INDLU yaBameli iwugqithise kancinci umthetho wokhathalelo lwempilo kwimpelaveki edlulileyo ebinconywa “njengembali” kwaye itshayela.
Zezo zinto-yimbali kunye nentlekele enkulu ngethemba lokuba umongameli weDemokhrasi kunye neCongress ekugqibeleni baya kwenza into ukulungisa inkqubo yokhathalelo lwempilo ekruqukileyo engumthombo wenkxwaleko kunye nokubandezeleka kwabantu abaninzi.
INdlu yoLondolozo lweMpilo olufikelelekayo lwaseMelika luya kunyanzela izigidi zabantu ukuba bathenge i-inshurensi yexabiso eliphezulu, i-inshurensi ephantsi kwiinkampani zabucala. Ibiya kufaka amakhulu eebhiliyoni zeerandi zabarhafi ezinokusetyenziswa ukwenza into eluncedo ngokhathalelo lwempilo kwiipokotho zezikhulu zeinshorensi. Inika amandla nakwisiqingatha "sokhetho lukawonke-wonke" lwenye indlela eqhutywa ngurhulumente kwabo bangakhuselwanga. Inikezela kulawulo olusebenzayo lwazo zonke kodwa izenzo ezimbi kakhulu ze-inshorensi yezonyango. Iqulethe imvume eyoyikisayo kwabo banxamnye nokuqhomfa eya kuba sesona sithintelo sibanzi sikarhulumente kodwa sibekwe kwilungelo labasetyhini lokuzikhethela.
Ngokuyeka naliphi na ilinge lokuphumelela utshintsho lokwenyani kwinkqubo, kwaye emva koko ulalanisa kwizikhundla ezisele zichaphazelekile, uninzi lweNdlu yeDemokhrasi ivelise umthetho wokhathalelo lwempilo oya kwenza umonakalo omkhulu kunokulunga-kwaye oko kuya kungcolisa imbono yohlaziyo kwixesha elizayo.
Kwaye oku kunokuba ngcono kunokuba i-Senate iza kuza nayo njengoko iqala iingxoxo malunga nomthetho onokuthi uphosakele ngakumbi ukusuka kwindawo yokulungisa ukhathalelo lwempilo. Ukongeza, umthetho oyilwayo weSenethi unokungavoti-hayi, ubuncinci, ngaphandle kokuzinikela ngakumbi-ngenxa yenkcaso yamaRiphabhlikhi kunye neeDemocrat ezimbalwa ezigcinayo.
Wonke umntu oyiDemokhrasi eWashington uyawuqonda lo mfanekiso umbi, kodwa bekusekho umoya ongeyonyani wokuzivuyisa emva kwevoti yeNdlu. Umongameli uBarack Obama uncome abenzi bomthetho "ngokuphendula ubizo lwembali," kwaye imanyano exhaswa yimanyano yezempilo eMelika ngoku yathi bavotela abantu baseMelika, ngokwenza ukhathalelo lwempilo lube lilungelo lomntu.
U-Rep. Tammy Baldwin, omnye weDemokhrasi ekhululekile kakhulu eWashington, wajonga ngaphaya kwayo yonke into engalunganga ngomthetho oyilwayo weNdlu kwaye wathi: "Ndiyakholelwa ngokwenene ukuba siya kujonga emva kwiminyaka ukususela ngoku kwaye sijonge ukugqithiswa kwesi senzo kubaluleke kakhulu. ukuwiswa koMthetho woKhuseleko lweNtlalo ngowe-1935 kunye noMthetho weMedicare kunye neMedicaid ngowe-1965.”
"Kubalulekile" mhlawumbi-kodwa hayi ngendlela elungileyo. Ivoti yeNdlu kwimpelaveki edlulileyo ifanele ukuhla embalini njengokuzinikela kubaphangi bokhathalelo lwezempilo ngokuchasene nenkxaso eyothusayo yoluntu yohlaziyo lokwenyani. Ukuba iyenzeka, iiDemokhrasi zenkululeko ezinje ngoBaldwin-owafungayo ukulwela umthetho owomeleleyo, emva koko wanikezela ngomda woloyiso lomsindo-ziya kukhunjulwa njengabo bavumela ukuba kwenzeke.
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NGAPHAMBI kokwenzakala kwevoti yokugqibela kumthetho oyilwayo kwabakho ukunyeliswa kwesilungiso esilingana nelinye lawona manyathelo afikelela kude achasene nokuqhomfa awakhe apasiswa eWashington.
Ngenjongo yokuphumelela inkxaso yomthetho opheleleyo ovela kwi-Demokhrasi egciniweyo, uSomlomo weNdlu uNancy Pelosi wagqiba ngomzuzu wokugqibela ukuvumela ivoti kwi-Stupak Amendment. Esi sihlomelo siza kuthintela ukubonelelwa kweenkonzo zokuqhomfa kungekuphela nje kwinkqubo eqhutywa ngurhulumente "yokhetho lukawonke-wonke", kodwa kuyo nayiphi na ipolisi ye-inshorensi yabucala efumanekayo ngokomthetho apho urhulumente abonelela ngayo nayiphi na inkxaso-mali kwaphela. Isihlomelo sipasiswe ngeevoti ze-64 Democrats kunye neRiphabhlikhi nganye kwiNdlu.
Ngazo zonke ii-akhawunti, uninzi lwabantu abaya kuthenga i-inshorensi yezempilo ngokuthi "utshintshiselwano lwe-inshurensi" olusekwe ngumthetho wohlaziyo luya kufumana uhlobo oluthile lwenkxaso-mali okanye ikhredithi yokunceda ngeeprimiyamu. Iinkampani ze-inshurensi ezibonelela ngoku ukukhutshwa kwezisu kuya kufuneka ziyilahle ukuba zifuna ukuthengisa imveliso yazo kuninzi lwabathengi abaza kubo ngotshintshiselwano.
Njengoko iblogi yaseWashington Post uEzra Klein eyibeka:
[V] eneneni bonke abasetyhini abane-inshurensi ngotshintshiselwano abazifumana bekwimeko engafunekiyo nengalindelekanga yokufuna ukukhupha ukukhulelwa abayi kuhlawulelwa inkqubo. Ukukhupha isisu akusayi kukhutshwa ngokusemthethweni kweli lizwe. Iya kudidiyelwa ngokulula, igcinelwe abo bazizityebi ngokwaneleyo ukuba bazihlawulele ngokwabo i-inshurensi okanye abanethamsanqa lokuyifumana kubaqeshi babo.
Ukuba iyenza ibe yinguqulelo yokugqibela yomthetho wokhathalelo lwempilo, i-Stupak Amendment iya kwenza kube nzima kunangaphambili ukukhupha isisu kwizigidi zabasetyhini abangakhuselwanga okwangoku kwaye kuya kufuneka bathenge-phantsi kwesoyikiso sesohlwayo semali-inshurensi yezempilo ngokusebenzisa utshintshiselwano lukarhulumente.
Nditsho nabasetyhini ngoku abane-inshurensi esekwe kumqeshi ejongana nokhathalelo lokuqhomfa baya kuziva iziphumo-abaqeshi abaninzi kulindeleke ukuba balahle ukhuseleko lwabaqeshwa babo kwaye babanyanzele kutshintshiselwano, apho iinkampani zeinshorensi ziya kuba nenkuthazo yokungakhuphi ukuqhomfa kuye nawuphi na owasetyhini.
U-Rep. Jan Schakowsky wayephakathi kwabaninzi benkululeko abathetha ngokuchasene nomlinganiselo wokuchasa ukhetho. "Esi sihlomelo siyindlela engasemva yokubhukuqa uRoe v. Wade; kukungabi namsebenzi kunye nesithuko kwizigidi zabasetyhini kwilizwe lethu," utshilo uSchakowsky.
Kodwa oku kwakungelula. USchakowsky wayesazi ukuba xa uPelosi evumele ukuvota kwisilungiso, kuya kudlula. Ukuba ngenene ebefuna ukuyiyeka, yena kunye noogxa bakhe bebefuna ukugrogrisa ngokuvotela umthetho oyilwayo ngokwawo. Kodwa phantse akukho namnye owakwenzayo.
U-Diana DeGette, inkokeli ye-Progressive kunye ne-Pro-Choice Caucuses kwiNdlu, ngoku ubanga ukuba abameli be-41 basayine ileta eya kuPelosi besithi abayi kuvota kwi-bill yokugqibela ukuba izithintelo zeStupak zihlala. Kodwa kutheni ezi 41 iintshatsheli zelungelo lomfazi lokukhetha zingazange zilwe xa zifumene ithuba okokuqala?
Nje ukuba iSenethi isebenze, kwaye iinkokeli zeziNdlu zimbini zeNkongolo zidibana kwikomiti yenkomfa ukuza nenguqulelo yokugqibela, uxinzelelo luya kuba lukhulu ngakumbi kwiinkululeko zeDemokhrasi ukuba ziginye iinkxalabo zabo malunga nazo naziphi na "iziphene." Asinakubathemba ukuba bayasigcina isithembiso sabo sokulwa ngokuchasene nezithintelo zokuqhomfa-okanye nawaphi na amanye amalungiselelo kolu tshintsho lwezempilo.
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I-LIBERAL DEMOCRATS iyavuma ukuba umthetho oyilwayo weNdlu "awufezekanga." Ubuncinci, nangona kunjalo, bathi, inikezela ngemimiselo ekudala ifuneka yezenzo ze-inshurensi ezaziwa kakhulu, kwaye yongeza inkxaso-mali eninzi kwinkqubo karhulumente ye-Medicaid yabahluphekileyo.
Eyona nto imangalisayo, nangona kunjalo, kukuba incinci kangakanani na kwicala le "pro" ye-pro-con balance sheet.
Ukwandiswa kweMedicaid, umzekelo, kuya kuba yilungiso lwexeshana, kwaye lungenakugcinwa kwixesha elide. Iindleko zokwandisa inkqubo ziya kuwela koorhulumente bamazwe, abajongene neengxaki ezinzima zohlahlo lwabiwo-mali, kwaye sele benciphisa izibonelelo kunye nokufaneleka.
Iinkampani ze-inshorensi ziyakuthintelwa ukuba zingabavumeli abantu abaneemeko ebezikho ngaphambili, kwaye baphinde bafumanise izizathu zokurhoxisa imigaqo-nkqubo emva kokuba umntu egula, okwaziwa njengokurhoxa. Kodwa zininzi izikhewu kwimigaqo emitsha yamagqwetha enkampani yeinshurensi ukuba azame ukuxhaphaza-kwaye ngenxa yokuba akukho lawulo kwiintlawulo zanyanga le, iinkampani zinokuphendula kuwo nawuphi na ummiselo osongela ukuchaphazela inzuzo yazo ngokubiza imali eninzi.
Isibonelelo esinye kwi-bill caps isixa-mali abanini-polisi kuya kufuneka bahlawule kwiindleko eziphuma epokothweni: i-$5,000 kumntu ngamnye kunye ne-10,000 yeedola kwiintsapho. Kodwa ngowuphi umntu osebenzayo okanye usapho olunamawaka eedola esandleni sokuhlawula iindleko zokhathalelo lwempilo oluphuma epokothweni? Ezi zixa-mali zingaphezu kokwaneleyo ukuqhuba abantu ebhankini.
Ngaphezulu koku, ubonisa uDkt Marcia Angell, umbhali we Inyaniso malunga neeNkampani zeDrug: Indlela abasikhohlisa ngayo kunye nento enokuyenza ngayo, kukho umbuzo wokuba nayiphi na imimiselo iya kunyanzeliswa. "[Q]uite ngaphandle komxholo wayo, umthetho oyilwayo untsokothile kwaye udidekile kangangokuba kuya kuthatha isixhobo esimangalisayo ukuwulawula kwaye uzame ukunyanzelisa imimiselo yawo," utshilo u-Angell.
"Ukhetho lukawonke-wonke" olunconyelwa kakhulu -omnye umboneleli oqhutywa ngurhulumente wokhuselo kubantu abangakhuselwanga-luye lwathotywa phantse yonke into. Xa kwakucetywa okokuqala, ukhetho lukawonke-wonke lwalunokubhaliswa kwabantu abazizigidi ezili-129. Ngoku, ngokoqikelelo, iya kugubungela phakathi kwezigidi ezi-6 kunye ne-11 yezigidi-malunga nesi-2 ekhulwini sabemi base-US ekupheleni okuphantsi-kwaye i-Ofisi yoHlahlo Lwabiwo-mali yeCongressional (CBO) iqikelela ukuba iipremiyamu kukhetho lukawonkewonke zinokubiza ngaphezulu kwezicwangciso zabucala.
Ukhetho lukawonke-wonke olu luncinci kwaye lubiza kakhulu aluyi kuba namandla okhuphiswano "ukugcina i-inshurensi yabucala inyanisekile" awathetha ngayo u-Obama. Ngokuchasene noko, iya kuba yindawo yokulahla elungele iinkampani ze-inshurensi-egubungela abona bantu bagulayo abo i-inshurensi yabucala bangathanda ukuba nabo njengabathengi.
Ngeli xesha, entliziyweni yomthetho oyilwayo wohlengahlengiso lwezempilo-njengaso sonke esinye isindululo esiqwalaselwayo ngexesha lengxoxo-mpikiswano yaseWashington-ngumlinganiselo abantu abaqhelekileyo abaya kuthi bawudelele ukuba ngaba umthetho ukhe wawiswa: Amagunya afuna abantu abangawuthobeliyo umthetho. ube ne-inshurensi ngomqeshi kwaye awufanelekeli inkqubo karhulumente efana ne-Medicare okanye i-Medicaid ukuthenga ipolisi ngokusebenzisa "ukutshintshiselana kwe-inshurensi."
Ukuba olu phawu lokhathalelo lwempilo olungaguquguqukiyo luxoxiwe ngokuphindaphindiweyo kumajelo eendaba aqhelekileyo, ngokuqinisekileyo kuya kubakho umsindo ongakumbi ngokuchasene nomthetho weCongress. Ngokusisiseko, urhulumente uceba ukunyanzela wonke umntu, ngaphandle kwezinto ezincinci, ukuba athenge imveliso enexabiso elingaphezulu, eneziphene, unyaka nonyaka, okanye ajongane nesohlwayo esiqatha semali.
Yingakho iinkampani ze-inshurensi-ngelixa zixhasa uqhanqalazo lweRiphabhlikhi ngokuchasene naluphi na uhlaziyo kuzo zonke-ziye zakuvuyela ukusebenzisana nolawulo luka-Obama ukubumba umthetho wokhathalelo lwempilo. KuMthetho oyilwayo weNdlu, iinkampani zifumene isohlwayo kuye nabani na ongathengi i-inshurensi ye-2.5 yepesenti yomvuzo wonyaka ohlengahlengisiweyo ngaphezu komda wokufayilisha okanye umyinge weprimiyamu yepolisi ekhoyo kutshintshiselwano lwe-inshurensi.
U-Karen Ignagni, umgcini we-inshurensi ophambili, wakhalaza malunga nezohlwayo ezithi zifakwe kancinci kancinci kwaye ukuxolelwa kokufikeleleka "kunesisa kakhulu." Kodwa oku kuncinci xa kuthelekiswa neenkampani zeinshorensi zengeniso eziya kuphuma emoyeni ngenxa yesigunyaziso.
Ummeli uDennis Kucinich–ovote ngokuchaseneyo nomthetho oyilwayo weNdlu-uqikelele ukuba ubuncinane abantu abazizigidi ezingama-21 kuya kufuneka bathenge i-inshurensi yabucala, okubangele "ubuncinci i-70 yeebhiliyoni zeedola kwingeniso entsha yonyaka [yeshishini], uninzi lwayo luvela kubahlawuli berhafu. . Oku kuya kukhokelela kwiindleko ezingakumbi, inkxaso-mali eyongezelelekileyo, kunye nenzuzo ephezulu yeenkampani ze-inshorensi-ibheyile phantsi komnqamlezo oluhlaza."
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AYO AYIKUPHELA kwento engalunganga ngomthetho oyilwayo weNdlu, nangayiphi na indlela.
Njengesiphakamiso esiqwalaselwayo kwi-Senate, i-House Democrats iceba ukuhlawula i-chunk enkulu yomthetho wabo kunye namakhulu eebhiliyoni zeedola "kwi-savings" kwinkqubo ye-Medicare yabantu abadala. Abaxhasi bomthetho oyilwayo bathetha ngokuphelisa ubuqhophololo kunye nokwenza inkqubo ibe yeyanamhlanje, kodwa "ukongiwa" kwe-Medicare kuthetha ukucuthwa kwenzuzo ye-Medicare-inyathelo elongezelelweyo lokukhutshelwa ngaphandle kwenkqubo edumileyo.
I-Big Pharma iya kufumana eyabo, nayo. Phantsi koMthetho oyilwayo weNdlu, abavelisi bamachiza ebhayoloji-lawo aveliswa ngebhayoloji, kuneenkqubo zekhemikhali-baza kufumana ixesha lokuhlala bebodwa le-12 leminyaka, kwaye linokuba lide kakhulu. Iziyobisi ze-Biologic zezinye zezona phuhliso zibalulekileyo zamva nje kwezonyango, ukubonelela ngonyango "olumangalisayo" olusindisa ubomi bomhlaza, isifo samathambo kunye nezinye iimeko. Zikwabiza kakhulu, zibiza amashumi amawaka eedola ngonyaka.
Kwaye baya kuhlala bebiza kakhulu, ukuba iiDemokhrasi eNdlu zifumene indlela yazo-umthetho wabo wokhathalelo lwempilo wandisa ixesha "lokukhetheka" xa iinguqulelo zamachiza ebhayoloji zithintelwe ukuya kwiminyaka eli-12. "Kwaye," wabhala uJane Hamsher, umseki weblogi ye-FireDogLake, "ngenxa yesolotya elithi 'evergreening' elinika iinkampani zamachiza ukuba ziqhubeke zilawula ukuba zenza utshintsho oluncinci kwichiza (njengokudala idosi yosuku-kanye apho imvelaphi Imveliso yayiphindwe kathathu ngemini), abasoze babe ngabenzi begeneric."
Kwelinye icala, isindululo sikaDennis Kucinich esasiza kukhusela ilungelo lamazwe ngamanye ukwenza inkqubo yokhathalelo lwempilo yombhatalwa omnye-into eyayiza kuba yinkxaso nje yophawu lwenkqubo eqhutywa ngurhulumente ebonelela ngokhuseleko. wonke umntu-wayekhutshiwe kumthetho oyilwayo ziinkokeli zeNdlu.
Nangona umthetho ugxile kwindlela abaya kukhuselwa ngayo abo bangakhuselekanga, umthetho oyilwayo weNdlu-kwaye nayiphi na inguqulelo yokugqibela evela emva kwengxoxo yeSenethi kunye nenkqubo yoxolelwaniso-iya kuba nefuthe elibanzi, kwaye hayi okuhle.
Okwangoku, iipesenti ezingama-60 zabasebenzi baseMelika bafumana i-inshurensi yabo yezempilo kwii-inshurensi zabucala, ikakhulu ngabaqeshi. Phantsi koMthetho oyilwayo weNdlu, abaqeshi baya kunikwa ithuba lokukhetha ukubonelela abasebenzi okanye ukuba negalelo kwingxowa-mali egameni labo. Ukuba abaqeshi babonelela nge-inshorensi, kufuneka bahlawule ubuncinane i-72.5 ekhulwini yentlawulo yabasebenzi, kunye nama-65 ekhulwini kwiintsapho.
Oko kunika iinkampani ezihlawula ipesenti ephezulu ngoku inkuthazo yokutshintsha iindleko kubasebenzi bade bafike kumda ogunyazisiweyo ngurhulumente. Kwaye ngenxa yokuba umthetho ungenzi nto ukuvala oko iinkampani ze-inshorensi zinokuzihlawulisa kwiipolisi, umkhwa uya kuba kukuba abaqeshi bayeke ukubonelela nge-inshorensi ngokupheleleyo, kwaye batyhalele abasebenzi babo kutshintshiselwano lwe-inshurensi.
Ngaphandle kwazo zonke iinkcukacha, kukho into ejijekileyo kunye ne-Orwellian engundoqo weNdlu "yomthetho obalulekileyo" wokunakekelwa kwezempilo. Amaqumrhu afanayo anoxanduva lwengxaki yokhathalelo lwempilo eshiye abantu abazizigidi ezingama-50 bengakhuselwanga kwaye ubuncinci abazizigidi ezingama-25 bengakhuselwanga, ngoyena nobangela wokubhanga, kwaye obulala abantu abangama-45,000 minyaka le bashiywe bephethe inkqubo. Iinkampani zeinshorensi zichazwa njengekuphela kwesisombululo kwingxaki eziye zayibangela.
Njengoko uKucinich etshilo kwisiteyitimenti malunga nesizathu sokuba avotele ngokuchasene nomthetho oyilwayo weNdlu:
Siye sakhokelwa ukuba sikholelwe ukuba kufuneka senze ukhetho lwethu lokhathalelo lwempilo kuphela ngaphakathi kolwakhiwo lwangoku lokuxhatshazwa, inkqubo ye-inshurensi yenzuzo eyenza imali ingaboneleli ngokhathalelo lwempilo. Asinakugxeka iinkampani zeinshorensi ngokuba yile nto ziyiyo. Kodwa sinokuwubeka ityala umthetho apho urhulumente ekhuthaza ukuqhubela phambili, ngokwenene ukomelezwa kweshishini le-inshorensi yezempilo yengeniso, eyona mthombo wengxaki.
Leyo yinyani yokhathalelo lwempilo olungaguqukiyo, olulethwe kuwe ngumongameli othembise ukuzisa utshintsho eWashington kunye neqela elilawula iCongress elibanga ukuba limele "abantu." Njengoko uGqr. Marcia Angell wagqiba:
Ingaba ityala leNdlu lingcono kunanto? Andicingi njalo. Iphosa nje imali eyongezelelekileyo kwinkqubo engasebenziyo nengazinzanga, enophuculo olumbalwa kuphela emaphethelweni, kwaye yongeza indima engundoqo yoshishino lwe-inshurensi yomtyali-mali.
Ingozi kukuba njengoko iindleko ziqhubeka zinyuka kwaye ukhuseleko luba luncinci, abantu baya kugqiba ukuba sizame ukulungiswa kwezempilo kwaye akuzange kusebenze. Kodwa eyona ngxaki iya kuba kukuba asizange siyizame ngokwenene. Ndingathanda ukusibona singenzi nto ngoku, kwaye sibe nethuba elingcono lokuzama kwakhona kamva kwaye siyenze kakuhle.
I-ZNetwork ixhaswa ngemali kuphela ngesisa sabafundi bayo.
Nikela