzo, kwaye i-26 ibandakanya ubuncinane inkonzo enye kwinqanaba ngalinye leyeza. Amazwe anesithoba awazange anikezele ukuxhaswa kweMedicaid kwanoma yintoni ukunakekelwa kakubi kweziyobisi kumanqanaba amabini okanye ngaphezulu kunyango.
Nangona kunjalo, ukunikezela kwezi nkonzo akuthethi ukuba babelula ukufikelela.
Phantse isiqingatha sa mazwe afuna uhlobo lwenkqubo yokubaluleka kwangaphambili ebizwa ngokuba ligunyaziso ngaphambi kokuba bahlawule ukunyamekela okunyamekileyo kwezonyango. Iintetho zithoba zongeza i-cap malunga nendlela enokusetyenziswa ngayo kwiinkonzo zokubuyisela umlutha.
UkuPhatha i-Opioid Abuse drug
Amachiza aphezulu asetyenziselwa ukunyanga umlutha we-opioid yi-buprenorphine (igama lomkhangeli we-Suboxone), i-methadone, kunye ne-naltrexone (amagama e-brand Depade, Revia, kunye neVivitrol). Iyeza ngalinye libophelela kwi-opioid receptors kwiingqondo ukuze zenze umphumo walo:
- I-Buprenorphine: I- Buprenorphine ihlala ikhethwa njengonyango kuba ihlala ide kakhulu emzimbeni. Ithintela umphumo osisigxina obopiate ngokuqhelekileyo ukubangela, kwaye unesigamu sokuphila ukususela kuma-24 ukuya kwi-42 iiyure.
- I-Methadone: I- Methadone yi-opiate eyenziweyo eyenza ukunciphisa izifiso. Nangona kunjalo, njengamanye ama-opioids, kunokubangela ukuxhomekeka kwenyama. I-Methadone idla ngokusetyenziswa njengonyango lokulondolozwa kwaye inokutshiyelwa ngaphandle kwexesha. Ubomi obunomlinganiselo walo buhluka, ukususela kwiiyure eziyi-8 ukuya kwezi-59.
- I-Naltrexone: I- Naltrexone ijoliswe ekunciphiseni iiminqweno ze-opioid kwaye kwezinye iimeko zisetyenziswe ukunyanga utywala. Isiqingatha sobomi sisithuba sama-4 ukuya kwi-13 iiyure.
Uphando lwezeMpilo lubonise ukuba wonke urhulumente kunye neSithili saseColumbia bahlasele i-buprenorphine, kwaye ama-forty-eight ashicilelwe i-naltrexone. Umlinganiselo we-methadone, nangona kunjalo, wawuncinci. Kuphela ama-32 aquka ukuquka i-methadone kwiiprogram zeMedicaid.
Ngokufanayo neengcebiso kunye neenkonzo zonyango, ukugunyazwa kwangaphambili kudlale indima ekukhuselweni kwamachiza. Uninzi lwamazwe ludinga ukugunyazwa kwangaphambili kwe-buprenorphine ngelixa enye yesithathu ifuna ikopi.
Kuphazamiseka xa ucinga ngako. Abantu abafuna uncedo kwi-opioid addiction banqatshelwe ukufikelela ngokukhawuleza kunyango xa bafuna kakhulu. Ukuncipha kwonyango yinto ebenokubangela ukuba baphinde babuye.
Ukuxhaswa Kwezimali kuxhomekeke kwiMedicaid
Ukulindela i-Medicaid ukulungisa ubhubhane lwesizwe akunakwenzeka, kungekhona ukuba inkxaso-mali kwiprogram iyanqunyulwa. Ngelishwa, oko kwenzeka.
Ukuba uMthetho woNxibelelwano loNxibelelwano olungcono ube ngumthetho, ukwandiswa kweMilicaid njengoko siyazi phantsi koMthetho woKhathalelo ongenakunqununu kuya kupheliswa. Imfuno yokubandakanya unyango lobisi kakubi njengenxalenye yeprogram yeMedicaid iya kuhamba.
Nokuba uthi ukuba ayengathathi nxaxheba kwi-Medicaid ukwandiswa kuya kuthinteka. Oku kungenxa yokuba inkxaso yemveli kwiinkqubo zeMedicaid iya kuguqula. Esikhundleni sokuba urhulumente wesigqeba afane nantoni na ukuba ilizwe ngalinye lichitha idola ngemali, uMthetho woNgcoliseko woLondolozo lweNgcaciso uya kunciphisa iindleko kwiintlawulo nganye . Oko kukuthi, ilizwe ngalinye liza kufumana inani elingu-dollar elinqununu ukusuka kurhulumente ngokusekelwe kwinani labantu ngabanye kwi-Medicaid kwimeko.
Ngokutsho kwe-Ofisi yeBhunga leNgxowa-mali, le nguqu kwinkxaso-mali iya kunciphisa i-$ 772 yezigidigidi ukusuka eMedicaid ngo-2026.
Oku kuza kubeka umthwalo omkhulu kwilizwe ukufumana enye inkxaso-mali xa ama-budget abo aseburhulumenteni sele sele ephantsi. Kulindeleke ukuba amazwe amaninzi aya kufuneka adume iinkonzo zeMedicaid ukuze ahlale ehamba. Ngokudabukisayo, iinkonzo zempilo yengqondo kunye nokunyangwa kweziyobisi zingabokuqala.
ILizwi
Akukho mbuzo ukuba uMthetho woNxibelelwano loLondolozo lweNtsebenzo olungcono luya kunciphisa ukufikelela kwiinkonzo zempilo yengqondo. Akunandaba nokuba u-Medicaid, isicwangciso sezempilo sabucala, okanye i-inshurensi exhaswe ngumqeshi. Utshintsho kwezi zicwangciso ezifunekayo, oko kukuthi, utshintsho kwiintlawulo zezempilo ezibalulekileyo, kuya kuthintela naziphi iinkonzo oya kuzifumana kwaye ziya kwenza kube nzima kulabo abanenkinga yokufumana umlingo wokufumana uncedo abayidingayo.
> Imithombo:
> Grogam CM, Andrews C, Abraham A, et al. Uphononongo lubonisa ukungalingani kwi-Medicaid Ukusetyenziswa kweMveliso yokuSebenza kweMveliso kunye ne-Opioid Use Use Disorder Medication. Aff Aff. Disemba 2016. 35 (12): 2289-2296. i-doi: 10.1377 / hlthaff.2016.0623
> HR 1628 . Ofisi yeSenate yaseUnited States. https://www.budget.senate.gov/imo/media/doc/SENATEHEALTHCARE.pdf. Ishicilelwe ngoJuni 22, 2017.
> HR 1628, uMthetho woNxibelelwano woNxibelelwano olungcono lwe-2017. https://www.cbo.gov/publication/52849. Ishicilelwe ngoJuni 26, 2017.
> Ukukhusela nokuLawulwa kweNkunkuma: Ukugqithisa i-Opioid - Ukuqonda ukuLazeka. Amaziko okuLawulwa kweNtsholongwane kunye noThintelo lweSifo. https://www.cdc.gov/drugoverdose/epidemic/index.html. Ukuhlaziywa ngoJuni 21, 2016.
> Rodriguez CH. Ubungqina beMilicaid for Addiction Treatment Ulwahluleka kakhulu. Iwebsite yeKaiser Health News. http://khn.org/news/medicaid-coverage-for-diction-treatment-varies-dramatically/. Ipapashwe ngoDisemba 6, 2016.