Kusintha kwa chithandizo cha zaumoyo kwakhala kulimbikitsana kosalekeza ku US kwa zaka zambiri. Mawu awiri omwe nthawi zambiri amagwiritsidwa ntchito pazokambirana ndi kulandira chithandizo cha zachipatala zonse ndi dongosolo lolipira limodzi. Iwo sali chinthu chomwecho, ngakhale kuti nthawi zina anthu amawagwiritsa ntchito mosiyana.
Ndipo ngakhale kuti olemba malipiro amodzi akuphatikizapo chilengedwe chonse, maiko ambiri apeza chilengedwe chonse popanda kugwiritsa ntchito njira imodzi yokhapira.
Tiyeni tiwone zomwe ziganizo ziwirizi zikutanthawuza, ndi zitsanzo zina za momwe akugwiritsidwira ntchito padziko lonse lapansi.
Universal Coverage
"Kugawanika kwachilengedwe" kumatanthawuza dongosolo la chisamaliro komwe munthu aliyense ali ndi chithandizo cha thanzi. Malingana ndi US Census Bureau, panali anthu okwana 28.1 miliyoni a ku America omwe alibe inshuwalansi mu 2016 (izi zinali zocheperachepera 46.6 miliyoni omwe sanalimbikitsidwe zaka khumi kale, kuchepetsa chifukwa cha kukhazikitsidwa kwa Care Affordable Care Act ).
Mosiyana ndi zimenezo, palibe nzika za Canada zomwe sizitsimikizidwe - dongosolo lawo la boma limapereka chidziwitso cha dziko lonse lapansi. Choncho, Canada ili ndi chithandizo chonse cha zachipatala, pamene United States siili (ndizofunika kudziwa kuti 28.1 miliyoni osatetezedwa ku US akuphatikizapo anthu oposa 4,7 miliyoni omwe sali ovomerezeka. Mchitidwe wa boma wa Canada sungapereke chithunzi kwa anthu osamukira kunja).
Ndondomeko Yomwe Amalipira
Kumbali ina, "malipiro amodzi-okha" ndi amodzi omwe ali ndi gulu limodzi-kawirikawiri ndi boma loyang'anira kupereka malipiro a zaumoyo. Ku US, Medicare ndi Veterans Health Administration ndizo zitsanzo za malipiro amodzi. Nthawi zina Medicaid imatchedwa kuti-payer system, koma imalumikizidwa pamodzi ndi boma la federal ndi boma lililonse la boma.
Kotero ngakhale kuti ndi mtundu wa chithandizo cha umoyo wothandizidwa ndi boma, ndalama zimachokera ku zigawo ziwiri osati imodzi.
Anthu omwe akuphimbidwa ndi malonda omwe amagwiritsidwa ntchito ndi ogwira ntchito kapena malonda awo pamsika ku US (kuphatikizapo mapulani a ACA-ovomerezeka) sali mbali imodzi ya malipiro amodzi, ndipo inshuwalansi yawo ya umoyo siyendetsa boma. M'misika iyi, makampani ambiri a inshuwalansi, omwe ali payekha ali ndi udindo wopereka malipiro a mamembala.
Kawirikawiri, "kufalitsa kwapadera" ndi "malipiro osakwatira amodzi" zimayendera limodzi, chifukwa boma la federal ndilo lofunikanso kwambiri kupereka ndi kulipira dongosolo la chithandizo chamankhwala chophimba anthu mamiliyoni ambiri. Zili zovuta kulingalira bungwe lachinsinsi ngati kampani ya inshuwalansi yomwe ili ndi chuma, kapena ngakhale chikhumbo chonse, kukhazikitsa dongosolo lonse la chithandizo chaumoyo.
Komabe, ndizotheka kukhala ndi chidziwitso chonse popanda kukhala ndi malipiro amodzi, ndipo mayiko ambiri padziko lonse achita izi. Akatswiri ena amanena kuti United States iyenera kusintha mwakachetechete kayendedwe kake kaumoyo kuti athe kupereka chithandizo cha boma cha chitetezo kwa odwala ndi osauka (monga mtundu wowonjezera wa ACA's Medicaid expansion ), pakufunikanso iwo omwe ali olemera a thanzi labwino komanso a zachuma kuti agule malonda awo.
Gridlock yandale imene yakhala ikuyang'anira pa Affordable Care Act pazaka zingapo zapitazi zimapangitsa kuti zikhale zovuta kulingalira ngati pempholi likupeza kupititsa kokwanira. Koma ndizotheka kumanga njira yotereyi, yomwe ingapereke chidziwitso kwa anthu onse komanso pokhala ndi malipiro angapo.
Ngakhale kuti n'zotheka kukhala ndi malipiro amodzi omwe alibe malipiro, sizingatheke kuti chichitike chifukwa chakuti wolipira yekhayo mosakayikira adzakhala boma la federal. Ngati boma liyenera kukhazikitsa dongosololi, sizingakhale zandale kuti iwo asatuluke nzika iliyonse payekha.
Socialized Medicine
Mawu ena omwe amagwiritsidwa ntchito pokambirana za olipira okha ndi omwe akupezeka padziko lonse lapansi, ndi omwe amachititsa kuti munthu amene akulipira yekhayo asamalire. Mu kayendedwe kabwino ka mankhwala, boma likulipiritsa chithandizo chamankhwala komanso limagwiritsira ntchito zipatala ndikugwiritsira ntchito madotolo ndi akatswiri ena azachipatala. Mu United States, boma la Veterans Administration (VA) ndi chitsanzo cha mankhwala osokoneza bongo, monga boma limagwira ntchito ndi ma ARV, komanso kulipira ngongole.
Nyuzipepala ya National Health Service (NHS) ku United Kingdom ndi chitsanzo cha boma limene boma limalipira ntchito komanso ali ndi zipatala ndikugwiritsira ntchito madokotala. Koma ku Canada, yomwe imakhala ndi malipiro amodzi okhaokha, zipatala zimagwiritsidwa ntchito paokha ndipo madokotala sagwiritsidwa ntchito ndi boma-amangopereka ndalama kwa boma kuti athandizidwe.
Zochitika Zathanzi Padziko Lonse
Malingana ndi deta yochokera ku bungwe la Economic Cooperation and Development, mayiko angapo athandiziridwa ndi anthu onse, ndipo 100 peresenti ya anthuwa akuphimbidwa. Izi zikuphatikizapo Australia, Canada, Finland, France, Germany, Hungary, Iceland, Ireland, Israel, Netherlands, New Zealand, Norway, Portugal, Slovak Republic, Slovenia, Sweden, Switzerland, ndi United Kingdom. Kuphatikizanso, mayiko ena ambiri apindula pafupi ndi chiwerengero chonse cha anthu omwe ali ndi inshuwalansi, kuphatikizapo Austria, Belgium, Japan, ndi Spain.
Mosiyana ndi zimenezi, 91 peresenti ya anthu onse a ku United States anali inshuwalansi mu 2016, ndipo kufufuza kwa Gallup kunasonyeza kuti chiwerengero cha anthu a ku America okhala ndi chithandizo cha umoyo anali atatsikira pansi pa 88 peresenti kumapeto kwa 2017.
Tiyeni tiwone njira zosiyanasiyana zomwe mayiko ena apindulira nawo:
Germany
Germany ili ndi chidziwitso chonse, koma sichigwira ntchito imodzi ya malipiro. M'malo mwake, aliyense amene akukhala ku Germany akufunika kuti azikhala wathanzi. Ambiri ogwira ntchito ku Germany amadzilembera mwachindunji mwa imodzi mwa ndalama zopanda phindu "ndalama zakuthupi," zomwe zimaperekedwa mwa kuphatikizapo ntchito ndi ntchito za abwana. Mwinanso, pali inshuwalansi yathanzi yaumwini, koma pafupifupi 11 peresenti ya anthu a ku Germany amasankha inshuwalansi ya thanzi laumwini.
Singapore
Singapore imakhala yowonjezereka, ndipo ndalama zambiri zothandizira zaumoyo zimaphimbidwa (pambuyo pa deductible) ndi boma la inshuwalansi yotchedwa MediShield. Koma Singapore ikufunanso kuti aliyense apereke pakati pa 7 ndi 9.5 peresenti ya ndalama zawo ku akaunti ya MediSave. Odwala akamasowa chithandizo chamankhwala nthawi zonse, akhoza kutenga ndalama kuchokera ku akaunti zawo za MediSave kuti azilipire ndalamazo, koma ndalamazo zingagwiritsidwe ntchito pazinthu zina monga mankhwala omwe ali pamndandanda wovomerezeka ndi boma. Kuonjezera apo, boma limapereka malipiro a chithandizo chamankhwala okha (osati ndalama za inshuwalansi, monga momwe ziliri ndi chithandizo chomwe chinagulidwa kudzera ku mgwirizano wa ACA ku US, mwachitsanzo), kotero kuti anthu ayenera kulipira chifukwa chisamaliro chawo n'chochepa kwambiri kuposa momwe chingakhalire.
Japan
Japan ili ndi chidziwitso chonse, koma sichigwiritsa ntchito njira imodzi yokhapira. Mapulogalamuwa amaperekedwa kudzera mwa inshuwalansi zamakono zokhudzana ndi umoyo wathanzi (Statutory Health Insurance System) (SHIS). Anthu akuyenera kulembedwa kuti apeze malipiro komanso kupereka malipiro opitirira pa chitukuko cha SHIS, koma palinso mwayi wogula inshuwalansi yaumwini, yowonjezerapo.
United Kingdom
UK ndi chitsanzo cha dziko lomwe lili ndi chiwerengero cha anthu onse omwe ali ndi malipiro amodzi , ndipo monga momwe taonera pamwambapa, dongosolo la UK lingathenso kutchulidwa ngati mankhwala a socialized, chifukwa boma liri ndi zipatala zambiri ndipo limagwiritsa ntchito opereka mankhwala. Zothandizira ndalama za National Health Service zimachokera ku msonkho wa msonkho. Nzika zitha kugula inshuwalansi yaumwini ngati akufuna, ndipo ingagwiritsidwe ntchito popanga zipatala zapadera, kapena kukwaniritsa mwamsanga kusamalira, popanda kuyembekezera zomwe NHS angapange chifukwa cha zovuta.
Zotsatira:
> Gallup. Ndalama Yopanda Uninsured ya US inakhala yolimba pa 12.2% mu Quarter lachinayi la 2017. January 16, 2018.
> Bungwe la Economic Cooperation and Development. Kuyeza Zaumoyo. May 2016.
> US Census Bureau, Health Insurance Coverage ku United States, 2016 . inasindikizidwa mu September 2017.
> US Census Bureau, Income, Umphaŵi, ndi Health Insurance Coverage ku United States, 2005 . Yofalitsidwa August 2006.