Malamulo a Zaumoyo wa Boma

Maboma ndiwo omanga makampani osamalira zaumoyo m’malire awo, akumagwira ntchito mogwirizana ndi malamulo a boma pamene akusungabe mwanzeru kwambiri pa kakonzedwe ka malamulo. Makonzedwe ameneŵa, oyambitsidwa ndi Demendment ya khumi, amapanga laboratori yachilengedwe kumene njira zosiyanasiyana zoperekera, kukongola, ndi kusamala ndalama zingayesedwe. Kumvetsa mmene maboma amayendetsera njira zawo zaumoyo n’kofunika kwa opanga malamulo, oyang’anira zaumoyo, ndi nzika zimene zimafuna kuona zimene zimagwira ntchito ndi zimene sizikuthandiza.

Nyumba ya malamulo ya boma, kazembe, ndi makampani a zaumoyo omwe amasonyeza kuchuluka kwa anthu a kumaloko, zinthu zofunika zandale, ndi zenizeni zachuma. Chotulukapo chake ndicho dongosolo lolinganizidwa bwino kwambiri limene limatulutsa zotulukapo zosiyanasiyana kwa nzika zikumadalira pa kumene zimakhala. Kuchokera ku zosankha zofutukuka [1] [[FLT: 1] ku zigamulo za anthu zamwadzidzidzi, zosankha zaumoyo, zaumoyo wa boma zimaumba kupezeka, kukhoza, ndi kusamala kwa mamiliyoni a Aamereka.

Ntchito ya Malamulo ndi ya Kukhazikitsa Malamulo

Maboma amatsata malamulo ena otsatizana kwambiri othandizira kusamala zaumoyo. Amalola madokotala, manesi, ndi akatswiri a zaumoyo ogwirizana, kukhazikitsa malamulo a makampani a inshuwalansi, ndi kuyang'anira mapangano ogulitsa m'misika yawo. Madipatimenti a inshuwalansi a boma openda ndalama amawonjezera, kusungitsa ogula, ndi kuyang'anira ntchito ya zachuma ya onyamula anthu. Panthaŵiyi, madipatimenti a zaumoyo amayang'anira matenda, zolembedwa zofunika, ndi malamulo a zaumoyo.

Maboma alinso ndi mphamvu yofotokozera mapindu ofunika a thanzi kupyola panthambi ya boma yokhazikitsidwa ndi Affordal Care Act. Mayiko ena amalamula kuti apereke chithandizo cha kubala, kusanthula khalidwe la autism, kapena mautumiki a zaumoyo owonjezereka. Malamulo ameneŵa angawonjezere kupezeka komanso kukwera mtengo kwa ndalama, kukakamiza opanga malamulo a boma kukhala malonda osalekeza pakati pa kuzungulira ndi kulemera.

Mose Wachidedi: Kufutukuka ndi Programu

Medicaid ndi gwero lalikulu la kufalitsa zaumoyo ku United States, akuyang'anira ana otsika oposa 80 miliyoni, achikulire, okalamba, ndi anthu opunduka. Maboma amatsogolera programu muugwirizano ndi boma, ndipo amasangalala ndi ufulu waukulu posankha mipata ya kulephera, kupindula mathirakiti, ndi malipiro a ndalama. Kusintha kumeneku kwapanga ntchito ya maprogramu osiyanasiyana kwambiri m’kuoloŵa manja ndi kufika.

Kukula kwa Madeti Opita Patsogolo Monga Mzera Wotsekereza

Chimodzi cha ziwonjezeko zamphamvu koposa za boma chinatsatira chigamulo cha Bwalo Lapamwamba cha 2012 chimene chinapangitsa Medicaid kuwonjezereka pansi pa lamulo la Affordal Care Act yodzisankhira ya maboma. Kuyambira kuma 2025, maboma 41, D.C., zakhala zikukula, pamene kuli kwakuti maboma 10 sanafutukule. Maboma aakulu amene apeza ndalama zofikira 138 peresenti ya umphaŵi wa boma, anaphimba mamiliyoni amene poyamba anagwera m'kamphindi. Mayiko osagwirizana ndi , opezeka ku South ndi mbali zina za Midwestwester, asiya achikulire ambiri osayembekezeredwa popanda zopereka zothekera.

Zotsatirapo zake zalembedwa bwino. kufufuza kofalitsidwa mu Health Affairs [FLT :1] kwasonyeza mobwerezabwereza kuti kufutukuka kwa maboma kumakhala ndi mitengo ya kuulutsa, kutsika kwa mtengo wa chisamaliro ku zipatala, ndi kuwongolera njira zotetezera. Maboma osafuna kukwera kwa ngongole za mankhwala ndi kusungidwa kwa anthu opeza ndalama zochepa. Chigamulo cha kusafutukuka chimasonkhezeredwa ndi boma chifukwa cha kusoŵa kwa ndalama zofanana, kutsutsa maprogramu anthano za makompyuta, kapena kukondera njira zina monga ntchito ndi chithandizo.

Kusinthasintha kwa Mapindu ndi Uyang’aniro

Pambuyo pa chigamulo chofutukuka, pali kusiyana kwakukulu m'njira imene amapangira maprogramu awo a Medicaid. Mayiko ena, monga California ndi New York, akupereka mapindu aakulu monga mano, maso, kumva, ndi thanzi la maganizo ndi mankhwala osokoneza bongo. Ena, kuphatikizapo Alabama ndi Mississippi, amapereka mapindu ocheperapo amene amafikiridwa ndi boma koma amaletsa mautumiki onga ngati kusamalira athano a munthu wamkulu kapena kuchiritsa thupi.

Kuloŵa kwa makampani osamalira odwala kumasiyananso. Maboma ambiri amapangana ndi mabungwe oyang'anira okha kuti apereke mautumiki a Medicaid, kulipira chiŵerengero cha anthu pa munthu mmodzi amene walembetsedwa. Ena amagwira ntchito ya malipiro a madongosolo a kulera a anthu otsalira, kapena kugwiritsira ntchito mafaelo opangidwa ndi ma projekiti. Njira iliyonse imakhala ndi malonda ochotsa: chisamaliro chokhoza kuwongolera dongosolo la chisamaliro ndi kukwera mtengo koma ingachepetsere kulinganiza ndi kupanga katundu wa oyendetsa ntchito za boma kaamba ka oloŵa mmalo a boma amene amawalola kuyesa njira zatsopano zofikira monga nyumba zaumoyo, mabungwe oŵerengera, kapena chithandizo chandalama kaamba ka kuyang'anira ntchito.

Atsogoleri a Zaumoyo a Anthu Onse ndi Zotsatira Zamwadzidzidzi

Maboma ali ndi udindo waukulu woteteza anthu awo mwa kuteteza matenda, kupititsa patsogolo thanzi lawo, ndi kukonzekera zamwadzidzidzi. Mliri wa CoVID-19 unasonyeza zotsatira za kuchenjera kwa boma, kuvumbula kusiyana kwakukulu kwa mphamvu ya kuyesa, makampani a katemera, ndi njira zopimira.

Kusokonezeka kwa Thanzi

Maboma akugwira ntchito maprogramu otetezera matenda osatha omwe amalimbana ndi zochititsa zazikulu za imfa ndi kupunduka: nthenda ya mtima, kansa, matenda a shuga, ndi kupuma. Zoyesayesa zimenezi kaŵirikaŵiri zimaphatikizapo mautumiki a fodya, makampani oletsa kunenepa, kupima kutuluka kwa kansa, ndi maprogramu a zaumoyo a anthu. Ndalama zimachokera ku msanganizo wa ndalama za boma, kusokonezeka kwa boma, ndi chithandizo cha anthu chapatokha. Maboma okhala ndi zipatala zaumoyo za anthu zokhoza kupambana m'chipatala ndi imfa zapasachedwa.

Maprogramu a boma lachilendo amaphatikizapo Massachusetts ’ zoyesayesa zolamulira fodya mokulira, zimene zimaphatikiza misonkho yokwera, malamulo autsi, ndi ntchito zoyendetsera kutulutsa makampani amphamvu kuti apeze kutsika kwa kusuta m'dziko. Colorado ̱ zosumika pa kutetezera kunenepa mwa kusintha kwa zinthu, monga ngati ndalama zoyendetsera njinga ndi alimi ̱ misika, yasonyeza kuti kuwonongeka kwa ntchito ndi chakudya chopatsa thanzi. Zitsanzo zimenezi zikusonyeza mmene kuyendetsa ndalama za boma zapamwamba poteteza kukhoza kubwezera thanzi la anthu.

Kusamalira Matenda a Anthu Onse

Boma likachitapo kanthu pa ngozi zaumoyo likusiyana mogwirizana ndi ulamuliro wa boma, atsogoleri andale, ndi mphamvu ya zaumoyo wa anthu. Mliri wa Covid-19, monga Vermont ndi Hawaii adapanga maprogramu ankhanza ndi kuyang'ana ndi kusungitsa mlingo wina wa matenda otsika kwambiri ndi imfa m'dzikolo. Mayiko ena, kuphatikizapo Florida ndi South Dakota, anatengera njira zololera njira zowonjezereka zimene zinapangitsa kupitirizabe kwa chuma ndi ufulu wa munthu aliyense payekha, zomwe zinapangitsa kuyambukiridwa kwa matenda aakulu komanso zinapanganso mapendedwe osiyanasiyana a malonda pakati pa thanzi ndi zotsatira zachuma.

Mliri wa opioid umapereka njira ina yothandizira boma. Mayiko onga Ohio ndi West Virginia, amene anayang'anizana ndi ziŵerengero zapamwamba kwambiri za imfa zowawa, awonjezera kuchuluka kwa ntchito ya naloxone, maprogramu a jekeseni, ndi kuwonjezereka kwa ndalama zothandizira kuchiritsa ndi mankhwala. Njira zimenezi zathandizira kuchepa kwaposachedwapa kwa imfa za anthu omwa mopambanitsa, kusonyeza kuti kachitidwe ka boma kochitidwa kangawongoletse mavuto aumoyo ovuta kwambiri.

Kusamalira Ntchito ya Madokotala

Antchito oyenera ndi oyendetsedwa bwino a zaumoyo ali ofunika kwambiri kuti dongosolo la zaumoyo lililonse lizigwira ntchito. Mayiko amagwiritsa ntchito ulamuliro wosiyanasiyana, kukonza maphunziro, ndi kulimbikitsa ndalama kuti athetse kusoŵa kwa nthaŵi yaitali, makamaka m’madera akumidzi ndi m’matauni omwe sagwiritsidwa ntchito bwino.

Licensure, Mbali Yake ya Chizoloŵezi, ndi Mabungwe a Interstate

Ziyeneretso za boma za inlamiswe zimakhudza mwachindunji kuperekedwa ndi kugaŵiridwa kwa akatswiri a zachipatala. Malamulo a ntchito zachipatala amagamula zimene madokotala, achipatala, ndi ogulitsa mankhwala angachite. Maboma okhala ndi ulamuliro wokwanira kwa anamwino, kuphatikizapo maboma 26 monga 2024, akuona kukula kwa mwamsanga m'maluso a chisamaliro chachikulu ndi kupezeka bwino m'madera akumidzi. Maboma okhazikitsa malamulo amafuna kuti madokotala aziyang'anira odziŵa ntchito zapamwamba ayang'anira ntchito zawo ayang'anizana ndi mavuto aakulu.

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Programu za Ndalama ndi Zopanga

Mayiko amapanga maprogramu a kulipira ngongole, maphunziro, ndi malo ophunzitsira anthu kuti akope anthu achipatala kumadera osoŵa kwambiri. National Health Service Corps, yowonjezera ndi maprogramu apamwamba a boma, amaika madokotala, mano, ndi othandizira zamaganizo m'malo odziŵika ndi boma a Health Professional Shortge Area. Mayiko onga Texas ndi California awononga ndalama zambiri powonjezera maprogramu a zamankhwala mwa kuphunzitsa malo a zaumoyo ndi akatswiri ophunzitsa anthu, kuwonjezera mwachindunji kachipangizo kachipangizo kabwino ka madokotala aakulu.

Madipatimenti a zaumoyo amafalitsa malipoti a ndalama zogulitsira katundu, malo, ndiponso kuchuluka kwa anthu, kudziŵitsa anthu kuti alembetse ntchito ndi kukonzanso njira zina. Mayiko ena akhazikitsa mabungwe a zaumoyo amene amagwirizanitsa aphunzitsi, olemba ntchito, ndi okonza malamulo kuti adziŵitse ntchito yophunzitsa anthu.

Zopereka Zosinthasintha ndi Kupereka Mawonekedwe

Maboma akupitirizabe kuchita monga malaboletale othandizira kukonza zinthu zatsopano ndi kukonzanso njira zoperekera chithandizo.

Mabungwe Osamalira Oŵerengeredwa ndi Chisamaliro Chosafunika

Maboma angapo akhazikitsa maprogramu a bungwe la ku Medicaid oŵerengera, amene amasunga mabungwe osamalira oyenera kulipira ndalama zonse ndi kusamala anthu oikidwa. Oregoṉ Mabungwe Olinganiza Ogwirizanitsa ndi Care Organization , adakhazikitsa mu 2012, pamodzi thanzi la thupi, ndi mautumiki a mano a bungwe limodzi, kuchepetsa ntchito za dipatimenti ya zamwadzidzidzi ndi kutumiza anthu kuchipatala pamene akuyendetsa kukwera kwa mtengo. Orice Carence Coltivanity akuthandizanso ogwirizanitsa ntchito za chithandizo cha m'deralo kuti akonzeretu mavuto, ofunikira thandizo lapamwamba, othandizira.

Maboma alinso ndi ntchito yopanga zitsanzo za chisamaliro zogwirizana za anthu aŵiri okhoza kupezeka pa ̵ anthu amene amayenerera zonse ziŵiri Medicare ndi Medicaid . Programu za chionetsero ku California, Massachusetts, ndi Minnesota zimayendera pamodzi pa maprogramu onse aŵiri kuti zipereke chithandizo kwa okalamba otsika ndi anthu opunduka. Mapimelo ameneŵa amachepetsa ndi kuwongolera mtundu wa moyo wa anthu amene amagwiritsira ntchito ndalama zambiri zaumoyo.

Kugula ndi Kupereka Masinthidwe Ozikidwa pa Phindu

Mabungwe a Medicaid m'maboma kuphatikizapo Arkansas, Tennessee, ndi Vermont atengera njira zogulira zofunika zimene zimathandizira kuti agwire bwino ntchito pa makilogalamu, zokumana nazo zodwala, ndi kuyendetsa bwino zinthu. Mwachitsanzo, makampani ambiri a Health Prepedical Reformation Program adasintha ndalama za Medicaid kutengera ku mawotchi otengera ndalama zimene apeza pa zochitika za kusamala kwa anthu ambiri monga kubwezeretsa ndi kusamalira kwa mayina.

Makonzedwe a zaumoyo a boma amatumikiranso monga malo oyeserako kulipira ndalama zosinthidwira. Maboma a California Public Grouceecees ’ System yopuma pantchito ndi Massachusetts & 8817; Group Inishuwarensis Komishoni yapanga zilozero, milongo ya milongo, ndi ndalama zoikika, kusonkhezera machitidwe a malonda ndi kupereka chidziŵitso chimene maboma ena angalandire. Kuyesayesa kumeneku kumasonyeza kuti maboma a boma angagwiritsire ntchito mphamvu yawo yogula zinthu kuyendetsa kusintha dongosolo ladziko lonse popanda kufuna lamulo latsopano la boma.

Mavuto Amene Amakhalapo Nthawi Zonse Ndiponso Kuyamba Kuona Zinthu Zofunika Kwambiri

Ngakhale kuti mayiko achita zinthu zambiri, maboma amakumana ndi mavuto aakulu posamalira anthu awo.

Kusiyana kwa Malo a Dziko ndi Kusiyana kwa Malo

Midzi ya m'midzi m'dziko lonselo imavutika ndi kutsekedwa kwa zipatala, kusoŵa kwa chakudya, ndi kuchepa kwa kupatsidwa chisamaliro chapadera. Zipatala za kumidzi makumi anayi ndi zisanu ndi ziŵiri zatseka pakati pa 2020 ndi 2024, kuyambukiridwa kwakukulu kumene sikunafutukule Medicaid. Telehealth persed pa mliring transparders perses , koma kupezeka kwa anthu ambiri sikunakhaleko. Malo ku Mountain West ndi ku South akuyang'anizana ndi mavuto aakulu pakati pa matauni ndi miliri ya kumidzi.

Mayiko a mitundu yosiyanasiyana ndiponso a mafuko osiyanasiyana amasiyana kwambiri ndi boma. Mayiko amene amafa ndi amayi oyembekezera ali ndi chiŵerengero chachikulu kuwirikiza katatu mpaka kanayi kuposa cha amayi achizungu amene amafa m’dzikolo, koma kusiyana kwake n’kochuluka m’mayiko okhala ndi malamulo oletsa kwambiri a Medicaid ndi mautumiki othandizira ana obadwa nawo. Mayiko amene apanga mapulogalamu a doula, maphunziro okondera ophunzitsa anthu opereka chithandizo, ndiponso kusonkhanitsa chidziŵitso cha mafuko akuwonjezeka m’kuchepetsa mipata imeneyi.

Mavuto a Mabanki ndi Kuchirikiza

Mdicaid ndi chinthu chimodzi chachikulu koposa m'ma bajeti a boma ambiri, kuwonongetsa pafupifupi 20 peresenti ya chiwonkhetso chonse cha ndalama zowonongedwa pa avareji. M’nyengo ya kutsika kwa chuma, kulembetsa kumawonjezereka modzifunira pamene ndalama za boma zikutsika, kuika chitsenderezo chowonjezereka pa ndalama za boma. Maboma ayenera kukweza misonkho, kuchepetsa ndalama zolipirira, kuchepetsa mapindu, kapena kutsalira zosungira za m'makampani kuti asungitse maprogramu awo. Mapeto a bungwe la zaumoyo wa anthu onse mu 2023 adachititsa kulephera kwakukulu kwa zofunika zokwaniritsa zofunikira zopimira mobwerezabwereza, kutsogolera mamiliyoni ambiri a ku kulephera kwa kulembetsa komiti za boma.

Malamulo atsopano othandizira kupezera ndalama, monga ngati misonkho yosamalira ndalama, kuyang'anira misonkho yosamalira, ndi kusamutsidwa kwa boma, amalola maboma kuwonjezera ndalama za boma zoyenderana. Komabe, njira zimenezi kaŵirikaŵiri zimatsutsana ndi kuyang'anira boma. Kukhazikika kwanthaŵi yaitali kudzafuna maboma kukhalabe olangidwa posamalira ndalama zimene zikutsatira kusintha kwa dongosolo la kutumiza zinthu kumene kumawongolera chipambano.

Kuyang’ana Mtsogolo: Mtsogolo mwa Kuyang’anira Zaumoyo kwa Boma

Maboma adzapitirizabe kukonza njira yoperekera mankhwala ochiritsira a ku America zaka zikubwerazi. Kusintha kwa mgwirizano wa boma kumathandiza kufufuza zinthu zimene zikugwira ntchito. Kudutsa kwa Inflatiation Reduction Act, komwe kumaphatikizapo makonzedwe a mtengo wa mankhwala ovomerezeka ndi kuwonjezera mtengo wa mankhwala operekedwa kwa Medicare Subve Confinity, kukupanga mphamvu zatsopano zimene maboma adzafunikira kuyendera. Panthaŵiyi, kuyambitsa luso la zopanga zokhala ndi luntha pofufuza ndi poyendetsa zinthu, kukula kwa mankhwala oyendera foni ndi kuwonjezera mtengo wa zopereka ndalama zamtengo wa ndalama zimene zilipo zonse ndi kuopsa kwa onse aŵiriwo ndi ogula ndi ogula zinthu a boma omwe akufunika kuyendetsa.

Opanga malamulo a boma angaphunzire kwa wina ndi mnzake kupyolera mwa mabungwe onga ngati National Bridges Association ndi National Academy for State Health Policy, zimene zimatheketsa chidziŵitso kugawana pa machitachita abwino koposa. Bipartisan pochitapo kanthu pa kuyenera kwa maganizo, kupenda imfa za amayi, ndi katemera wa ana amasonyeza kuti malamulo a boma angalekane. Pamene dziko likulimbana ndi chiŵerengero cha anthu okalamba, kuchuluka kwa matenda aakulu, ndi kuchuluka kwa thanzi, ma democracy pamlingo wa boma, malaboratoriation a democracy a kachitidwe kofunikira kaamba ka kupita patsogolo.