Izingxoxo zikahulumeni nezinkampani zokwelapha zingakhipha izindleko?
Izindleko zemithi ziyanda. Ngo-2014, abaseMelika bachitha ngaphezulu kwamaphesenti angu-12 emithini yemithi kadokotela kunango-2002. Yilokho kunjalo, ingabe kukhona ongakwenza ukuze ukhokhele imithi emincane ? Ingabe ikhona indlela uhulumeni angasiza ngayo ?
Izinkokhelo zezinkampani zokwelapha
Izimbangela eziningi zenza kube nemali eyengeziwe ekudleni kwezidakamizwa. Ngezinye izikhathi, kungenzeka kube nezinkinga zokukhiqiza ezikhawulela ukuthi imithi iyatholakala kangakanani.
Ngezinye izikhathi, imithi ingase ibe yodwa yohlu layo ukuphatha isimo esithile. Kulezi zimo, kungase kube nokwenyuka kwesidingo kanye nezindleko ezengeziwe ezihlobene nomuthi.
Izinkampani zokwelapha zingakwandisa izintengo zemithi ngenzuzo. I-Turing Pharmaceuticals yabangela ukungqubuzana ngo-2015 phezu kweDaraprim (pyrimethamine), imithi esetshenziselwa ukwelapha i - toxoplasmosis yokutheleleka nge-AIDS kanye nezinye izifo ezithathelwanayo. UMartin Shkreli, isikhulu esiyinhloko senkampani, uthenge i-patent yesidakamizwa futhi wandisa inani lemithi engaphezu kwamaphesenti angu-5 500, kusuka ku-$ 13.50 kuya ku-$ 750 ipilisi.
Izinkampani zokwelapha zithi amanani aphezulu ayadingeka ukuze akhokhele ucwaningo olwengeziwe nokuthuthukiswa kwamaphrojekthi. Ngaphandle kokuphenywa okuqhubekayo, abantu bangabhekana nezifo ezingase ziphathwe.
Izidakamizwa Izindleko Zingaphansi Kwezwe Lwamanye amazwe
Emazweni ahlangene, ayikho imithethonqubo ekhona yokuvimbela ukuqhubekela phambili kwezindleko zemithi yezidakamizwa eMedare.
Uhulumeni wesifunda ushiya imikhakha yamanani kuze kube sezingeni elihle le-capitalist kanye nokuncintisana kwemakethe.
Izindleko zezidakamizwa zilawulwa ngendlela ehlukile emhlabeni jikelele. Yingakho uvame ukubona ukuthi izidakamizwa ezifanayo ezithengiswa kumaMelika zingabiza kakhulu kwamanye amazwe.
| Isidakamizwa | Canada | i-United Kingdom | I-united states |
|---|---|---|---|
| I-Advair (ye-asthma) | $ 74.12 | $ 46.99 | $ 309.60 |
| I-Crestor (ye-cholesterol ephezulu) | $ 32.10 | US $ 25.80 | $ 216.00 |
| Humira (for arthritis ye-rheumatoid) | $ 1,164.32 | $ 1,157.53 | $ 3,430.82 |
| Januvia (ngesifo sikashukela) | $ 68.10 | $ 48.00 | $ 330.60 |
| I-Lantus (yesifo sikashukela) | $ 67.00 | $ 63.65 | $ 372.75 |
Abanye abantu bacabanga ukuthi kungcono ukuthenga izidakamizwa ezivela kwamanye amazwe njengendlela yokunciphisa izindleko kodwa uMedare awuboni ngaleyo ndlela. I-Medicare ngeke ikhokhele kunoma imiphi imithi ethengwe ngaphandle kwe-United States.
Abantu abakwelaseMedare abakwazi ukusebenzisa imithi yamakhuphoni
Izinkampani eziningi zokwelapha zithengisa amanani aphakeme kodwa ziphikisana nalezi zindleko ngokunikeza amakhuphoni amayeza kanye namavoti. Inkathazo kukhona imithetho enendawo evimbela abantu abaningi ekusebenziseni lezo izaphulelo.
Kukhona isimiso sokuphikisana no-kickback ngaphakathi kwe-Social Security Act. Ithi umuntu noma inhlangano ayikwazi ukunikeza izinsizakalo kumuntu ngokubuyisela kokudluliselwa noma ukukhokha okungathatha imali kwizinhlelo ze-Federal. Imithi, ngeshwa, yehlela kulolu hlobo. Lokho kusho ukuthi noma ubani osebenzisa i-Medicare angeke asebenzise ngokunenzuzo lezi izaphulelo zedokotela.
Amakhuphoni namavoti akhuthaza abantu ukuthi basebenzise imali emithini ebiza kakhulu. Uma izaphulelo zingasatholakali, uhulumeni uzoshiywa ukukhokhela okunye okubiza imali kunokuba isiguli sisebenzise imithi engabizi kakhulu. Isimiso sokuphikisana nokubheja phambili senzelwe ukuvikela uhulumeni emisebenzini yobuqili kodwa ekugcineni kuphazamise abathengi.
Ukuxoxisana nezinkampani zokwelapha
Uma iziguli zingenakuthola izaphulelo ngokuqondile ezinkampanini zemithi, kufanele uhulumeni axoxe ngezintengo eziphansi ezidakamizwa ngenxa yabo? Impendulo emangalisa ukuthi kakade bayayenza. Ukuze uthole i-Medicaid, izinkampani zigunyazwe ukunikeza iziphuzo zamanani ezidakamizwa. Ku-Veterans Administration (VA), izinkampani ezidakamizwa kumele zikhokhise intengo ephansi kakhulu ayinikela kunoma ubani emkhakheni wangasese. Akumangalisi ukuthi imishanguzo ehlinzekwa ngalezi zenye izinhlelo zikahulumeni ezishibhile kuneMedare.
Kungani lokhu kungeke kwenzeke ku-Medicare futhi?
I-Medicaid ine-formulary eyodwa esimweni ngasinye.
I-VA ine-formulary eyodwa. Lokhu akunjalo uma kuziwa ku-Medicare. I-D yezinhlelo zokudakamizwa kwezidakamizwa ziqhutshwa izinkampanini zomshuwalense wangasese kanti inkampani ngayinye inezinhlobo eziningi ze-formularies ngezindleko ezahlukene ezixhunywe ngamunye wabo. Okubaluleke nakakhulu, lezi zinshuwalense zihlose ukwenza inzuzo.
Lokhu kubangela izinselele kuhulumeni. Okokuqala, kuzodingeka ushintshe umthetho wamanje ongabandakanyi uhulumeni ekungeneni kwamanani emithi yezidakamizwa. Okwesibili, kufanele uthathe isinqumo sokuqhubeka nokuxoxisana. Uhulumeni angakwazi kanjani ukulawula kahle izinkampanini eziningi lapho izidakamizwa ezihlukene zihileleka ku-formulary ngayinye? Ingabe ingashintsha indlela amafomula afakwe ngayo? Kungabe kuyadingeka ukuthi i-formulary yendawo yonke? Yiziphi izinhlobo zezidakamizwa okufanele zilawulwe? Kungabe kudinga ukulungiswa kabusha kwenzuzo ye-Part D?
Lokhu kungukuphikisana okuqhubekayo kanye nokwakhiwa kwezombusazwe. Ihhovisi le-Congressional Budget liphakamisa ukuthi ukuxoxisana kwamazinga ngeke kuthinte kakhulu imali yokusebenzisa imali. Lokho akuyona impendulo abaningi baseMelika abafuna ukuzwa. Abaningi asebekhulile bahluleka ukuthola imithi ngesikhathi sokuphila kwabo lapho bedinga ukunakekelwa kwezempilo kakhulu. Kukhona okudingeka kwenziwe ukuze kuqedwe izindleko ezikhulayo zemithi kadokotela ezweni lethu.
Imithombo:
Kubanski J, Neuman T. Ukufuna Ukulondoloza Emkhakheni Wezinkinga Zezidakamizwa. I-Henry J. Kaiser Family Foundation. http://kff.org/medicare/issue-brief/searching-for-savings-in-medicare-drug-price-gogotiations/. Ishicilelwe ngo-February 9, 2016.
I-Langreth R, i-Migliozzi B, i-Gokhale K. I-US Inika Okunye Okudinga Izidakamizwa Eziphezulu Kunezinye Amazwe. Bloomberg. http://www.bloomberg.com/graphics/2015-drug-prices/. Kushicilelwe ngo-December 18, 2015.
Ihhovisi le-Inspector General. Amakhuphoni Womkhiqizo Wezokwelapha Zomuthi. http://oig.hhs.gov/fraud/docs/alertsandbulletins/2014/SAB_Copayment_Coupons.pdf. Kushicilelwe ngo-September 2014.
I-Pollack A. Izidakamizwa Ziya kusuka ku-$ 13.50 i-Tablet kuya ku-$ 750, ebusuku. I-New York Times. http://www.nytimes.com/2015/09/21/business/a-huge-overnight-increase-in-a-drugs-price-raises-protests.html?_r=0. Ishicilelwe ngo-September 20, 2015.
Shih C, Schwartz J, Coukell A. Uhulumeni Uzoxoxisana Kanjani Ne-Medicare Ingxenye D Amanani Ezidakamizwa Asebenza? Ibhulogi yezempilo. http://healthaffairs.org/blog/2016/02/01/how-would-government-gotiation-of-medicare-part-d-drug-prices-work/. Ishicilelwe ngo-February 1, 2016.