Iningi lethu aliqondi ukuthi kungani ukunakekelwa kwempilo kuyabiza kakhulu. Siyazi ukuthi izindleko zokunakekelwa kwezempilo zithatha ingxenye enkulu kakhulu yomkhiqizo wethu wangaphakathi. Kodwa, kungani izindleko zokunakekelwa kwezempilo zikhula ngokushesha kunomnotho?
I-poll yesi-2005 i-USA Today / Kaiser Family Foundation / i-Harvard School of Health Public yabonisa ukuthi abaseMelika bacabanga ukuthi izinkampani zokuhaha nemithi yomshuwalense zihaha, kanti izinsolo zokwelashwa ezingekho emthethweni ziyizinto ezibaluleke kakhulu ezibangela izindleko zokunakekelwa kwezempilo.
Labo baseMelika babengalungile. Ngenkathi kunezinto eziningana ezibangela izindleko ezikhulayo zokunakekelwa kwezempilo, omunye wabo upheqa bonke abanye.
Isici esisodwa senza isigamu sokukhula kwezindleko
Ukubika ngezingxenye ezingaphezu kwesigamu ukwanda kwezindleko, into eyodwa enkulu kunazozonke ezisekelwe ekukhuleni kwezindleko zezempilo kuyintuthuko kwezobuchwepheshe ekunakekeleni ukwelashwa . Ngenxa yentuthuko yezokwelapha, singaphulukisa noma siphathe izimo ezisetshenziselwa ukusibulala. Kodwa, lezo zindlela zokwelashwa ezintsha ziza ngamathegi wamanani.
Isibonelo, yonke insimu yomuthi wokufakelwa komzimba isuqalile kusukela ngasekupheleni kwawo-1960. Uma udinga ukufakelwa kwenhliziyo ngo-1965, wafa. Manje, uma unenhlanhla ngokwanele yokuba nomnikeli, amakhulu ezinkulungwane zamaRandi kamuva unenhliziyo entsha.
Ukunyakaza okuncane, ukushintshwa okuhlangene sekuye kwaba yindawo evamile emashumini ambalwa ambalwa adlule. Akuyona into engavamile ukuba umuntu oyedwa abe namajoyini amaningi esikhundleni sakhe, noma abe nomunye ofanayo ophindwe izikhathi eziningi.
Kodwa, ukuthuthuka kwamasu okuhlinza akuyona kuphela intuthuko kwezobuchwepheshe bezokwelapha okwandisa izindleko zokunakekelwa kwezempilo. Yonke insimu ye-DNA ebizwa ngokuthi i-biopharmaceuticals iye yavela kusukela ngawo-1980. Isibonelo, i-Enbrel, umjovo osetshenziselwa ukuvimbela imiphumela ekhubazayo ye-arthritis ye-rheumatoid kanye ne-ankylosing spondylitis, ibiza cishe u-$ 20,000 ngonyaka.
Akuyona nje izindleko zobuchwepheshe obusha ngokwabo, noma. Kubuye kube nezindleko zokuqhubeka nokuhlinzeka ukunakekelwa kwezempilo kumuntu onompilo wakhe wendluliselwa ngenye yalezi zindlela zobuchwepheshe.
Thatha isifo senhliziyo njengesibonelo. Eminyakeni edlule kwakukhona i-nitroglycerine, i-oxygen, ne-morphine. Uma ungumuntu oneminyaka engu-50 ubudala obenesifo senhliziyo, kungenzeka ukuthi ngeke usinde iminyaka eminingi ngoba ubuchwepheshe bezokwelapha ngokwanele lesi sifo abukho.
Manje, ungabekwa kwisimiso esifana ne-Lipitor isikhathi eside ngaphambi kokuba ube nesifo sokuthoma kwesifuba sokuqala. Ukuqala kwakho kwezimpawu kungase kubambezeleke iminyaka. Uma ekugcineni uveza izimpawu, ungaphathwa ngezinto ezinjenge- angioplasty , stents , nokuhlinzwa kokudlula, okungenzeka ukwandise impilo yakho amashumi eminyaka.
Kodwa, izindleko zalawo mashumi eminyaka akuyona nje izindleko ze-Lipitor kanye ne-stent. Kuyizindleko zazo zonke ezinye izinsizakalo zezempilo ozitholile ngoba uphile iminyaka eminengi. Uma ngabe ushonele eneminyaka engama-50 kusuka ekuhlaselweni kwenhliziyo yakho, ngabe ngabe wayedinga ukuguqula amadolo uma uneminyaka engu-62 ubudala. Ngeke uphathwe umdlavuza we-prostate uma uneminyaka engu-70 ubudala. Zonke lezo zindleko zokunakekelwa kwempilo zenziwa njengomphumela oqondile wokuthuthukiswa kobuchwepheshe bezokwelapha okukuvumela ukuba uphile isikhathi eside ngokwanele ukuze udinga ukwelashwa kwezinye izinto.
Kuthiwani ngamanye ama-50%?
Nakuba ukuthuthukiswa kwezobuchwepheshe bezokwelapha kubangelwa ukukhushulwa okungenani ngo-50% ezindleko zokunakekelwa kwezempilo, kusekhona amanye ama-50% azobhekwa. Okunye okunye okukhuphuka kwezindleko kubangelwa ukwandisa izinzuzo zomuntu siqu nokwandiswa komshuwalense wezempilo. Zombili lezi zici zidala isidingo esengeziwe sokunakekelwa kwezempilo. Abantu abacebile bangakwazi ukukhokhela ukunakekelwa kwezempilo okungaphezulu, ngakho basebenzisa ukunakekelwa kwempilo okungaphezulu. Abantu abanomshwalense wezempilo bayasuswa emithwalweni yezindleko zangempela zokunakekelwa kwezempilo, ngakho-ke badla ukunakekelwa kwezempilo okungaphezulu.
Ukungcola, ukukhwabanisa nokuhlukunyezwa, kanye nokushintsha kwezibalo zabantu njengokuguga kwabantu kanye nokwanda kwamazinga okukhuluphala kunomthelela ekukhuleni kwezindleko zezempilo.
Kodwa akukho ngisho nokufika eduze nomthelela wentuthuko kwezobuchwepheshe kwezokwelapha.
Kungani izindleko ezanda ukwelashwa zithinta?
Ukusetshenziswa kwemali yokunakekelwa kwezempilo e-United States kwaphuma kusuka ku-4.7% we-GDP ngo-1960 kuya ku-14,9% we-GDP ngo-2005. Manje, kuphakeme nakakhulu. Uma izindleko zokunakekelwa kwezempilo ziqhubeka nokunciphisa ingxenye ekhulayo yengeniso yesizwe sethu ngonyaka, ekugcineni ngeke ibe namandla. Okwamanje, kusenza sincintisane kancane emakethe yemhlaba wonke.
Ngomhlangano we-CNBC ka-Mashi 1, 2010, umlingisi wezigidigidi uWarren Buffett waqhathanisa izindleko zethu zokunakekelwa kwezempilo emthonjeni, ethi "konke esikhiqiza ukuthumela ngaphandle, konke esikuncintisana nayo ... kubhekene nezindleko ..."
Yini esingayenza ngakho?
Asifuni ukumisa ukuthuthukiswa kobuchwepheshe obusha bezokwelapha, nakuba kubangela ukuthi izindleko zokunakekelwa kwezempilo zikhuphuke. Ukuthuthuka kwezokwelapha ngokuvamile kuyinto enhle.
Esikhundleni salokho, kufanele sisebenzise ucwaningo lokuqhathanisa ukucubungula ngokucophelela inzuzo yobuchwepheshe obusha ngamunye ngokumelene nokwelashwa esinawo kakade. Kudingeka sibone uma ubuchwepheshe obusha buphatha ngempela inkinga kangcono kunezobuchwepheshe obudala. Uma kunjalo, ingabe leyo nzuzo ihambisana nazo zonke iziguli? Noma, ingabe amaqembu athile weziguli angcono ekutholeni ukwelashwa okudala? Njengamanje, asinalo ulwazi olwanele mayelana nokusebenza okuqhathaniswa kwezokwelapha ezihlukene ukwenza izinqumo ezigcwele mayelana nokuthi yiziphi izindlela zokwelapha ezingcono kakhulu ezimweni.
Ukwengeza, kufanele sikhiphe noma silawule imfucuza, ukukhwabanisa nokuhlukunyezwa. Kufanele sikhuthaze izinguquko zokuphila ukuze kunciphise izinga lokukhuluphala ngokweqile. Futhi, kufanele sihlinzeke ngokucacile ngokwezindleko zezinsizakalo zokunakekelwa kwezempilo ukuze abathengi ngabanye babe nomqondo onembile wokuthi insizakalo ngayinye yokunakekelwa kwezempilo abayisebenzisayo idinga ngempela.
Imithombo: Izindleko Zokunakekelwa Kwezempilo: I-Primer kaHenry J Kaiser Family Foundation, Ukuguqulwa Kwezobuchwepheshe kanye Nokukhula Kwezempilo Ukusetshenziswa Kwezimali ZikaHhovisi Lama-Budget , I-Long-Term Outlook for Health Care Ukusetshenziswa kweHhovisi le-Budget ye-Congressional .