Ininzi yethu ayiyiqondi isizathu sokuba unyango lwemali lubiza kakhulu. Siyazi ukuba iindleko zempilo yononophelo zithatha isahlulo esiphezulu semveliso yethu yasekhaya. Kodwa, kutheni iindleko zempilo yononophelo zikhula ngokukhawuleza kunexabiso lentengo?
I-poll ka-2005 nge-USA Today / iKaiser Family Foundation / iSikole sase-Harvard yezeMpilo zikaRhulumente yabonisa ukuba amaMerika acinga ukuba iinkampani ezixhamle imithi kunye ne-inshorensi, kwaye izigwebo zonyango zonyango zizinto ezibalulekileyo ezibangela ukunyuka kweendleko zempilo.
Abo baseMerika babengafanelekanga. Nangona kukho izinto eziliqela ezithintela kwiindleko zokunyuka kwezempilo, enye yazo ihamba phambili.
Enye into ebangela isigxina sokwanda kweendleko
Ukuphendula ngeengxelo ezingaphezulu kwesigamu sokwanda kweendleko, enye yeyona nto ibalulekileyo ekunyusweni kweendleko zonyango ezonyukayo uphuhliso lwezobuchwepheshe kwiinkonzo zonyango . Siyabulela kwimpumelelo yezokwelapha, sinokuphilisa okanye siphathe iimeko ezazisetyenziswa ukusibulala. Kodwa, ezo zonyango zonyango ziza nezithengiso zamanani.
Ngokomzekelo, yonke intsimi yonyango yokuguqulwa komzimba iguqukile ukususela ekupheleni kwawo-1960. Ukuba wawufuna ukutsalwa kwentliziyo ngo-1965, wafa. Ngoku, ukuba unethamsanqa ngokwaneleyo ukuba ube nomnikeli, amakhulu eminyaka weedola kamva unentliziyo entsha.
Ukutshintshwa okuncinane, ukutshintshwa ngokuhlangeneyo kuye kwaba yindawo eqhelekileyo kwiminyaka embalwa edlulayo. Akuqhelekanga ukuba umntu oyedwa abe namajoyina amaninzi atshintshe, okanye abe ne-joint joint at times multiple times.
Kodwa, ukuqhubela phambili kwezocwangciso zokugqirha akuyiyo kuphela intuthuko kwezobuchwepheshe bezobuchwephesha okwandisa iindleko zempilo yononophelo. Yonke insimu ye-DNA i-biopharmaceutical recombinant iguqukile ukususela ngo-1980. Ngokomzekelo, i-Enbrel, ijojo esetyenziselwa ukuthintela iziphumo ezinobungozi be-rheumatoid arthritis kunye ne-anondlosing spondylitis, ixabisa malunga ne-$ 20,000 ngonyaka.
Akunjalo nje ngeendleko zeteknoloji entsha, nokuba. Kwakhona iindleko zokuqhubeka nokubonelela ngononophelo lwempilo kumntu ogxininiswa ngumnye walabu buchwepheshe obutsha.
Thatha isifo sengqondo njengomzekelo. Kwiminyaka edlulileyo kukho nitroglycerine, oksijini, kunye ne-morphine. Ukuba uneminyaka engama-50 ubudala enesifo senhliziyo, awuzange uphumelele kwiminyaka emininzi ngenxa yokuba iteknoloji yokunyanga ngokufanelekileyo isifo ayikho.
Ngoku, unokufakwa kwisimo somfanekiso njengoLigitor ixesha elide ngaphambi kokuba ube ne-twinge yokuqala yeentlungu zesifuba. Ukuqala kwakho kwempawu kunokulibaziseka iminyaka. Ukuba ekugqibeleni uhlakulele iimpawu, unokuphathwa ngezinto ezinjenge- angioplasty , i- stents , kunye nokuhlinzwa ngokugqithiseleyo, okunokwenzeka ukuwandisa ubomi bakho kwiminyaka emininzi.
Kodwa, iindleko zala mashumi eminyaka ayikho nje iindleko ze-Lipitor kunye ne-stent. Kwakhona iindleko zazo zonke ezinye iinkathalo zempilo ozifumanayo ngenxa yokuba uhlala iminyaka emininzi. Ukuba wawusweleke kwiminyaka engama-50 ukusuka ekuhlaselweni kwentliziyo yakho, wawungeke ufune ukuguqula idolo xa uneminyaka engama-62 ubudala. Ubungeke uphathwe ngumhlaza wesibeletho xa uneminyaka engama-70 ubudala. Zonke ezo ndleko zonyango zenzeke njengengxelo ngqo yenkqubela phambili kwezobuchwepheshe bezobugcisa ezikuvumela ukuba uphile ixesha elide ukufuna unyango kwezinye izinto.
Kuthiwani ngamanye ama-50%?
Nangona uphuhliso lwezekhnoloji yezobugcisa lujongene no-50% wenyuka kwiindleko zempilo yononophelo, kusekho enye i-50% ekufuneka ibalwe. Uninzi lweendleko zenyuka liye ngenxa yokwandisa imali engenayo kunye nokwandiswa kwe-inshorensi yempilo. Zombini kwezo zinto zidala isidingo sokwanda kweempilo. Abantu abacebileyo banako ukufumana unonophelo lwempilo emininzi, ngoko basebenzisa ulondolozo lwempilo. Abantu abane-inshorensi yempilo bayasuswa kwimithwalo yexabiso eliyinyaniso lononophelo lwempilo, ngoko banokunyamekela impilo yoncedo.
Inkunkuma, ukukhwabanisa, kunye nokusetyenziswa kakubi, kunye nokutshintsha kwimiba yabantu njengokuguga kwabantu kunye nokunyuka kwamazinga okunyanya kuninzi kunenxa yokunyuka kweendleko zonyango.
Kodwa akukho nto isondela nakwiimpembelelo zentuthuko kwezobuchwepheshe bezobugcisa.
Kutheni iindleko ezikhulayo zempilo yononophelo?
Imali yokunakekelwa kwempilo eMelika iphuma kwi-4.7% ye-GDP ngo-1960 ukuya kwi-149% ye-GDP ngo-2005. Ngoku, iphakamileyo. Ukuba iindleko zonyango ziqhubeka nokunyusa inxalenye eyandayo yenzuzo yesizwe ngamnye kunyaka, ekugqibeleni iya kuba yinto engaqinisekanga. Okwangoku, kusenza sibe nokuncintisana ngokuncinci kwimarike yehlabathi.
Kwintlanganiso ye-CNBC ka-Matshi ka-2010, umnini-mali we-billionaire uWarren Buffett uthelekise iindleko zonyango ezonyukayo kwi-tapeworm, esithi "yonke into esiyivelisayo yokuthumela ngaphandle, into esiyincintisana nayo ... ithwala iindleko ..."
Yintoni esinokuyenza ngayo?
Asifuni ukuyeka ukuphuhliswa kobuchwepheshe bonyango, nangona bangela ukuba iindleko zonyango zikhuphuke. Uphuhliso lwezonyango ngokuqhelekileyo luyinto entle.
Kunoko, sifanele sisebenzise uphando olulinganiselayo lokucwangcisisa ngokucokisekileyo inzuzo yeteknoloji nganye entsha malunga nokunyanga esele sinayo. Kufuneka sibone ukuba iteknoloji entsha ithatha ingxaki ngakumbi kunezobuchwepheshe obudala. Ukuba kunjalo, ngaba inzuzo ihambelana nazo zonke izigulane? Okanye, ngaba amaqela athile abagulane angcono ukufumana unyango oludala? Okwangoku, asinalo ulwazi olwaneleyo malunga nokusetyenziswa okuthelekisayo kwonyango oluhlukeneyo ukwenza ukhetho olupheleleyo malunga nokuba unyango luhle kangakanani kwiimeko.
Ukongezelela, kufuneka sikhiphe okanye silawulwe inkunkuma, ubuqhetseba nokusetyenziswa kakubi. Sifanele sikhuthaze ukutshintsha kwezinto zokuphila ukwenzela ukunciphisa izinga lokunyameka. Kwaye, kufuneka sikwazi ukubonelela ngokucacileyo kwiindleko zeenkonzo zononophelo zezempilo ukuze abathengi ngabanye babe nombono ochanekileyo wendlela inkonzo nganye yokunakekelwa kwezempilo eyisebenzisa ngayo iindleko.
Imithombo: Iindleko zonyango lwezeMpilo: I-Primer kaHenry J Kaiser Family Foundation, iTshintsho loThuthulo kunye noKhuseleko lweZonyango zokuThengwa kweeNgxowa-mali yi-Congressional Budget Office , i -Long-Term View of Health Care .