Okudingeka Ukwazi Ngezokwelapha ngemali
UMongameli uTrump wenza izithembiso emkhankasweni wokwenza umkhankaso wokugcina iMedare. Ngaphansi kwezimo ezingenakuqeda izinzuzo ze-Medicare. Ngeshwa, kuze kube manje, amazwi akhe awahambisani nezenzo zakhe. I-GOP ineMithi kanye neMedicaid ezinkampanini zayo futhi ithatha izinyathelo zokunciphisa izimali kulokho okubonayo njengezinhlelo zokufaneleka. Yilokho okudingayo ukwazi ngemali ye-Medicare eya 2018 nangaphezulu.
Iyini Inzuzo?
Abantu abaningi abamboni i-Medicare njenge "ilungelo". Phela, bakhokha intela kwi-Medicare Trust Fund ngokusebenzisa iminikelo yabo yentela ngesithembiso sokufinyelela ekunakekelweni kwezempilo okungabizi uma bekhulile noma kufanele bakhubazeke.
Kodwa-ke, ngenkathi ilungelo legama linemibono ye-pejorative eminye imibuthano, i-Medicare ne-Medicaid yizinhlelo zokufanelekela izincazelo. Ngokwesichazamazwi se-Merriam Webster, inzuzo yindlela yohulumeni ehlinzeka izinzuzo kumalungu eqenjini elicacisiwe noma yizimali ezixhasa noma eziswelwa yiloluhlelo.
Ukuqonda i-Medicare Trust Fund
Kunamachibi amabili e-Medicare izimali. Owokuqala yi-Medicare's Hospital Insurance [HI] Fund Fund, okukhulunywe ngayo ngokweqile njengesiKhwama seMedricare Trust. Lesi sikhwama sikhokhisa amasevisi wakho we-Medicare Part A , okuyisikhathi sokuhlala esibhedlele esibhedlela, ukuhlala ekhaya okuphuthumayo isikhathi eside ngemuva kokuhlala esibhedlela, ukunakekelwa kwezempilo kwasekhaya, nokunakekelwa kwezempilo.
Lesi sikhwama yilapho imali yakho yokukhokha intela yakho ihamba khona.
Ngeshwa, i- Hospital Insurance Trust kulindeleke ukuba ihlulwe ngo-2029 . Lokhu kusho ukuthi ngeke kube nemali eyanele yokukhokha zonke izinsizakalo ezenza namhlanje. Ngaleso sikhathi, kungase kuphela bakwazi ukukhokhela amaphesenti angu-88 alawo masevisi.
Isikhwama sesibili se-Medicare yi-Supplementary Medical Insurance (SMI) Trust.
Lokhu kuthemba kusekelwe kuma-premium okhokhela i-Medicare Part B no- Part D. Lezi zingxenye ze-Medicare zikhokhela umsebenzi wegazi, ukuvakashelwa udokotela, ukuhlola izithombe, imithi yomzimba / yomsebenzi / inkulumo, imithi yokugonywa, ukuhlolwa kokuvimbela, ukuhlinzwa (izinqubo ezithile), nezinye izinsizakusebenza.
Medicare, I-Federal Deficit, kanye no-2018 Budget Budget
Ngonyaka we-2016, inani lezindleko zezeMpilo kaZwelonke (NHE) libiza amaRandi ayizigidi eziyizigidi eziyizigidi eziyizigidi ezintathu zamaRandi, kubalwa amaphesenti angu-17.9 weGross Domestic Product (GDP).
Ukusetshenziswa kweMedricare kubiza u-672.1 billion, okumele kube ngamaphesenti angama-20 e-NHE kanye namaphesenti angu-3.58 weGDP. Ukusetshenziswa kwe-medicaid kwaba ngu-R55.5 billion, amaphesenti angu-17 e-NHE, nama-3.03 amaphesenti we-GDP.
I-GOP ifuna ukunciphisa ukuthi i-GDP isetshenziswa kangakanani ezinhlelweni zokufaneleka.
Ukuze kube njalo, iNdlu Yabameli base-US yadlulisela isinqumo sesabelomali sonyaka wezimali 2018 ngo-Agasti 2017. Evoti yenkampani, isiphakamiso se-GOP sasihlanganisa ama-dollar angu-487 billion ekusikeni kuMedare, ukwanda kweminyaka yobudala ye-Medicare kusuka ku-65 kuya ku-67 iminyaka ubudala, kanye nokwaziswa kwangasese kwe-Medicare ngehlelo voucher. Ngokuqondene neMedicaid, iminikelo yombuso izoshintshwa ibe yizinkokhelo zamanye amazwe noma ivimbele izibonelelo , ngokunciphisa kakhulu imali kwihlelo cishe ngama-dollar ayi-1 trillion.
Isixazululo sesabelomali sathunyelwa eSenate lapho sidluliselwa khona ngo-Okthoba 19. Inguqulo evunyelwe iSénate yabuyela eNdlu lapho yadluliselwa khona ngo-Okthoba 26. Ngalesi sikhathi, izinguquko ezihlongozwayo ezinhlelweni ezifanelekile azihlelwa ematheni ngoba akukho mthetho othize ozokwenza. Imibiko ye-GOP ihlela ukubhekana nomthetho ngalezo zinkinga ngonyaka omusha. Kunalokho, lokho isabelomali sonyaka wezimali ka-2018 okwakwenzekile kwakubeka uhlaka lomThethosivivinywa weNtela we-GOP.
Umthethosivivinywa weNtela we-GOP
Umthethosivivinywa weNtela we-GOP, owaziwa nangokuthi uMthetho Wokukhokhiswa Kwezezimali kanye Nemisebenzi, wakhulisa ukuphikisana okukhulu ngokuvumela ukusikeka kwentela kwabammebile baseMelika phezu kwezinga eliphansi neliphakathi.
Lo mthethosivivinywa uphinde walinganiselwa ukuthi ukwandisa ukulahlekelwa kukazwelonke ngamadola ayizigidi eziyizinkulungwane ezingu-1,5 eminyakeni engaphezu kwengu-10.
Okudingayo ukuqonda ukuthi umthetho uthinta kanjani Medicare. Ekuboneni kokuqala, umthethosivivinywa wentela weSenate awuqedi ngokuqondile ukusetshenziswa kwemali ye-Medicare. Ngeke uthole lawo mazwi abhalwe kulo mthethosivivinywa. Kodwa-ke, izoqhubeka nokwehliswa okungenani $ 28 billion kusuka Medicare minyaka yonke eminyakeni eyishumi ezayo.
Yilahle ekuhlinzekeni kwe-PAYGO.
Umthetho we "pay-as-you-go", umthetho we-bipartisan owenziwe njengengxenye yoMthetho we-Omnibus Budget Reconciliation Act ka-1990, wenzelwe ukugcina ukulahleka kokuhlola. Isebenza ngale ndlela. Lapho iCongress idlula noma yikuphi okwenyusa ukulahlekelwa kweminyaka emihlanu kuya kwengu-10 kodwa lokho akubandakanyi ukukhokha imali engenayo, i-PAYGO igxila kuyo. Ukuphathwa kuyadingeka ukuthi kuqaliswe ukuchithwa kwemali kwezinye izinhlangano ezingekho ngaphansi kwezikhulu (Medicare, Subsidies Agricultural and Supports) , Uhlelo Lokulungiswa Kwengozi Lokunakekelwa Kwengozi Engazinzile, Ukusebenza Nokusekela Amasiko Ne-Border Patrol, Ukuphathwa Kwezimali Zomfundi, nezinye izinhlelo). Isinqumo sokuthi ukuchitha imali ngokuqondile kuyokwenzelwa kanjani umqashi.
Ngeshwa, yilokho esikubukayo noMthethosivivinywa Wentela we-GOP:
I-PAYGO ingadinga ukuthi iCongress inciphise ukusetshenziswa kwemali ngonyaka wezimali 2018 nge $ 136 billion. Imali evunyelwe ukunconywa ezinhlelweni ezingenasidingo ezigunyaziwe ezilinganiselwe kulinganiselwa ukuthi yizigidi eziyizinkulungwane ezingu-114 zamaRandi. Lokho kusho ukuthi inani elivumelekile eligcwele lizonqunywa kuzo zonke izinhlelo, kuhlanganise neMedare.
I-PAYGO ivumela izinhlelo ezithile ukuba zinqunywe ngamaphesenti angu-100 kodwa i-Medicare inekhanda. Ukwehliselwa ku-Medicare kunomkhawulo kuphela kumaphesenti angu-4 wesabelomali sohlelo. Ngo-2018 okungaba ngu-$ 28 billion. Ngo-2027, ngenxa yezindleko zemali kanye nezindleko ezikhulayo zokunakekelwa kwezempilo, ukuthi inani lamaphesenti angu-4 kulindeleke ukuthi likhule lifike ku-$ 56 billion ngonyaka.
Njengoba i-GOP isivele ihlose ukwelashwa okuphawulekayo ku-Medicare ku-Budget Budget ka-2018, akunakwenzeka ukuthi ukuphathwa kuzobheka ukuvimbela ukusikeka okudingekayo ngaphansi kwe-PAYGO. Ngisho noma befuna, ngeke bakwazi ukushintsha noma ukuyeka ukubusa kwe-PAYGO kwisinqumo sesabelomali. Bodingeka bashintshe umthetho wePAYGO uqobo. Ngalesi sikhathi, akukho mbiko ukuthi ukuphatha kuhlose ukwenza kanjalo.
Izwi elivela
Naphezu kwezithembiso eziphambene nalokho, ukuphathwa kweTrump kunomthetho ozokwenza ukuthi kutholakale imali kuM Medicare. I-GOP ichaze izinhlelo zokushintsha uMedare njengoba siyazi. Isabelomali sonyaka we-2018 sihlose ukunciphisa imali ye-Medicare, ukwandisa iminyaka yokufaneleka yokunakekelwa, nokubeka eceleni uhlelo ngokusebenzisa uhlelo lwevoksi. Umthethosivivinywa weNtela we-GOP uzokhipha imali kaMedare nge okungenani $ 28 billion ngonyaka kusukela ngo-2018.
> Imithombo:
> Imiphumela Yomthetho ozophakamisa ukulahlekelwa yi-$ 1.5 trillion esilinganiselwe Ngonyaka we-2018-2027. Ihhovisi le-Budget ye-Congressional. https://www.cbo.gov/publication/53319. Ishicilelwe ngoNovemba 14, 2017.
> I-FY 2018 Ukulungiswa Kwemali Yezindlu Nethonya Labo Kubantu abadala. Ikomidi likazwelonke lokulondoloza ukuvikeleka komphakathi kanye nemithi. http://www.ncpssm.org/PressRoom/NewsReleases/Release/ArticleID/1712/FY-2018-House-Budget-Resolution-and-Its-Effect-on-Seniors. Ishicilelwe ngo-Agasti 2, 2017.
> Indlela Imithetho Ye-PAYGO Engayithinta Ngayo Ukuguqulwa Kwentela. IKomidi leSabelomali seSifundazwe esithintekayo. http://www.crfb.org/blogs/how-paygo-rules-could-affect-tax-reform. Ishicilelwe ngo-Okthoba 18, 2017.
> Ukukhokhelwa Kanjani Imithi? Medicare.gov. https://www.medicare.gov/about-us/how-medicare-is-funded/medicare-funding.html.
> Ishidi Lamaqiniso Wezezimali Zikazwelonke. Amasevisi weMediare and Medicaid Services. https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet.html. Kubuyekezwe i-Disemba 6, 2017.