Kuphatikizidwa kumaphatikizidwa pa mapulani onse atsopano ndi aang'ono
Pambuyo pa Ntchito Yabwino Yothandizira (ACA, yomwe imadziwikanso kuti Obamacare) inayamba kugwira ntchito, momwe kufotokozera kumene amaperekedwa ndi inshuwalansi zaumoyo kumasiyana kwambiri kuchokera ku mayiko ena. Kuziteteza kwa anthu ogulitsa anthu kumakhala malamulo osiyana siyana a boma omwe anali amphamvu m'mayiko ena komanso ochepa mwa ena.
Zofuna za boma zomwe zili zowonjezereka kuposa ACA zikugwiritsabe ntchito, koma m'mayiko onse, ACA yakhazikitsa zochepa zoyenera.
Mapindu a Zaumoyo Ofunika (EHBs) ndi mitundu khumi ya chithandizo chamankhwala chomwe chiyenera kuchitidwa - popanda malire a dollar pachaka kapena phindu la moyo - gulu lonse lirilonse ndi magawo ang'onoang'ono ali ndi mapulogalamu abwino a January 2014 kapena mtsogolo. EHBs imaphimbidwa mosasamala kanthu kuti ndondomeko ikugulitsidwa mwa kusinthana kapena kusinthanitsa .
Ndondomeko ya agogo ndi abambo omwe adakalipobe adakalipobe, koma adali ndi masiku abwino kwambiri asanafike chaka cha 2014. Choncho zofunikira za EHB sizikugwira ntchito kwa agogo ndi abambo ambiri, kupatulapo chisamaliro chodziletsa, chomwe chiyenera kuti chiphimbidwe kwa agogo aakazi-koma osabereka- mapulani. Zofunikira za EHB sizigwiranso ntchito pazinthu zazikulu za gulu .
Nazi zomwe EHB ziri, ndi momwe amagwirira ntchito:
Mapulogalamu Opondereza
Izi zikuphatikizapo kuyendera maofesi a madokotala ndi zipatala, komanso chisamaliro cha chipatala choperekedwa kuchipatala.
Kusamalira matenda, matenda a chisamaliro, ndi ntchito zothandizira
Kusamala kumachitika popanda kugawa ndalama kwa wodwalayo (mwachitsanzo, kampani ya inshuwalansi imalipiritsa ndalama zonse), koma ngati ntchito yothandizirayi ili pamndandanda wa chisamaliro chodzitetezera.
Pali mabungwe atatu omwe amagwiritsidwa ntchito popanga mndandanda wa chisamaliro chodziteteza. Mndandandawu wapangidwa makamaka pogwiritsa ntchito maulendo omwe amalandira chiwerengero cha "A" kapena "B" kuchokera ku US Prestective Services Task Force (USPSTF). Kuyezetsa khansa ya m'mimba kwa amayi a zaka zapakati pa 40 mpaka 49 kumangokhala ndi "C" yochokera ku USPSTF, koma kupatulapo kunaphatikizidwa kuti kuikidwe pamndandanda wa zithandizo zothandizira pansi pa ACA.
Kuphatikiza pa malangizo a USPSTF, Komiti Yowonongetsera Katemera wa CDC (ACIP) imapereka malangizo othandizira katemera, ndipo Health Resources ndi Services Administration (HRSA) imapereka malangizo othandizira kusamalira amayi, makanda, ndi ana.
Kachilombo kamaphimbidwa pansi pa chisamaliro chodziletsa, chomwe chikutanthauza kuti chiripo popanda ndalama kwa inshuwalansi. Koma ndondomeko za inshuwalansi za umoyo zimangoyenera kubwereza gawo limodzi mwa mitundu yonse ya ma ARV omwe amavomerezedwa .
Zipangizo Zowopsa
Ngakhale ogulitsa inshuwalansi zaumoyo akhoza kuchepetsa kufotokozera kwambiri kwa opa-intaneti, zomwe sizowona pa maulendo apadera.
Bungwe lanu la inshuwalansi la umoyo silingathe kugawana ndalama zapamwamba pa chisamaliro cha chipatala chachipatala, ndipo ziyenera kukulolani kupita ku chipinda chodzidzidzidwa kwambiri, ngakhale kuti sichiri m'ndondomeko yanu.
Chofunika kuti inshuwalansi yathanzi ipeze chithandizo chodzidzimutsa chimafikanso ku zoyendetsa ambulansi, kuphatikizapo ma ambulansi.
Ndikofunika kuzindikira kuti kulipira ngongole kungathe kukhala vuto mu nthawi yovuta pamene zipinda zam'chipatala zowonongeka ndi / kapena ma ambulansi amagwiritsidwa ntchito. Ngakhale kuti ACA imafuna kuti ogwira ntchito azitsatira chithandizo chamwadzidzidzi pazomwe amagwiritsidwa ntchito pa intaneti ngakhale ngati chipatala kapena odwala ambulansi ali osatayika, sichikakamiza chipatala, madokotala odwala, kapena kampani ya ambulansi kuti azilipira wodwalayo kalata yawo, pamwamba pa zonse zomwe zimaperekedwa ndi kampani ya inshuwalansi ya wodwalayo.
Maboma ena adaletsa kubweza ngongole pazidzidzidzi, ndipo malamulo omwewo akuganiziridwa-koma sanafike-ku federal level.
Kuchipatala
Izi zimaphatikizapo kuchuluka kwa chisamaliro cha kuchipatala, kuphatikizapo chithandizo cha madokotala ndi anamwino, ma laboratory odwala matenda osokoneza bongo komanso ntchito za mankhwala, ndi chisamaliro cha opaleshoni.
Mapulogalamu a Zipatala
Ntchito ya labu imene ikugwera pansi pa chithandizo chodziletsa chomwe chafotokozedwa pamwambachi chikukhudzidwa ndi kugawana mtengo kwa wodwalayo.
Ntchito zina zofunikira za labu zimaphimbidwa ndi ndondomeko yogawa ndalama zowonongeka.
Kusamalidwa ndi Kusamalidwa kumene
Izi zikuphatikizapo kusamalidwa, kubereka, ndi kusamalidwa kumene, ngakhale kuti kuyang'anitsitsa kwa amayi asanakwatire nthawi zambiri kumaphatikizidwa ndi chisamaliro (kutchulidwa pamwambapa) ndipo angapangidwe popanda kugawa ndalama kwa mayi woyembekezera.
Malinga ndi HRSA, chisamaliro cha amayi oyembekezera chitachitika pansi pa gulu la chisamaliro cha amayi. Ndipo ngakhale kuti nthawi zambiri amapezeka kamodzi pachaka, bungweli limanena kuti nthawi zina "maulendo angapo amafunika kuwunikira kuti athe kupeza njira zonse zothandizira."
Kuwonjezera pa kudzifufuza okha, pali mayesero ena enieni (omwe ali ndi matenda a shuga, a Hepatitis B, ndi a Rh Ophatikizana) omwe amaperekedwa kwa amayi omwe ali ndi pakati pa chithandizo chodziletsa, popanda kugawa ndalama.
Matenda a maganizo ndi mankhwala osokoneza bongo
Izi zimaphatikizapo kuchipatala ndi kuchipatala kwa matenda a umoyo ndi mankhwala osokoneza bongo.
Zofuna za umoyo waumoyo zisanayambe ku ACA, ngakhale kuti ACA inalimbikitsa lamulo lachigwirizano kuti ligwiritse ntchito mapulani a malonda komanso malingaliro omwe amagwiritsidwa ntchito ndi abwana. Pansi pa zofunikira zaumulungu, ndondomeko ya thanzi silingathe kuchepetsa malire operekera kuchipatala kusiyana ndi chithandizo cha mankhwala / opaleshoni.
Mapatala, kuphatikizapo mano ndi masomphenya kusamalira ana
Mosiyana ndi ma EHB ena, mano a ana sagwiritsidwa ntchito muzinthu zambiri za inshuwalansi. M'malo mwake, kusinthana kungangopereka njira yokhayokha yogwiritsira ntchito mano a mano.
Ngati kusinthanitsa kumagulitsa malingaliro a mano okhaokha, ndipo banja limagula ndondomeko ya thanzi kuphatikizapo ndondomeko ya ubongo ya ana, chokhacho mtengo wa dongosolo la thanzi limawerengedwa pamene ndalama zawo zowonjezereka zikuwerengedwa. Izi zingasinthe, komabe, pansi pa lamulo loperekedwa ndi IRS mu July 2016 . Pansi pa lamulo lofunsidwa, mtengo wa chithandizo cha ana odwala mano amatha kukhala nawo muyeso yowonjezera ndalama, ngakhale kutsekedwa kwa mano kumagulitsidwa pogwiritsa ntchito malingaliro osiyana, m'malo mwa gawo lokhazikitsa dongosolo la thanzi.
Palibe chofunikira kuti mapulani azaumoyo aziphimba mano kapena masomphenya akuluakulu.
Mankhwala osungirako mankhwala
Magulu a anthu onse ndi ang'onoang'ono ayenera kuika mankhwala osokoneza bongo, ndipo mankhwalawa ayenera kuphatikizapo mankhwala amodzi m'madera onse a United States Pharmacopeia (USP) ndi kalasi (kapena zambiri, ngati dongosolo la ndondomeko ya boma likuphatikizapo zambiri).
Ma formulamu amakhalanso ndi mauthenga ochokera ku komiti za pharmacy ndi mankhwala (P & T), koma amasiyana kwambiri kuchokera ku inshuwalansi ya umoyo wina kupita kwina.
Pansi pa ndondomeko zothandizira zothandizira zomwe zatchulidwa pamwambapa, ndondomeko zaumoyo ziyenera kubisa-popanda mtengo kwa ogulitsa - pafupifupi mtundu umodzi wa mtundu uliwonse wa kachilombo ka HIV kovomerezeka kwa amayi.
Kwa mankhwala ena, ndondomeko ya kugwiritsira ntchito ndalama, komanso mapulani angafunike kupititsa patsogolo mankhwala (chofunika kuti inshuwalansi ayambe ndi mankhwala odalirika kwambiri komanso oopsa kwambiri kuti awone ngati akugwira ntchito, asanayesetse mankhwala oopsa kwambiri) .
Ambiri ogulitsa inshuwalansi amaika mankhwala osokoneza bongo m'magawo atatu, kuyambira pa imodzi mpaka 4. Mankhwala amodzi ali ndi ndalama zochepa kwambiri, ndipo madokotala anayi (kapena mankhwala apadera) ali ndi mtengo wapamwamba kwambiri.
Ntchito zothandizira komanso zothandiza
Izi zikuphatikizapo mankhwala komanso zipangizo zomwe zimafunikira kuti akonzedwe ndi kukonzanso.
Mapulogalamu othandizira otsogolera amayang'ana kubwezeretsanso mphamvu, monga ntchito kapena mankhwala opatsirana potsatira ngozi kapena kupwetekedwa.
Mapulogalamu othandizira amathandiza kuti munthu akhale ndi luso poyamba, monga kulankhula kapena ntchito yothandizira mwana yemwe sakuyankhula kapena kuyenda mogwirizana ndi zomwe akuyembekezera.
Zolinga za chiwerengero cha maulendo pa chaka zimagwiritsidwa ntchito (ngakhale mapulani sangapangitse malire a dola pa EHBs, pitani malire amaloledwa). M'madera ena, malirewo amagwiritsidwa ntchito pokhudzana ndi mankhwala, kuphatikiza ntchito, mankhwala othandizira, pamene ena ali ndi malire osiyana pa mtundu uliwonse wa mankhwala.
> Zotsatira:
> Pakati pa Odziwitsa Anthu ndi Kuwunika kwa Inshuwalansi, Matenda a Mental Health and Addiction Equity Act.
> Zolinga za Kuletsa ndi Kuteteza Matenda, Komiti Yolangizira Zopangira Katemera (ACIP).
> Dipatimenti ya US Health and Human Services, Health Resources ndi Services Administration.
> Department of Health and Human Services, United States, Health Resources ndi Services Administration, Women's Preventive Services Guidelines.
> US of Preventive Services Task Force, USPSTF A ndi B Recommendations.