I-Medicare iyisistimu yokukhokha eyodwa kodwa ingwanele?
Noma ubani okholelwa ukuthi uhlelo lwezempilo lwaseMelika lungcono kakhulu emhlabeni luyamangala. Iqiniso yi-United States isebenzisa kakhulu ekunakekelweni kwezempilo komuntu ngamunye kodwa inemiphumela emibi kakhulu yezempilo.
Ukuhlaziywa yi-The Commonwealth Fund ngokukhethekile kubheke izizwe ezingu 11 ezithuthukile. Idatha yabuthelwa kuzo zonke izigaba ezinhlanu: 1) inqubo yokunakekelwa (ukunakekelwa kokuvimbela, ukunakekelwa okuphephile, ukunakekelwa okuphephile, kanye nokubandakanyeka ngesineke), 2) ukusebenza kahle, 3) ukufinyelela (ukukwazi ukukwazi ukukwazi nokukwazi ukugcina isikhathi), 4) ukulingana kubantu abaphansi nasezingeni eliphezulu -uzuza, futhi 5) imiphumela yokunakekelwa kwempilo (impilo yabantu, ukufa okubangelwa ukunakekelwa kwezempilo kanye nemiphumela eqondene nezempilo).
Okudabukisayo ukuthi, i-US ibeke isilinganiso se-10 sokusebenza kahle kwezokuphatha kanye ne-11 yokufinyelela, ukulingana, kanye nemiphumela yokunakekelwa kwezempilo.
Amazwe ahlukanise ngaphezu kwe-United States ohlwini ayenokuthile okufanayo - ukunakekelwa kwempilo yonke jikelele . Umbuzo uwukuthi noma ngabe i-United States kufanele ilandele yini kulezi zinyathelo noma cha.
I-Medicare njengohlelo lokukhokha olulodwa
Phakathi nomkhankaso wokhetho lukaMengameli we-2016, owayenguNobhala kaHulumeni u-Hillary Clinton uthe uMediare wayengumuntu oyedwa okhokhelwa. Kusho ukuthini lokho?
Uhlelo lokukhokha olulodwa olulodwa lapho inhlangano eyodwa, ngokuvamile uhulumeni, ilawula futhi ikhokhela ukunakekelwa kwezempilo. "Umkhokhi ongashadile" uvame ukushintshaniswa negama elithi "ukunakekelwa kwempilo yonke jikelele" ngokwemigomo ebekiwe, nakuba kungenjalo okufanayo.
E-America, i-Medicare ibilokhu isistimu yokunakekela impilo esiyibheke kuyo njengoba sikhula. Kuyindlela yokukhokha eyodwa ngoba uhulumeni uxhasa uhlelo lwezempilo ngezintela esizikhokhela kuso .
Lokho kusho ukuthi akusiyo ukunakekelwa kwempilo yonke jikelele ngoba ayihlanganisi wonke umuntu. Kunalokho, kunomkhawulo kubantu abaneminyaka engu-65 nangaphezulu noma kulabo abakhubazekile abathile .
Ngokweqile kungukuthi ngenkathi uMedarele eqala njengendlela yokukhokha eyodwa-yeqiniso, sekuguquke ekubeni into engaphezulu.
Uhulumeni wesifunda ubeka izindinganiso zalokho okumelwe zifakwe kodwa abantu bangase bakhethe ukubhalisela uhlelo lwe- Medicare Advantage , oluqhutshwa izinkampanini zomshuwalense wangasese, ngokuphambene neMederal Medicine, eqhutshwa uhulumeni.
Medicare for All vs. Medicare for More
I-Medicare inganwetshwa futhi itholakale kuwo wonke amaMelika. Ngaleyo ndlela, i-Medicare ingaba ukunakekelwa kwezempilo jikelele. Loluhlelo lwaluvunyelwa uSenin Bernie Sanders waseVermont futhi waziwa ngokuthi Medicare for All.
Ngesikhathi sokucela kwakhe umbusi we-2016, owayenguNobhala kaHulumeni uHillary Clinton waphakamisa ukuthi "Medicare for More" njengendlela yokwandisa i-Medicare. Esikhundleni se-Medicare kubo bonke, uhlongoza ukunciphisa izinga lokufaneleka lomuthi kusukela ku-65 kuya ku-50 ubudala.
Lokhu kuzosiza kanjani?
Abantu abakuleli qembu lobudala bathambekele ekubeni nemibandela eminingi yezokwelapha kanye nemibandela eminingi yezokwelapha kusho ukuthi ukusetshenziswa kwemali yokwelashwa okungaphezulu. Okungenani amaphesenti angu-87 aseMelika aneminyaka engama-65 kuya kwengu-74 ubudala anesifo esingenani esisodwa esingokwempilo. Inombolo iyanda kuma-92 amaphesenti kulawo angama-75 nangaphezulu. Izinombolo zinciphisa ngamaphesenti angu-72 uma sibheka intsha eneminyaka engu-50 kuya kwengu-64 ubudala, hhayi okwamanje ehlanganiswe i-Medicare.
Uma umuntu ehlangabezana ne-eligibility criteria ye-Medicare, baqala ukukhokha imali yokukhokha ngenyanga.
Le mali ifakwa echibini futhi isetshenziselwa ukukhokhela izinsizakalo zabo bonke abazuzayo. Uma bebancane, abantu baseMelika abanempilo bangenezela kulelo damu, khona-ke into ethakazelisayo izokwenzeka kuMedare njengoba sazi namuhla. Kuzoba nemali engaphezulu yokwabelana. Nakuba kwakuzoba nabantu abaningi echibini, bekuyoba nenani elincani elijwayelekile lemibandela yokwelashwa okufanele libheke. Lokhu kungase kwengeze iminyaka yokugcina kwi-Medicare Trust Fund .
Izinzuzo Zokunakekela Impilo Yonke
Iqiniso liwukuthi izindleko zokunakekelwa kwezempilo ziye zanda ngokukhudlwana phezu kweminyaka, hhayi ngenxa yentengo yezezimali noma ubuchwepheshe bezokwelapha ezibiza kakhulu kodwa ngenxa yebhizinisi elikhulu kanye ne-capitalist.
Uma nje izinkampani zomshuwalense ezizimele kanye nezinkampani zokwelapha ziphethe izintambo zemali, izindleko zezempilo zizoqhubeka zikhuphuka. Uhlelo lokukhokha olulodwa luzosusa izisusa eziqhutshwa ngenzuzo yokunakekelwa kwezempilo kodwa yini enye eyinikeza yona?
Wonke umuntu angaba nokufinyelela okulinganayo kokunakekelwa kungakhathaliseki ubudala, imali, noma ikhono. Futhi, ngeke usadinge ukuthola udokotela "kwinethiwekhi" yakho ngoba bonke odokotela babeyoba kwinethiwekhi yakho. Ama-Copay nama-deductibles azohamba.
Ucwaningo lukazwelonke oluvela ePew Research Center ngo-2017 lwaphawula ukuthi amaphesenti angama-66 aseMelika akholelwa ukuthi uhulumeni kufanele aqinisekise ukufinyelela kokunakekelwa kwezempilo nokuthi amaphesenti angu-33 anomuzwa wokuthi uhlelo olulodwa lokukhokha luyindlela engcono kakhulu yokuhamba.
I-Cons ye-Universal Health Care
Ama-dollar namasenti akuzona izindleko kuphela zokunakekela impilo yonke. AmaMelika angeke nje adinge ukucabangela ukwanda kwentela abazoyikhokha kodwa nokuthi ukuhlanganiswa kwendawo yonke kuyoba kanjani ukukhathalela abakutholayo. Izikhathi zokulinda izinsizakalo ezingekho eziphuthumayo zizobe zinde. Ngabantu abaningi ohlelweni, ukufinyelela kudokotela wabo wokuzikhethela kungathinteka izikhathi ezilindile zokulinda. Abanye abantu kungadingeka bashintshe odokotela ukuze bathole ukunakekelwa okungekho okwenzekayo ngesikhathi esifanele.
Izikhathi zokulinda emazweni anakekelwa impilo yonke angaba isikhathi eside. EDenmark, isikhathi sesikhathi sokuthola ukuhlinzwa kwe-cataract ngemuva kokuba isinqumo senziwe ukuphatha izinsuku ezingu-112. Ngeke ukwazi ukuthola indawo ye-hip e-England izinsuku ezingu-78. Ukuhlinzwa okukhethiwe e-Ireland noma eNorway kuzokushiya ulinde izinsuku ezingama-75. Lokho kusho ukuthi amacala aphuthumayo athathwa ngokuphuthumayo. Akukho ukubambezeleka ekunakekeleni uma uyidinga ngempela.
Esikhathini eside, i-United States ingasindisa izindleko jikelele futhi ithuthukise imiphumela yokunakekelwa kwempilo ngaphansi kwesimiso somhlaba jikelele, kodwa ingabe abaseMelika banesineke ukulinda isikhathi sabo?
Izwi kusuka
Uhlelo lwezempilo lwe-US lunokukhetha ukwenza. Kungathuthukisa phezu kwendlela yokukhokhela eyodwa ye-Medicare, okwandisa ukufinyelela kwayo kwabaseMelika abaningi. Ngaphandle kwalokho, lingalandela indlela eya ekunakekelweni kwempilo yonke jikelele ukuthi amazwe amaningi athuthukile aboniswe ukuthi asebenza kahle futhi asebenza kahle ngemiphumela engcono yempilo. Ukuyishumi nanye okuhle ekunakekeleni kwezempilo emhlabeni wonke akulungile. I-America ifanelwe kangcono.
> Imithombo:
> Aaron HJ. Ngumuphi Umgwaqo Wokuya Emhlabeni Wonke? N Engl J Med. 2017 Dec 7; 377 (23): 2207-2209. i-doi: 10.1056 / NEJMp1713346.
> Izimo Ezihlala Ngesikhathi Ephakathi Kwabadala baseMelika. Iwebhusayithi ye-AARP. http://assets.aarp.org/rgcenter/health/beyond_50_hcr_conditions.pdf.
> Kiley J. Ukuxhaswa Komphakathi Kokuhlinzekwa Kwempilo Ekhokhayo Yodwa Kukhula, Kuqhutshwa yizidemokhrasi. I-Pew Research Centre. http://www.pewresearch.org/fact-tank/2017/06/23/public-support-for-single-payer-health-coverage-grows-driven-by-democrats/. Ishicilelwe ngo-June 23, 2017.
> Schneider EC, Sarnak DO, Squires D, Shah A, Doty MM. Isibuko, Isibuko 2017: Ukuqhathaniswa Komhlaba Wonke Kubonisa Ukungahleleki Nezikhundla Zokunakekelwa Kwezempilo Okungcono Kwe-US. I-Commonwealth Fund. http://www.commonwealthfund.org/interactives/2017/july/mirror-mirror/. Kushicilelwe ngo-July 2017.
> Viberg N, Forsberg BC, Borowitz M, noMolin R. International Ukuqhathaniswa Kwezingqikithi Zokulinda KwezeMpilo - Ukulinganiselwa kanye Nemigomo. Inqubomgomo Yempilo . Septemba 2013; 112 (1-2): 53-61. doi: http://dx.doi.org/10.1016/j.healthpol.2013.06.01