Kunokuningi Kunokuphepha Kokuphela Kwesineke
Bona ukubuyekeza ka-2012 ngezansi.
Kungakhathaliseki ukuthi ungumhlomulo weMedare noma cha, inqubomgomo eyaqala ukusebenza ngo-2008 izothinta wena. Inqubomgomo entsha ikhuluma ngokuthi "akukho mcimbi" ovuna ngesikhathi sokuhlala esibhedlela. Uma le nqubomgomo iqala ukusebenza, uMagare wayeka ukukhokhela ezinye zezinkinga ezibangelwa esibhedlela.
Izenzakalo ezingakaze zifakwe kuhlu lukaMedricare ziyizinkinga ezinjengokuhlinzwa okungalungile, ukuxilongwa ngegazi elingalungile, izilonda zokucindezela (ukulala), ukuwa noma ukuhlukunyezwa, kanye nokutheleleka kwe-nosocomial (izifo ezitholwa esibhedlela) ezihlobene nokuhlinza noma izidakamizwa.
Eyisishiyagalombili zitholakala ohlwini lwama-28 alukho neze izenzakalo , okuthiwa yi-Yebo, ngoba, akufanele neze zenzeke kunoma yisiphi isiguli.
Ngaphezu kwalokho, uma kwenzeka kungakaze kwenzeke umcimbi, i-Medicare ithi isiguli kungenzeka ukuthi singakhokhiswa ukunakekelwa okwengeziwe okudingekayo ukubhekana nomcimbi ongakaze ube khona. Konke lokho kusho ukuthi, yebo, esibhedlela kuyodingeka ukuthi ihlanganise izindleko ezengeziwe ezivela ezinkingeni ezengeziwe isiguli esiye sabhekana nazo.
Ngokushesha, kunezindlela eziningi le nqubomgomo entsha ye-Medicare engeke ibe yimuphi umcimbi uzosithinta:
- I-Medicare ithi isizathu sayo esisodwa senqubomgomo entsha ukuthuthukisa ukuphepha nokubaluleka kweziguli. Ngokuqinisekile, izibhedlela kuzodingeka ziqale ukubuka imikhuba ephephile ukuqinisekisa ukuthi iziguli azihlupheki kulezi zinkinga, uma kungenasizathu esithile kunokunciphisa izindleko zesibhedlela.
- Abanakekeli bezeMpilo bavame ukulandela ukuhola kukaMedare, futhi abaningi bazimisele ukufeza inqubomgomo efanayo. Kuzo zonke izindawo, labo bomshuwalense bazisa izibhedlela ukuthi ngeke bakhokhele amaphutha esibhedlela, futhi ezimweni eziningi, uhlu lwabo lwamaphutha lungaphezulu kakhulu. Lokho kusho ukuthi lezozinkampani zomshuwalense wezempilo zizobe zisindisa izindleko zokugula okuqhubekayo emakhakheni abo omshwalense. Kodwa-ke, ngenkathi singathemba ukubona ama-premium anciphisa, cishe kuningi ukulindela izindleko eziphansi zokudluliselwa kumakhasimende.
- Kufanele kube nomthelela omkhulu kumabhajethi kaMedare. Ngonyaka ka-2007, labo abayisishiyagalombili azange zenzeke izindleko kuphela. Njengabakhokhi bentela, kufanele sijabule ukubona lezi zindlela hhayi nje kuphela ngenxa yokuphepha kwethu njengeziguli kodwa nasemagodini ethu, futhi.
- Izisho okungenani ezingu-20 zicabangela inqubomgomo efanayo yeziguli ze-Medicaid. Cishe amazwe angu-12 asevele asetshenzisile uhlobo oluthile lwenqubomgomo engekho-yekhokha-ye-never-events.
Ingabe Yonke Ngempela Ngokuphepha Kokubekezela?
Abaningi abagulisa isiguli kanye neziguli bajabula kakhulu! Ngokuqinisekile, le nqubomgomo izokwenza iziguli zesibhedlela zivikeleke. Futhi kungani kungadingeki ukuthi isibhedlela sibe nesinye seziphambeko zabasebenzi futhi sizikhokhele lezo zindleko? Sizokugcina imali, futhi. Yeka umqondo omuhle!
Akunjalo ngokushesha . Kufanele kuqaphele izwi ngoba alilula kangako njengoba lizwakala.
Inkinga yokuqala yilokhu. Kungenxa yokuthi umcimbi ongakaze ube nalolo gama, akusho ukuthi akakaze kwenzeke. Abachwepheshe basitshela ukuthi izifo eziningi ohlwini aluvikeleki ngempela, ikakhulukazi izinkinga ezinjengezinkinga zokulala noma izifo ezisekelwe ku-catheter.
Ngaphezu kwalokho, ezinye izibhedlela zihlukumezeka ukuze zifinyelele izidingo njengoba kunjalo. Yebo, abaningi bayokwenza umzamo wokuqeda konke okungakaze kube khona izenzakalo, kodwa kuyodingeka bathole izindleko zezinkinga ezenzekayo. Labo abangakwazi ukubhekana nezinkinga zezimali bangase baphume ibhizinisi. Abanye bazophakamisa amanani angakhuliswa, ngeminye iminikelo ezigulini zabo ukuthi i-Medicare ayifuni.
Iziguli ezihlakaniphile ziyazi nokuthi izinguquko ezinkulu zenqubomgomo zivame ukuholela emiphumeleni engahlosiwe. Ngama-pluses amaningi angabangela inqubomgomo entsha, iziguli kudingeka ziqaphele izinkinga ezingase zenzeke ukuze zisikhokhele ngisho nangaphezulu imali noma izinga lethu lokuphila.
Nazi ezinye izinkinga okufanele uziqaphele ngoba inqubomgomo ye-Medicare Never Event ka-2008 ihlala, futhi njengoba izibhedlela zizama ukulungisa:
- Izibhedlela zingadinga ukuthi iziguli zihlolwe kabanzi ngaphambi kokuba zivunyelwe ukukhombisa ukuthi zinezifo noma ezinye izinkinga ngaphambi kokuba zifike. Ukuhlolwa okwengeziwe kunezindleko ezengeziwe, yiqiniso, futhi nje kuyindlela yokuzivikela. Ngeke kube nzuzo kumguli.
- Isiguli esinegciwane noma elimele singase sikhululwe ngokushesha. Uma kudingeka adluliswe kabusha kamuva, isibhedlela sizokwazi ukufakazela, ngokusebenzisa lezo zivivinyo zokungeniswa ezengeziwe, ukuthi ufike ngenkinga. Lokhu kusho ukuthi uM Medicare uzophela ukukhokhela noma kunjalo, kodwa isiguli siyobe sesithunyelwe okungenani kabili, ngenkathi silimala noma sigula.
- Iziguli zingase zingadliwa ngokweqile ngama-antibiotic ukuvimbela ukutheleleka, okuholela ekumenikeleni okungaphezulu, okuholela ezenzakalweni eziningi kamuva kwezifo ezingelapheki.
- Iziguli zingakhokhiswa nge-extra-of-pocket eyengeziwe "okungeziwe" engekho emshuwalense noma kunjalo, futhi okungase kungalungile.
Uma ngabe kukhona kulezi zinkinga kwenzeka kuwe, uzofuna ukuwabika ku-Medicare. Kuhlala kubonakala uma sizoba nendlela yokuzivikela kuzo. Njengoba isikhathi siqhubeka futhi okuningi kuyaziwa ngale nqubomgomo entsha, ngizogcina lesi siza Sokuthuthukiswa Kwamapulangwe sibuyekezwa.
Ukubuyekeza ka-2012
Ngokwemibandela ye-Care Affordable Act (ukuguqulwa kwezempilo), izibhedlela manje kudingeka ukuba zihlolwe futhi zibike okuhlangenwe nakho kwesineke nokwaneliseka. Lena enye indlela yokwenza okusobala okudingekayo ukuze kugcinwe izibhedlela ekunakekelweni kwekhwalithi kweziguli zabo. Funda kabanzi mayelana nesipiliyoni sesiguli kanye nokuhlolwa kokwaneliseka, noma ufunde ukuthi ugcwalisa kanjani inhlolovo yokwaneliseka kwesiguli lapha .