Ohulumeni boMbuso bawumgogodla wesimiso sezempilo somphakathi wase-United States, besebenzisa igunya lomthetho-sisekelo lokuvikela nokuthuthukisa inhlalakahle yezakhamuzi zabo. Nakuba uhulumeni kahulumeni umisa izindinganiso zesizwe futhi unikeza izimali, izifundazwe zinomthwalo wokufeza izinhlelo zansuku zonke, ukuphoqelela, nokusungulwa kwezimiso zempilo yomphakathi. Ukusukela ekuqondiseni izikhungo zezempilo ukuze kuqondiswe ukubheduka kwezifo nokuthuthukisa imfundo yezempilo, ohulumeni basebenza ezingxenyeni eziphambili zempilo yabantu. Lesihloko esandisiwe sihlola umsuka womthetho wezwe wempilo yomphakathi, sichaza imithwalo yemfanelo eyisisekelo, izinhlelo ezinkulu zempilo, ihlola izinselele eziqhubekayo, futhi siqokomisa indima eqhubekayo yezezempilo yezizwe ekuvikeleni impilo yomphakathi.

INhlangano Yomthetho - sisekelo Yegunya Lempilo LoMbuso

Ukuqonda ukuthi kungani ohulumeni bezwe benamagunya abanzi kangaka empilo yomphakathi kudinga ukubheka uMthetho-sisekelo wase-U.S. Isichibiyeli seshumi esigciniwe esigcinwe ezindaweni ezingaphathiswa ngokuqondile uhulumeni wezwe. Phakathi kwalamandla agciniwe amandla amandla okulawula [[] . . . . igunya lokumisa imithetho nezimiso ezidingekayo ukuze kuvikelwe impilo, ukuphepha, nenhlalakahle yomphakathi. Lesisekelo esingokomthetho sinikeza amandla aqinile empilweni ngaphandle kokulinda iziqondiso zikahulumeni.

Ngokuhamba kwesikhathi, iNkantolo Ephakeme iye yawasekela ngokungaguquguquki amaphoyisa kahulumeni empilweni yomphakathi. Amacala aphawulayo anjenge-Jacobson v. iMassachusetts[FLT: 1] (05) yaqinisekisa ukuthi imibuso ingagunyaza ukugoma ukunqanda ingxibongo, imise isibonelo esisaqhubeka sithonya umthetho wempilo yomphakathi namuhla. Ngenxa yalokho, ohulumeni bombuso banga:

  • License futhi lilawule abanakekela impilo (izimfijoli, abahlengikazi, izibhedlela, imitholampilo)
  • [ Beka izinga lempilo nokulondeka [ lokudla, amanzi, nezindawo zomsebenzi
  • Ama-mantenute okugoma [ kwabezesikole
  • Abantu abaQuarantine ukuze kuvinjelwe ukusakazeka kwezifo
  • Izibalo ezibalulekile [ (ukuzalwa, ukufa, imibiko yezifo)

Lenkululeko engokomthetho - sisekelo isho ukuthi amasu empilo yomphakathi angahluka kakhulu kuye ngombuso ngamunye, abonise izindinganiso zendawo, isimo sezulu sezombangazwe, nesidingo sabantu.

Imithwalo Yemfanelo Yohulumeni Bombuso Empilweni Yomphakathi

Iminyango yezempilo yoMbuso nezinhlangano ziphethe i-tekstry yemithwalo yemfanelo ethinta cishe zonke izici zenhlalakahle yomphakathi. Lemisebenzi ihlanganiswa kakhulu emithethweni yesizwe nasemithethweni yokuphatha. Ngezansi kubhekiselwa phambili ezingxenyeni eziyinhloko zomthwalo wemfanelo wempilo kahulumeni.

Imfundo Yempilo Nokuthuthukisa

Izwe lihola imizamo yokwazisa izakhamuzi ngezingozi zempilo nezimiso ezinempilo. Inkampane yempi yokubhema i-campel, ukuvivinya umzimba, ukudla okunomsoco, kanye nobulili obulondekile ivamile. Ngokwesibonelo, izifundazwe eziningi ziqhuba imikhankaso yezokulwa ne-tobacco exhaswe ngemali yokukhokha noma iminikelo evela eCentre of Disease Control and Prevention (CDC). Imfundo yezempilo ephumelelayo inciphisa umthwalo wezifo ongamahlalakhona futhi inika abantu amandla okwenza izinqumo ezingoko.

Ukuvimbela Izifo Nokuzilawula

Ohulumeni basebenzisa izimiso zokuhlola izifo ezibanzi ukuze baqaphele ukuqubuka kwezifo ezithathelwanayo ezinjengemkhuhlane, isimungumungwane, isifo sofuba, ne-COVOVID-19. Bahlela ukuhlolwa kokucwaninga, ukuhlola, ukuxhumana, nokuthumela imiyalezo yomphakathi. Izinhlelo zokuhlomisa i-memunition ziyitshena letshena legumbi legumbi: ihlela izimfuneko zomjovo wokugoma ukuze ungene esikoleni, igcine izisekelo zokugoma, futhi isebenzise imitholampilo yokugoma yomphakathi. Ngokwe- CDC[FLT], ukuhlobela ukugoma kwesimiso sokugoma kwezwe kwezwe, kuqokomisa amandla ezimiso zomthetho zomphakathi zokuvimbela nokuphuma.

Ukutholakala Kwempilo Nezinga Lempilo

Nakuba uhulumeni kahulumeni uphethe iMedicare futhi wengamela izimakethe ze-Affordcable Care Act, izifundazwe zilawula kakhulu ukungenela kwezempilo. Zigunyaza izibhedlela, amakhaya asebekhulile, nezikhungo zokuhlinza, ziqinisekisa ukuhambisana nezindinganiso zokuphepha nezinga eliphezulu. Amazwe futhi asebenzisa iMedicaid, uhlelo oluhlangene lwesifundazwe olunikeza ukuthengwa kwabantu abahlawulwayo nemikhaya ephansi. Izimiso ezingokokuthi inzuzo ezivalelwe, kanye nezinga lokukhokhelwa kwemali zinqunywa kunqunywa ngokwezinga lombuso phakathi kweziqondiso zikahulumeni. Ngaphezu kwalokho, amalungiselelo empilo, kuhlanganise nezingalo ezihlangene zomphakathi nezokukhokha izintambo.

Ukulungiselelwa Okuphuthumayo Nokusabela

Ohulumeni bahulumeni bayizinhlangano eziholayo zezezimo eziphuthumayo zempilo yomphakathi emingceleni yabo. Basungula futhi balondoloze amasu okuhlinza okuphuthumayo, bagcine izinto zokwelapha (njengemijovo nezidakamizwa), futhi baxhumane neminyango yezempilo yendawo, izibhedlela, nezithakazelo zokuqala. Phakathi nezinhlekelele zemvelo (amaquacane, amalangabi, izikhukhula, noma izibhebhebhe, bamisa izikhungo eziphuthumayo, bathumela izibhedlela, futhi bakhipha iziyalezo zokukhipha isikhala noma izikhungo. I-Public Health Emedybration Extentenstry (P) uhlelo lwezemvelo (, exhaswe yi-CDC, isekela lamandla ombuso.

Ukubuyiselwa Kwempilo Endaweni Ezungezile

I-odocs imisa imithetho evikela umphakathi ezingozini zendawo ezungezile. Lokhu kuhlanganisa ukugada izinga lomoya namanzi, ukwengamela ukulahlwa kwemfucumfucu, ukuhlola izindawo zokudlela namachibi okubhukuda, nokulawula izibulala zinambuzane namakhemikhali ezimboni. Izifunda eziningi zinezinhlangano ezivikela indawo ezungezile ezimisa izindinganiso eziqinile kunezomthetho kahulumeni. Ngokwesibonelo, ukubekwa kwe-California 65 kudinga izixwayiso ngemikhiqizo enezingamakhemikhali eziwayo ukuthi abangela umdlavuza noma ukulimala kokuzala.

Ukuvinjelwa Nokulawulwa Kwezifo Okungamahlalakhona

Ngaphandle kwezifo ezithathelwanayo, kusho ukusingatha izimo ezingamahlalakhona njengesifo senhliziyo, isifo sikashukela nomdlavuza. Bafaka izinhlelo zokuhlola izinhlelo (isinye isigamu nomdlavuza webele), bakhuthaza ukudla okunempilo nomzimba ngezinguquko zezimiso, futhi basekele izinhlelo zokuvimbela isifo sikashukela. Iminyango yezempilo yezempilo yoMbuso ngokuvamile ibambisana nezinhlangano zomphakathi ukuze kuncishiswe ukuhlukana kwempilo kubantu abangaphansi kwenani labagciniwe.

Izimiso Eziyinhloko Zezempilo Zomphakathi Ezilawulwa Ohulumeni BoMbuso

Ohulumeni boMbuso banezinhlelo eziningi ezihlasela imiphakathi ethile nezinkinga zempilo.

Izinhlelo Zokufunza

Iminyango yezempilo yoMbuso iphatha izinhlelo zobuntwana nezokugoma kwabantu abadala. Ithenga imijovo ngenani elincishisiwe ngohlelo lwe-university Vaccines for Children (VFC), iyisasaza emitholampilo enikeza abampontshelwayo, kanye nokugoma ngemizila. Izizwe eziningi zisebenzisa iziteshi zokugoma ze-intanethi ezivumela abagodli nezikole ukuba ziqinisekise umlando womjovo wezingane. Phakathi nobhadane we-COVOVAD, izindawo zokugoma ezilawulwa uhulumeni zaba isici esibucayi sokusabela kwesizwe.

Izinkonzo Zempilo Zezingane Nezempilo

Isihloko V se-Social Security Act sinikeza izimali ezizweni zikahulumeni zezinhlelo zezempilo zomama nezezingane. Izwe lisebenzisa le mali ukusekela ukusebenzelana kokunakekela kwangaphambi kokubeletha, ukuvakashela ekhaya omama abasha, ukuhlolwa kwezinsana ngezifo zofuzo, nezinkonzo zokungenela ngokushesha ekubambeni ijubane lokukhula. Le zinhlelo zihlose ukunciphisa ukufa kwezinsana, ukuthuthukisa imiphumela yokuzala, nokuqinisekisa ukukhula kwezingane ezinempilo.

Ukulawula Ugwayi Nokukuvimbela

Izinhlelo zokulawula ugwayi kahulumeni zihlanganisa imfundo, izinkonzo zokulungisa izimali, nokumisa umthetho. Izifundazwe eziningi ziye zaphakamisa ubudala obuncane kakhulu ukuze zithenge ugwayi ziwu - 21, zisebenzisa imithetho yomoya okhululekile ngaphakathi, futhi ugwayi okhokhelwa intela enzima. Imishini yentela kagwayi nezindawo zokumangalela ivame ukuxhasa imikhankaso yokuvimbela. Ngokwe- CDC Office on Smoking and Health, izinhlelo zokulawula ugwayithi oluqinile lubona ukwehla kakhulu ezilinganisweni zokubhema.

Usizo Lokudla Nokuvimbela Ukukhuluphala

I-Special Nutrition Program ye-Oliginal Orsution for Women, Infants, and Children (WIC), inikeza ukudla okunomsoco, ukuncelisa ibele, kanye ne-astemical Nutrition Application program yezempilo. I-oral Confective Application program (SNAP) isebenzisa i-USDA. Izindlela zokuvimbela ukukhuluphala zihlanganisa ukukhuthaza izitini zesaladi ezikoleni, ukusekela izimakethengiso zabalimi ezamukela i-SNAP, kanye nokwakha izimiso zendawo ezikhuthaza ukuhamba nokukhuthulula.

Impilo Yengqondo Nezindlela Zokusetshenziswa Kwayo

Izikhulu zezempilo yengqondo zikahulumeni zengamela izimiso zezempilo zengqondo yomphakathi, kuhlanganise nezibhedlela zezwe ezisebenza ngengqondo, izikhungo zempilo yengqondo yomphakathi, nezinhlelo zokungenela ezibucayi. Eminyakeni yamuva, izikhulu zikahulumeni ziye zandisa amathuba okwelapha okusetshenziswa kwemithi e-opioid ekusebenziseni i-opioid futhi zafakwa ezinkonzweni ezilimazayo ezinjengokusakaza i-naloxone. Zonke izifunda ziyakwazi ukuvimbela ukusetshenziswa kabi kwemithi kanye nokwelashwa okunikezwa yi-Substance Abuse and Mental Health Service Administration (SA).

Ukunqanda Izifo Ezithathelwanayo Nemisebe Yesifo Esithathelwanayo

Ukuhlolwa kokuhlolwa komphakathi wempilo kahulumeni wezindawo zokucwaninga ngezifo zomphakathi kuhlanganisa ama-rabies kuya e-Zika. Banomthwalo wokubika izifo ezingenakuboniswa ku-CDC kanye nokuhlola isayensi ye-exdemiology. Izimiso zokuhlola i-Syndromic zihlola ukuhambela komnyango wesimo esiphuthumayo kanye nokwaziswa kwangempela kokuhlola izindlela ezingavamile ezingase zibonise ukuqubuka. Le khono yabonakala ibalulekile phakathi nesifo se-H1N1 kanye nenhlekelele ye-COVID.

Izinselele Ezibhekene Nezimiso Zezempilo ZoMbuso Zomphakathi

Naphezu kwendima yabo eyinhloko, ohulumeni bombuso babhekana nezithiyo ezinkulu ezisongela ikhono labo lokuvikela impilo yomphakathi ngokuphumelelayo.

Umkhuba Wokungakhathaleli

Izinhlangano zezempilo zikahulumeni ziye zabhekana nokuhlelwa kwemali esetshenziswayo amashumi eminyaka. Ngokwezilinganiso ze-American Public Health Association, ukusetshenziswa kwempilo yomphakathi ngokwesilinganiso somphakathi kuye kwancipha ezifundeni eziningi kusukela e-Great Recessition. Phakathi nezikhathi ezingezinkulu, impilo yomphakathi ngokuvamile iyindawo yokuqala encitshiswe lapho uhulumeni uhlela imali eqinile. Lokhu kusekela ukuntengantenga kwemali kunciphisa amandla emisebenzi, izakhiwo, nezinhlelo zokuvimbela. Umqedazwelo we-COVOVID uye washintsha lomkhuba wesikhashana ngemiba yombuso omkhulu, kodwa amazwe amaningi aye azama ukusekela ukuvota okunga.

Ukuswelakala Nokutubeka Kwamandla

Ukuswelakala ochwepheshe bezempilo yomphakathi abaqeqeshiwe − ochwepheshe bezempilo, ochwepheshe besayensi yebhayoloji, othisha bezempilo, ochwepheshe bezempilo . . Izinhlangano zezempilo zezwe ezilinganiselwe ezihlobene nezisebenzi ezizimele, ezifuna ukuthwala imithwalo yemisebenzi, kanye nokulahlekelwa okungokomzwelo kwempendulo ephuthumayo kunezela ekuvukeleni okukhulu. I-de Beaumont Foundation’s Public Health Workticession Interces and Neefed Bears Survey (PH WINS) ithola njalo ukuthi izisebenzi zezempiliso zezwelo ezempilo ezingamashumi amane% zezwelonke zihlela ukushiya imisebenzi yazo phakathi neminyaka emihlanu.

Ukwenziwa Kwezombangazwe Nezesayensi Yemvelo

Izinqumo zempilo yomphakathi ziya ngokuya zithatheka. Imithetho yesifihlakalisi, izimfuneko zomjovo, kanye nokuvalwa kwesikole phakathi nobhadane kwaba yizindawo ezishayelelayo ezingxabanweni zendlu kahulumeni nasenkantolo. Ezinye izifundazwe ziye zamisa imithetho evimbela igunya lezikhulu zezempilo ukuba zihlele ukuhlukaniswa kwabantu noma zidinge ukugonyelwa. Ukuwohloka okunjalo kungaholela ekuxabaniseni izinqubo ezisemisweni zezwe futhi kuqede ukwethemba komphakathi empilweni. Izikhulu zezempilo hulumeni kumelwe zihambe endaweni enezimpikiswano lapho ukutusa okusekelwe ekwakheni kungangqubuzana khona nezingcindezi zezombangazwe.

Ukuhlukana Kwemininingwane Nezigebengu Zobuchwepheshe

Iminyango yezempilo yoMbuso ivame ukuthembela ezimisweni zokwaziswa eziphelelwe isikhathi ezihlangene kabi nezindawo zokuhlola ze-othone, zendawo, nesibhedlela. Izincazelo eziguquguqukayo zezezimali, ukulibala ukubika, nokungahambisani kuvimbela ukusabela okusheshayo ekuvulekeni kwezinsongo. Phakathi no-COVID-19, izifunda eziningi zizama ukwakha amabhodi ahlolayo anamuhla nezimiso zokumisa ukugoma. Ukufaka enqoloba enqolobaneni yezempilo yomphakathi yanamuhla kusemqoka phambili esikhathini esizayo.

Ukungaqondi Komphakathi Nokufunda Empilweni

Izilinganiso ezingalungile ngemijovo, ukwelashwa, kanye nezempilo yomphakathi ziye zanda kakhulu enkathini yobuchwepheshe. Iminyango yezempilo kahulumeni ichitha umzamo omkhulu wokumelana nokulandisa okungamanga, kodwa izinga lokungatholi ulwazi kuyi-webhusayithi ngokuvamile linqoba iziteshi ezingokomthetho zokuxhumana. Ukungafundi zezempilo eziphansi kwezinye izizwe kwenza imizamo yokukhuthaza ukuziphatha okuvimbela nokuvumelana nezimiso zezempilo zomphakathi. Izwe kumelwe lisebenzise izindlela zokuxhumana eziphambili ezingokwesiko kanye nomngane womphakathi othembekile ukuba livale le mingcele.

Ukungafani Kwempilo Nokungakhethi

Umehluko ophawulekayo emiphumeleni yempilo uyaqhubeka phakathi kwemikhakha yobuhlanga, yesizwe, yezezwe, nezenhlalo. Ohulumeni boMbuso banamandla okuhlasela imithombo yezenhlalakahle egciniwe, kodwa ngokuvamile izinhlelo zempilo ziye zakhiwa ngaphandle kwe-lens elinganayo. Ngokwesibonelo, izindawo zasemaphandleni zingase zingakholeki ekunakekeleni okukhethekile, futhi izindawo ezimbalwa zingase zibhekane nemithwalo ephezulu yokungcola. Amazwe athola impilo kuzo zonke izimiso ezihlelwa ukuba abhekane ngokuhlelekile nokuvimbela impilo ezenhlalo, kodwa intuthuko ihlala ingekho.

Ukuhlangana Phakathi KoMbuso Nendima Yempilo Yomphakathi

Ohulumeni boMbuso abasebenzi endaweni engenalutho. Uhulumeni kahulumeni unikeza izimali, usizo lobuchwepheshe, kanye nobuholi besizwe ngezinhlangano ezinjengeCDC, iNational Institutes of Health, ne-Food and Drug Administration. I-United States kumelwe ivumelane nemithetho kahulumeni enjenge-HIPAA ne-Clinical Laboratory Reconficementmentments (CLIA). Nokho, amazwe alondoloza inkululeko enkulu yokungenisa. Amanye amazwe aye asungula imithetho ekhululekileyo, izinhlelo zokushintshana ngezinaliti, futhi akhokhela izimvume zokugula ezithi kamuva ezithonyeza ukuthatha isinyathelo sikahulumeni. Lolu budlelwane bezwe elinohulumeni buye wathonya ukusebenza komphakathi. Ngesinye isikhathi, ukuphikisana kwezentengo yomphakathi wonke.

Ukubheka Phambili: Ukuqinisa Amandla Ezwe Empilo Yomphakathi

Isifo se-COVOID-19 sadalula kokubili amandla kanye nobunzima bezimiso zempilo zombuso. Ukuqhubekela phambili, abenzi bezimiso kuwo wonke amazinga baqaphela isidingo esiphuthumayo sokuxhasa imali, izimiso zemininingwane yesimanje, uphayiphi onamandla, kanye namapulani angokomthetho asekela isenzo sezempilo somphakathi esifike ngesikhathi ngaphandle kokuphazamisa ngokungadingekile. Izinhlangano ezinjenge [[FLT:] Inhlangano yesizwe ye-SProvince Information Aderss (NASCIO)[FLT] kanye nezenzo ezisekela ukuThwa kwempilo yomphakathi wonke umphakathi azilungiselwa nje. Izinhlangano ezinjenge-ASCOM] izikhulu zenkululeko yomphakathi. [FTY:]

Isiphetho

Ohulumeni boMbuso bangabadlali ababalulekile esimisweni sempilo yomphakathi wase-U.S. amaphoyisa abo asemthethweni awenza akwazi ukulawula ukunakekelwa kwempilo, ukulawula izifo, ukukhuthaza ukuziphatha okunempilo, nokulungiselela izimo eziphuthumayo. Nokho ukuswelakala kwezisebenzi, ukuswelakala kwezindawo ezihlukene zezombangazwe, kanye nezikhala zemininingwane kudala izinselele ezinkulu. Ukuqonda izinga nemingcele yegunya likahulumeni, kanye nokusekela imithetho eqinisa izakhiwo zempilo yomphakathi ukuze kuvikelwe impilo yazo zonke izakhamuzi. Njengoba umugqa ophambili wempilo yomphakathi eMelika, izifundazwe kumelwe zihlonyiswe ngemithombo yezentengo, i-Iquality, futhi zisekele izicelo zezwe ezidingekayo ukuba zibhekane nazo zombili izingcingo ezivamile nezisongelayo.