Kwakabva: The Nation
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Shanduko yehutano hwehutano ndiyo yave iri nyaya yakakwikwidzwa zvakanyanya mumagakava emutungamiri weDemocratic. Bernie Sanders naElizabeth Warren vanga vachisundidzira mubhadharo mumwe chete weMedicare kune Yese chirongwa, pasi peiyo inshuwarisi yeruzhinji yaizovhara munhu wese. Vaizorambidza inishuwarenzi yega yega, kunze kwezvinhu zvisina kuvharwa nehurongwa hweveruzhinji, sekuvhiya kwekunakisa kana makamuri epachivande muzvipatara. Vamwe vanokwikwidza veDemocrat vanofarira shanduko ye "ruzhinji" iyo yaizounza Medicare-yakafanana neinshurensi yeruzhinji asi yaizobvumira mainishuwarenzi akazvimirira kushandawo. Ivo vanorumbidza nzira iyi senzira isinganyanyi kushungurudza yekuvharirwa kwepasirese iyo inochengetedza sarudzo yemahara yemainishuwarenzi kune vanhu vanofara nezvirongwa zvavo. Uye vamwe vatsigiri vesarudzo vanoenda mberi, vachiti hurongwa hwacho huchachinja zvisingarwadze kumubhadhari mumwe chete sezvo hurongwa hweveruzhinji huchikunda mainishuwarenzi akazvimirira.
Ndiko kutaura kunonyaradza. Asi nyaya yesarudzo yeruzhinji inotsamira pakukanganisa kwehupfumi uye fungidziro dzisina musoro nezvekuti inishuwarenzi yakazvimirira inoshanda sei. Mainishuwarenzi akazvimirira aratidza hunyanzvi hwekuita mutambo uyu kudzivirira kukwikwidza kwakanaka, uye vakashandisa hukuru hwavo hwekunyengetedza kukanganisa kuedza kwevatongi kuti vadzore kushungurudzwa kwavo. Izvi zvakaita kuti vakwanise kubvisa mazana emabhiriyoni emadhora kubva muhurongwa hwekuchengetedza hutano gore rega rega kuti vawane purofiti yavo nemitengo yepamusoro uku vachimanikidza vanachiremba nezvipatara kutambisa mabhiriyoni emamwe mapepa ane chekuita nekubhadharisa.
Iwo madora anofanira kubva kumwe. Kana veinishuwarenzi vakazvimirira vaida kuti vatengi vavo vabhadhare mari izere yezvirongwa zvepachivande, havaizokwanisa kukwikwidza nehurongwa hweveruzhinji senge chirongwa cheMedicare chekare, vane mutengo wepamusoro wakaderera zvikuru. Asi izvi hazvisi izvo: Kutaura zvazviri, vateresi-kusanganisira avo kwete akanyoresa muurongwa hwepachivande-tora tebhu kune yakawanda yeakavanzika inshuwarisi 'hutsotsi. Uye mutengo wakakwira wekuchengeta inishuwarenzi yakazvimirira iri mhenyu yaizoita kuti zvidhure zvakanyanya kubhadhara mamiriyoni makumi matatu asina inishuwarenzi muUnited States uye kuvandudza kuvharirwa kwemakumi emamiriyoni ane zvirongwa zvisina kukwana.
Zvikumbiro zveruzhinji zvinouya mumhando nhatu huru:
ยงโA nyore kutenga-mukati. Zvimwe zvikumbiro, kusanganisira izvo by Joe Biden uye Pete Buttigieg, yaizopa chirongwa cheMedicare-chakafanana neruzhinji chekutengeswa pamwe chete nezvirongwa zvepachivande pamichinjiro yeinishuwarenzi yave kuwanikwa pasi peAffordable Care Act. Aya magadzirirwo ekutenga-mukati angaderedza kudiwa kwemitero mitsva, sezvo vazhinji vakanyoresa vaizobhadhariswa mapremium. Asi makumi emamiriyoni aizoramba asina kuchengetedzwa kana nekuvharwa kwakapusa, havasati vakwanisa kubhadhara.
ยงโBhadhara kana kutamba. Iyi mutsauko (yakafanana nechirongwa chakafambiswa ne Centre for Progress America uye yakatsigirwa na Beto O'Rourke) yaizopa vashandirwi sarudzo pakati pekutenga inishuwarenzi yakazvimirira kana kubhadhara mutero wakakwirisa wekubhadhara (zvinenge zvikamu zvisere muzana). Chero ani zvake asina kuvharirwa nemushandirwi-anobhadhara anozvinyoresa muurongwa hweveruzhinji. Sarudzo yeruzhinji ingave dhiri yakanaka kune vashandirwi vangazofanira kubhadhara mari inodarika zvikamu zvisere kubva muzana zvemubhadharo wavo wepachivande-semuenzaniso, vashandirwi vane vakura kana vazhinji vashandi vechikadzi (vanowanzo shandisa zvakanyanya kutarisirwa uye kuwana mibairo yakakwira) kana nevashandi vakawanda vanotambira mari shoma (avo 8 muzana yemuhoro imari ishoma). Asi mafemu mazhinji anoshandisa vashandi vechidiki, varume, kana vanobhadharwa zvakanyanya (semuenzaniso, mari nehunyanzvi) vangangogara neinishuwarenzi yakazvimirira.
ยงโMedicare Advantage kune Vese. Iyo yeruzhinji sarudzo nzira inofarirwa na Kamala Harris yaizotevedzera yazvino Medicare Advantage chirongwa. Medicare Advantage zvirongwa ndezvokutengeserana zvinotarisirwa kuchengetedza zvigadzirwa zvinopihwa neakazvimirira einishuwarenzi kune vakuru. The Centers for Medicare and Medicaid Services (CMS), iyo federal agency inotungamirira Medicare, inounganidza mitero inobhadhara purogiramu uye inopa mari ($ 233 mabhiriyoni 2018) pamwe chete nemakambani einishuwarenzi. Pasi pemaitiro aya, sarudzo yeruzhinji yaizoshanda padivi pezvirongwa zveMedicare Advantage uye kukwikwidzana nazvo, sezvinoitwa nehurongwa hweveruzhinji hweMedicare parizvino.
Hapana mamodheru anoshanda ekutenga-mukati kana kubhadhara-kana-kutamba yeruzhinji sarudzo akasiyana aripo muUnited States kana kumwewo. Asi makumi emakore echiitiko neMedicare Advantage inopa zvidzidzo pamusoro pechirongwa ichocho uye kuti makambani einishuwarenzi ega ega anozvitorera sei purofiti uye anosundira kurasikirwa kune avo vanopikisana neruzhinji-maitiro anovabvumira kuhwina mukwikwidzi vachityaira mutengo wemunhu wese.
MuUS Health Inishuwarenzi, Vakomana Vakanaka Vanopedza Pakupedzisira
Urongwa hwesarudzo hweveruzhinji hunoita kuti vakanyoresa vawane kuwana rubatsiro rwezveutano rwechokwadi havakwanise kukwikwidzana neveinishuwarenzi vakazvimirira vanonzvenga vanorwara zvinodhura uye vanotadzisa kuwana rubatsiro. Pasinei nekuva nemari yepamusoro inenge kanomwe iyo yechinyakare Medicare (13.7 versus 2 muzana), Medicare Advantage zvirongwa zvakakura nekukurumidza. Ivo zvino vanovhara vanopfuura chikamu chimwe muzvitatu chevanobatsirwa neMedicare, kubva pa13 muzana muna 2005. Makaro akadenha kushanda zvakanaka, uye kuedza kwevanotonga kuenzanisa nzvimbo kwakakurirwa nehurongwa hwemainishuwarenzi hunoita purofiti hwekuitenderedza.
Mainishuwarenzi epachivande anoshandisa zvirongwa zvinokatyamadza zvekuwedzera purofiti izvo zvingave zviri kunze kwemiganhu yehurongwa hwehurumende. Zvirongwa izvi, izvo zvinoramba zvichishanduka zvichienderana nekuedza kwevatongi kuzvipikisa, zvinodzika kusvika kunzira ina dziri pamutemo, pamusoro pekubiridzira kunomboitika.
ยงโKutadzisa kutarisira kunodhura. Zvirongwa zvinoedza kukwezva vane pundutso, vanyoreri vakaderera nekuvavimbisa kuwana kuri nyore uye kunochipa kwekutarisirwa kwemaitiro ezvinetso zvidiki. Panguva imwe cheteyo, vanoisa zvipingamupinyi kumasevhisi anodhura anotyisidzira purofiti โ semuenzaniso, zvinodiwa zvemvumo zvisati zvaitika, mari yekubhadhara yakakwira, network yakamanikana, uye zvirambidzo zvekushandisa zvinodhaka izvo zvinorangira vanorwara zvisingaite. Nepo iyo yakazara yeruzhinji Medicare chirongwa chibvumirano nechero mupi anoda, vazhinji veinishuwarenzi vakazvimirira havabatanidzi (semuenzaniso) cystic fibrosis nyanzvi, uye vashoma Medicare Advantage zvirongwa zvinovhara kuchengetedza kunzvimbo dzegomarara seChirangaridzo Sloan Kettering. Uyezve, makambani einishuwarenzi emishonga ekugadzira mishonga anowanzoisa mishonga yoseโkunyangwe mishonga isingadhuriโinodiwa nevane chirwere cheshuga, schizophrenia, kana HIV muchikamu chepamusoro chekubhadharana.
Mainishuwarenzi ane maitiro ekutanga kune hombe bhiri iri "kuramba kurambwa" anoodza mwoyo varwere vazhinji kutevera zvavanoda. Uye sezvakakurukurwa pazasi, kana kunetsa pamusoro pezvikumbiro kunodzinga vamwe vakanyoresa kure, kunyange zviri nani: Vanorwara zvakanyanya ndivo vanonyanya kunetseka uye nekudaro vanogona kuchinja kune anokwikwidza.
ยงโCherry-kunonga uye lemon-kudonha, or kusarudza kunyoresa vanhu avo vanoda kutarisirwa zvishoma uye kudzinga vanorwara zvisina basa. Nhamba shoma yevarwere vanorwara zvakanyanya ndiyo inomiririra mari zhinji yekurapa gore negore. Chirongwa chinonzvenga kunyange vashoma vevarwere vanodiwa zvakanyanya vanokunda, nepo chirongwa chinokwikwidza chinotambira vese vanouya chinorasikirwa.
Mumusika wevanoshandira, kunhonga cherry kuri nyore: Mainishuwarenzi epachivande anopa maprimiyamu anoyevedza kumabhizinesi ane vechidiki, vashandi vane hutano uye mitengo yakakwira kune avo vane vashandi vakura, vanorwara. Setsamba zhizha rino ku The New York Times kutaura, semakasino, makambani einishuwarenzi ehutano ane purofiti nekuti anoziva kusawirirana kwechero bheti yaanoisa-uye imba inohwina nguva dzose.
Iyo CMS, mune dzidziso, inoda Medicare Advantage zvirongwa zvekutora vese vanouya uye kuvarambidza kumanikidza vanhu kunze kana varwara. Asi kuedza kwevanotonga kutevedzera zvinodiwa izvi kwakakurirwa neinshuwarisi 'chicanery. Kuti udzivise vanorwara, veinishuwarenzi vakazvimirira vanoshandisa network yevanopa uye madhizaini ekugadzira mishonga. Kunyangwe kurambidzwa kumanikidza kunyoresa kunze, varwere vanoda masevhisi anodhura senge dialysis kana kuchengetwa kwevakoti. kuchinjanisa mumapoka kubva kuzvirongwa zvepachivande kuenda kune yechinyakare, yakazara yeruzhinji Medicare. Uye sechisarudzo chekupedzisira, Medicare Advantage zvirongwa zvichadaro rega kupa coverage mune imwe dunhu mavakaunganidza vanyoreri vakawandisa vasina purofiti, zvakafanana nevatambi vekasino ejection vari kurova imba.
Chekupedzisira, Medicare Advantage inoronga cherry-tora kuburikidza nezvirongwa zvekushambadzira zvakanangwa. Kare, izvi zvaireva kusaina-kudya kwemanheru mumaresitorendi zvakaoma kuwana kune vanhu vanoshandisa mawiricheya kana kupa mahara. fitness centre nhengo, perk inonyanya kufadza kune vakwegura vane hutano. Asi nzira dzepamusoro-tekinoroji dzave pedyo nekona. Will Oscar, inshuwarisi yehutano yakavambwa nemukoma waJared Kushner - ane kambani yevabereki veGoogle akakosha investorโ ramba muedzo wekushandisa Google trove yedata rako kunanga kunyoresa kushambadza kune vane pundutso vakanyoresa sevanofarira tennis uye kudzivirira vatengi vezvipfeko zvakakura kana vanhu vakatsvaga online kurapwa kwembereko?
ยงโUpcode, kana kuita kuti vakanyoresa vataridzike sevanorwara pabepa kupfuura zvavari kuita kuti vawedzere mari inobhadharwa. Kurwisa kunhonga cherry, CMS inobhadhara Medicare Advantage inoronga maprimiyamu epamusoro kune vakanyoresa vane zvimwe (uye zvakakomba) kuongororwa. Semuenzaniso, chirongwa cheMedicare Advantage chinogona kuunganidza mazana emadhora mwedzi wega wega kubva kuhurumende nekunyora kusuwa kwechinguvana kwemunhu akanyoresa se "kuora mwoyo kukuru" kana kudana kurwadziwa kwemabvi zvishoma "degenerative arthritis." Kupfurikidza nokushandisa kunzverwa kunonzwika kwakakomba kuhosha duku, zvirongwa zveMedicare Advantage zvinowedzera zvisiri izvo miripo yavanounganidza kubva kuvateresi nemabhiriyoni emadhora nepo vachiwedzera zvishoma kana kuti kusarega kumari dzavo dzokutarisira.
Kunyangwe kukwidziridzwa kwakawanda kunogara mukati metsamba yemutemo uye kungotambanudza izwi rekurapa, kuongororwa kweCMS's (kashoma) kwemachati evakanyoresa kunoratidza kuti zvirongwa zveMedicare Advantage zviri kuunganidza. Madhora mabhiriyoni 10 pagore kubva kuvateresi nokuda kwezvirwere zvakagadzirwa zvachose. Uye icho chingori chikamu chidiki chidiki chekutora kwavo kwese kubva kuupcoding. Mainishuwarenzi akazvimirira anochengeta yakawanda yeiyi mari yakabiwa kuitira purofiti yavo uye pamusoro, asi vanoshandisa chikamu chekuwedzera mari (somuenzaniso, magirazi emaziso kana kuderera zvishoma mubhadharo wepachedu yekuchengeta) izvo zvinokwezva vatsva vakanyoresa uye kubatsira zvirongwa zvepachivande kuita sezvisingakundike zvechinyakare. Medicare.
ยงโKunyengetedza kuti uwane mubhadharo wakawandisa uye kukanganisa vatongi. Congress yakaraira kuti CMS ibhadhare zvirongwa zveMedicare Advantage ne2 muzana (uye kunyanya uko mari yekurapa yakaderera kupfuura avhareji). Pamusoro peizvozvo, Seema Verma, maneja weCMS yaTrump, atora matanho achawedzera maprimiyamu zvakanyanya uye kupa "mabhonasi emhando" asina chikonzero, kusateerera zano kubva kuMedicare Payment Advisory Commission kuti mubhadharo udzimurwe nekuti hurumende yave kutobhadhara zvirongwa zvega. Uye akaraira shanduko kuCMS's Medicare webhusaiti kuti ridza zvikomborero yeMedicare Advantage kunyoresa.
Muchidimbu, inshurensi yeruzhinji inosarudzwa neveruzhinji iyo, sechinyakare Medicare, isingaedze kunzvenga vanyoreri vasingabatsiri inoturikirwa nezvakawanda kupfuura chikamu chayo chevarwere vanorwara, vanodhura uye inozova dziva rinodhura zvakanyanya, rine njodzi huru. Kuedza kweCMS kwemakumi emakore ekuyera nhandare kwakakanganiswa nekukwidziridzwa kwemainishuwarenzi, zvichireva zvivimbiso zvavo zvemakwikwi akanaka. Uye makambani einishuwarenzi akashandisa tsandanyama yavo yezvematongerwo enyika kuchengetedza uye kuwedzera mukana wavo wekukwikwidza pane yechinyakare Medicare. Mhedzisiro: Hurongwa hweveruzhinji (uye vateresi) vanotora kurasikirwa uku ivo veinishuwarenzi vakazvimiririra vachibvisa purofiti, kusaenzana kwakakura zvekuti zvirongwa zvepachivande zvinogona kukurira hurongwa hweveruzhinji kunyangwe vachipambadza mari yakawanda pamutengo wepamusoro, mihoro yeCEO, uye purofiti yevaridzi.
Mubhadhari Mumwechete Aizochengeta, Sarudzo Yeruzhinji haiite
Gore rino chete, veinishuwarenzi vakazvimirira vachatora $252 bhiriyoni kupfuura yavanobhadhara, yakaenzana ne12 muzana yemari yavo yavanobhadhara. A single-payer system ine mari yepamusoro inofananidzwa neMedicare's (2 muzana) inogona kuchengetedza nezve $ 220 bhiriyoni nemari iyoyo. Sarudzo yeruzhinji inogona kuchengetedza zvishoma-zvichida zero, kana yakawanda yeruzhinji kuvharwa kweruzhinji ikafambiswa kuburikidza neMedicare Advantage zvirongwa, iyo pamusoro, pa13.7 muzana, yakatokwira kupfuura avhareji yeinishuwarenzi yekutengesa.
Zvakare, sarudzo yeruzhinji yaizochengetedza zvishoma kana kusatoita pazvipatara 'nevanachiremba'-yepamusoro-soro kubhadharisa nemitengo yekutonga. Mugadziriro inobhadhara munhu mumwe chete, zvipatara nezvimwe zvivako zvoutano zvaigona kutsigirwa nemari yenyika yose, mari yakawandaโyakafanana nenzira iyo maguta anobhadhara nayo madhipatimendi emotoโzvichibvisa kudikanwa kwokuti ndyiko dzinoparirwa nomurwere mumwe nomumwe uye kuunganidza muripo kwavari namainishuwarenzi avo. Iro hurongwa hwekubhadhara bhajeti repasi rose hwakacheka mitengo yekutonga muzvipatara muCanada neScotland kusvika hafu yezinga reUS. Kushingirira kwevanobhadhara vakawanda kunodzivirira kufambiswa kwekutonga kwakadaro, kunyangwe kana vese vanobhadhara vachibhadhariswa mareti mamwe chete. (Pasi peMaryland's yakanyorwa zvisirizvo bhajeti repasi rose, zvipatara zvehurumende zvinobhadharisa mayunifomu asi zvichiramba zvichibhadharisa murwere wega wega; tsvakiridzo yedu inoratidza kuti mari yavo yekutonga haina kudzika zvachose, sekureva kwemitengo yavo yepamutemo.)
Saizvozvo, kune varapi nevamwe varapi, kuomarara kunobatanidzwa mukubhadharisa vakawanda vanobhadhara, kubata neakawanda zvinodhaka formularies uye kutumira network, kuunganidza co-kubhadhara uye deductibles, uye kuwana kutumira uye kupihwa mvumo kwekutanga kunokwidza mutengo wepamusoro wehofisi uye mitoro yezvinyorwa.
Kuwanda kwepamusoro kunowanikwa kune vanobhadhara vakawanda kunoisa muripo wakavanzika pamari dzinofanira kubhadhariswa vanachiremba nezvipatara varwere vese โ kwete chete avo vanobhadharwa neinishuwarenzi yakazvimirira. Zvese zvataurwa, shanduko yesarudzo yeruzhinji ingapira mari inosvika mabhiriyoni mazana matatu nemakumi mashanu emadhora pagore emubhadharo mumwe chete wemubhadharo wepamusoro pemutengo wepamusoro wevanopa, pamusoro peiyo $350 bhiriyoni mukuchengetedza kwainogona kubaira gore negore pamusoro pemari yeinishuwarenzi.
Chekupedzisira, sarudzo yeruzhinji inogona kukanganisa kurongeka kwehutano hwakanaka iyo yakakosha kukuchengetedza kwenguva refu pasi pemubhadhari mumwe chete. Dhora rimwe nerimwe iro chipatara chinoisa muzvivako zvitsva kana kuti michina inowedzera mari yaro yokushandisa namasendi 20 kusvikira ku25 mugore riri rose rinotevera. Parizvino, zvipatara zvinowana purofiti (kana kuti โzvakasaraโ zvezvisina purofiti) zvine mari yekuwedzera masevhisi ekuita mari uye kutenga midziyo yemhando yepamusoro, ingave ichidiwa kana kwete, uku vachiregeredza mabasa akakosha asi asina pundutso. Semuenzaniso, zvipatara zvakatenderedza nyika zvakaisa mari muproton-beam-radiation therapy nzvimbo dzinodhura mazana emamiriyoni emadhora chimwe nechimwe. (Oklahoma City chete ikozvino ine piri.) Zvakadaro pane humbowo hushoma hwekuti michina iyoyo iri nani pakushandisa kwakawanda pane yavo yakachipa. Saizvozvo, zvipatara zvakamhanya kuvhura zvirongwa zvekuvhiya zvemwoyo uye zvemapfupa, kazhinji padyo nearipo. Aya madhipatimendi ekudyara anokwidza mitengo uye pamwe anokanganisa kunaka.
Zvichakadaro, rubatsiro rwekutanga uye hutano hwepfungwa hwapera simba, uye zvipatara zvekumaruwa nezvimwe zvivakwa zvakasungwa mari izvo zvinopa kutarisirwa kunodiwa zvakanyanya kusvika pakuvhara. SekuCanada nenyika dzinoverengeka dzeEurope, hurongwa hwemubhadharo mumwe chete hunogona kupa mari kuzvipatara zvitsva kuburikidza nerubatsiro rwehurumende zvichibva pakuongorora kwakajeka kwezvido, pachinzvimbo chekuverengera kuzvipatara zvakazvimirira. shandisa purofiti yavo nekuchenjera. Urongwa uhu hwakabatsira dzimwe nyika kunangidzira mari kunzvimbo nemasevhisi ane kudiwa kukuru uye kudzivirira kupa mari zvivakwa zvinoparadza kana zvisina basa. Zvikumbiro zvesarudzo zveveruzhinji zvinosimudzira nzira dzekubhadhara dzazvino dzinokanganisa mari uye kukwidza mitengo yenguva refu.
Nekuti sarudzo yeruzhinji yaizosiya nzira yekubhadhara isiri kushanda iripo, yaizopira mari zhinji inochengeterwa kuburikidza nemubhadharo mumwe chete. Chinokosha ndechekuti sarudzo yeruzhinji inogona kudhura zvakanyanya kana kuunza zvishoma pane anobhadhara mumwechete.
Wadii Kupinza Germany, Swiss, kana Dutch Health Care?
Vatsigiri vesarudzo dzeveruzhinji vanowanzo taura Germany, Switzerland, neNetherlands semienzaniso yekuti mainishuwarenzi akazvimirira anogona kugara pamwe chete nehurongwa hwekuchengetedza hutano hweveruzhinji. Asi vanofuratira misiyano yakakura pakati peinishuwarenzi yapachivande yenyika idzodzo neyedu.
The nonprofit German "zvirwere zvechirwere,โ iyo inofukidza 89 muzana yevagari vemo (vapfumi vokuGermany chete ndivo vanobvumirwa kutenga mari yokuvanda kubva kumakambani einishuwarenzi anoita purofiti), anodzorwa pamwe chete nevashandirwi nemibatanidzwaโzvakasiyana zvikuru nezvinoitwa nomushandirwi wedu. Hurumende inoraira mapremium akafanana emari yese yehurwere, inotora mari kubva kune avo vane njodzi yakaderera uye inopa rubatsiro kune vakura nevanorwara, uye inobhadhara zvakananga kuvakwa kwechipatara kwakawanda. Mari dzese dzehurwere dzinopa mapakeji ekubatsirikana akafanana, bhadhara muripo wakafanana, uye nekuchengetedza rubatsiro kubva kune chero chiremba kana chipatara.
Kunyangwe iwo madhairekitori akasiyana, imwe yakaomesesa kudzora hutongi hunoshanda mukati Siwizarendi, ane hurongwa hwakabva pamuenzaniso weGermany wepakutanga waOtto von Bismarck, uye somuGermany, hurumende inopa mari yakawanda yekuvaka zvipatara. Nepo ma-inshurensi epurofiti anogona kutengesa kuvharwa kwekuwedzera, zvisingabatsiri chete zvinotenderwa kupa iyo yakatemerwa bhenefiti package.
Kubva 2006, Netherlands yanga ichichinja kubva kuGerman-style yepasi rose yekuvhara system kuenda kune imwe. nzira yakanangana nemusika inotsigirwa nevatungamiriri vemakambani. Zvisinei, hurumende inobhadhara zvakananga kune zvose zvekugara kwenguva refu, uye maitiro akasimba ekururamisira uye kuenzana akamanikidza vose vanoita zvehurumende uye vega kuti vadzivise kukanganisa kwekubatana kwevanhu. Netherlands yagara ichifarira kuwana kwakagadzirira kwekutarisirwa, uye hurongwa hwayo haisati yadzika (zvakadaro) mugomba rakadzika-dzika rekuAmerica. Asi pasi pehutongi hutsva, mari yekutonga yechipatara yakakwira kusvika kuUS, mutengo wehutano wakawedzera nekukurumidza, vanachiremba vanonyunyuta nemitoro isingagoneki yekutonga, uye kunyangwe munyika diki yakadaro, makumi ezviuru zvevanhu havana kuchengetedzwa. Mainishuwarenzi anopedza mari yakawanda pakushambadzira nekushambadza, uye mari yeinishuwarenzi yakazvimiririra inodhura avhareji yegumi nenhatu muzana yemapremium avo. Uyezve, United States neNetherlands handiziyo chete nzvimbo dzine mari dzepamusoro-soro dzeveinishuwarenzi dzakakwirira: Vanoita avhareji ye13 muzana muSwitzerland, 12.4 muzana muGermany, uye 20.9 muzana muUnited Kingdom.
Kusandura makambani einishuwarenzi ane simba guru, anofambiswa nepurofiti kuti ave mainishuwarenzi asina purofiti muSwiss kana German mold zvingave zvinorema kusimudza sekutora Medicare for All. Uyewo hatigoni kuvimba nedziviriro yetsika idzo kusvika zvino dzapfavisa tsika dzechiDutch dzeinishuwarenzi dzoutsinye ndokudzivisa kuchinjwa kwebudiriro yenyika iyoyo yokutarisira utano.
Pfungwa yekupedzisira: Nepo kubvumira mainishuwarenzi ega ega kukwikwidza nehurongwa hweveruzhinji hunoenderana nepiritsi rechepfu, zvakafanana hazvisi zvechokwadi kune ekuwedzera zvirongwa zvepachivande izvo zvinotenderwa kuvhara chete izvo zvinhu zvisingabatanidzwe kubva kune veruzhinji. Kunyange Canada ichirambidza kutengeswa kwekuvhara kwakavanzika iyo inodzokorora mabhenefiti ehurongwa hweveruzhinji, yagara ichibvumira kuvharwa kwekuwedzera, uye izvo hazvina kukanganisa hurongwa hwayo.
Kushanda kwemubhadharo mumwe chete kuchaita kuti kuvharika kwepasirese kukwanise uye kupa munhu wese muUnited States sarudzo yavo yemahara yevanachiremba nezvipatara. Asi chinangwa ichocho chicharamba chisingasvikike kana veinishuwarenzi vakazvimiririra vakabvumidzwa kuenderera mberi nekutamba sisitimu. Kuchengetedza kusarudzwa kweinishuwarenzi kune vamwe kunosimudzira dambudziko rekukwanisa kutenga iro rakanganisa hutano hwehutano hweUS kwezvizvarwa. Vatsigiri vesarudzo yeruzhinji vanoiratidza seisingakanganisi, sarudzo yemahara yemubhadharo mumwe chete. Iyo inogona kuve yakanaka yekushambadzira rhetoric, asi inotyisa mutemo.
David U. Himmelstein ndiye Purofesa Anoremekedzwa weHutano hweHurumende paCity University yeNew York paHunter College.
Steffie Woolhandler ndiye Purofesa Anoremekedzwa weHutano hweHurumende paCity University yeNew York kuHunter College.
ZNetwork inopihwa mari chete kuburikidza nerupo rwevaverengi vayo.
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