Kuyang'ana Mapulani Kusintha Mankhwala ndi Medicare
Purezidenti Donald Trump analonjeza anthu a ku America pa njira yachitukuko. Obamacare obwereza komanso kusunga Medicare anali pamwamba pa mndandandandawo. Kodi Purezidenti wathu akutsatira malonjezowa?
Kuyang'ana Malonjezo a Trump
Monga chikumbutso, Pulezidenti Trump adalengeza pa dongosolo lachisanu ndi chiwiri la thanzi. Ndi kusintha kotereku, adalonjeza kuti adzakhalanso ndi thanzi labwino.
- Pewani Ntchito Yopereka Chithandizo Chamtengo Wapatali, aka Obamacare
- Lolani kugulitsa mapulani azaumoyo kudutsa mndandanda wa dziko malinga ngati ndondomeko zaumoyo zikutsatira malangizo a boma
- Lolani anthu kuti adzipereke malipiro a inshuwaransi ya thanzi pa msonkho wawo wa msonkho
- Lolani anthu kuti agwiritse ntchito Mauthenga Okhudzidwa ndi Thanzi la Umoyo (HSA)
- Chofunika chofuna kuwonetsera mtengo kudutsa dongosolo la chithandizo chaumoyo
- Pewani zopereka za federal kuti zifotokoze za Medicaid
- Lolani kuwonjezeka ku misika yaulere, kuphatikizapo kugula mankhwala osakwera kunja, kuchepetsa mtengo wa mankhwala opatsirana
Kodi Purezidenti Trump akupereka malonjezo ake?
Trump Imachita Mtheradi
Ziribe kanthu momwe mukuyang'anirako, ndalama za Medicaid ndizocheka. Izi zingakhudze anthu angati omwe angakwanitse kupeza chithandizo chamankhwala kudzera pulogalamuyi.
Obamacare obwereza
Pamene Ntchito Yabwino Yopereka Chithandizo Yopindulitsa inayamba mu 2010, panali anthu ambiri ochokera ku America omwe sali ovomerezeka okwana 48 miliyoni, pafupifupi 15,7 peresenti ya anthu.
Malingana ndi Centers for Medicare ndi Medicaid Services, lamulo la chilamulo linachepetsa chiwerengerocho kufika pa 9.2 peresenti pofika mu 2015.
Obamacare analola achinyamata kukhalabe ndi zolinga za makolo awo nthawi yayitali, kulepheretsa makampani a inshuwalansi kuti ayambe kulipira ndalama zowonjezereka zomwe zakhalapo kale , zowonjezeredwa kuti ziwonjezeke ku mapulogalamu a Medicaid omwe adakalipo ndipo adayambitsa Health Insurance Marketplace ngati njira yabwino kwambiri kwa iwo omwe sanakumane nawo Njira za Medicaid.
Mwachidule, phindu la inshuwalansi yapadera pa nthawiyo linali lokwanira kwambiri kuti anthu ambiri aziyang'anira.
Ambiri amanena kuti Obamacare anapitirizabe kuchoka pazinthu zaumoyo kuchokera ku ndalama. Zokonzedweratu pamakonzedwe ambiri zakhala zazikulu kwambiri moti anthu ambiri sangakwanitse. Kodi ndikobwino kusiyana ndi kusakhala ndi thanzi labwino?
Pogwiritsa ntchito American Health Care Act (AHCA), Purezidenti Trump akufuna kuti asinthe malamulo ambiri olembedwa ndi Obamacare. Pochita izi, Congressional Budget Office ikuyesa kuti anthu okwana 14 miliyoni adzataya mwayi wathandizira inshuwalansi chaka chamawa ndi anthu 23 miliyoni m'zaka 10. Kuti tifotokoze momveka bwino, ngati tikutsatira zochitika za Obamacare, anthu okwana 28 miliyoni ochepera zaka 65 adzakhala osatetezedwa mu 2026 koma ndi AHCA, chiwerengero chimenecho chidzadumpha kufika pa miriyoni 51.
Kudula malipiro a boma ku Medicaid
Obamacare adalimbikitsa kuti adziwe kuti adasankha kupitiriza kukula kwa Medicaid . Mayiko amenewo analandira madola a boma kuti awathandize, ndalama zokwana 100 peresenti ya ndalama zowonjezereka kwa zaka zitatu ndi 90 peresenti ya ndalama mwa 2020. Kuwonjezeka kwa Medicaid kudzaimitsa pansi pa AHCA, ngakhale kuti Trump ikuyendetsa ndalama zomwe analonjeza kupyolera mu 2020 .
Pambuyo pofotokozera Obamacare, AHCA ikufuna kudula ndalama zina zomwe zimaperekedwa kuzinthu za Medicaid. Lamuloli linapereka malire othandiza ndalama kuti zisawononge ndalama . Kuchokera mu 1965, mayiko adalandira ndalama za dollar kwa Medicaid malinga ndi chiwerengero cha anthu omwe adzalandira pulogalamuyi. Kuleka malire kungasinthe zonse, kupereka ndalama zokwanira za Medicaid mosasamala kanthu za zosowa za boma. Kusintha kwa ndalama kumakhudza maiko onse, osati okhawo amene adalimbikitsa kuwonjezeka kwa Medicaid.
Kuchepetsa thandizo la federa la Medicaid limapangitsa katundu wolemetsa kuti apeze zofunika pamoyo wawo. Mayiko ambiri akulimbana ndi kuchepa kwa ndalama monga momwe ziliri.
Mu 2016, oposa theka la maikowa adapeza ndalama zochepa kusiyana ndi ndalama zomwe analinganiza ndipo 19 a iwo adayenera kupanga ndalama zapakatikati pa chaka kuti azikhalabe.
Bungwe la Congressional Budget Office likunena kuti AHCA idzachepetsa ndalama za madola 800 biliyoni pazaka 10 zikubwerazi. Mwa kuika zolemetsa zambiri pazimene zimapereka ndalama, ndi ndani komanso Medicaid yomwe ikuphimbayo ingasinthe. Maboma ena amatha kusankha kukhazikitsa zikalata zolembera kapena kukhazikitsa mndandanda wa mapulogalamu a Medicaid opindulitsa kwa anthu omwe amakwaniritsa zofunikira. Maboma ena akhoza kukakamizika kudula phindu kuti asunge ndalama. Ena akhoza kuchita zonsezi.
Thumba Ligwira pa Medicare
Pa njira yachithandizo, Pulezidenti Trump adalonjeza kuti sadzadula Medicare phindu, koma AHCA idzakhala ndi zotsatira zothandizira odwala Medicare. Anapanganso malonjezano ambiri kwa anthu achikulire a ku America omwe adayenera kuchitapo kanthu.
Kuyankhulana ndi Ma ARV
Momwemonso mankhwala omwe amagwiritsidwa ntchito ku United States nthawi zambiri amatsika pang'ono m'mayiko akunja. Mwachitsanzo, Advair, mankhwala omwe amagwiritsidwa ntchito pochizira mphumu , amawononga ndalama zokwana madola 309.60 pamwezi ku United States koma zimangodola $ 74.12 ku Canada komanso $ 46.99 ku United Kingdom. Pakalipano, Medicare salola olembetsa kugula mankhwala awo kunja kwa dziko kuti agwiritse ntchito mankhwala osakwera. Pulezidenti Trump akufuna kusintha izo. Komabe, makampani opanga mankhwala atha kukhazikitsidwa.
Pulezidenti Trump akufunanso kukambirana ndi makampani a American mankhwala kuti azikhala bwino. Mankhwala a Medicare Part D omwe amagwiritsidwa ntchito panopa akuyendetsedwa ndi makampani a inshuwalansi, ndipo malamulo alipo omwe amalepheretsa boma la boma kuti lipite patsogolo pa mitengo. Apanso, pali makampani opanga mankhwala omwe amawathandiza kuti apitirizebe kutsatira malamulowa.
Pogwiritsa ntchito ndalama zokha khumi zokha zachipatala zomwe zinanenedwa za mankhwala, Congressional Budget Office (CBO) imanena kuti sangayembekezere kuchepetsa ndalama zomwe zingathandize kuchepetsa ndalama. Mndandanda wa madandaulo ena umasonyeza kuti Medicare ikhoza kupulumutsa ndalama zokwana madola 16 biliyoni chaka chilichonse pakukambirana ndi kuchepetsa mtengo wa mankhwala a dzina lachidziwitso kuti awonetsere boma la federal lomwe lapangana kale ku Medicaid ndi Administration Veterans .
Pakadali pano, palibe ndondomeko ya malamulo yomwe yatengedwa kuti athetse mitengo ya mankhwala.
Kusungitsa Misonkho
Pulezidenti Trump angapereke mwayi kwa anthu a ku America kupulumutsa pamisonkho. Padakali pano, opindula a Medicare saloledwa kugwiritsa ntchito mwayi wa ndalama zachuma. Chifukwa cha kusintha kwa malamulo, odwala omwe amagwiritsa ntchito Medicare akhoza kupatula malipiro a msonkho kuti athe kulipira ndalama zothandizira.
Pogwiritsa ntchito ndalama zowonjezera msonkho wogulitsa (ndalama zokwana madola 1,608 mpaka $ 5,143 a Medicare Part B mu 2017) , akuluakulu angapulumutse zambiri pantchito yawo yopuma pantchito.
Apanso, palibe kuyesa kutengapo kuti izi zitheke.
Obamacare Wowonjezera Amakhudza Matenda
Ngakhale chidwi chakhala chikugwiritsidwa ntchito pa Medicaid ndi osatonthozedwa, kuthetsedwa kwathunthu kwa Care Affordable Care Act kungakhale ndi zotsatira zazikulu kwa anthu a Medicare . Obamacare anathandiza kukhazikitsa mapulogalamu othandizira kuchipatala, kuchepetsa chinyengo cha Medicare, ndi kukhazikitsa njira zatsopano zowonjezera zomwe zingasunge ndalama pulogalamuyi. Zinaonjezeranso kufalitsa kwa Medicare, kupanga ntchito zothandizira ngati colonoscopies ndi mammograms kwaulere mukalandira kulandira kuchokera kwa wopereka nawo gawo . Chofunika kwambiri, chinathandiza kuchepetsa mtengo wa mankhwala osokoneza bongo kwa anthu omwe ali pa ndondomeko ya Gawo D.
Poyamba, zinalibe bwino momwe AHCA angayankhire nkhaniyi, koma zikuwoneka kuti sikuti zonse zomwe azimayi a Obamacare ali nazo ndizokhazikika. AHCA sichidzasintha malingaliro opindulitsa, ndipo izi zidzalola kuti dzenje lidzatseke pofika chaka cha 2020 monga momwe zakhalira.
Chimene chimasintha ndi misonkho. AHCA idzachotsa mankhwala a Medicare omwe amalandira ndalama zambiri, zomwe zikutanthauza kuti ndalama zochepa zidzakhalapo kwa Medicare Trust Fund m'kupita kwa nthawi. Ndipotu, akuganiza kuti Dipatimenti ya Medicare Trust idzataya chisankho cha 2025, zaka zitatu zisanachitike kuposa zomwe zinanenedwa mu 2016, ngati AHCA ikuchitika.
Tidzachita chiyani ngati Medicare ikutaya ndalama ?
Zoona Zenizeni Zotsogolera Utumiki
Pulezidenti Trump adagwira ntchito ndipo adasaina lamulo lolamulira pa January 20, 2017, tsiku la kutsegulira kwake. Lamuloli linalamula kuti mabungwe a federal abwerere ku Obamacare "kufikira momwe chiloledwa ndi lamulo". Lamuloli silinayambe kuwononga mtengo wodalirika wa Act Act ndipo silinatchule momwe mabungwe angapitirire pazovutazo.
Ngakhale adanena kuti sangakhudze pulogalamu ya Medicare, Pulezidenti Trump dzina lake Tom Price monga Mlembi wa Health and Human Services omwe adatsimikiziridwa pa February 10 pambuyo pa zokambirana za Senate. Mtengo wakhala woposa mawu okhudzana ndi kufunafuna mankhwala ambiri a Medicare. Iye adalonjeza kuti ntchito ya Medicare yokhala ndi mwayi wapadera ndi dongosolo la "Njira Yabwino" lomwe linayambitsidwa ndi GOP mu 2016. Kuphatikiza apo, adalimbikitsa kudulidwa kwakukulu ku pulogalamu ya Medicaid.
Pulezidenti adagwiranso ntchito Seema Verma kuti ayendetse Centers kwa Medicare ndi Medicaid Services (CMS). Wothandizira zaumoyo ndi woyambitsa SVC. Inc., ntchito yake ku Indiana inatsogolera kufunika koti anthu a Medicaid azilipiritsa mwezi uliwonse kapena kutaya malipiro awo kwa miyezi isanu ndi umodzi. M'madera ena, iye wagwira ntchito pa zofuna zomwe zimafuna anthu pa Medicaid kulipira mbali ina ya chisamaliro chawo kapena kuti awafunse kugwira ntchito kapena kuyang'anitsitsa ntchito. Pakadali pano, wapereka gawo pamtundu wa boma, koma mu udindo wa federal, akhoza kusintha miyezo m'dziko lonse lapansi.
Malonjezo ambiri apangidwa ndipo ndithudi anthu ambiri adzakhudzidwa. Pulezidenti Trump watumiza zizindikiro zosiyana kwa anthu a ku America. Zomwe walonjeza panthawi yachitukuko sizinali zogwirizana ndi zochita zake monga Purezidenti. Cholinga cha Obamacare chikhoza kuchitika, ngati pang'ono, ngati AHCA ikuchitika. Kudula kwa Medicaid ndikutsimikiza kutsatira. Kodi chiti chidzachitike kwa Medicare, komabe, ndi masewero oganiza.
Mawu ochokera
Cholinga cha AHCA chinapititsa Nyumba ya Aimuna ya US, koma mpaka itavomerezedwa ndi Senate, Ntchito Yopereka Chithandizo Chamtengo Wapatali imakhala lamulo la dzikolo. Pulezidenti Trump adalonjeza kubwezeretsa Obamacare, koma AHCA monga momwe adalembedwera idzanyalanyaza mbali zokha za lamulo. Analonjeza kuti Medicare idzasankhidwa, koma AHCA idzadula ndalama ku Medicare. Ndiyambe kumayambiriro kwa kayendetsedwe ka pulezidenti, ndipo nthawi yokhayo idzauza ngati Pulezidenti adzatsatila malonjezano omwe adawapanga kwa anthu omwe adamvotera paulendowu.
> Zotsatira:
> Chithandizo Chamankhwala Chamagulu cha Amereka: Kutsimikizira Mtengo. Congressional Budget Office. https://www.cbo.gov/publication/52486. Lofalitsidwa March 24, 2017.
> Njira Yabwino: Masomphenya Athu a Chikhulupiriro cha America - Health Care. Bwino.GOP. http://abetterway.speaker.gov/_assets/pdf/ABetterWay-HealthCare-PolicyPaper.pdf. Idasindikizidwa pa June 22, 2016.
> Mlimi Wowonjezerapo Ndalama Zomwe Amayembekezera M'madera Ambiri Kuyambira Kuchokera. Webusaiti ya Govern.com. http://www.governing.com/topics/finance/gov-nasbo-state-spending-survey-2017.html. Idasindikizidwa pa December 13, 2016.
> Kuyankhulana kwa Madokotala Ochepetsa Zamankhwala ku Medicare Part D. Komiti Yachiwiri Kusunga webusaiti ya Social Security ndi Medicare. http://www.ncpssm.org/EntitledtoKnow/entryid/2061/negotiating-for-lower-drug-costs-in-medicare-part-d.
> Numeri zolembetsa za Obamacare. Zoonadi za Obamacare webusaiti. http://obamacarefacts.com/sign-ups/obamacare-enrollment-numbers/. Inapezeka pa April 18, 2016.