Mankhwala a Medicare, The Physician Shortage, ndi Mankhwala a Drug Costs
Pulezidenti Trump adalonjeza malonjezano ambiri pazokambirana . Mmodzi wa iwo anali kusunga Medicare- ndiko kuti, iye sakanatha kudula Medicare. Lonjezo linanso linali loti pulogalamuyo ikhale yotsika mtengo kwambiri kwa opindula. Ndi ndondomeko yake ya bajeti ya 2019, iye amapanga kusintha kwakukulu kwa Medicare zomwe zimachita ndi kusakwaniritsa lonjezo limenelo.
Ndalama Zimapereka kwa Medicare
Kusintha koyamba kukutsutsana ndi zomwe Purezidenti adalonjeza.
Chaka chachuma (FY) 2019 bajeti imapanga $ 236 ku Medicare kudula zaka zoposa 10.
White House ikunena kuti opindula sadzawona kuchepa kwa phindu lawo. M'malo mwake, amanena kuti kuchepa kwa ndalama kumabwera kuchokera ku mbali zina za pulogalamu ya Medicare. Zomwe sizinafotokozedwe koma zatsikira malipiro kwa madokotala ndi zipatala zikuyembekezeredwa.
Kuchepetsa Zopereka Zamankhwala
Bungwe la American Medical Colleges linapanga phunziro mu 2017 lomwe limalimbikitsa zomwe kafukufuku wa zaumoyo akhala akuwopa-dokotala. Pofika chaka cha 2030, dzikoli liyenera kukhala lalifupi madokotala oposa 40,800 pazochitika zonse zapadera.
Mu 2016, panali madokotala 953,695 omwe ali ndi chilolezo chochita ku United States. Pa chiwerengero chimenecho, 27.1 peresenti ya madokotala anali pakati pa zaka 56 ndi 65. Enanso 13.1 peresenti anali 66 ndi zaka. Pakali pano, panali 19,254 omaliza sukulu zachipatala chaka chimenecho.
Oposa 40 peresenti ya madokotala akuyandikira zaka zapuma pantchito ndipo ochepa chabe akulowa ntchito, sipadzakhala madokotala okwanira kuti akwaniritse zofuna za mwana wokalamba wamwamuna wokalamba, osatchula kuchuluka kwa anthu omwe ali ndi inshuwalansi pansi pa Care Affordable Care Act.
Ngakhale kuti ndalamazi ndizofunikira, ndalama za 2019 biliyoni zimapereka $ 48 biliyoni kuti adziwe maphunziro a zachipatala (GME) zaka zoposa 10.
Ndalama za GME zimalipiritsa maphunziro a zachipatala . Masukulu ambiri azachipatala akhoza kutsegulira ndi kuphunzitsa ophunzira, koma osakhala ndi mwayi wophunzira, omaliza maphunzirowo akuyang'anitsitsa. Kuchepetsa ndalama zothandizira kukhalamo kungathe kuchepetsa chiwerengero cha anthu omwe amaphunzitsidwa chaka chilichonse, kuwonjezereka kwa kuchepa kwa madokotala.
Mauthenga Osunga Zaumoyo
Pulezidenti Trump adalimbikitsa Medicare kuti alolere kugwiritsa ntchito ndalama zachuma (HSA) , ndipo zikuwoneka kuti akutsatira lonjezolo.
HSA ndi akaunti yopezera msonkho yomwe imagwiritsidwa ntchito pazinthu zamagetsi. Anthu amatha kusunga ndalama pa msonkho wongowonjezera msonkho ndikusiya ndalama za msonkho pokhapokha ngati ndalamazo zikupita kumalipiro oyenera a zachipatala. Mpaka bungwe la budget la FY 2019, IRS sinawalole kuti Medicare apindule kupereka nawo ma HSAs.
Mu 2018, munthu akhoza kupulumutsa ndalama zokwana $ 3,450 mu HSA ndi banja pafupifupi $ 6,900. Anthu opitirira zaka zisanu ndi ziwiri akhoza kusunga $ 1,000 pachaka ngati sakanakhala pa Medicare. Zomwe angaloledwe kwa odwala omwe amagwiritsidwa ntchito ndi Medicare sakhala bwino.
Mankhwala a Medicare Part B
Si mankhwala onse a mankhwala omwe amalembedwera ku Medicare Part D. Mankhwala ena amabwezedwa pansi pa Medicare Part B.
Mankhwalawa akuphatikizapo, koma osagwiritsidwa ntchito, mankhwala osokoneza bongo, mankhwala osokoneza bongo, mankhwala osokoneza bongo, mankhwala osokoneza bongo, mankhwala osokoneza bongo, mankhwala opatsirana pogonana, mankhwala a nebulizer, osteoporosis mankhwala, tizilombo toyambitsa matenda, ndi katemera wina .
Pansi pa Medicare Part B, mankhwala ambiriwa amabwezedwa ngati ataperekedwa ndi kuchitidwa ku ofesi ya dokotala kapena chipatala chachipatala. Chifukwa cha ndalama zomwe zinawonjezera pakukonzekera, kusungira, ndi kupereka mankhwalawa chifukwa chogwiritsa ntchito mankhwalawa, malowa aloledwa kupereka madola 6 peresenti kusiyana ndi mtengo wogulitsa mankhwalawa.
Cholinga cha bajeti cha FY 2019 chimapangitsa kumapeto kwa gawo lachiwiri B la mankhwala ndikusintha mankhwalawa ku Gawo D. Pogwiritsa ntchito gawo lachigawo B, gawo la D, Medicare ogulitsa sangathe kukhala ndi udindo woyang'anira mankhwala mu ofesi. Mmalo mwake, wodwalayo angadzalembetse mankhwalawa ndi kuwabweretsa kwa dokotala wawo kuti apereke. Izi zikhoza kuchotsa malingaliro alionse a zachuma amene wothandizira angakhale nawo pakuika mankhwala apamwamba. Pa nthawi yomweyi, zimakhala zovuta kwambiri kuti wodwala athe kupitilapo.
Kuchepetsa Kulembetsa Mankhwala Ochepetsa Mankhwala
Kuchepetsa mtengo wa mankhwala a mankhwala nthawi zonse wakhala wofunika kwambiri, ndipo bajeti ya FY 2019 imatsindika kwambiri kuchita zimenezo. Pepala loyera la Council of Economic Advisers limafotokoza njira zingapo, ngakhale kuti sizinawonekere kuti ndi yani ya maofesi omwe azitsatira.
Pepala loyera limalepheretsa kuika mtengo kwa boma . GOP akadali wokhulupirira wamphamvu pa msika waufulu. Sichimathandizanso kutumiza mankhwala osakwera mtengo kuchokera kunja. Cholinga chake ndi kulimbikitsa malonda a ku America.
Njira imodzi ndiyowonjezera kuti FDA ifulumire kugwiritsa ntchito mankhwala osokoneza bongo kapena mankhwala opatsirana omwe alibe ovomerezeka. Mwachidule, izi zikhoza kuwonjezera mpikisano pamsika ndikuchepetsa ndalama.
Njira inanso ndiyokulitsa mgwirizano pakati pa odwala ndi makampani othandizira zaumoyo. Ogwiritsira ntchito angafunike kugawana malonda omwe amapeza kuchokera ku makampani opanga mankhwala ndi odwala. Zingathetseretsa kuti Medicare opindula angagwiritse ntchito mwayi wopanga mankhwala.
Njira yomwe Purezidenti Trump amathandizira idzathetsa kugawana mtengo , mwachitsanzo, ndalama zothandizira ndalama, zomwe zimaperekedwa kwa anthu omwe ali ndi mankhwala osokoneza bongo ndalama zokwana madola 8,418 kapena kuposerapo pachaka. Mwamwayi, kuti muwononge ndalamazo, ndalama zowonjezera ndalama zikhoza kuwonjezeka kwa opindula omwe sangakwanitse.
Mawu Ochokera
Ndondomeko ya bajeti ya FY 2019, ikadutsa, idzakhala ndi ubwino komanso mankhwala a Medicare. Ngakhale kuti zingathandize kuchepetsa mankhwala osokoneza bongo kwa ena okalamba (kuonjezera ena) ndikuwalola kuti agwiritse ntchito ndalama zosungirako zaumoyo, zimadula ndalama zothandizira pulogalamu ya Medicare komanso kuwonjezereka kwa kusowa kwa madokotala.
> Zotsatira:
> Kukonzekera kwa 2017: Zokakamizika za Wopereka Udokotala ndi Kufuna - Mapulani kuchokera mu 2015 mpaka 2030. Association of American Medical Colleges. Chiwongoladzanja Lofalitsidwa pa February 28, 2017.
> Zowonjezeredwa ku Chaka Chachuma 2019 Budget. Office of Management ndi Budget. https://www.whitehouse.gov/wp-content/uploads/2018/02/Addendum-to-the-FY-2019-Budget.pdf. Inatulutsidwa pa February 12, 2018.
> Chaka cha Ndalama 2019: Ndalama ya ku America. Office of Management ndi Budget. https://www.whitehouse.gov/wp-content/uploads/2018/02/budget-fy2019.pdf. Inatulutsidwa pa February 12, 2018.
> Kusintha Mitengo ya Biopharmaceutical kunyumba ndi kunja kwina. Bungwe la Aphungu a zachuma. https://www.whitehouse.gov/wp-content/uploads/2017/11/CEA-Rx-White-Paper-Final2.pdf. Lofalitsidwa February 2018.
> Achinyamata A, Chaudhry HJ, Xiaomei Pei X, Arnhart K, Dugan M, Snyder GB. Madokotala Owerengedwa Ovomerezeka ku United States 2016 . J Med Regul. 2017; 103 (2): 2-21.http: //www.fsmb.org/globalassets/advocacy/publications/2016census.pdf.