Mufesi wangu muCalifornia akavhunduka pandakamuudza kuti vanhu VOSE zvino vari paMedicare neMedicaid vaizomanikidzwa kupinda muchirongwa chitsva chemishonga yemishonga yeMedicare (Chikamu D). "Medicaid ichabhadhara mishonga yese inodiwa nevanhu," akadaro. "Medicare ichava shoma yekubatsira."
Nekurwiswa kwemaBush manejimendi kusakwanisa uye mashoma ehurumende marongero anokonzeresa kuregeredza kunouraya munyika yedu nekune dzimwe nyika, dzimwe nguva nyaya-dzonk-mhando dzemhando dzakadai semhedzisiro yemishonga yemunhu mumwe ari munjodzi inowira pasi pemanera uye don't. t kuwana attention.
Ndichapedza imwe nguva ndiri pachirongwa ichi chinoita sechidiki cheMedicare chechirongwa chemishonga chichave nemhedzisiro yakaipa kuvanhu vangangosvika miriyoni matanhatu paMedicare neMedicaid, muhofisi-kutaura kunonzi "vaviri vanokodzera" - DEs kwenguva pfupi.
Kuti ukwanise kuwana Medicaid munhu anofanira kunge ari murombo zvakanyanya asina kana midziyo, saka boka iri ndiro rine hurombo pakati pevanobatsirwa neMedicare. Havakwanisi kubhadhara mishonga yavo uye kuwana mishonga yemahara kubva kuhurumende.
Kunyoresa hakusungirwi muchirongwa chitsva cheMedicare chemishonga yemishonga yevakuru kutanga Ndira 1, 2005. Zvisinei Congress neBush vakaona zvakakodzera kuti zvive zvinosungirwa kuti DE inyore muchirongwa.
Saka chii chinonetsa kana zvese zvirongwa zveveruzhinji zvichipa kuvharwa kwezvinodhaka? Iko kuunzwa kwemakambani einishuwarenzi akazvimirira anozotungamira chirongwa cheMedicare drug.
Iye zvino, Medicaid inobhadhara zvakananga mishonga yemishonga yeDEs - hapana pakati. Asi pasi pechirongwa chitsva cheMedicare drug corporation makambani einishuwarenzi - musika - achadzora chirongwa che "ruzhinji". The Medicare prescription drug plan PRIVATIZES the pharmaceutical benefit.
Iyi switchover inoreva shanduko yakakura yemagadzirirwo ekuti DE vanhu vanowana sei mishonga. Nema inshuwarisi akazvimirira oga anotarisira chinhu chekutanga ndechekuita purofiti kubva kune vakanyoresa.
Vanhu vakaremara zvakanyanya uye vanorwara zvisingaperi vakaiswa muzvirongwa zveveruzhinji seMedicaid nekuti mari yavo yekurapa inowanzokwira uye mainishuwarenzi epachivande anoda kuaburitsa nekukurumidza nekuti haana pundutso. Kumberi mainishuwarenzi cherry tora uye havadi huwandu uhu muzvirongwa zvavo zvakavanzika. Pakuremara vashandirwi vazhinji vanoshuvira kushandura vashandi kubva kukambani-yakabhadharwa-yezvirongwa zvepachivande kuenda kuMedicare semupi wavo wekutanga. Izvi zvinotevera kuti kana chinangwa chiri chekupa hurongwa hunoenderana nezvido zveDEs, hazvina musoro kuti hurumende yemubatanidzwa imanikidzire boka iri muzvirongwa zvecapitalist. Ndinofanira kugumisa kuti hurumende inodzorwa neRepublican yave zvakare - sezvayakaita nehurongwa hwayo hweMedicare HMO - ichienda kunopa mhirizhonga yekudya kumakambani einishuwarenzi nepo DEs ichinetsekana kutsvaga nzira dzekupona nadzo shanduko huru iyi. Semuenzaniso, chirongwa cheMedare chemishonga chinosanganisira zvakasiyana-siyana zveinishuwarenzi, mapremium, ma-co-payments uye zvinodhaka zvakavharwa. Yakagadzirirwa kuva basa rinovhiringidza.
Mari yekubhadhara ichavharwa nechirongwa cheMedare chemishonga yeDEs, asi avo vari kupiwa mishonga yavo zvakananga neMedicaid vachafanira kuvimba nezvirongwa zvemishonga zvepachivande zvingave kana kusavhara mishonga yose yavari kutora iye zvino. Semuenzaniso, iyo Center for Medicare uye Medicaid Services (CMS) yakaita mirau iyo iyo yakavanzika inishuwarenzi inofanirwa kutevedzera. CMS yakatotaura kuti mimwe mishonga iyo nyika zhinji inovhara kuburikidza nezvirongwa zvavo zveMedicaid-senge benzodiazepines-haizovharwa nechirongwa cheMedicare drug.
CMS iri kubvumira zvirongwa zvepachivande kubuda mukuvhara kirasi yese yebenzodiazepines - zvinodhaka zvinowanzo shandiswa kurapa spasticity, kusagadzikana, kuvhunduka uye mamwe mamiriro akakomba.
CMS iri kumanikidza maDEs muchirongwa cheMedicare drug asi haimanikidze mainishuwarenzi ega ega kuti aenderere mberi nemishonga yemunhu iripo. Imwe inshuwarisi yega yega inogona kuuya neyayo fomulary uye zvine mukana mukuru wekuti hapana chirongwa chinovhara iyo chaiyo mishonga iyo munhu angave achitora (uye anofanira kutora nekuti ivo vanoshandira ivo pachavo).
Kazhinji maDE akashanda nanachiremba kwemakore kuti vauye nemusanganiswa wemishonga inovashandira. Pasi pechirongwa cheMedicare drug chirongwa maDE anotarisirwa kuchinjika kune akachipa generic zvinodhaka uye / kana kuita zvimwe zvigadziriso zvingasashanda kune yavo chaiyo musanganiswa wemamiriro. Vazhinji veboka iri havagone kuita kana mumwe chete wemishonga yavanofanira kunwa asi vangangotarisana nemamiriro ezvinhu akaomarara zvekuti vangasakwanise kubhadhara muhomwe yemushonga unokosha. Makumi ezviuru zvevanhu munyika yose vachakanganiswa, nekuti vanoda mishonga chaiyo (kwete inotsiva) yemamiriro avo. Kupfuurirazve, CMS inobvumira chero anishuwarenzi yakavanzika kuDIRA mushonga kubva pafomulary chero nguva yainosarudza kuzviita. Co-kubhadhara chikamu chemutambo. Sezvo zvirongwa zvisati zvave kuwanikwa kuti zviongorore hapana anoziva kuti zvakadii. Chero huwandu huchawedzera kuomerwa kweDEs vanogara pazasi kana pa-urombo hwakagadziriswa mari. Privatization yeMedicare yakakundikana munguva yakapfuura. Semuyenzaniso, indasitiri yakazvimirira payakapinda nekunyoresa vakuru paMedicare muzvirongwa zvehutano zvinotarisirwa, mitengo yakakwira mudenga. HMOS yakazotanga kurasa vabatsiri veMedicare kubva kuzvirongwa zvavo. Sei ichifanira kubudirira panguva ino nemishonga yemishonga? Zvirongwa zvezvinodhaka zvepachivande zvinogadzira maformularies zvichienderana nekufungidzira kweactuarial yezvinozoita ivo mari yakawanda. Panogona kunge paine kukwira kwemitengo uko indasitiri yakazvimirira inobatsirikana nepo vagari vachipunzika asi nekufamba kwenguva maDEs haasi kuzoonekwa sevagadziri vepurofiti kumakambani einishuwarenzi aya. Mutungamiri Bush akaita njodzi kubva pamushonga uyu "benefit" nekusarudza kuisa maDEs pamutsara usipo wemusika nemafungiro ake ekuchengetedza inishuwarenzi nemabhizinesi emishonga.
Izvozvo hazvisi zvisingatarisirwi.
Izvo zvisingatarisirwi ndezvekuti masangano enyika akaremara haana kuungana kuti amise kufudzwa kweDE muchirongwa ichi checrapshoot Medicare drug.
Maonero mumaziso emufesi wangu akaudza zvese - kwaive kutyisa kufunga nezvezvingangove mberi kusvika Ndira 1. Kurudziro yake: โUdza munhu wese kuti awane mwedzi mitatu yemushonga wese waanotora mukupera kwaZvita panguva iyi. vachiri paMedicaid."
Ndiwo mutemo wazvino uno. Hurongwa huri nani hungave hwekuita kuti nyika dzivhare mishonga iyo makambani einishuwarenzi asingade. Pamwe ipapo dzimwe dziviriro chaidzo dzinozova mutemo.
Russell ndiye munyori we "Beyond Ramps: Kuremara pakupera kweSocial Contract" (Common Courage Press).
http://www.martarussell.com