Oorhulumente bezonyango baseUnited States basisiseko senkqubo yoluntu yoluntu lwaseUnited States, besebenzisa igunya elingokomGaqo-siseko ukukhusela nokukhuthaza intlalo-ntle yabemi babo. Ngoxa urhulumente wesizwe emisela imigangatho yesizwe kwaye enika inkxaso-mali, amaphondo ajongene nokuphunyezwa kwemisebenzi yemini yonke, ukunyanzeliswa, kunye nokuhlaziywa kwemigaqo-nkqubo yempilo kawonke-wonke. Ukusuka ekulawuleni amaziko empilo ukulawula ukuqhambuka kwezifo nokulungisa imfundo yezempilo, oorhulumente basebenza kwimiqathango yabemi. Eli nqaku landisiweyo lihlolisisa imvelaphi yesiseko yamandla karhulumente oluntu, ukuchaza iimbopheleleko ezingundoqo, uphandolo oluqhubekayo, kwaye libalase indima eqhubekayo yokhuseleko lwempilo yabantu.

Isiseko somGaqo-siseko sesiGunya lezeMpilo kaRhulumente

Ukuqonda isizathu sokuba oorhulumente bephethe amandla abanzi empilo kawonke-wonke kufuneka ujongo kumGaqo-siseko wase-U. Ugcino lweSihlalo seshumi kumagunya anganikwanga ngokukhethekileyo kurhulumente wezwe. Phakathi kwala magunya agciniweyo kukho amandla e-apolitiki[[FLT:]] .(] igunya lokumisela imithetho nemiyalelo efunekayo ukukhusela impilo, ukhuseleko, kunye nentlalo-ntle kawonke-wonke. Esi siseko somthetho sibangela ukuba kusebenze ngokungqongqo kwimicimbi yempilo ngaphandle kokulindela ulawulo lwesizwe.

Ekuhambeni kwexesha, iNkundla ePhakamileyo iye yawaxhasa ngokuqhubekayo amapolisa karhulumente kwimpilo kawonke-wonke. Amatyala e-Londerpolate anjenge- Jaconson v. Massachusetts[[FLT: 1] [05] (05] yaqinisekisa ukuba amaziko anokugunyazisa ukugonywa komqhaqho-goqo, amisela umzekelo oqhubeka uphembelela umthetho wempilo kawonke-wonke namhlanje. Ngenxa yoko, oorhulumente bamazwe banakho:

  • License kwaye lilawule abanikezeli bezempilo (iingcali zezifo, abongikazi, izibhedlele, ikliniki)
  • [[UMTL:0] Beka imilinganiselo yempilo nokhuseleko ukwenzela ukutya, amanzi, kunye neendawo zomsebenzi
  • Amanyathelo okugoma ekufikeni esikolweni
  • Abantu bobuQuarantine ukuthintela ukusasazeka kwezifo
  • ICeboslect nokuhlalutya amanani abalulekileyo (ukuzalwa, ukufa, iingxelo zezifo)

Oku kuphakama komgaqo - siseko kuthetha ukuba iindlela zonyango lukawonke - wonke zinokuhluka ngokuphawulekayo kumazwe ngamazwe, zibonakalisa imilinganiselo yasekuhlaleni, iimeko zezobupolitika neemfuno zabemi.

Iimbopheleleko zoorhulumente bakarhulumente kwimpilo kawonke-wonke

Amasebe ezempilo kunye namasebe esizwe athwala izibuko elibanzi loxanduva oluchaphazela phantse zonke iinkalo zoluntu olunentlalo entle. Le misebenzi idla ngokudityaniswa kwimimiselo yorhulumente nemithetho yolawulo. Ngasezantsi kujongwa ngokunzulu kwimimandla yokuqala yoxanduva lwempilo karhulumente.

Imfundo yempilo nokukhuthazwa

Amazwe akhokelela kwimigudu yokwazisa abahlali ngeengozi zempilo nesimilo esisempilweni. Ikampeni zokutshaya i-cantes, ukuvivinya umzimba, ukuzondla, nokukhusela iintlobano zesini. Umzekelo, amaphondo amaninzi asebenzisa amaphulo alwa ne-tobacco eendaba axhaswa ngemali yokuhlawula okanye inkxaso evela kwiZiko loLawulo lwezifo kunye neSithintelo sezempilo. Imfundo yempilo esebenzayo inciphisa umthwalo wezifo ezinganyangekiyo kwaye inika abantu amandla okwenza ukhetho olunolwazi.

Ukuthintelwa Nezifo

Oorhulumente basebenzisa iinkqubo zokuhlola izifo ezibanzi ukufumanisa ukuqhambuka kwezifo ezasulelayo ezifana nomkhuhlane, imasisi, isifo sofuba, kunye ne-COVID-19. Balungelelanisa uvavanyo lwelaboratori, ukuvavanya, ukunxibelelana, kunye nokuthumela imiyalezo kawonke-wonke. Iinkqubo zokwenza uhlolo zilelo-mbombo: zimisela iimfuno ze-antimun-yo yokungena esikolweni, zigcina ii-registrationries, kwaye ziqhuba amakliniki-yomgamfa. Ngokutsho kwe-CDC[FLT], ukushukuma kwemiqathango yemiqathango karhulumente kuyahluka, kuqwalase iziphumo zemigaqo-nkqubo yokwayasekhaya kunye nokuphuma.

Ukufumaneka konyango nomgangatho

Ngeli xesha urhulumente wengingqi elawula iMedicare kwaye evelela iintengiso zeAffordble Care Acts, amazwana alawula ngokuphawulekayo ukufikelela kwezempilo. Agunyazisa izibhedlele, amakhaya asebezeli, kunye namaziko otyando oluhlalisa abantu, ukuqinisekisa ukuhambelana nemigangatho yokhuseleko nomgangatho ophezulu. Amazwe akwasebenzisa iMedicaid, inkqubo edityaniswe ngurhulumente enika inkcaso kubantu ngabanye abafumana imali ephantsi kunye neentsapho. Imigaqo engqinelayo, iinzuzo ezigutyungelweyo, kunye nentengo yemali yokuhlawulela ixhomekeke kwimiqathango yorhulumente. Ngaphezu koko, umisela izicwangciso ze-inshorensi, kuquka intengo zemali kunye nobuchule bonxibelelwano.

Ukulungiselelwa Kwamaxa athile Nokusabela

Oorhulumente bangamaqumrhu akhokelayo ongxamiseko lwezempilo kawonke-wonke kwimida yabo. Baphuhlisa baze bagcine amalungiselelo ongxamiseko, bagcine izinto zonyango (njengemichiza kunye neziyobisi ezilwayo), badibanise namasebe empilo asekuhlaleni, izibhedlele, kunye nabokuqala abaphendulayo. Ngexesha leentlekele zendalo (amaqunube, imililo yengozi, iimpuphuma) okanye iindyikitya, bamisela amasebe ongxamiseko, izibhedlele, kunye nemiyalelo yokukhupha isikhuseli esikhuselekileyo. Ucwangciso lwempilo lwezemvelo (PHLT) lwenkqubo ye-CD:1], oluxhaswe yi-CD, ixhasa ezi misebenzi yombuso.

Ukubuyiselwa kwempilo ekwimekobume

Irejista ingumthetho onyanzelisa ukuba uluntu lukhuseleke kwiingozi zemekobume. Oku kuquka ukugada umgangatho womoya namanzi, ukongamela ukulahlwa kwenkunkuma, ukuhlola iivenkile zokutyela namadama okuqubha kawonke-wonke, kunye nokulawula izibulala-zinambuzane nemichiza yemizi - mveliso. Amaphondo amaninzi anemibutho yokhuseleko lwemeko-bume emisela imilinganiselo engqongqo kunemiqathango karhulumente. Ngokomzekelo, ukubekwa kweKhalifoniya 65 kufuna izilumkiso kwimveliso ezinamachiza aziwayo ukubangela umhlaza okanye umonakalo wokuzala. Ezi zinto zisemgangathweni zinciphisa ngokungqalileyo iingozi zemeko-ogxampyuthe kunye nemichiza.

Ukuthintelwa Nezifo Ezingamahlalakhona

Ngaphandle kwezifo ezasulelayo, amajelo athetha ngeemeko ezinganyangekiyo ezinjengesifo sentliziyo, isifo seswekile nomhlaza. Baxhasa iinkqubo zokuhlola (umz., ukuxilongwa komhlaza webele nowesibeleko), ukukhuthaza ukutya okusempilweni nomzimba ngokutshintsha kwemigaqo, nokuxhasa iinkqubo zokuthintela isifo seswekile. Iisebe lezempilo laseburhulumenteni zidla ngokusebenzisana nemibutho yoluntu ukunciphisa ukwahlukana kwempilo kubemi abagciniweyo.

Iinkqubo zempilo karhulumente ezingundoqo ezilawulwa nguorhulumente

Oorhulumente basebenzisa iinkqubo ezininzi ezihlasela abantu abathile neengxaki zempilo.

Iinkqubo Zokonyuswa

Amasebe ezempilo karhulumente alawula iinkqubo zogonyo lobuntwana kunye nezikolo ezikhulileyo. Athenga amachiza angenwa ngamaxabiso aphantsi kwinkqubo ye-Vaccines for Children (VFC), awasasaze kwiikliniki zokugoma, kunye nenkcaso yokugoma. Amaphondo amaninzi asebenzisa izibheno zokugoma ngekhompyutha ezivumela abanikezeli kunye nezikolo ukuqinisekisa imbali yentlalo-mlingo yomntwana. Ngexesha lokuqinisekisa iziphumo ze-COVOVID, iindawo zokugoma ezisetyenziswa ngurhulumente zaba yinxalenye ephambili yokuphendula kwesizwe.

ISebe leMicimbi yeNkcubeko neMidlalo

Isihloko V soMthetho weNtlalo-ntle sinika inkxaso-mali kumaphondo esizwe enkqubo yezempilo yoomama neyomntwana. Ama-United States asebenzisa le mali ukuxhasa inkqubo yonyango lokunyamekela abantwana ngaphambi kokubeleka, ukutyelela abahlaziyi, ukuxilonga abantwana abasandul' ukuzalwa ngeengxaki zemfuza, kunye neenkonzo zokubonelela kwangethuba lokukhula. Ezi nkqubo zijolise ekunciphiseni ukufa kwabantwana, kuphucule iziphumo zokuzala, kwaye kuqinisekise ukukhula komntwana osempilweni.

Ukulawula Icuba Nokulikhusela

Iinkqubo zokulawula icuba lemeko zidibanisa imfundo, iinkonzo zowiso-mthetho, kunye nokunyanzeliswa kwemigaqo-nkqubo. Amazwana amaninzi aye anyusa ubudala obuncinci bokuthenga icuba abe ngama-21, asebenzisa imithetho yomoya okhululekileyo ngaphakathi, kunye nemidiza erhafu kakhulu. Iirhafu zecuba kunye neendawo zokulwa ityala zidla ngokuxhasa amaphulo okuthintela ukutshaya. Ngokutsho kwe-CDC i-Ofit malunga nokutshaya nempilo [, iziphumo ezinenkqubo zokulawula icuba elivuthayo zibona ukuncipha okukhulu kumgangatho wokutshaya.

Uncedo Lokondleka Nokukhusela Ukutyeba Ngokugqithiseleyo

Amazwe asebenzisa iNkqubo eSitheleyo yeSomali yeNtlalo-ntle yaBafazi, yeNcasa, neyabantwana (iWic), ukulungiselela ukutya okunesondlo, ukuncancisa ibele, kunye nezonyango. Kwakhona alawula iNkqubo ye-Someral Nutrition Application Program (SNAP) enxulumene ne-USDA. Amanyathelo okuthintela ukutyeba okutyeba aquka ukukhuthaza ii-saladi ezikolweni, ukuxhasa iimarike zabalimi ezamkela i-SNAP, kunye nokwakha iinkqubo zokusingqongileyo ezikhuthaza ukuhamba nokuhamba nokutyhala.

Impilo yengqondo kunye nokusetyenziswa

Amagosa ezempilo yengqondo karhulumente ajonge iinkqubo zoluntu zempilo yengqondo, kuquka izibhedlele zesizwe, izibhedlele zengqondo zoluntu, kunye neenkqubo zongenelelo lwengqondo zoncedo-mpilo. Kwiminyaka yakutshanje, amatyala aye andisa amathuba okufumana unyango oluxhaswe ngamayeza okusebenzisa i-opioid kunye noncedo olufakwe ekunciphiseni iinkonzo eziyingozi ezifana nokusasazwa kwe-naloxone. Onke amaphondo ayakwazi ukuthintela ukusetyenziswa kakubi kweziyobisi kunye nesithintelo sonyango esinikwa iSubstance Abuse-Abuse and Mental Health Administration (SA).

Ulawulo Lwezifo Ezasulelayo Nemichiza Ebangelwa Zizifo

Uvavanyo lwezakhono zonyango lwezigulana zelizwe loluntu olubanzi, ukusuka kwimichiza engaqhelekanga ukuya kwintsholongwane yaseZika. Baye banoxanduva lokuxela izifo ezinokuboniswa kwiCDC kunye nokuqhuba uphando lwezifundo ze-epidemiology. Isixokelelwano sophando lwe-Syndromic siqwalasela utyelelo lwesebe longxamiseko kunye nolunye ulwazi lwexesha lokwenene lokufumana iipatroge ezingaqhelekanga ezinokuphawula ukuqhama. Oku kwangqinelana oku kubalulekile ngexesha le-H1N111 kunye nengxaki ye-COVOVID.

Iingxaki Ezijamelene Nenkqubo Yezempilo Yorhulumente

Phezu kwayo nje indima yabo ephambili, oorhulumente bazama ukumelana nemiqobo ephawulekayo esongela amandla abo okukhusela impilo kawonke wonke ngokunempumelelo.

Isiko Lokungacolisi

Amaziko karhulumente onyango lwempilo kawonke-wonke aye ajongana noqingqo-mali kangangamashumi eminyaka. Ngokwezingxinaniso ze- I-American Public Health Association, ukuchithwa kwempilo kawonke-wonke kuphelile kumazwe amaninzi ukususela kwi-Great Recession. Ngexesha elingengawo amaxesha, impilo kawonke-wonke idla ngokuba ngummandla wokuqala oqingqiweyo oqinileyo. Oku kuthintela ukudodobala kwemisebenzi, iziqobo, kunye neenkqubo zokuthintela. I-COVID i-19 yesifo yawuguqula okwexeshana lo mgaqo-manyeneyo, kodwa amazwe amaninzi aye azama ukuxhasa uhlahlomelo lwemeko-mali.

Ukuphelelwa ngumsebenzi nokutshiswa

Ukunqongophala okukhulayo kweengcali zezempilo zoluntu eziqeqeshiweyo , iingcali zebhayoloji, abafundisi-mpilo, iingcali zemekobume ./ii-applications ingcali zezonyango. Imibutho yezonyango enxulumene necandelo loluntu. Imivuzo ephantsi kwemivuzo enxulumene necandelo lomntu elizimeleyo, ifuna ukuthwaliswa kwemisebenzi, kunye noxinzelelo lweemvakalelo lwempendulo yongxamiseko lunegalelo elikhulu. I-de Beaumont Foundation’s Public Health Working Infectives and Neearsive Survey Survey (PHWINS) ifumanisa ukuba abaqeshishi besebe besebe bezonyango belonkeneempume belo ukuba bagqibela iziphumo zemisebenzi yabo kwiminyaka emihlanu emihlanu emihlanu.

Ukwenziwa Kwengcamango Yezobupolitika Neyeengcamango

Izigqibo zempilo kawonke-wonke ziya zitshintsha. Izigunyaziso zesigqubuthelo, iimfuno zonyango, kunye nokuvalwa kwesikolo ebudeni bobhubhani zaba ziindawo ezingqukuva kwingxoxo yendlu karhulumente kunye nokumangalelwa. Amanye amazwe aye amisela imithetho ethintela igunya lamagosa empilo ukuba alawule ukwahlukana okanye afune ukugonya. Ukungalingani komhlaba kungakhokelela ekugqwetheni imigaqo egqwethekileyo ekwimida yesizwe kwaye kuphelise ukuthembana koluntu kukhokelo lwempilo. Amagosa ezonyango asekuhlaleni kufuneka ahambele kwindawo eneengxubevange apho imigaqo esekelwe kwimicimbi yezopolitiki isenokungqubana neengcinezelo zezobupolitika.

Ukwahlulwa kogcino-lwazi kunye neemPayipi zobugcisa

Amasebe ezempilo karhulumente asoloko exhomekeke kwiinkqubo zogcino-lwazi eziphelelwe lixesha ezidityaniswe kakubi nogcino-lwazi lwasekuhlaleni, lwasekuhlaleni, kunye nezibhedlele. Iinkcazelo ezitshintsha-tshintshayo, ukulibaziseka kokunika ingxelo, nokungabikho kwentsebenziswano kuthintela ukusabela okukhawulezileyo kwizisongelo ezivelayo. Ngexesha le-COVID-19, amazwe amaninzi azama ngamandla ukwakha iibhodi zokujonga iingqikelelo kunye nenkqubo zokumisa ukunqanda ukukrala. Ukuveliswa kwesiseko sogcino-lwazi lwempilo lwamachiza lanamhlanje kusesona siphambili kwikamva.

Ukungawazi Uwonke - wonke Nokufunda Ngempilo

Amanyathelo aphosakeleyo ngemichiza yokugonya, unyango, kunye nezempilo kawonke-wonke aye anda kakhulu kwixesha lamanani. Amasebe ezonyango aseburhulumenteni achitha umgudu omkhulu wokulwa noluvo lobuxoki, kodwa umlinganiselo we-intanethi owenziweyo udla ngokuwaphazamisa amajelo onxibelelwano asemthethweni. Ukungafundi kwempilo aphantsi kwezinye iindawo kwenza kube nzima ngakumbi ukukhuthaza imigaqo yokukhusela isimilo nokuthobela imiyalelo yempilo kawonke-wonke. Amazwe kufuneka asebenzise iindlela zonxibelelwano ezifanelekileyo kunye neqabane elithembekileyo labathunywa boluntu ukuvala ezi zibhulo.

Ukwahluka Kwempilo Nokulingana

Umahluko obalulekileyo kwiziphumo zempilo uyaqhubeka kwiimeko zobuhlanga, zentlalo, kunye nezentlalo-ntle. Oorhulumente baseburhulumenteni banamandla okuhlasela ubuncwane bokukhusela abantu abaphantsi kwengingqi, kodwa ngokufuthi iinkqubo zempilo ziye zaphunyezwa ngaphandle kwe-lens elinganayo. Umzekelo, iindawo zasemaphandle zisenokungafumani nkathalo ekhethekileyo, kwaye abamelwane abambalwa basenokujamelana nemithwalo ephezulu yongcoliso. Amazwe afumana impilo kuzo zonke iinkqubo zokuthetha ngokucwangcisiweyo ngemiqobo yempilo elungelelanisiweyo, kodwa inkqubela-phambili isenokuhlala ingalingani.

Indima yempilo yoluntu neyoluntu

Oorhulumente abasebenzi kwi-athom. Urhulumente wesizwe unika inkxaso-mali, uncedo lobugcisa, kunye nokhokelo lwesizwe ngoorhulumente abanjengeCDC, amaZiko eSizwe eMpilweni, kunye noLawulo lweFood and Drug. Amazwe kufuneka athobele imithetho karhulumente enjenge-HIPAA yobumfihlo kunye nomthetho weSivumelwano lwelebhureji (CLIA). Noko ke, amazwe agcina ububanzi belungenelele ekungeniseni. Amanye amazwe aye avelisa imithetho ekhululekileyo, atshintshisa iinkqubo zokutshintshana iinaliti, aza ahlawula imiqathango ephembelela kamva impembelelo kwisenzo sikarhulumente sorhulumente. Lo manyano lwamazwe olunolwano-orhulumente luye lwasebenzisanamdlamdla wokwenza intsombululo, maxa wambini olufuna ulungiso lwempilo lonke uluntu.

Ukukhangela phambili: Ukuqinisa ubuchule bemeko yempilo kawonke-wonke karhulumente

Isifo se-COVID-19 sibhenca amandla kunye nobunzima benkqubo yorhulumente yonyango. Ukuhambela phambili, abenzi benkqubo kuwo onke amanqanaba bayayiqaphela imfuneko engxamisekileyo yenkxaso-mali, iinkqubo zogcino-lwazi ezikhoyo, umbhobho woomatiloshe, kunye nezakhiwo ezisemthethweni ezixhasa isenzo sonyango lukawonke-wonke esifike ngexesha elifanelekileyo ngaphandle kokuchasana okungeyomfuneko kwenkululeko yomntu ngamnye. [[FLT:] Intlangano enjenge-[FLT] Imanyano yesizwe yoomatiloshe olungundoqo (NASCIO)[FLT] kunye noncedo lwempilo yoluntu olulungiselelweyo. kunye noncedo lwemeko yoluntu lwemihla ngemihla yoluntu.[5]

Isiphelo

Oorhulumente babalulekile kumaziko empilo kawonke-wonke e-U.S. amagosa abo omgaqo-siseko awenza akwazi ukulawula ukunyamekela impilo, ukulawula izifo, ukukhuthaza ukuziphatha okusempilweni, nokulungiselela iingozi. Kodwa phantsi kokungakhathalelwa, ukunqongophala kwabasebenzi, ukuhlaliswa kweengingqi zezobupolitika, kunye nezithuba zedata zibangela iingxaki ezinzulu. Ukuqonda umgangatho kunye nemiqathango yegunya lesizwe, . /ukukhuthaza imithetho ekhuthaza ukukhusela impilo kawonke wonke ("iyimfuneko ukukhusela impilo yabo bonke abemi.) Njengoko umgca ophambili wempilo kawonke-wonke eMelika, kufuneka uxhotyiswe ngoovimba, ulawulo, i-Iquququ, kwaye uxhase imfuneko yokuba bahlangabezane neemfuno zombini ezifunekayo nezisongelo ezingaqhelekanga.