Imfuno Ekhulayo Ihunyushwa Eminye Imali Yabahlengikazi Abaningi
Njengokuthi abaqeqeshiwe bezempilo bebengakabi nokufunwa okuphezulu, imithombo eminingi ikhomba izitayela ezibonisa ukuthi uMthetho Wokunakekelwa Ongenakusiza (ACA) uqhubeka ukwandisa isidingo sabasebenzi abaningi bezempilo. I-ACA, ebizwa nangokuthi i-Obamacare noma ukuguqulwa kwezempilo, yi-akhawunti eminingi eyenza ukwanda kwedinga ikakhulukazi odokotela nabahlengikazi, futhi kungenzeka ukuthi kubangele ukuntuleka kwezinto ezimbi ezindaweni ezithile zezwe, ikakhulukazi ngezinsizakalo zokunakekelwa okuyinhloko.
Izizathu zokuthi kungani i-ACA ifuna ukwandiswa kwezidingo zabasebenzi bezempilo
Enye indlela i-ACA yokwandisa ukufunwa yikunciphisa inani labantu kulelizwe abangaqinisekisiwe inqubomgomo yokunakekelwa kwezempilo. Ngokwandisa izinga le-insured, lokhu, futhi, kwakha isidingo esengeziwe sezinsizakalo zezempilo. Imithombo ethile, kuhlanganise neYunivesithi yaseBradley, ibika izinga elingavunyelwe ukuthi libe ngaphansi kwamaphesenti angu-9.2, okuyizinga eliphansi kakhulu eminyakeni engama-50. Umbiko wabo mayelana nomthelela we-ACA kwabasebenzi abahlengikazi kanye nokubhalisa abafundi abafunda esikoleni sabahlengikazi uthi "ukuqaliswa kwe-ACA kuveza ithuba elingakaze lenzeke kuma-APRNs (Abahlengikazi abaPhezulu abaBhalisiwe abaBhalisiwe) ukuthatha izinyathelo zobuholi ekuhlinzekeni ngokuyinhloko nokuqinisa amasevisi okuvimbela . "
Okunye okukhulayo ekudumeni nasekufuneni kuyizinhlelo zokudokotela zokuhlengikaza (DNP), ngokusho kweNyuvesi yaseBradley. "Abahlengikazi bezokwelapha abahlengikazi baye baqhubekela phambili ngolwazi lomgomo kanye namakhono okukhuthaza," kusho umbiko, ngokuphawula ukuthi abafundi abangu-18 352 ababhalise izinhlelo ze-DNP ngo-2013-2014.
Ukwanda Kwezokunakekelwa Kwempilo Yengqondo
Ngaphezu kokuntuleka emkhakheni wokunakekelwa okuyinhloko, ukunakekelwa kwempilo yengqondo kubuye kube nomuzwa wokucindezela emsebenzini, ngemuva kwe-ACA. Ukuze kusize ukuhlangabezana nesidingo esikhulayo, izikole eziningi zandisa izinhlelo zezinga eliphezulu ekululekeleni nasekuphatheni impilo. Ngokusho kweYunivesithi yaseBradley, cishe ingxenye (amaphesenti angu-47,4) aseMelika azothola uhlobo oluthile lwempilo yengqondo ekuphileni kwabo bonke.
Izinga lokugula ngengqondo e-United States liphakathi kwamazwe aphezulu kakhulu, ngokusho kwe-World Health Organization (WHO).
Abaqeqeshi abaPhuthumayo abaSebenzayo
Abaqashi abaningi nezindawo zokunakekelwa kwezempilo baphendukela kubahlinzeki abaqeqeshiwe abaphambili, njenge-NPs (abahlengikazi abahlengikazi) kanye nama-PA (odokotela bamazisi) ukusiza ekuhlangabezaneni nesidingo ekunakekelweni okuyisisekelo kanye nempilo yokuziphatha. Abaqeqeshi abasebenza ngokuqhubekayo kakade babhekene nesipingo ekufuneni nasekuqeshweni komsebenzi, iningi lamafemu okuqasha libika. Isibonelo, i-Medicus Firm, udokotela kazwelonke wezokwelapha kanye nomsebenzi ophambili wezokwelapha osebenza ngokuzikhandla, uye wabonisa ukwanda okweqile emsebenzini wokubeka kwabahlinzeki abangewona odokotela ngo-2014 no-2015, ngokusho kombiko wabo wokufinyeleleka wonyaka wokusebenza komsebenzi kazwelonke. Ngonyaka wezi-2015, ukuhlinzekwa kwabahlinzeki bezobuchwepheshe obuphakeme kwakhula kwaba ngamaphesenti angama-8.3 emaklayenti aphelele emaklayenti ezweni lonke, kusuka kumaphesenti angu-6.34 ngonyaka odlule, kanti amaphesenti angu-1.32 ngo-2012. Ngo-2015, Abasizi Bokwelashwa babeyizinsizakalo ezine ezinezinhlinzeko eziqhubekayo ngamakhasimende we-Medicus Firm .
Indlela Impumelelo Yokwenyuka Ngayo Impumelelo Yokunakekelwa Kwezempilo Kwezitholampilo
Njengoba kunesidingo esikhulu kanye nokuntuleka okungase kube khona kuvela umkhuba wokuhola amaholo.
Ukufuna kanye nemishayo yezinyanga kanye nabaqeqeshi abaphambili abahlengikazi bebelokhu behamba phambili iminyaka eminingana. Ukwengeza, ukusabalala kokusayina amabhonasi kuye kwabangela ukuthi i-perk ibe ilindeleke kakhulu odokotela lapho beqashwa, okungenani okungamaphesenti angu-70 wokubekwa okubandakanya ibhonasi yokubhalisa. Ngokombiko we-Medicus Firm's placement, isilinganiso sebhonasi sokusayina odokotela sakhulile sibe ngu-$ 23,663, kanti ezinye izazi ziyala amabhonasi ayisithupha okubhalisa ama-$ 100,000 kuya ku-$ 250,000.
Muva nje, ukusayina amabhonasi ama-NP kanye nama-PA kwakungeke kuzwakale, kodwa kamuva nje ukusetshenziswa kokubhalisa amabhonasi ukukhohlisa ukuqhutshwa phambili kwemitholampilo yokwamukela umsebenzi kuba yindawo evamile.
Ibhonasi yokubhalisa ejwayelekile yama-PAs yayingama- $ 6,250 ngo-2015, ngaphezulu kokuphindwe kabili i-$ 3,000 isilinganiso seminyaka emibili ngaphambili.
Ngaphandle kokusayina amabhonasi, amaphakheji okuthutha nawo anikezwa ukusiza ngezindleko zokuthuthela emphakathini omusha, futhi ukubuyiselwa kwemali mboleko yomfundi nakho kuyindoda ethandwayo odokotela, abavame ukuqala imisebenzi yabo nge $ 150,000 - $ 250,000 esikweletini somboleki esikoleni.
Akuzona zonke lezi zindlela ezibangelwa ukuguqulwa kwezempilo. Ngenxa yokuguga nokuthuthuka kwezokwelapha, isidingo sokunakekelwa kwempilo sase sisezingeni eliphakeme, kanti ukusetjenziswa koMthetho Wokunakekelwa Okungenakusiza kungase kwandezelele isidingo ngokuvumela abanye baseMelika bathole ukutholakala komshuwalense wezempilo. Kodwa-ke, kwezinye izindawo zasemaphandleni, ikakhulukazi emasimini adingekayo kakhulu okukhulunywe ngenhla njengokunakekelwa okuyinhloko, kanye nokuziphatha kokuziphatha, ukuhlinzekwa akuqinisekisi njalo ukufinyelela kwadokotela , ngenxa yokuntuleka ezindaweni eziningi kanye nokunye okukhethekile. Ngakho-ke, ukwandisa ububanzi bemithi yokwelashwa okuphambili kanye nokuthola ezinye izindlela zokwandisa ukufinyelela kwabahlinzeki (telemedicine, njll) kubaluleke kakhulu ekuhlangabezaneni nesidingo sezinsizakalo zokunakekelwa kwezempilo.
Izindleko zezokwelapha zihamba phambili
Imiholo yabahlengikazi yabonisa ukwanda kwezici eziningi zika-2015, ngokusho kwemibiko yango-2016. I-Medical Group Management Association (MGMA), kanye nezinkampani eziningana zokuqasha, kubika umkhuba wokwenyuka kwamaholo odokotela ezinkampanini eziningi kusukela ngo-2014 kuya ku-2015.
Imiholo ye-Medicus Firm's yabonisa ukukhuphuka kulo lonke ibhodi okokuqala ngqa, ngokusho kukaJim Stone, umongameli. "Zonke izinto ezikhethekile zibike ukwanda kusukela ngo-2014 kuya ku-2015, okuyinto yokuqala yokuhlola kwethu wonyaka," esho. "Yize izinkokhelo ziningi kakhulu, eminyakeni eminingi edlule yocwaningo lwamaholo wonyaka, kuneminyaka embalwa eyabonisa izinga lokukhula kancane, futhi liye lancipha ngokubika ngezikhathi ezithile. Lona unyaka wokuqala engiwukhumbulayo zonke izici eziveza ukunyuka okuqinile ekukhokheleni, "kusho uMatshe.