Zimene Mukuyenera Kudziwa Zokhudza Zamankhwala Zopereka Ndalama
Pulezidenti Trump adalonjeza pa njira yopewera Medicare. Simungathe kudula Medicare phindu. Mwamwayi, mpaka pano, mawu ake sakugwirizana ndi zochita zake. GOP ili ndi Medicare ndi Medicaid m'makampani ake ndipo ikuchitapo kanthu kuti athe kuchepetsa ndalama kwa zomwe zikuwona ngati mapulogalamu oyenerera. Izi ndi zomwe muyenera kudziwa pothandiza ndalama za Medicare kupita mu 2018 ndi kupitirira.
Kodi Choyenera N'chiyani?
Anthu ambiri samawona Medicare ngati "ufulu". Ndipotu, amalipira misonkho ku Medicare Trust Fund pogwiritsa ntchito zopereka zawo zothandizira msonkho pogwiritsa ntchito lonjezo loti athe kupeza chithandizo chamankhwala chokwera mtengo ngati ali okalamba kapena ayenera kukhala olumala.
Komabe, ngakhale kuti mawuwa ali ovomerezeka ali ndi ziganizo zamagulu ena, Medicare ndi Medicaid ali ndi mapulogalamu oyenerera. Malingana ndi dikishonale ya Merriam Webster, choyenera ndi pulogalamu ya boma yopereka phindu kwa mamembala a gulu linalake kapena ndalama zothandizira kapena zogawidwa ndi pulogalamuyi.
Kumvetsa ndalama za Medicare Trust
Pali madamu awiri a Medicare ndalama. Yoyamba ndi Medicare's Hospital Inshuwalansi [HI] Trust Fund, yomwe imatchulidwanso kuti colloquially ngati Medicare Trust Fund. Ndalama iyi imapereka thandizo lanu la Medicare Part A , yomwe imakhala malo opita kuchipatala, malo osungirako okalamba omwe amatha nthawi yayitali atakhala kuchipatala, chisamaliro chaumoyo, komanso chisamaliro cha kuchipatala.
Ndalamayi ndi kumene ndalama zanu za msonkho zimapita.
Mwamwayi, chipatala cha inshuwalansi cha chipatala chikuyembekezeka kukhala chosungidwa ndi 2029 . Izi zikutanthauza kuti sipadzakhala ndi ndalama zokwanira zogulira ntchito zonse zomwe zikugwira lero. Panthawi imeneyo, ikhoza kutheka kokha kuti atha kupereka magawo 88 pazinthu za mautumikiwa.
Thupi lachiwiri la Medicare ndi Trust Supplementary Medical Inshuwalansi (SMI) Trust.
Chikhulupiliro chimenechi chimachokera ku malipiro omwe mumapereka kwa Medicare Part B ndi Part D. Ziwalo izi za Medicare zimalipira ntchito ya magazi, maulendo a madokotala, maphunziro ojambula, ntchito zakuthupi / ntchito / kulankhula, mankhwala oletsa mankhwala, kuyezetsa njira zothandizira, opaleshoni (njira zina), ndi zina zothandizira.
Medicare, Ndalama za Federal, ndi Budget ya 2018
Mu 2016, ndalama zonse za National Health Expenditures (NHE) zinagula madola 3.3 trillion, zomwe zimagwira 17.9 peresenti ya Gross Domestic Product (GDP).
Mankhwala a Medicare amawononga madola 672.1 biliyoni, omwe amaimira 20 peresenti ya NHE ndi 3.58 peresenti ya GDP. Ndalama za Medicaid zinakhala $ 565.5 biliyoni, 17 peresenti ya NHE, ndipo 3,03 peresenti ya GDP.
GOP akuyang'ana kuchepetsa momwe GDP imagwiritsira ntchito pulogalamu yoyenera.
Kuti izi zitheke, Nyumba ya Aimuna ya ku America inapereka chigamulo cha bajeti chaka cha 2018 mu August 2017. Mu voti ya pulezidenti, bungwe la GOP linaphatikizapo $ 487 biliyoni mu kudula kwa Medicare, kuwonjezeka kwa Medicare oyenerera zaka 65 mpaka 67 wazaka zapakati, ndi madokotala a Medicare ndi pulogalamu ya voch. Malingana ndi Medicaid, zopereka za federal zidzasinthidwa kukhala malipiro a anthu kapena kubwezera ndalama , kuchepetsa ndalama pulogalamuyi pafupifupi $ 1 trillion.
Chigamulo cha bajeti chinapitanso ku Senate komwe idaperekedwa pa Oktoba 19. Ndime yavomerezedwa ndi Senate ndipo idabwerera ku Nyumba yomwe idaperekedwa pa Oktoba 26. Panthawiyi, kusintha kwapadera kwa mapulogalamuwa sikuyikidwa pamwala chifukwa palibe lamulo lapadera lokhazikitsa. Malipoti a GOP akukonzekera kuthetsa malamulo pazochitika mu chaka chatsopano. M'malo mwake, zomwe bajeti ya chaka cha 2018 yachita pa ndalama zimayika maziko a Bill Bill Tax.
Bill BOP Tax Tax
Bill BOP Tax, yomwe imadziwikanso kuti Tax Cuts ndi Jobs Act, inayambitsa mikangano yambiri pokhudzana ndi kuchepetsa msonkho kwa anthu olemera a ku America pa anthu osauka ndi apakati.
Ndalamayi imanenedwa kuti ikuwonjezereka ndalama zokwana madola 1.5 triliyoni pa zaka khumi.
Chimene mukufunikira kumvetsa ndi momwe lamulo limakhudzira Medicare. Poyang'ana koyamba, msonkho wa msonkho wa Senate sukhazikitsa mwachindunji ndalama za Medicare. Simungapeze mawu amenewa olembedwa mu biliyi. Komabe, izi zidzakopetsa ndalama zokwana madola 28 biliyoni kuchokera ku Medicare pachaka pazaka khumi zotsatira.
Limbani mlandu pa PAYGO thandizo.
Lamulo la "pay-as-you-go", lamulo la bipartisan lomwe linakhazikitsidwa ngati gawo la Omnibus Budget Reconciliation Act ya 1990, linapangidwa kuti liwonongeke. Zimagwira ntchito motere. Pamene Congress ikudutsa miyeso yowonjezereka kwa zaka zisanu ndi zisanu koma izi sizimaphatikizapo ndalama zowonongeka, PAYGO imalowetsamo. Oyang'anira amafunikanso kukhazikitsa kudula kwa mapulogalamu ena a federal (Medicare, Agricultural Subsidies and Supports) , Ndondomeko Yowonongeka Kwowononga Ngozi, Ntchito ndi Thandizo kwa Customs ndi Border Patrol, Ufulu Wopereka Ngongole wa Ophunzira, ndi mapulogalamu ena). Chigamulo cha malo enieni omwe angagwiritsire ntchito ndalama angapangidwe mu sequester.
Mwatsoka, ndizo zomwe tikuyang'ana ndi Bill BOP Tax:
PAYGO imafuna kuti Congress iwononge ndalama mu chaka cha 2018 ndi $ 136 biliyoni. Ndalama yomwe imaloledwa kudula ku mapulogalamu ovomerezeka omwe si ovomerezeka akuyembekezeka kukhala $ 114 biliyoni. Izi zikutanthauza kuti ndalama zonse zovomerezeka zingadulidwe kuchokera ku mapulogalamu onse, kuphatikizapo Medicare.
PAYGO imalola mapulogalamu ena kudula ndi 100% koma Medicare ali ndi kapu. Kudula kwa Medicare kumangokhala 4 peresenti ya bajeti ya pulojekitiyo. Kwa 2018 zomwe zingakhale $ 28 biliyoni. Pofika chaka cha 2027, chifukwa cha kupatsirana kwa ndalama komanso kuchuluka kwa ndalama za chithandizo chamankhwala, kuti peresenti 4 peresenti iyenera kuwonjezeka kufika $ 56 biliyoni pachaka.
Popeza GOP adali atachita kale kudula kwa Medicare mu Budget ya 2018, sizingatheke kuti bungwe lidzawoneka kuti lizitha kuchepetsa zofunikira pa PAYGO. Ngakhale iwo akufuna, sakanatha kusintha kapena kusiya ulamuliro wa PAYGO mu chigamulo cha bajeti. Ayenera kusintha lamulo la PAYGO palokha. Panthawiyi, palibe malipoti kuti bungwe likufuna kuchita zimenezo.
Mawu Ochokera
Ngakhale malonjezo omwe amatsutsana nawo, bungwe la Trump lili ndi malamulo omwe angapeze ndalama kwa Medicare. GOP wanena mapulani oti asinthe Medicare monga tikudziwira. Chiwongoladzanja cha Chaka cha 2018 chofuna kubweza ndalama chimapangitsa kuchepetsa ndalama za Medicare, kuonjezera zaka zoyenera kuti asamalire, komanso kupititsa patsogolo pulogalamuyo pogwiritsa ntchito pulogalamu ya voch. Bill BOP Tax imatha kudula Medicare ndalama ndi $ 28 biliyoni pachaka kuyambira mu 2018.
> Zotsatira:
> Zotsatira za malamulo omwe angakweretse mavuto mwa $ 1.5 trillion pa nthawi ya 2018-2027. Congressional Budget Office. https://www.cbo.gov/publication/53319. Lofalitsidwa November 14, 2017.
> FY 2018 Kusintha kwa Nyumba ya Nyumba ndi Zomwe Zimakhudza Okalamba. Komiti Yachigawo Yopulumutsa Chitetezo cha Anthu ndi Medicare. http://www.ncpssm.org/PressRoom/NewsReleases/Release/ArticleID/1712/FY-2018-House-Budget-Resolution-and-Its-Effect-on-Seniors. Idasindikizidwa pa August 2, 2017.
> Momwe malamulo a PAYGO angakhudzire kusintha kwa msonkho. Komiti Yopereka Ndalama Yaikulu Yachigawo. http://www.crfb.org/blogs/how-paygo-rules-could-affect-tax-reform. Lofalitsidwa pa October 18, 2017.
> Kodi Medicare Imaperekedwa Bwanji? Medicare.gov. https://www.medicare.gov/about-us/how-medicare-is-funded/medicare-funding.html.
> Gulu la National Health Expenditure Fact Sheet. Centers for Medicare ndi Medicaid Services. Chiwongola dzanja Idasinthidwa pa December 6, 2017.