Mkangano wandale pazakusintha kwa inshuwaransi yazaumoyo ku California, zotsika mtengo komanso zopezeka, sizikuthetsedwa. Nthawi yomwe zidzachitike sizikudziwika. Zambiri zimangotsala pang'ono kutha.
Gov. Arnold Schwarzenegger adayitanitsa msonkhano wapadera wa Nyumba Yamalamulo kuti athane ndi vutoli posachedwa. Pansi pa lingaliro la bwanamkubwa la $ 14 biliyoni la "udindo wogawana" womwe udakali wamoyo ndikuwunikiridwanso kuchokera pamalingaliro ake a Januware, onse okhala m'boma amayenera kugula inshuwaransi yazaumoyo. Anthu aku California amatha kupeza inshuwaransi pogwira ntchito. Kapena atha kugula malonda pamsika. Ndalama zapachaka zosakwana $25,525 za anthu pawokha ndi $51,625 zamabanja zingawayenerere kukhala ndi mapulogalamu othandizira okhometsa msonkho. Dongosolo lake liperekanso ngongole yamisonkho kwa anthu aku California omwe sanayenere kulandira thandizo koma omwe amalipira ndalama zoposa zisanu pachaka za inshuwaransi yazaumoyo, malinga ndi Kaiser Daily Health Policy Report.
Kupitilira apo, bwanamkubwa akufuna kupereka ndalama zothandizira zaumoyo pobwereketsa lottery yaboma, yomwe ili pagulu, ku kampani yabizinesi ya $ 2 biliyoni pachaka, lingaliro lochokera kwa Kathleen Brown waku Goldman Sachs, malinga ndi nkhani yaposachedwa ya NY Times. Ndi mwana wamkazi komanso mlongo wa abwanamkubwa aku California akale, yemwenso ndi phungu wosapambana wa demokalase. Nyumba Yamalamulo pa Seputembara 10 idavomereza Assembly Bill 8, "bilu yokwanira yazaumoyo yomwe imapangitsa kuti chithandizo chamankhwala chikhale chosavuta komanso chotsika mtengo," adatero atolankhani a Fabian Nรบรฑez, wokamba nkhani wa Assembly. AB 8, ndondomeko yokonzanso zaumoyo wa Nunez ndi Don Perata, mtsogoleri wa Senate, safuna kuti anthu onse azigula inshuwalansi ya zaumoyo. AB 8 imafuna olemba anzawo ntchito kuti alipire chithandizo chamankhwala m'njira ziwiri. Amalipira mpaka 7.5 peresenti yamalipiro awo kuti azilipira chithandizo chamankhwala chochokera kwa olemba anzawo ntchito. Kapena olemba ntchito angapereke ndalama ku thumba la boma lomwe limalipira anthu omwe alibe inshuwalansi chifukwa cha ntchito. Bwanamkubwa sanagwirizane ndi zomwe amalipira olemba anzawo ntchito pansi pa AB 8 ndipo adatsutsa.
Ngakhale kusiyana pakati pa kusintha kwa chisamaliro chaumoyo ndi AB 8, onsewa ali ndi kufanana kwakukulu m'njira. Mwachidule, zosintha zonse ziwirizi zimasewera ndi chidwi chapadera chomwe chimathandizanso andale omwewo. Ndikutanthauza makampani apadera azaumoyo, omwe makampani a inshuwaransi amagwira ntchito yayikulu. Ma inshuwaransi angapowa amatolera ndalama zolipirira ndikuzigwiritsa ntchito polipira anthu omwe ali ndi inshuwalansi. Zomwe makampani samagwiritsa ntchito popereka chithandizo chamankhwala ndi phindu. Ichi ndichifukwa chake kupezeka kwa inshuwaransi yazaumoyo komanso kukwanitsa kulipirira vuto lomwe likukulirakulira. Chifukwa chake kazembe ndi ma Democrat otsogola akusunga makampani omwe amayambitsa vuto lazaumoyo pamasewerawa zimapangitsa kuti kufanana kwaumoyo kukhale konyenga. Pali njira yabwino yothetsera zomwe zikuvutitsa dongosolo laumoyo. Ganizirani zosintha za Senator wa boma Sheila Kuehl (D-Santa Monica). Ndiwothandizira Senate Bill 840, California Health Insurance Reliability Act. Imatchedwanso chisamaliro chaumoyo chopereka malipiro amodzi. Boma la boma likanati, kupatula cholinga chofuna kupeza phindu, likhala pakati, m'malo mwa makampani ambiri a inshuwaransi omwe akugwira ntchito pano. Zofufuza za anthu ndi kafukufuku zikuwonetsa modabwitsa kuti nzika zambiri zimakonda njira yachipatala yophweka komanso yotsika mtengo ngati imeneyi.
Tiyeni tiyambe ndi lingaliro lomwe bwanamkubwa, ma Republican ndi ma Democrat ambiri amagawana. Mitengo ya inshuwaransi yachipatala yapayekha-malipiro, ndalama zolipirirana, ndalama zochotsera ndi mankhwala-zikupitilira kuchuluka kwa anthu ogwira ntchito.
Pakadali pano, inshuwaransi yazaumoyo ikuposa ndalama za olemba anzawo ntchito, makamaka ang'onoang'ono, amalonda am'deralo ndi a pop. Chifukwa cha kukwera kwa mitengo ya inshuwaransi, olemba anzawo ntchito akupereka chithandizo chamankhwala chotsika mtengo komanso chokwera mtengo kwa antchito omwe akucheperachepera. Ma inshuwaransi omwe akukweza mitengo yawo zomwe zikukankhira olemba anzawo ntchito akudziwa bwino izi. Ndili ndi zambiri zoti ndinene pakuchepa kwa inshuwaransi yazaumoyo yotengera ntchito pang'ono.
Ndi chiyani chomwe chikukweza mitengo ya inshuwaransi yazaumoyo? Logic imatiuza kuti mphamvu yoyendetsa singakhale mtengo waumoyo wofanana kwa onse aku California. Pafupifupi m'modzi mwa anthu asanu aliwonse m'boma alibe chithandizo chamankhwala.
Mwachidule, wolipira m'modzi amathetsa vuto la kusalingana kwa chithandizo chamankhwala chifukwa chokhala chuma chamakampani. Kunena zoona, oyang'anira mabungwe ali ndi udindo wovomerezeka kwa eni ake omwe amaika zosowa zawo kuti apindule kuposa zomwe odwala amafunikira. Limenelo ndi lamulo la mabungwe. Oyang'anira omwe amaphwanya ufulu walamulo wa eni ake ndi ophwanya malamulo.
Chifukwa chake malingaliro osintha zaumoyo monga abwanamkubwa ndi AB 8 omwe amavomereza makampani ambiri a inshuwaransi omwe akupitiliza kulipira opereka chithandizo chamankhwala monga madokotala ndi zipatala ndi zolakwika. Izi, ndithudi, ngati cholinga ndi kukwaniritsa kufanana kwa chithandizo chamankhwala. Kupanda kutero, kuphatikizika kwathunthu kapena pang'ono kwa inshuwaransi yazaumoyo wamba kumatsimikizira kusalingana pazifukwa za kuchepa kwa ndalama ndi chuma pakati komanso pakati pa anthu aku California.
Bwanamkubwayo adatsutsa SB 840 Nyumba Yamalamulo yoyendetsedwa ndi Demokalase itavomereza lamuloli mu Seputembala 2006. Pakadali pano ogwira ntchito masauzande ambiri m'chigawo cha Sacramento anali kusiya ntchito mwa zina kuti atsutse kukwera mtengo kwa chithandizo chamankhwala. Kupsinjika ndi kupsinjika uku kukugweranso pamitu ya anthu aku America m'dziko lonselo, pafupifupi 47 miliyoni popanda, kapena pafupifupi munthu wachisanu ndi chimodzi aliyense ku US Ndipo AB 8 angasunge njira yolipirira ma inshuwaransi ambiri omwe amalipira azachipatala, ndikuchotsa mpikisano ndi SB 840.
Ponena za kulowererapo kwa boma pamsika, bwanamkubwayo akuti amathandizira mpikisano wamsika. Koma akuzithamangitsa potsimikizira mamiliyoni a mfundo zatsopano kwa ma inshuwaransi apadera kudzera mu mfundo zake zovomerezeka. M'malo mwake, pempho lake limapangitsa makampani akuluakulu ku boma lalikulu la boma. Kuyankhula za mayankho okhudzana ndi msika monga momwe bwanamkubwa amachitira pamene ambiri omwe akutenga nawo mbali akucheperachepera ndi mphamvu zazikuluzikuluzi ndizo zisudzo zandale.
Cholinga cha malingaliro osintha mfundo za bwanamkubwa ndi AB 8 ndizosavuta komanso zomveka bwino ndi atolankhani abizinesi. โBizinesi ya boma yakhala yofunika kwambiri kwa a inshuwaransi ya zaumoyo popeza kukula kwa maakaunti othandizidwa ndi owalemba ntchito kwatsika,โ inatero Dow Jones Newswires posachedwapa. Potengera izi, wolipira m'modzi adayamba kuzimiririka pazithunzi za radar ku Capitol Julayi uno. Kutha kwa SB 840 kunathandizira kukwera kwa AB 8 komanso malingaliro osintha abwanamkubwa.
Kumbukirani tsiku la SB 840 mu media dzuwa linabwera mwa gawo kuchokera ku mphamvu ya California Nurses Association/National Nurses Organising Committee. Bungwe la ogwira ntchito lidapereka mamembala ake ambiri achikazi pakuwonekera koyamba kwa filimu ya Michael Moore Sicko mu Sacramento's Crest Theatre masika atapereka umboni ku Nyumba Yamalamulo. Ku Capitol, adalankhula ndi atsogoleri za zolakwika zingapo zachipatala chapano. Mosakayikira, chovulaza kwambiri ndi kuzunzika kwa anthu chifukwa cha makampani a inshuwaransi omwe amapindula mwa kuchedwetsa ndi kukana chithandizo chamankhwala chamtengo wapatali kwa omwe ali ndi ma policy.
CNA/NNOC imathandizira SB 840 ngati njira yokhayo yeniyeni yochitira bizinesi monga mwachizolowezi pakusintha kwaumoyo. Izi zikusonyeza kusiyana kwa ndondomeko za ndale mkati mwa bungwe la ogwira ntchito. Ngakhale CNA/NNOC idalowa nawo AFL-CIO m'mwezi wa Marichi, AFL-CIO's California Labor Federation imathandizira AB 8 ngati njira yotsika mtengo kwa anthu ogwira ntchito motsutsana ndi kukonzanso kwa bwanamkubwa. Kuti izi zitheke, CLF idatsogolera miliri ya AB 8 ku Capitol ya boma.
Pansi pa chisamaliro chaumoyo cha omwe amalipira kamodzi ku California, padzakhala, makamaka, kukulitsa zomwe zilipo tsopano pansi pa Medicare, pulogalamu ya federal kwa anthu azaka 65 ndi kupitilira apo. Palibe phindu popereka chithandizo chamankhwala pansi pa olipira m'modzi okha. Chifukwa chake, mtengo woperekera Medicare ndi gawo laling'ono poyerekeza ndi la inshuwaransi yazaumoyo. Musachite mantha. Medicare si mankhwala ochezera anthu. Komabe, ndi malipiro amodzi okhawo omwe amapereka chithandizo chamankhwala payekha: chiropractic, mano, chithandizo chadzidzidzi, chipatala, thanzi la kunyumba, chisamaliro cha amayi akhanda ndi nthawi yayitali, thanzi labwino, chithandizo chamankhwala, chithandizo chamankhwala, mankhwala olembedwa, chisamaliro choyambirira ndi chodzitetezera, kukonzanso (kuwonjezera kugwiritsa ntchito mankhwala osokoneza bongo), opaleshoni ndi chisamaliro cha masomphenya. Bill Congressman John Conyers' HR 676 Bill, Expanded and Improved Medicare for All act, yomwe ili ndi othandizira nawo 85, ikulitsa Medicare kwa nzika zonse zaku US. Oregon AFL-CIO yakhala bungwe la 25 la boma la AFL-CIO lovomereza HR 676.
"HR 676 ingathetse bizinesi ya inshuwaransi ndikusunga ndalama zokwanira kulipira aliyense ku United States popanda ndalama zolipirira, zochotsa, komanso zolipira," atero a Congressman Dennis Kucinich (D-OH) m'mawu atolankhani posachedwapa. . Maziko a zonena zake ndi lipoti la Oct. 15 pa pulogalamu ya mankhwala ya Medicare's Part D ndi Komiti Yoyang'anira ndi Kusintha kwa Boma ku Congress.
Pansi pa dongosolo lamakono la olipira angapo, makampani ambiri a inshuwaransi amapereka ndalama zothandizira chithandizo chamankhwala kuti apindule. Pokhala ndi anthu ambiri omwe amalipira inshuwalansi, nzika za US zimalipira kawiri zomwe anzawo akumayiko otukuka amapereka chithandizo chamankhwala ndipo amakhala ndi moyo waufupi, malinga ndi zomwe bungwe la Organization for Economic Co-operation and Development linanena.
Wolipira m'modzi amatengera komwe mapulani osintha abwanamkubwa ndi a Democrats amatha ndikuzimitsa kampopi wa olipira angapo, mgodi wagolide kwa ma inshuwaransi ambiri, omwe amapeza phindu pakuchedwetsa ndikukana kulipira kwachipatala. Komanso phindu la ma inshuwaransi limapezeka ngati zopereka za kampeni kwa akuluakulu osankhidwa. Ndipo nkhani zofalitsa nkhani zaulere zomwe zimati zaufulu zimapeza gawo lokonzekera bwino la phindu la inshuwaransi monga ndalama zotsatsa, pakugwa kwaulere kuchokera ku kuwonongedwa kwa nyumba. Ingofunsani a Greg Pruitt, wapampando ndi wamkulu wa McClatchy Co.
Kukhazikitsidwa kwa chithandizo chamankhwala omwe amalipira kamodzi ku California kungathetse vuto lazaumoyo m'boma ndikutsogola mwa umunthu kudziko lonselo. Chisamaliro chaumoyo chiyenera kukhala chobadwa nacho kwa onse aku California ndi aku America. Zoonadi kumeneko kungakhale kusintha kwakukulu kwa mkhalidwe wamakampani ndi boma. Komabe, unyinji wa anthu ukawona kusintha kwakukulu ndi kokulirapo mโmiyoyo yawo. Akufuna kuti tsopano, popeza kuvota ndi kufufuza kwamakampani odziwika bwino kukuwonetsa anthu akukomera dongosolo losavuta lotere kusiyana ndi lowopsa lomwe lili pano.
SB 840 idzapita patsogolo ku Capitol mu January 2008, adatero Sara Rogers, mlangizi wa Sen. Kuehl. Nthawi yomweyo, thandizo lazachipatala likukulirakulira pakuvotera kovomerezeka ku California komwe ovota angasankhe tsogolo la dongosolo laumoyo wa olipira mu Novembala 2008.
"The California Health Security Plan ingakhale yaulere-popanda kulipira co-pay, osachotsa ndalama, osalipidwa-ndipo idzapereka chisamaliro chaumoyo kwa onse aku California," adatero Jim Smith potulutsa atolankhani. "Ndondomekoyi yaperekedwa kwa Attorney General waku California kuti alembe mutu, chidule chake komanso kuperekedwa kwa zopempha kuti aziyike pamavoti. Tikuyembekeza kukhala ndi madandaulo mu Novembala uno."
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Seth Sandronsky amakhala ndikulemba ku Sacramento