Kutheni iMelika Yona Yodwa Ihlabathi Elichumileyo Ngaphandle Kwempilo Yonyango Yonke
Iindleko ezinkulu zokubonelela ngononophelo lwempilo zonyango kwenza ulondolozo lwempilo lwabantu bonke lube neendleko ezinkulu kubaorhulumente.
Unonophelo lwempilo yonk Okanye, amazwe angamisela ukuba wonke umntu athenge inshuwalense yezempilo. Ngoxa i-Obamacare yayinegunya, kwakunamathuba amaninzi okuba yinto yonke. Amazwe ambalwa athembele ekuhlawuleni kwangaphambili. Uninzi lweenkqubo zokunakekelwa kwempilo lwehlabathi jikelele luxhaswa ngemali engaphezulu kweyodwa kule ndlela.
Kwamazwe amaninzi, urhulumente uyahlawula unyango lwempilo olunikezelwa ngamashishini abucala. Ezi ziquka iinkqubo e-Australia, eCanada, eFransi, eJamani, eSingapore naseSwitzerland. Imizekelo yase-US i-Medicare, Medicaid, ne-TRICARE. I-United States ikwabonelela ngoncedo lweenkampani ze-inshorensi zempilo ngokusebenzisa i-Obamacare.
Xa urhulumente ahlawula kwaye unikezela iinkonzo, leyo yonyango. UBukumkani baseUnited Kingdom. I-United States inayo kunye neSebe leeMfazwe yeMpi kunye nemikhosi.
Amazwe amaninzi adibanisa i-universal health coverage kunye nezinye iinkqubo zokuzisa ukhuphiswano.
Ezi ziquka ukuhlawula njengoko uhamba, i-prepay, kunye nemifanekiso yomshuwalense yabucala. Ezi zikhetho zinokunciphisa iindleko, ukwandisa ukhetho, okanye ukuphucula ukunakekelwa.
Xa oorhulumente behlawula unyango lwempilo, basebenza ukuqinisekisa ukuba oogqirha nezibhedlele banikezela ngononophelo olungcono kwixabiso elifanelekileyo. Kufuneka baqoke kwaye bahlalutye idatha. Basenokusebenzisa amandla abo okuthenga ukuchaphazela ababoneleli bezempilo.
Imfuno yokunakekelwa kwempilo kwendalo yonke yaqala ngowe-1948, unyaka uMbutho wezeMpilo weSizwe wamemezela ngononophelo lwempilo ilungelo lomntu.
Inzuzo
Unonophelo lwempilo yonk URhulumente ulawula ixabiso leyeza kunye neenkonzo zonyango ngokuthetha kunye nemimiselo.
Iphelisa iindleko zolawulo zokujongana nabanini-mali bobucala bezemfihlo. Oogqirha bajongana ne-arhente enye karhulumente. Oogqirha base-US kufuneka bajongane neenkampani ezininzi ze-inshurensi yabucala, i-Medicare kunye neMedicaid. Ibeka iinkqubo iinkqubo zokukhokha kunye nemigqaliselo. Iinkampani akudingeki ukuba ziqeshe abasebenzi ukuba bajongane nemithetho eyahlukeneyo yenkampani ye-inshorensi yempilo.
Ikhuthaza izibhedlele kunye noogqirha ukuba banikeze umgangatho ofanayo wenkonzo ngexabiso eliphantsi. Kwiindawo ezikhuphisanayo ezifana ne-United States, ababoneleli bezempilo bayagxila kwi-teknoloji entsha. Banikela ngeenkonzo ezibiza kakhulu kwaye bahlawula oogqirha abaninzi. Bazama ukuncintisana ngokujolisa kwezobutyebi. Bahlawula ngaphezulu ukuze bafumane inzuzo ephezulu. Ikhokelela kwiindleko eziphezulu.
Ulondolozo lwempilo jikelele ludala abasebenzi abanezempilo. Izifundo zibonisa ukuba ukunakekelwa kokukhusela kunciphisa isidingo sokusetyenziswa kwegumbi lokugada. Ngaphambi kwe-Obamacare, iipesenti ezingama-46 zegumbi lokuphuthuma izigulane zahamba ngenxa yokuba zazingekho ndawo.
Basebenzisa igumbi lexakeka njengogqirha wabo oyintloko.
Ukunyamekela kwasekuqaleni kwabantwana kuthintela iindleko zentlalo ezayo. Ezi ziquka ulwaphulo-mthetho, ukuxhomekeka kwezenhlalakahle kunye nemicimbi yempilo. Imfundo yempilo ifundisa iintsapho indlela yokwenza impilo enempilo, ukukhusela izifo ezingapheliyo.
Oorhulumente banokubeka imimiselo kunye neerhafu ukukhokela uluntu ngokubhekiselele kukhetho oluphilileyo. Imimiselo yenza ukhetho olungenampilo, olufana neziyobisi, ezingekho mthethweni. Iirhafu zesono , ezinjengezo zi-cigarettes kunye notywala, zibenza zibiza kakhulu.
Iingxaki
Impilo yolondolozo lwempilo yonk Izifo ezingapheliyo, ezifana nesifo sikashukela nesifo senhliziyo, zenza iipesenti ezingama-85 zeendleko zonyango. Ezi zifo ziyakuthi zithintelwe ngokukhetha ngokuphila. Abangama-5 ekhulwini abadlulileyo kubalula ama-50 ekhulwini kwiindleko zonyango.
Iipesenti ezingama-50 ezinempilo zidla kuphela iipesenti ezi-3 zendleko zonyango lwempilo.
Ngenxa yokunakekelwa kwezempilo jikelele, abantu abanakho ukunyamekela ngempilo yabo. Abanalo inzuzo yezimali yokwenza njalo. Ngaphandle kwe-copay, abantu bangasebenzisa ngokugqithiseleyo amagumbi kunye noogqirha.
Uninzi lweenkqubo zezempilo zendalo jikelele zibika ixesha elide lokulinda iinkqubo ezikhethiweyo. Urhulumente ugxile ekuboneleleni ngononophelo lwempilo kunye noxakeka.
Imirhumo yokulawula intlawulo ibalwa ukugcina iindleko eziphantsi. Oogqirha banomncinci omncinci wokubonelela ngononophelo lwekhwalithi ukuba abahlawulwa kakuhle. Basenokuchitha ixesha elingaphantsi isigulane ukuze bagcine iindleko zabo phantsi. Bafumana inkxaso engaphantsi kobuchwepheshe obutsha bokugcina ubomi.
Iindleko zonyango zonyango zigqithise uhlahlo lwabiwo mali Ngokomzekelo, amanye amaphondo aseCanada achitha ama-40 ekhulwini lwabiwo-mali kwiinkonzo zempilo. Oku kunciphisa imali ngezinye iinkqubo ezifana nemfundo neziseko.
Ukunciphisa iindleko, urhulumente anganciphisa iinkonzo ngeendlela eziphantsi zokuphumelela. Akunakho ukufaka izidakamizwa kwiimeko ezingaqhelekanga. Inokukhetha ukunyamekela ngokunyamekela kokunyamekela kokunyuka komgangatho wokuphila. Ngakolunye uhlangothi, inkqubo yezokwelapha yase-US yenza umsebenzi wobuqhawe wokulondoloza ubomi, kodwa ngeendleko. Ukunyamekela izigulane kwiminyaka emithandathu yokuphila yenze i-one-fourth ye-Budget budget. Kwinyanga yabo yokugqibela yobomi, isiqingatha siye kwigumbi lexakeka. Inxalenye yesithathu kwinqanaba lokunyamekela, kwaye enye yesihlanu iya kuhlinzwa.
Amazwe athuthukileyo kunye noNcedo lwezeMpilo jikelele
Kusuka kumazwe angama-33 athuthukileyo, 32 anakekelwa ngoncedo lwezempilo jikelele. Bafumana enye yezinto ezintathu ezilandelayo.
Kwindlela yokuhlawula enye, irhafu karhulumente abemi bayo ukuhlawula unyango lwempilo. Ezilishumi elinambini zamazwe angama-32 zile nkqubo. UBukumkani baseUnited Kingdom ngumzekelo wonyango onokuhlawula omnye umntu. IiNkonzo zikarhulumente, kunye nabanikezeli ngeenkonzo ngabasebenzi bakaRhulumente. Amanye amazwe basebenzisa uluntu kunye nabanikezeli benkonzo yabucala.
Amazwe ayisithupha agxininisa umyalelo we-inshorensi. Kudinga ukuba wonke umntu athenge i-inshorensi, nokuba ngumqeshi okanye urhulumente. IJamani ngumzekelo omhle wale nkqubo.
Amazwe asithoba aseleyo asebenzisa iindlela ezimbini. Iirhafu zikaRhulumente abemi bayo ukuhlawula iinkonzo zempilo zorhulumente ezisisiseko. Abemi banokukhetha iinkonzo ezingcono kunye ne-inshurensi yabucala yangasese. IFransi ngumzekelo omhle.
Isishwankathelo samaZiko asixhenxe weZizwe zeMpilo
E-Australia : I- Australia iyakwamukela inkqubo emibini. Urhulumente uhlawula i-sibini kwisithathu, kwaye icandelo labucala lihlawula enye yesithathu. Inkqubo yoluntu jikelele ibizwa ngokuba yiMediare. Wonke umntu ufumana ukuxhaswa. Oku kuquka ukutyelela abafundi, abantu abafuna ukukhuphela, kunye nabo baneefasta zesikhashana. Abantu kufuneka bahlawule iidraucable ngaphambi kokuba iintlawulo zikaRhulumente zikhawulwe. Ingxenye yabemi baye bahlawula i-inshurensi yempilo yabucala ukuba bafumane umgangatho ophezulu wokunyamekela. Abo bathenga i-inshuwalense yabucala ngaphambi kokuba bafike kwi-30 bafumane isaphulelo sokuphila. Imimiselo kaRhulumente ikhusela abantu abadala, abahlwempuzekileyo, abantwana nabasemaphandleni.
Ngo-2016, ukunakekelwa kwempilo kwindleko ze-9.6 ekhulwini ze-Australia. Iindleko ze-capita yi-US $ 4,798. I-OECD ibike ukuba iipesenti ezingama-22.4 zezigulane zibike ixesha lokulinda ngaphezu kweeveki ezine ukuze ubone ingcali. Ngakolunye uhlangothi, kuphela iipesenti ezi-7.8 zezigulane zanyuka amayeza ngenxa yokuba indleko yayiphezulu kakhulu. Ngo-2015, ixesha lokuphila lobomi base-Australia laliyiminyaka engama-84.5.
IKhanada : ICanada inenkqubo yokuhlawula omnye. Urhulumente uyahlawula iinkonzo ezinikezelwa yinkqubo yokubonelela yangasese. Urhulumente uyahlawula iipesenti ezingama-70 zokunyamekela. I-inshurensi eyongezelelweyo eyongezelelweyo ihlawula umboniso, ukunakekelwa kwamazinyo, kunye neziyobisi zemithi. Izibhedlele zixhaswa ngemali. Banika ukunakekelwa kwamahhala kubo bonke abahlali kungakhathaliseki ukuba banakho ukuhlawula. Urhulumente ugcina izibhedlele kwibhajethi ehleliweyo yokulawula iindleko. Ibuyisela oogqirha kwintlawulo-yeenkonzo. Ixoxisana namaxabiso amaninzi kwiyeza zonyango.
Ngo-2016, ukunakekelwa kwezempilo kuxabisa i-10.6 pesenti ye-GDP yeCanada. Indleko ngomntu ngamnye yayingu-US $ 4,752, kunye neepesenti ezingama-10,5 zezigulane zityhulwa imiqathango ngenxa yeendleko. Ukunyuka kwama-56.3 ekhulwini kwezigulane kulinde ngaphezu kweeveki ezine ukufumana ingcali. Ngenxa yoko, izigulane ezininzi ezinokukwazi ukuzenza zikwazi ukunyamekela ukuya eUnited States. Ngo-2015, ukulindela ubomi kwakuyiminyaka engama-82.2. I-Canada inamazinga aphezulu okusinda komhlaza kunye namazinga aphantsi okungeniswa esibhedlele ngesifo sesifo sikashukela nesifo sikashukela.
EFransi : IFransi inomgangatho obhetele ombini. Inkqubo ye-inshorensi yempilo yonyango ihlanganisa iipesenti ezingama-75 zemali yokunakekelwa kwempilo. Ezi ziquka izibhedlele, oogqirha, iziyobisi kunye nempilo yengqondo. Oogqirha bahlawulwa ngaphantsi kwamanye amazwe, kodwa imfundo yabo kunye ne-inshurensi ikhululekile. Urhulumente waseFransi uhlawulela nokukhulelwa ekhaya, umnxeba kunye nokunyamekelwa kwabantwana. Kulo, i-tax tax fund iipesenti ezingama-40, iirhafu zerhafu zihlawula iipesenti ezingama-30, kwaye ezinye zivela kwiirhafu kunye neerhafu zotywala. Iinkampani zenkxaso-mali zinesithathu kwisibhedlele. Izigulane zinika ukunakekelwa okulinganayo.
Ngo-2016, ukunakekelwa kwezempilo kuxabisa i-11.0 yeepesenti ye-GDP. Kwakuyi-US $ 4,600 ngomntu ngamnye. Ngo-2013, iipesenti ezingama-49.3 zezigulane zabika ixesha lokulinda kweeveki ezine ukufumana ingcali. Kodwa kuphela iipesenti ezingama-7.8 zezigulane ezithintekayo ngenxa yeendleko. Ngo-2015, ukulinda ubomi bekuyiminyaka engama-85.5.
IJamani : I- Jamani ine-inshorensi yempilo enyanzelekileyo idayiswa ngama-130 angenzi-nzuzo. Iquka ukulaliswa kwezibhedlele, izigulane, izidakamizwa zonyango, impilo yengqondo, ukunakekelwa kwamehlo, nokunyamekela. Kukho ii-copays zokubhedlelelwa esibhedlele, imiqathango kunye nezibonelelo zonyango. Kukho uxhoso olongezelelweyo lokunyamekela kwexesha elide. Imali ivela kwiirhafu zerhafu. Urhulumente uyahlawula uninzi lwempilo yononophelo. Inciphisa inani leentlawulo kunye nenani labantu abagqirha ngalinye ugqirha. Abantu bangakwazi ukuthenga ngaphezulu.
Ngo-2016, ukunakekelwa kwezempilo kuxabisa i-11.3 yeepesenti ye-GDP. I-US $ 5,550 engama-5,550 ngomntu ngamnye. Kuphela iipesenti ezingama-3.2 zezigulane ezityhulwa imiqathango ngenxa yeendleko. Kwakhona, i-11.9 ekhulwini yezigulane zibike ixesha lokulinda kweeveki ezine ukuze ubone ingcali. Kodwa abaninzi baseJamani banokufumana usuku olulandelayo okanye ukutyunjwa kwamanye ngamaxesha kunye neengcali eziqhelekileyo. Ngo-2015, ukulinda ubomi bekuyiminyaka engama-83.1.
ISingapore : Inkqubo yesibini yeSingapore iyona yezona zinto zilungileyo kwihlabathi. Iibini zesithathu ziyimfihlo kunye neyesithathu zenkcitho kawonkewonke. Inika iiklasi ezintlanu zokunakekelwa kwezibhedlele. Urhulumente ulawula izibhedlele ezibonelela ngoncedo oluphantsi okanye olukhululekile. Isetha imigaqo elawula iindleko zenkqubo yonakekelo yonakekelo lwempilo. Abantu banokuthenga amazinga aphezulu okunakekelwa kwe-deluxe ngemali. Abasebenzi bahlawula iipesenti ezingama-20 zomvuzo wabo kwiingxelo ezintathu zokugcina imali. Umqeshi uhlawula elinye iipesenti ezili-16 kwi-akhawunti. I-akhawunti enye yendlu, inshshurensi okanye imali-mali. I-akhawunti yesibini yimivuzo yokuthatha umhlalaphantsi, kwaye okwesithathu kukunyango lwempilo. I-akhawunti yeMedisave iqokelela i-7-9.5 yepesenti yengeniso, ifumana inzala, kwaye ifakwe kwi-43,500 engenayo engenayo. Amaphesenti angaphezu kwe-90 yabemi abhalisa eMedishield, inkqubo yomshuwalense eyingozi. I-Medifund ihlawula iindleko zempilo emva kwee-akhawunti zeMedisave ne-Medishield ziphelile. Abadala bahlawula ukunyamekela ekhaya. Xa umqeshwa ejika engama-40, inxalenye yengeniso idibene ngokuzenzekelayo kwi-akhawunti.
Ngo-2009, iSingapore yachitha i-4.9 ekhulwini ye-GDP yayo kwiinkonzo zempilo. Yiyo US $ 2,000 ngomntu ngamnye. Ngo-2015, ukulindela ubomi kwakuyiminyaka engama-83.1.
ISwitzerland : Ili lizwe linempilo yomshuwalense wezempilo ochaphazela bonke abahlali. Umgangatho wokunyamekela ngowona ungcono kwihlabathi. Ubungakanani bubonelelwa ngamashishini aneshishino lomshuwalense wabucala. Abantu banokuthenga i-inshurensi yokuzithandela ukufikelela kwizibhedlele ezingcono, oogqirha kunye nezinto eziphathekayo. Urhulumente uyahlawula iipesenti ezingama-60 zezempilo kwilizwe. Unonophelo lwamazinyo alufakwe. Umbono ugcinwa kuphela kubantwana. Urhulumente uncedisa iiprayimari kwiintsapho ezinomvuzo ongezantsi, malunga neepesenti ezingama-30 zexabiso. Kukho iindleko zee-coinsurance ze-10 zeenkonzo kunye neepesenti ezingama-20 zamachiza. Iindleko ze-out-of-pocket zikhutshwa ngokunyamekela ukubeleka, ukunakekelwa kokukhusela, kunye nokulaliswa kwezibhedlele. Urhulumente ubeka amaxabiso.
Ngo-2016, imali yokunyamekela ngempilo yayiyi-12,4 ekhulwini ye-GDP. Kwakungu-US $ 7,919 ngomntu ngamnye. Kwakukho ama-11,6 eepesenti zezigulane ezaqhekeza imimiselo ngenxa yeendleko. Kwakhona, iipesenti ezingama-20.2 zezigulane zazisa ixesha lokulinda kweeveki ezine ukuze ubone ingcali. Ngo-2015, ukulindela ubomi kwakuyiminyaka engama-83.4.
Ubumbuso waseUnited Kingdom : I-UK inamachiza ahlawulelanayo. ISebe lezeMpilo leSizwe liqhuba izibhedlele kwaye lihlawula oogqirha njengabasebenzi. Urhulumente uhlawula iipesenti ezingama-80 zeendleko ngeentlawulo jikelele. Ihlawulela zonke iinkathalo zonyango, kubandakanywa amazinyo, ukunakekelwa kwezibhedlele, kunye nokunyamekelwa kwexesha elide kunye nokunakekelwa kwamehlo. Kukho ii-copays zamachiza. Bonke abahlali bafumana ukunakekelwa kwamahhala. Abaveleli bafumana unonophelo lweengxamiseko kunye nezifo ezithintekayo. Ininshuwalense yabucala yeenkqubo zonyango ezikhethiweyo ziyafumaneka.
Ngo-2016, iindleko zonyango lwama-9.7 ekhulwini le-GDP. Iindleko kwakuyi-US $ 4,193 ngomntu ngamnye. Iipesenti ezingama-2.3 kuphela zezigulane ezityhulwa imiqathango ngenxa yeendleko. Kodwa i-29.9 yeepesenti zezigulane zabika ixesha lokulinda kweeveki ezine ukufumana ingcali. Ukugcina amaxabiso aphantsi, ezinye iziyobisi ezibizayo nezingaqhelekanga azifumaneki. Izibhedlele zinokuxhamla ixesha elide lokulinda. ngo-2018, ukuqhuma komkhuhlane kwandise amaxesha okulinda kwiiyure eziyi-12. Kodwa amaninzi amanqanaba empilo, njengamazinga okufa kwabantwana, angcono kunomyinge. Ngo-2015, ukulindela ubomi kwakuyiminyaka eyi-81.2.
Ukuthelekisa ne-United States
I-United States inomxube we-inshurensi karhulumente kunye nobucala. URhulumente uhlawula iindleko ezininzi, kodwa unika inkxaso ye-inshurensi yezempilo yangasese ngokusebenzisa i-Obamacare. Ingxenye yesithathu yeendleko kukuba kulawulo, kungekhona ukunyamekela. Ababoneleli ngeenkonzo zonyango bayabucala. Amashumi amabini anesithandathu yabemi bafumana i-inshurensi yabucala kubaqeshi babo. Ipesenti ezilishumi elinesihlanu zifumana i-Medicare kulabo abangama-65 nangaphezulu. Urhulumente wephondo unika imali yeMedicaid kwiintsapho eziphantsi kwemali kunye ne-CHIP kubantwana. Ihlawulela i-veterans, iCongress, kunye nabasebenzi baseburhulumenteni. Nangona konke oku, kukho izigidi ezingama-28 zaseMerika ezingenayo inqaku. Baye baxolelwa kwi-Obamacare igunya okanye abanako ukuthenga i-inshurensi.
Ngo-2016, ukunakekelwa kwezempilo kubiza i-18 ekhulwini ye-GDP. Kwakuyimali engama-9,892 e-US ngomntu ngamnye. Iepesenti ezingama-18 zezigulane zityhulwa imiyalelo ngenxa yeendleko. Kodwa i-4.9 ekhulwini kuphela yezigulane zibike ixesha lokulinda kweeveki ezine ukuze ubone ingcali. Ngo-2015, ukulindela ubomi bekuyiminyaka engama-79.3. Isizathu sesithathu sokubangela ukufa kwaba yimpazamo yezokwelapha. Umgangatho wokunyamekela uphantsi. Ilingama-28 ngokweManyano yeziManyeneyo.
Kutheni iUnited States ineendleko eziphezulu kunye nomgangatho ophantsi? Uninzi lwezigulane aluhlawuli iinkonzo zonyango. Ngenxa yoko, abakwazi ukuthenga othengisa intengo kunye neenkqubo zesibhedlele. Akukho sizathu sokhuphiswano kubaboneleli banikezela ngeendleko eziphantsi. URhulumente unokuxoxa ngexabiso elincinci kulabo abathwalwe yi-Medicare kunye neMedicaid. Kodwa iinkampani ze-inshurensi zempilo zokhuphiswano azikwazi ukulingana.
Iinshurensi kunye neenkampani zonyango zifuna ukugcina isimo-quo. Abafuni ukuba urhulumente anqande amaxabiso. Bafuna ukukhusela ukunakekelwa kwezempilo jikelele. Kodwa ama-60 ekhulwini aseMelika afuna i-Medicare kubo bonke. ECalifornia, eOhio, eColorado, eVermont naseNew York zihambela ukunakekelwa kwempilo kwihlabathi jikelele kwilizwe labo.
Isatifiketi seMpilo yokuThengiswa kweMpilo yonke
| Izwe | Uhlobo | % yeGDP | Ngekhapital nganye | Lindela i-4+ wks | Umyinge Wokufa Kwemntwana | WHO usetyenziso |
|---|---|---|---|---|---|---|
| Ostreliya | 2-tier | 9.6% | $ 4,798 | 22% | 3.1 | 32 |
| Khanada | Ongatshatanga | 10.6% | $ 4,752 | 56.3% | 4.3 | 30 |
| Fransi | 2-tier | 11.0% | $ 4,600 | 49.3% | 3.2 | 1 |
| Jemani | Umthetho | 11.3% | $ 5,550 | 11.9% | 3.2 | 25 |
| Singapho | 2-tier | 4.9% | $ 2,000 | 2.2 | 6 | |
| Swizalend | Umthetho | 12.4% | $ 7,919 | 20.2% | 3.6 | 20 |
| UK | Ongatshatanga | 9.7% | $ 4,193 | 29.9% | 3.7 | 18 |
| US | Ngasese | 18.0% | $ 9,892 | 4.9% | 5.6 | 37 |
Imbali emfutshane yoNonophelo lweMpilo eMveli eMelika
Ngomnyaka we-1993, uMongameli uClinton wanyanzelisa ukunyamekela impilo yonk UMongameli wokuqala uHillary Clinton wayekhokele phambili. Ukunyamekela kwe-Hillary kusetyenziswa isicwangciso sokhuphiswano olulawulwayo ukufezekisa injongo yaso. URhulumente uya kulawula iindleko zegqila kunye nee-premiums. Iinkampani ze-inshorensi yezempilo ziza kukhuphisana ukubonelela ngeepakethe ezona zifanelekileyo kunye nezona ziphantsi. Esi sicwangciso sichasene kakhulu noogqirha, izibhedlele, kunye neenkampani zomshuwalense ukuba zidlule iCongress.
Ngomkhankaso wongameli we-2008, uSenin Barack Obama ucebisa uncedo lwezempilo jikelele. Isicwangciso sokuphucula impilo yoncedo sika-Obama sicetywayo inkqubo eqhutyelwa esidlangalaleni, efana neyayithandwa yiCongress. Abantu banokuthenga u-rhu lumente "ukhetho lwabantu" okanye bazokuthenga i-inshorensi yangasese ngokutshintshiselana. Akukho mntu unokuphika i-inshorensi yempilo ngenxa yeso simo esele sikhona. Urhulumente wephondo uza kwandisa inkxaso ye-Medicaid. Kuza kubonelela ngemali kwabo bawenza kakhulu ukuba bakwazi ukufumana iMedicaid. Naphezu kwazo zonke ezi zinzuzo, abantu abaninzi babesaba ukunyanzelwa kwelo rhulumente karhulumente kwimpilo yabo. Bathi bekukhokelela endleleni eya kumayeza asekuhlaleni.
Emva kokunyulwa ngo-2009, u-Obama wanconywa ngononophelo lwempilo yonk Yanikwa inshurensi yonyango efana ne-Medicare kubo bonke abayifunayo. Abo bavuyiswa yi- inshorensi yempilo yabo esele ikwazi ukuyigcina. Ubungakanani boorhulumente bombuso buchaza ukuba bube nokuthengisana kwamanani aphantsi kunye nokunciphisa ukungaphumeleli. Ngokudibanisa uninsured ndawonye kunye, kunciphise umngcipheko we-inshurensi.
Iiprayimari zenyanga ziyi-$ 70 zomntu ngamnye, i-$ 140 yecala, i-$ 130 yentsapho engumzali omnye, kunye ne-$ 200 kuzo zonke ezinye iintsapho.
Kwabanika abaqeshi ukhetho, ngokunjalo. Ukuba banikezela i-inshurensi yezempilo eyayiyilungileyo njengecebo lika-Obama, bahlala begcina oko babenayo. Ukuba akunjalo, abaqeshi bahlawula irhafu yeerhafu yeerhafu, efana nokuhlawulwa kwemisebenzi, ukunceda ukuhlawula isicwangciso sika-Obama. Abasebenzi abazizimeleyo bahlawula irhafu efanayo.
Ikhusele impilo yengqondo, yomama kunye nomntwana. Ukukhawulelana neendleko eziphuma ngaphandle kweendleko ezihlawulwa ngabhalisi kwaye zinikezelwa ngokukhawuleza kweziyobisi. Ulwalamano olulawulwa ngumbutho olulawulwe ngumbutho olulawulwe ngumbutho. U-Obama wathembisa kwakhona ukuphucula ulwazi lwempilo yesigulane ngempilo phantsi kwenkqubo yonxibelelwano.
Isicwangciso esithembisa ukunyusa iindleko zempilo nge-1.5 ekhulwini ngonyaka. Urhulumente wezepolisi unokusebenzisana ngamaxabiso aphantsi kwaye unciphise ukungabi nako. Iindleko zezempilo ezingaphantsi ziguqulelwe kwii-2,600 zama-savings ngaphezulu kwintsapho nganye ngo-2020 kunye ne-R10 000 ngo-2030. Iyanciphisa ubuninzi bebhajethi ngamaphesenti angama-6 e-GDP ngo-2040. Oku kuya kunciphisa ukungaqeshwa kwabangama- 0.25 ekhulwini ngonyaka, ukudala imisebenzi engama-500 000.
Isicwangciso sonyango lwempilo ka-Obama sika-2009 sanciphisa ukutyelela kwigumbi lokuxakeka ngongxamisekileyo. Oku bekuya kugcina i-$ 100 yezigidigidi, okanye iipesenti ezi-0.6 ze-GDP, ngonyaka. Intshurensi yempilo exhaswe nguRhulumente yasusa lo mthwalo kumashishini amancinci . Kuya kubavumela ukuba banokukhuphisana ngakumbi kwaye batyelele abasebenzi abanezakhono eziphezulu.
Kwakhona, abaninzi abantu babesaba ukhathalelo lwempilo jikelele. Ngo-2010, iCongress yadlulisa uMkhuseli weMonde kunye noMthetho woNonophelo oThathaka . Ingaphezulu kwesigama (57 ekhulwini) yamaMelika angacingi ngokucacileyo ukuba i-ACA iyinakekelo lwempilo jikelele. Uzame ukunyanzelisa i-inshorensi yempilo enyanzelekileyo, efana nesicwangciso seJamani. Kodwa yavumela ezininzi ukuxolelwa. Kwakhona kwavumela amazwe ukuba anqume ukuba ngaba aya kwandisa iMedicaid. Ngenxa yoko, abantu abayizigidi ezili-13 abanakho i-inshurensi. Isicwangciso serhafu seTump sisusa isigunyaziso ngo-2019.