I-Medicare yinkqubo yokuhlawula omnye kodwa ngaba yanele?
Nabani na okholwayo kwinkqubo yokunakekelwa kwempilo yaseMerika yinto efanelekileyo kwihlabathi iyimangalisa. Inyaniso yiUnited States isebenzisa uninzi kunakekelo lwempilo ngamnye kodwa inemiphumo embi kakhulu yezempilo.
Uhlalutyo lweNgxowa-mali ye-Commonwealth ibukele ngokukodwa kwiintlanga ezili-11 eziphuhlisiwe. Iinkcukacha zahlanganiswa kwiinkalo ezintlanu: 1) Inkqubo yokunyamekela (ukunakekelwa kokukhusela, ukunakekelwa okukhuselekileyo, ukunakekelwa ngokufanelekileyo kunye nokunyamezela isigulane), 2) ufikelelo lokuphatha, 3) ukufikelela (ukukwazi ukufikelela kunye nokukhawuleza), 4) ukulingana kubantu abaphantsi kunye nabaphakamileyo -iyiphumela, kunye ne-5) iziphumo zonyango lwempilo (impilo yabantu, ukufa kwabantu abangenayo kwiinkonzo zempilo kunye neziphumo zempilo ezithile).
Okudabukisayo ukuba, i-US ibeke u-10 ubuchule bokuphatha kunye ne-11 yokufikelela, ukulingana, kunye neziphumo zonyango lwempilo.
Amazwe abekwe ngaphaya kweUnited States kwoluhlu ayenento enye efanayo - ukunakekelwa kwezempilo jikelele . Umbuzo kukuba ingaba iUnited States kufuneka ilandele kule miqathango.
I-Medicare njengeNkqubo yokuhlawula yedwa
Ngethuba lokhankaso loongameli luka-2016, owayenguNobhala weeNkokheli kaRhulumente uHillary Clinton wathi i-Medicare yinkqubo yokuhlawula omnye. Ithetha ntoni le nto?
Inkqubo yokuhlawula enye yinye apho enye inhlangano, ngokuqhelekileyo urhulumente, ilawula kwaye ihlawulele impilo yakho. I-"Payer single" ihlala ishintshana kunye negama elithi "ukunakekelwa kwezempilo jikelele" ngokwemigaqo, nangona ayenjalo ngokufanayo.
E-America, i-Medicare iye yinkqubo yokunakekelwa kwezempilo esibheke kuyo njengoko sikhula. Yinkqubo yokuhlawula omnye kuba urhulumente uxhasa inkqubo yezempilo ngeentlawulo esizihlawula kuyo .
Oko kwathiwa, akusiyo yonakekelo lwempilo yonke ngenxa yokuba ayigqubuthele wonke umntu. Kunoko, kunqamlekileyo kubantu abaneminyaka engama-65 nangaphezulu okanye kulabo abanokukhubazeka okuthile .
I-Tricker mhlawumbi kukuba ngelixa i-Medicare iqalile njengenkqubo yokuhlawula enye yinyaniso, iguqukele ekubeni yinto engakumbi.
Urhulumente wephondo ubeka imigangatho yento ekufuneka ikhutshwe kodwa abantu banokukhetha ukubhalisela iSicwangciso seMpilo ye- Medicare , esiqhutywa yiinkampani zomshuwalense yabucala, ngokuchasene ne-Medicare yendabuko, eqhutywa nguRhulumente.
I-Medicare kubo bonke abantu kunye neMedareri
I-Medicare inokwandiswa kwaye ifumaneke kubo bonke abantu baseMerika. Ngaloo ndlela, i-Medicare ingaba yinyango yoncedo jikelele. Isicwangciso esinjalo savunyelwa nguSenat Bernie Sanders waseVermont waza waziwa ngokuba yi-Medicare kubo bonke.
Ngethuba lokubhikisha kwakhe kumongameli we-2016, owayengumNobhala kaRhulumente uHillary Clinton wacebisa "i-Medicare for More" njengendlela yokwandisa i-Medicare. Esikhundleni se-Medicare kubo bonke, ucebise ukunciphisa umlinganiselo weemfuno ze - Medicare ukufaneleka ukusukela kwiminyaka engama-65 ukuya kuma-50 ubudala.
Oku kunceda njani?
Abantu beli qela le minyaka bavame ukuba nenani leemeko zonyango kunye neemeko zonyango ezingakumbi zithetha inkcitho yokunakekelwa kwempilo. Ubuncinane ama-87 ekhulwini kumaMerika aneminyaka engama-65 ukuya kuma-74 ubudala anesibhakabhaka esisodwa esisodwa. Inani landa kuma-92 ekhulwini kule minyaka engama-75 nangaphezulu. Amanani anciphisa ukuya kuma-72 ekhulwini xa sibona abantu abancinci be-50 ukuya kwengu-64 ubudala, kungekhona okwangoku kugqitywa yi-Medicare.
Xa umntu edibana ne-criteria yokufaneleka kwi-Medicare, baqala ukuhlawula iiprayimari zenyanga zonyango.
Le mali ifakwa kwi-pool kwaye isetyenziswe ukuhlawula iinkonzo kubo bonke abaxhamli. Ukuba abancinci, abantu baseMelika abanempilo bongezwa kule dama, ngoko into enomdla yayiza kwenzeka kwi-Medicare njengoko siyazi namhlanje. Kuya kuba nemali eninzi yokwabelana. Nangona bekuza kubakho abantu abangakumbi echibini, bekuza kubakho inani elincinci lomgangatho wezonyango zokulungisa. Oku kunokongeza iminyaka yokugcina kwi-Medicare Trust Fund .
Iinkonzo zoNonophelo lwezeMpilo
Iinyaniso kukuba iindleko zonyango zonyango ziye zanda ngokukhawuleza ngaphezu kweminyaka, kungekhona ngenxa yokunyuka kwamaxabiso okanye iteknoloji yonyango eyindleko kodwa ngenxa yezoshishino ezinkulu kunye neengxowa-mali.
Ngaphandle nje kokuba iinkampani zomshuwalense yabucala kunye neenkampani zonyango zibambe iintambo zemali, iindleko zonyango ziya kuqhubeka zikhuphuka. Inkqubo enye yokuhlawula iya kususa iinjongo eziqhutywe ngenzuzo kwimpilo yezempilo kodwa yintoni enye enika yona?
Wonke umntu uya kuba nokufikelela okulinganayo kwenkathalo kungakhathaliseki ubudala, ingeniso okanye ubuchule. Kwakhona, awuyi kuphinda ufumane ugqirha kwi "intanethi" yakho kuba bonke oogqirha babeya kubakho inethiwekhi. Iikopi kunye neentengo ezidityanisiweyo ziya kuhamba.
Ucwaningo lwesizwe oluvela kwi-Pew Research Centre ngo-2017 lubonise ukuba ama-66 ekhulwini aseMelika akholelwa ukuba urhulumente kufuneka aqinisekise ukufikeleleka kwezempilo kwaye ama-33 ekhulwini anoluvo lokuba inkqubo enye yokuhlawula iyindlela engcono yokuhamba.
Umxhelo woNonophelo lwezeMpilo
Iidola kunye neentente azikho iindleko kuphela zonyango lwempilo jikelele. Amazwe aseMelika ayengafuneki nje ukuba acinge ngokunyuka kwerhafu ababeza kuhlawula kodwa nendlela yokufikelela kwindalo yonkqantosi yayiza kubangela ngayo ukunakekelwa abayifumanayo. Ukulinda amaxesha kwiinkonzo ezingezizo ziza kufikelela ixesha elide. Ngabantu abaninzi kwinkqubo, ukufikelela kudokotela okhethiweyo kunokuchaphazeleka ngamaxesha amaninzi okulinda. Abanye abantu kufuneka batshintshe oogqirha ukuba bafikelele ngononophelo olungapheliyo ngexesha elifanelekileyo.
Lindela amaxesha kumazwe anonophelo lwempilo yendalo yonke. EDenmark, ixesha elifanelekileyo lokufumana utyando lwe-cataract emva kokuba kwenziwe isigqibo sokwenza unyango ngeentsuku eziyi-112. Awukwazi ukufumana indawo ye-hip eNgilani kwiintsuku ezingama-78. Ukuhlinzwa okhethwayo e-Ireland okanye eNorway kuya kukushiya ulinde iintsuku ezingama-75. Oko kwathiwa, amatyala anxamisekileyo athatyathwa ngokukhawuleza. Akukho ukulibaziseka ekunyamekelweni xa uyifunayo ngokwenene.
Kwixesha elide, iUnited States ingasindisa kwiindleko ezipheleleyo kunye nokuphucula iziphumo zonyango phantsi kwenkqubo yendalo yonke, kodwa ngaba baseMelika banomonde wokulinda ithuba labo?
ILizwi
Inkqubo yokunakekelwa kwezempilo yase-US inokhetho lokwenza. Iyakwazi ukuphucula imodeli yayo ye-Medicare, ikhulise ukufikelela kwayo kumaMerika amaninzi. Ngenye indlela, inokulandela indlela yokunakekelwa kwezempilo kwintlalo jikelele ukuba amazwe amaninzi aphuhlisiwe abonise ukuba ixabiso elininzi kwaye lisebenza kakuhle ngeziphumo zempilo ezingcono. Eyona nto yeshumi elinesibini ekunakekelweni kwezempilo emhlabeni jikelele ayilungele. IMelika ifanelekile.
> Imithombo:
> Aaron HJ. Yiyiphi iNdlela eya kuMbakala weSizwe? N Engl J Med. Ngo-2017 u-Dec 7; 377 (23): 2207-2209. I-doi: 10.1056 / NEJMp1713346.
Imibandela engapheliyo phakathi kwabadala baseMerika. Website ye-AARP. http://assets.aarp.org/rgcenter/health/beyond_50_hcr_conditions.pdf.
> I-Kiley J. Inkxaso Yoluntu 'Yokuhlawula Ngabodwa' Umgangatho Wezempilo Ukhula, Uqhutywe yiDemokhrasi. IPew Research Research Centre. http://www.pewresearch.org/fact-tank/2017/06/23/public-support-for-le-payer-health-coverage-grows-driven-by-democrats/. Ipapashwe ngoJuni 23, 2017.
> Schneider EC, Sarnak DO, Squires D, Shah A, Doty MM. I-Mirror, Mirror 2017: Ukuqhathaniswa kwamazwe ngamazwe kubonakalisa i-Flaws kunye namathuba okuNgcono kwezempilo eMelika. IFundwealth Fund. http://www.commonwealthfund.org/interactives/2017/july/mirror-mirror/. Epapashwe ngoJulayi 2017.
> Viberg N, Forsberg BC, Borowitz M, kunye neMolin R. IiNgqungquthela zamaZwe ngamaZwe amaxesha okulinda kwiZonyango lwezeMpilo - iMida kunye neenjongo. Nkqubo wezeMpilo . Septemba 2013; 112 (1-2): 53-61. i-doi: http://dx.doi.org/10.1016/j.healthpol.2013.06.01