Newt Gingrich adalumbira m'ma 90s kuti awonetsetse kuti Medicare "idzafota pa mpesa". Zomwe adayesa kuchita ndiye kuti asokoneze cholinga cha Medicare, kuti athetse vuto la njala.
Dongosolo la Medicare rollback lidakulitsa zovuta zamagulu olumala pamenepo. Tsopano congress ndi masewera obwereza. Komabe, nthawi ino nyamboyo ndi yonyenga kwambiri - GOP ikukonzekera kuti ipereke phindu lochulukirapo lamankhwala kuti akope osadziwa. Dongosololi ndikupanga kusintha kofunikira ku Medicare komwe kudzakhala ndi zotsatira zoyipa kwa anthu olumala.
Anthu opitilira 13 miliyoni pa Medicare ali ndi olumala kapena matenda osatha. Osauka kwambiri ndi omwe ali pachiwopsezo kwambiri amasankhidwa kukhala "oyenerera awiri" -oyenerera onse ku Medicare ndi Medicaid. Popeza alibe inshuwaransi ina yachiwiri monga ndondomeko ya MediGap, oyenerera awiri amadalira kwambiri Medicaid kuti athandizidwe ndi mankhwala osokoneza bongo komanso mautumiki ndi zipangizo kuti akwaniritse zosowa zawo zachipatala.
Chofunikira ndichakuti pansi pa dongosolo lamankhwala oyenerera awiri oyenerera adzataya mwayi wopeza mankhwala.
Dongosolo lomwe likufunsidwalo limalola kukhazikitsidwa kwa Medicare formularies yomwe ingalepheretse kupeza mankhwala ofunikira ndikuletsa Medicaid kuti ikhale ngati wolipira wachiwiri wamankhwala osati pa formulary. Izi zikuwonetsa kukakamiza anthu olumala amitundu yonse kuchita popanda mankhwala omwe amafunikira.
Pazaka khumi zikubwerazi, dongosolo la Medicare likusintha chuma kuchokera ku pulogalamu yopambana ya boma kupita ku gawo lapadera, lopeza phindu.
Zokonda zonse zapadera zomwe zimapita ku ndalamazo pambuyo pa kutembenuka sizingaimitse phindu la phindu kuti lizindikire ngati izi zimabweretsa kuvulala kosafunikira komanso koopsa kapena zotsatira zofooketsa zomwe zimafuna kuchipatala kapena chithandizo china chamankhwala chamtengo wapatali kwa anthu omwe alipo panopa a Medicaid. Zimatenga nthawi yayitali kuti magulu olimbikitsa zaumoyo alembe zowononga ndikupereka umboni woterewu kuti uchitidwe mozama ku DC.
Bili yoyipayi idzachotsanso zothandizira kuchoka kwa anthu omwe amafunikira chisamaliro chovuta kapena pafupipafupi, monga olumala ndi omwe ali ndi matenda aakulu, kupita ku Medicare omwe ali ndi thanzi labwino.
Zambiri zomwe zili m'gawo la bilu zimagawika dziwe la Medicare m'njira yomwe ingabweretse ndalama zambiri komanso kusamalidwa bwino kwa anthu olumala komanso matenda osatha. Kuphatikizidwa pamodzi, zinthu zingapo zomwe zili mu biluyi zimachepetsa mwayi wa Medicare womwe watumikira dziko lino bwino kwa zaka makumi anayi zapitazi.
Consortium for Citizens with Disabilities (CCD), bungwe lokhazikitsidwa ku Washington la mabungwe olumala mdziko lomwe limalimbikitsa anthu olumala 54 miliyoni ndi matenda osachiritsika (pamodzi ndi mabungwe akulu akulu akulu a 40) atuluka mwamphamvu motsutsana ndi biluyi.
CCD ikupereka kuwunika kwabwino kotereku momwe dongosolo lamankhwala lolembera lingawonongere chisamaliro chaumoyo wa anthu:
* Health Savings Accounts, yomwe imadziwikanso kuti Medical Savings Accounts (MSAs), ingawononge dongosolo lazaumoyo ndipo ingakhale yovulaza makamaka kwa anthu olumala ndi ena omwe amadalira inshuwaransi kuti apeze ndalama zambiri. Maakaunti Osunga Zaumoyo amapereka chilimbikitso kwa anthu athanzi komanso opeza bwino kuti achoke pamsika wa inshuwaransi. Izi zitha kuchotseratu inshuwaransi yomwe ilipo yomwe ikufuna kufalitsa zoopsa zosayembekezereka zopezera ndalama zothandizira anthu ochepa olumala komanso omwe ali ndi vuto lalikulu mdera lonse.
* Medicare Competitive Bidding for Durable Medical Equipment idzachepetsa kwanthawi yayitali kwanthawi yayitali komanso mwayi wopeza zida zapamwamba zothandizira anthu olumala. Kuphatikiza apo, mpikisano wotsatsa malonda umachepetsa kusankha kwa opindula.
* Chiwonetsero Chothandizira Kwambiri: Chiyembekezo cha Medicare-for-service kupikisana mwachindunji ndi mapulani aumoyo omwe amasamalidwa chimakhala ndi chiopsezo chochuluka pamalingaliro achinsinsi kuti asankhe opindula athanzi ndikuwonjezera mtengo wa anthu olumala omwe amakhalabe ku Medicare. * Kuyesa Kuyesa Gawo B Kumasokoneza Chiyambi cha Medicare monga inshuwaransi, zomwe zimapangitsa kuti anthu ambiri olemera (ndi athanzi) azisiya pulogalamuyo pakapita nthawi, motero kuchepetsa chiopsezo chowonjezereka ndikukweza ndalama kwa anthu olumala.
* Kusunga Mtengo: Kufunika kulowererapo kwa DRM ngati ndalama zomwe zimaperekedwa zimaposa 45% ya ndalama zomwe zimagwiritsidwa ntchito pamapulogalamu ndi njira yomwe sinachitikepo yomwe idapangidwa kuti ilimbitse dzanja la omwe ali m'tsogolomu omwe akufuna kuchepetsa kuyenerera kwa pulogalamuyo ndikukondera mtundu wothandiza kwambiri.
* The Asset Test mu lipoti la msonkhano ukhoza kulepheretsa opindula ndi Medicare pafupifupi 135 miliyoni omwe ali ndi ndalama zosachepera XNUMX% zaumphawi kuti athandizidwe ndi malipiro awo a mankhwala olembedwa, deductibles, ndi co-payments. Mayesowa ndi osafunika ndipo amabwera pamtengo wobweretsa zolemetsa zazikulu zoyang'anira mayiko kuti agwiritse ntchito mayeso otere. Zingafunikenso kuti akuluakulu aboma afunse mafunso ovutirapo okhudza chuma chaopindula ndi Medicare ndikupanga zisankho zovuta zokhudzana ndi mtengo wa katundu wamunthu. Ndizokayikitsa kuti kuyesaku kudzachitika mofanana kapena mwachilungamo m'madera onse.
Onse olumala ndi osapunduka amataya mwa kufooketsa dongosolo la inshuwaransi yaboma. Msonkhanowu ukhoza kukhala woopsa kwambiri kwa anthu olumala kusiyana ndi msonkhano wa Gingrinch. Uwu ndi mtundu wa bilu yomwe George W. Bush adzasaina. Imakhala ndi chizindikiro cha Texan - yambitsani chiwongola dzanja ndikuchepetsa machitidwe othandizira aboma kukhala otsika kwambiri kuti athetse anthu osaukawo.
Marta Russell atha kupezeka pa [imelo ndiotetezedwa] http://martarussell.com