Washington da kulle a wani takun saka na rufewa sama da buƙatun Demokraɗiyya guda biyu 'yan Republican ba za su yarda ba: ci gaba da tallafin Dokar Kulawa Mai araha da (na dabam amma masu alaƙa) fa'idodin kiwon lafiya na tarayya ga baƙi ba bisa ƙa'ida ba. Waɗancan faɗan gaskiya ne, amma sun rasa babban direban farashi. Tallafin ACA kadai ya kai kusan rabin abin da al'umma za ta ceci idan muka koma matakan inshorar lafiyar kwakwalwa kafin 1990.
Abin da ya canza ba tausayi ba ne; siyasa ce. Daidaiton lafiyar kwakwalwa, ya rasu a shekarar 1996 a matsayin Dokar Daidaita Lafiya ta Hauka (MHPA), kuma ya faɗaɗa a cikin 2008 azaman (hankali na siyasa) Paul Wellstone da Pete Domenici Haɓaka Lafiyar Hauka da Dokar Daidaituwar Addiction (MHPAEA), yana tilasta masu inshora don rufe rikice-rikice na tunani da abubuwan amfani yayin da suke yin cututtukan zuciya ko ciwon sukari.
Amma ka dakata da wannan kalmar, daidaito. Ba mu taɓa buƙatar wata doka da za ta tilasta wa asibitoci yin maganin cututtukan zuciya, shanyewar jiki, zubar jini na ƙwaƙwalwa, karyewar ƙasusuwa, ko ciwon huhu ba. Waɗannan su ne m, bayyane, yanayi masu barazana ga rayuwa. Babu mai inshorar da ke buƙatar jagorar ɗabi'a don amincewa da kulawa ga wani mai jini ko duka a kan titi. PARITY ta zama gaskiya tare da (masu ilimi na farko, sannan gwamnati) sun sake bayyana gwagwarmaya a matsayin cuta; yanke shawarar cewa damuwa, ADHD, jaraba, ko rashin “rashin yanayi” dole ne a bi da su (kuma a biya su) kamar ciwon zuciya na zuciya.
Ko da yarda da jaraba na iya lalata rayuka, yadda Washington ta zaɓa don "kafa"Abubuwa da wuya su yi kama da gyara a tsanake, sai dai hade da yadda Mista Bean zai iya"kafa" abu: mai nauyi da hannu, kuma ba a yi amfani da shi ba - kuma mai caca na iya "kafa" tseren, don haka masu gaskiya suna tafiya tare da cin nasara, ita kanta gwamnati ba ta da wata manufa ta riba, amma jami'anta suna yin: ta hanyar gudunmawar yakin neman zabe, kwangilar tuntuba, cin hanci da rashawa, da kuma fadada tsarin mulki.
"Parity" yana jin ɗan adam. A aikace, ya gyara wahalhalu na likita, ya ƙarfafa dogaro na rayuwa, kuma ya gina masana'antar da ba za ta taɓa yin maganin komai ba. Wanene ba zai so a kula da schizophrenia da mahimmanci ba? Amma umarnin ya bazu fiye da rashin lafiya mai tsanani. ADHD, damuwa, Autism, jaraba - sau ɗaya dangi, bangaskiya, ko juriya na sirri (hannun hannu tare da cibiyoyin kiwon lafiyar hankali, da mafi tsananin rashin jin daɗi na zamantakewa da ƙa'idodin shari'a) - ya zama yanayi na dindindin.
Daidai da matasa, yana iya zama da wahala a yi tunanin yanzu, amma kafin daidaito da tattalin arzikin jiyya, Amurkawa sun jimre baƙin ciki, tsoro, yaƙi, da rashin tabbas ba tare da fayil ɗin likita don hawa ciki ba. Iyalai sun kasance lafiyayyu. Coci-coci sun cika. Yara sukan girma tare da iyaye biyu. Akwai shiru da stoicism - amma kuma juriya. Ba mu ɗauki kowane baƙin ciki ko ƙulli a matsayin cuta ta rayuwa da ke buƙatar alƙawura na mako-mako ba.
Sakamakon: an kiyasta $ 250 biliyan a cikin ƙarin farashin shekara-shekara sama da 1990 tushe. ACA ba ta haifar da wannan ba; ya kafe shi a bayan gwamnatin tarayya. Yanzu muna da tsarin da ya yi tsada don dorewa kuma yana da tsarki don gyarawa - "mai araha" kawai ta hanyar yin alama.
Ciwon Bincike
Parity ya juya gwagwarmaya na yau da kullun zuwa lambobin da za a iya biya. Yi la'akari da tsarin da aka saba: uwa mai damuwa, yaro marar hutawa, kimantawa a makaranta - kuma ba zato ba tsammani ADHD, amphetamines, zaman jiyya, IEP, watakila SSI cak. Taimako, amma kuma dogaro - masu biyan haraji ke biya a kowane mataki.
Autism ya bi wannan hanya, kamar yadda aka bayyana a cikinRage Ciwon Autism's Surge.” Bincike a California ya haura daga ƴan ɗari a cikin 1980s zuwa sama 200,000 yau – sau huɗu tun daga 2011. Wannan ba kawai “fadakarwa ba ne.” Ƙarƙashin Dokar Ilimin Mutum Masu Nakasa (Dabara), makarantu suna samun ƙarin $ 13,000 da yaro tare da alamar Autism a saman kashe kuɗi na asali. Kudin ilimi na musamman na ƙasa ya ci tura $39 biliyan a 2020. Kuɗin SSI na Autism ya karu da kashi 154 cikin ɗari tsakanin 2004 da 2014.
An sake yin jaraba, kuma. A cikin "Methadone Maintenance Ignited America's Opioid Crisis," Na kwatanta tsarin methadone: likitanci, daidaitawa, yin monetize. Ƙaunar jaraba ta zama rashin lafiya mai tsanani, ba karkata ba; "farfadowa" yana nufin "maintenance," ba "natsuwa ba." Tare da Parity, Lambobin jaraba na narcotic sun ninka sau biyu. Abubuwan da ba a iya gani, kafin (1970s) dalilin cutar ta opioid yana tafiya hannu-da-hannu: likitancin jarabar narcotic a matsayin "cuta" tare da "maganin" narcotics na kulawa, misali, methadone.
Ƙirƙirar "banbancin neuro" (wannan riba) zuwa ci gaban hockey-stick sakamako ne mara makawa na tsarin da ba a sami buƙatu ba, an gano shi: haifar da tabbatar da "tabbatar da jinsi."
Tatsuniyar Vietnam
Dalili akan wannan tsarin ya ta'allaka wani bangare akan tatsuniya. Masu tsara manufofi sun yi iƙirarin cewa Vietnam ta samar da ƙarni na tsofaffin sojan tabar heroin da ke buƙatar magani na tsawon rai. Amma masanin ilimin halayyar dan adam Lee Robins na binciken 1974 ya sami in ba haka ba: 34% sun yi amfani da tabar heroin a Vietnam, 20% sun cika ka'idodin dogaro - amma 1% kawai ya kasance cikin jaraba bayan dawowa gida. Sun warke ta hanyar aiki, aure, alhakin - ba asibitoci ba. Washington ta yi watsi da juriya kuma ta ba da tallafi ga asibitocin methadone da yawa ta wata hanya.
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Daidaiton Chiropractic
Mun taba ganin wannan a baya. Inshorar mota mara kuskure a cikin shekarun 1970s ya buƙaci masu insurers su biya don raunin haɗari ba tare da ƙararrawa ba. Chiropractors sun ninka.
Masana'antar balloon daga ƙasa $ 1 biliyan a farkon shekarun 1980 zuwa $ 15 biliyan nan da 2022. Lokacin da jihohi suka kafa kofa na kashe kuɗi na dala $2,000 don hana zamba, masu samarwa suna tsara jiyya na yau da kullun don isa gare ta.
A cikin asibitin shiga kaina, zan ga marasa lafiya bayan haɗari sau ɗaya ko sau biyu; chiropractors sun gan su kowace rana har sai da Kariyar Kariyar Rauni ta tafi. Lauyoyin sun ce marasa lafiya kada su koma wurina. Farfadowa ya ragu saboda wahala ta biya.
Parity ya yi daidai da lafiyar hankali: jiyya ba tare da fita ba, bincikar cututtuka ba tare da ƙare ba.
A Way Out
Nufin Parity na tausayi ne. Tasirinsa yana lalata. Amsar ba zalunci ba ce amma gyara: dawo da asusu, ba kula da rayuwa ba; tallafa wa al'umma, ba bureaucracy; lada waraka, ba rashin taimako ba. Addiction karkata ne, ba makoma ba. Autism wani lokaci nakasu ne, wani lokacin bambanci - ba koyaushe hukuncin rai ba ne. Daidaiton gaskiya yana nufin daidaiton damar murmurewa, ba garantin samun kuɗin shiga don rashin lafiya ba.
Kamar yadda Washington ta yi jayayya game da tallafin ACA, ya kamata ta fuskanci abin da ke haifar da farashin farashi: tsarin da ya juya wahala zuwa samfurin kasuwanci.
An sake bugawa daga marubucin Mayarwa
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Dokta Randall Bock ya sauke karatu daga Jami'ar Yale tare da BS a cikin ilmin sunadarai da kimiyyar lissafi; Jami'ar Rochester, tare da MD. Ya kuma binciki abin ban mamaki 'kwanciyar hankali' da ya biyo bayan cutar ta Zika-Microcephaly ta Brazil ta 2016 da firgita, a ƙarshe ya rubuta "Juyar da Zika."
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