Ukuguqulwa kwezempilo kwintetho eqhubekayo e-US iminyaka emashumi. Amagama amabini aqhelekileyo asetyenziswa kwingxoxo yinkxaso yonyango jikelele kunye nenkqubo yokuhlawula omnye. Akunjalo into efanayo, nangona abantu bambi bawasebenzisa ngokungafaniyo.
Nangona iinkqubo zokuhlawula omnye umntu zibandakanya ukukhutshwa kwendalo yonke, amazwe amaninzi aphumelele ukufihla yonke indawo ngaphandle kokusebenzisa inkqubo enye yokuhlawula.
Makhe sijonge ukuba lithetha ukuthini na amagama amabini, kunye neminye imizekelo yendlela asebenze ngayo emhlabeni jikelele.
Umyinge
"Inkcazo yendalo yonke" ibhekisela kwinkqubo yokunakekelwa kwempilo apho wonke umntu unempilo. Ngokwe-US Census Bureau, kwakukho i-28.1 yezigidi zabantu baseMerika ngaphandle kwenkonzo ye-inshorensi yempilo ngo-2016 (oku kwaphungulwa ngokukhawuleza ukusuka kwizigidi ezingama-46.6 ezingazange ziqinisekiswe iminyaka elishumi ngaphambili, ukunciphisa ngenxa yokuphunyezwa koMthetho wokuNakekelwa ongenakuncedo ).
Ngokwahlukileyo, akukho nabemi baseCanada abangaqinisekisiweyo - inkqubo yabo yokusebenza karhulumente inikezela ngokukhawuleza. Ngaloo ndlela, iCanada inakekelwa ngoncedo lwezempilo jikelele, ngelixa i-United States ingabalulekanga (kubalulekile ukuqaphela ukuba i-28.1 yezigidi ezingaxhaswanga kwi-US ibandakanya i-4.7 yezigidi ezingabhalwanga ngabangaphandle. I-system ye-Canada-run system does not provide a coverage to immigrants).
Inkqubo yokuhlawula omnye
Ngakolunye uhlangothi, "inkqubo yokuhlawula omnye" inye apho kukho elinye iqumrhu-ngokuqhelekileyo urhulumente ojongene nokuhlawulwa kwamabango enkonzo. EU.S., i- Medicare kunye noLawulo lwezeMpilo weeVeter ziyimimiselo yenkqubo yokuhlawula omnye. Ngamanye amaxesha ukuxilongwa kuthiwa yi-system-payer system, kodwa ngokwenene uxhaswa ngemali kunye noRhulumente wephondo kunye norhulumente ngamnye karhulumente.
Ngoko nangona luhlobo loluntu oluxhaswa ngemali oluxhaswa nguRhulumente, inkxaso-mboleko ivela kwimithombo emibini kunokuba ibe nye.
Abantu abafakwe phantsi kwezicwangciso zempilo ezixhaswe ngumqeshi okanye izicwangciso zempilo nganye zemakethe e-US (kubandakanywa nezicwangciso ze-ACA-ezihambelanayo) azikho inxalenye yenkqubo yokuhlawula omnye, kunye ne-inshorensi yabo yezempilo ayisebenzisiyo. Kule marike, amawaka ahlukeneyo, iinkampani zomshuwalense yabucala zinoxanduva lokuhlawula izimangalo zamalungu.
Kwiimeko ezininzi, i-"universal coverage" kunye "nenkqubo yokuhlawula omnye" ihamba ngokulandelana, ngokuba urhulumente wephondo ochaphazelekayo unomdla kakhulu wokulawula nokuhlawula inkqubo yokunakekelwa kwempilo ebandakanya izigidi zabantu. Kunzima ukucinga into eyenziwa ngasese njengenkampani yomshuwalense enezinto eziphathekayo, okanye kwinqanaba elibanzi, ukuseka inkqubo yokunakekelwa kwezempilo yonqulo lonke.
Nangona kunjalo, kunokwenzeka ukuba kubekho ukuhamba ngokubanzi ngaphandle kokufumana inkqubo yokuhlawula omnye, kwaye amazwe amaninzi emhlabeni jikelele akwenzile njalo. Ezinye iingcali zicebise ukuba i-United States kufuneka ihlaziye ngokunyanisekileyo inkqubo yayo yokunakekelwa kwempilo yangoku ukubonelela nge-intanethi yokukhuseleka ngemali yabagulayo kunye nabampofu (uhlobo lwenkqubo ekhulisiwe ye- ACA's Medicaid expansion ), ngelixa ifuna abo banenhlanhla bulumko-bulumko kunye nezezimali ukuthenga imigaqo yabo.
I-gridlock yezopolitiko eye yahlala phezu koMthetho woNonophelo ongenakunqwenelekayo kwiminyaka emininzi edlulileyo yenza kube nzima ukucinga ukuba isiphakamiso esinokufumana i-traction eyaneleyo. Kodwa kunokwenzeka ukuba kusetyenziswe inkqubo enjalo, eyayiza kubonelela ngeenxa zonke xa ikwaba neerhafu ezininzi.
Nangona kunokwenzeka ukuba kunokwenzeka ukuba ube nenkqubo yokuhlawula enye yelizwe ngaphandle kokufumana inkcazo yempilo yonke, akunakwenzeka ukuba kwenzeke ngenxa yokuba umhlawuli-ntlawulo omnye ongenakuqinisekiswa ukuba ngu-federal government. Ukuba urhulumente wesigqeba kufuneka asebenzise inkqubo enjalo, ayiyi kuba yinto ebonakalayo kwezopolitiko ukuba angabandakanyi nawuphi na ummi woluntu kwi-health coverage.
LwezoLuntu
Elinye iqela elithetha ngokubhekiselele kumhlawuli-ntlawulo kunye nomhlaba wonke, kodwa yinkqubo apho umvuzo-ntlawulo omnye athatyathwa khona. Kwiinkqubo zonyango oluntu, urhulumente uyahlawula unyango lwempilo kwaye usebenza nezibhedlele kwaye uqeshe oogqirha kunye nabanye oogqirha. E-United States, inkqubo yoLawulo lwe-Veterans (VA) ngumzekelo wonyango oluluntu, njengoko urhulumente asebenza kwaye asebenza okokuba izibhedlele ze-VA, kwaye zihlawula iibhili.
INkonzo yezeMpilo kaZwelonke (i-NHS) e-United Kingdom ngumzekelo wenkqubo apho urhulumente ahlawula khona iinkonzo kwaye enezibhedlele kwaye aqeshe oogqirha. Kodwa eCanada, ene-system-payer system ne-universal coverage, izibhedlele ziqhutywe ngasese kwaye oogqirha abaqeshwanga ngu rhu lumente-bamane banqabise urhulumente ngeenkonzo ezibonelela zona.
Umgangatho Wezempilo Ehlabathini
Ngokweenkcukacha ezivela kwi-Organisation for Economic Cooperation and Development, amazwe amaninzi aphumelele ukufikelela kwiphepha, kunye neepesenti ezingama-100 zabantu. Oku kuquka iAustralia, iKhanada, iFinland, iFransi, iJamani, iHungary, i-Iceland, i-Ireland, i-Israel, i-Netherlands, iNew Zealand, iNorway, iPortugal, iSlovak Republic, iSlovenia, iSweden, iSwitzerland kunye ne-United Kingdom. Ukongezelela, amanye amazwe amaninzi aphumelele kufuphi nokufihlakeleyo kwindalo engaphezulu kwama-98 ekhulwini lwabemi bensikelelo, kuquka i-Austria, iBelgium, iJapane neSpain.
Ngokwahlukileyo, kuphela i-91 engama-100 e-US yabemi be-insured ngo-2016, kwaye ukulandelela kweGalp kubonise ukuba ipesenti yabantu baseMelika abanempilo yokuhlaselwa behlile ngaphantsi kwe-88 ekhulwini ngasekupheleni kuka-2017.
Makhe sijonge ngeendlela ezahlukeneyo apho amanye amazwe afumane ukufikelela kwiphepha le-universal (okanye ngasekuhlaleni jikelele):
Jemani
IJamani ihamba ngokubanzi, kodwa ayisebenzisi inkqubo enye yokuhlawula. Kunoko, wonke umntu ohlala eJamani uyadingeka ukuba agcinwe ngezempilo. Abaninzi abasebenzi baseJamani babhalise ngokuzenzekelayo kwenye yee-100 zeengxowa-mali "zokugula," ezihlawulwa ngokuhlanganiswa komsebenzi kunye neminikelo yomqeshi. Ngaphandle koko, kukho izicwangciso ze-inshorensi zempilo ezizimeleyo, kodwa malunga neepesenti ezili-11 zabantu baseJamani bakhetha i-inshurensi yempilo yabucala.
Singapho
ISingapore ine-coverage yonke, kwaye iindleko zonyango zempilo ezinkulu zigqityiwe (emva kwe-deductible) yenkqubo yomshuwalense osebenza ngurhulumente obizwa ngokuba yi-MediShield. Kodwa iSingapore ifuna ukuba wonke umntu abe negalelo phakathi kwe-7 ne-9.5 yepesenti yengeniso yabo kwi-akhawunti ye-MediSave. Xa izigulane zifuna ukunakekelwa kwonyango rhoqo, ziyakuthatha imali ngaphandle kwee-akhawunti zabo zokuhlala zihlawulele-kodwa imali ingasetyenziselwa iindleko ezithile nje, njengamachiza eluhlu oluvunywe nguRhulumente. Ukongezelela, urhulumente uncedisa ngokukhawuleza indleko zempilo ngokwayo (kunokuba iindleko ze-inshorensi, njengokuba kunjalo ngophahla oluthengiweyo ngokusebenzisa i-ACA-edityaniswe ukutshintshana e-US, umzekelo), ukuze inani labantu lihlawule ngenxa yokunyamekela kwabo kuncinci kunokuba kungenjalo.
Japhan
IJapan ine-universal coverage, kodwa ayisebenzisi inkqubo enye yokuhlawula. Ubungakanani bubonelelwa ngokukodwa kwamashumi ama-inshorensi ye-inshorensi yempilo kwiNkqubo ye-inshurensi yezempilo (Statutory Health Insurance System (SHIS). Abahlali kufuneka babhalise kwi-postage kwaye bahlawule iiprayimari eziqhubekayo kwi-SHIS, kodwa kukho inketho yokuthenga i-private insurance, eyongezelelweyo inshorensi yempilo.
IUnited Kingdom
I-UK ngumzekelo welizwe elinenkqantosi yomhlaba wonke kunye nenkqubo yokuhlawula omnye , kwaye njengoko kuphawuliwe ngasentla, inkqubo ye-UK inokuthi ichazwe njengonyango oluntu, kuba urhulumente unabo abaninzi kwizibhedlele kwaye uqeshe ababoneleli bezonyango. Inkxaso yeeNkonzo zezeMpilo zeSizwe yase-UK ivela kwingeniso yerhafu. Abahlali banokuthenga i-inshorensi yempilo yabucala ukuba bafuna, kwaye ingasetyenziselwa iinkqubo ezikhethiweyo kwizibhedlele ezizimeleyo, okanye ukufumana ukufikelela ngokukhawuleza kokunyamekela, ngaphandle kwexesha lokulinda elingafakwa yi-NHS ngeemeko ezingezoxakeka.
Imithombo:
> Gallup. Inani le-Uninsured yase-US elondolozwe kwi-12.2% kwi-Quarter yesine ka-2017. NgoJanuwari 16, 2018.
> Umbutho woQhagamshelwano loQoqosho noPhuhliso. Ukulinganisa iMpilo. Meyi 2016.
> I-US Census Bureau, i- Health Insurance Coverage e-United States, ngo-2016 . papashwa ngoSeptemba 2017.
> I-US Census Bureau, Income, Inhlupheko, kunye neMpilo Yomshuwalense eMpilo eMelika, ngo-2005 . Upapashwe ngo-Agasti 2006.