Da zarar a cikin wata shudin wata ko makaho ya sami adon, ko haka ake cewa. Amma, yaro, shin wanda ke zaune a ofishin shugaban kasa ya sami MOAPA (Uwar All Policy Acorns):
KIWON LAFIYA KAWAI ZAN TAIMAKA KO YARDA SHINE AIKAWA KUDIN KAI GA JAMA'A, BABU ABINDA ZAI ZUWA GA MANYAN, FAT, KAMFANONIN ARZIKI MAI ARZIKI, WADANDA SUKA YI ARZIKI DA ARZIKI, KUMA SUKA KASHE AMERICA DON ISA.
ZA A BAR MUTANE SUYI TATTAUNAWA, SU Syi KANSU, MAFI KYAU, INSURANCE. WUTA GA MUTANE!
Majalisa, kada ku ɓata lokacinku da kuzari akan wani abu.
Wannan ita ce kawai hanyar samun babban Kiwon lafiya a Amurka !!!
SAMUN SHI, YANZU.
Shugaban DJT
Trump ya bugi ƙusa daidai a kai. Sama da duk wasu dalilai, dalilin da ya sa muke da tsadar lafiyar gudu shi ne cewa ainihin hanyar biyan kuɗi don kula da lafiya a Amurka jaki ne.
Tsarin biyan kuɗi na ɓangare na uku na dala tiriliyan 5 na sashin kula da lafiya na Amurka gaba ɗaya ba ya da kyau lokacin da yakamata ya kasance a bayyane. Hakanan ana tattara shi sosai lokacin da yakamata a keɓance shi sosai; kuma an ba shi cikakken tsarin mulki da kuma sarrafa shi lokacin da gasa tattalin arzikin kasuwa na 'yanci ya kasance mafi mahimmanci.
Wato, ya kamata masu amfani da kowane mutum su ga cajin da ake yi musu katin kiredit ko wasu asusun biyan kuɗi kowane lokaci da duk lokacin da aka yi amfani da sabis na kiwon lafiya ko kuma kuɗi na gaskiya na inshorar lafiya an biya. Hakazalika, ya kamata masu samarwa koyaushe su kasance suna kallon kafaɗunsu-kamar a duk sauran kasuwannin tattalin arziki-a farashi, ayyuka, da ƙimar ƙimar abokan fafatawa.
Amma abin da muke da shi, maimakon haka, tsari ne mai banƙyama, haɗaɗɗiya, tsattsauran ra'ayi, tsarin biyan kuɗi kafin a biya wanda ya saba da inshorar tushen haɗari. Wannan tsarin karkatacciyar hanya yana ba da cikakken kariya ga masu amfani da masu samarwa idan ya zo ga kowane ilimi, da ƙarfafawa ga, tattalin arziƙin amfani da sabis na likita.
Lalle ne, idan mota sayayya kasance a kan irin wannan homogenized, pooled pre-biyan tsarin kowa da kowa zai a tuki a Lamborghini, Rolls-Royce, Mercedes, ko ma Cadillac ko biyu. Za ku zama mai shayarwa don fitar da alamar Koriya, Akwatin tattalin arzikin Mexico - wanda a zahiri akwai miliyoyin akan hanyoyin Amurka a yau.
Tabbas, sun yi farin cikin kiran wannan haɗaɗɗiyar hanyar haɗin kai, hanyar daidaita farashin kula da lafiya "ƙimar al'umma" underwriting. Amma babu wani abu da ya yi kama da inshora "rubutu" game da shi. Yanayi ne kawai na ƙara duk farashin na lokacin lissafin kuɗi da kuma rarraba ta adadin raka'a "insured" a cikin tafkin. Bayan wannan babban darasi na lissafi, kowane ɗayan inshorar yana samun alamar farashi ɗaya, adana don bambance-bambancen girman dangi kuma, ƙarƙashin ObamaCare, rangwamen siginar nagarta don rashin shan taba.
Don mu shiga cikin al’amarin, saboda haka, kalmar da ta dace kawai ga abin da ya wuce na “inshorar lafiya” a Amurka a yau ita ce “ƙananan zamantakewa.” Wato, ainihin ƙayyadaddun ƙididdiga masu girman kai-daidai-dukkan farashin farashi wanda asalinsa injin hauhawa ne, wuce gona da iri, da sharar gida kamar ƴan wasu shirye-shiryen tattalin arziki a Amurka ko Chinar kwaminisanci, ga wannan al'amari.
Saboda haka, ba shi da mahimmanci ko muna magana ne game da Medicare, Medicaid, ObamaCare Exchange tsare-tsaren, tsare-tsaren ƙungiyar ma'aikata, ko rashin daidaituwa da tsarin tsare-tsaren inshora na kasuwanci wanda har yanzu yana rataye a cikin kwandon. Halayen gama gari na duk waɗannan tsare-tsaren shine cewa suna haɓaka ƙimar biyan kuɗi ta hanyar kawar da farashin tushen haɗari ga kowane mabukaci/mai amfana, wanda ta ma'anarsa, ba shakka, ya haɗa da ixnay akan farashi don "sharuɗɗan da suka riga sun kasance."
Bugu da ƙari, lokacin da turawa ya zo, wannan shine koyaushe ƙarshen wasan na tsawon shekaru da yawa a Washington don "inshorar lafiyar ƙasa," wanda a ƙarshe ya ƙare a cikin matasan 2010 da ake kira ObamaCare. Babban manufar na karshen, wanda a karshe ya ba shi isasshiyar siyasa don wucewa, shine kawar da shi wanda ya riga ya kasance sharuɗɗa a cikin rubutun inshorar kiwon lafiya kuma ta haka kusan gabaɗayan ikon yin rubutun ƙima na tushen likitanci.
Wato, dokar ObamaCare ta jefar da jaririn da ruwan wanka. Bayan haka, lokacin da kake da bans akan farashi don haɗari ko don yanayin da aka rigaya ko matsayin lafiyar masu amfana don goyon bayan tsarin "ƙimar al'umma", kuna da "inshora" a cikin suna kawai.
A zahiri, kawai abin da ObamaCare ya ba da izini wanda har ma yayi kama da rubutun tushen haɗari shine bambance-bambancen ƙima dangane da shekaru (iyakance zuwa kewayon 3:1), girman dangi, ƙauye da yanayin ƙasa na birni, da kuma hukuncin da aka ambata na shan taba.
Sakamakon tsare-tsare masu cancantar musanya na ObamaCare na al'umma, ba shakka, an soke sauran kasuwar inshorar mutum da ƙananan ƙungiyoyi kafin 2010. Wannan saboda idan ba ku hadu da ƙayyadaddun bayanan shirin ObamaCare ba, shirin ku baya samun babban tallafin kuɗaɗen haraji, wanda a yanzu ke zubowa daga cikin asusun Uncle Sam da aka buge akan kudi kusan Dala biliyan 100 a kowace shekara.
A takaice dai, Uncle Sam yanzu yana tura karas na dala biliyan 100 a kowace shekara don tilastawa duka mutum da ƙananan kasuwar inshorar likitanci zuwa ga mafi girman girman-daidai-dukkan gadon Procrustean. Don haka, sai dai idan kun ba da duk fasalulluka da sharuɗɗan da aka keɓe a ƙasa, “babu kaska, babu wanki” ga gidan Main Street mai wahala wanda babban tsarin aikin likita na tushen aiki ya rufe (duba Sashe na 2).
Magidanta masu kula da lafiya waɗanda ke da kuɗaɗen aikin likita na yau da kullun za su iya gwammace su tabbatar da kansu waɗannan farashin na yau da kullun, wanda babban shirin likitanci ke ɗauke da babban abin cirewa na shekara-shekara da ƙaramin ƙima don ƙididdige haɗarin wani bala'i mai ƙarancin mitar likita. Irin wannan tsarin inshora na bala'i na dangi mai ƙarancin haɗari mai lafiya na mutum huɗu yana iya sauƙin farashi ƙasa da $ 10,000 a kowace shekara ko ma $ 5,000 idan abin da aka cire ya isa sosai, yayin da har yanzu yana kare kariya daga lalacewar kuɗi.
Sabanin haka, farashin ainihin shirin cancantar ObamaCare na iyali mai mutane huɗu cikin sauƙi ya kai dala 25,000 a kowace shekara a kasuwannin kula da lafiya na yau da kullun. Don haka mafita ta tushen Washington koyaushe iri ɗaya ce: Babban kuma ƙarin cikakkun tallafin masu biyan haraji don rage kashe kuɗin aljihu na ƙayyadaddun tsarin aiki da shirye-shiryen Cadillac da ake gudanarwa don sarrafa matakan farashi.
Ba abin mamaki ba ne, don haka, don me yasa ko da tsarin da ake tsammani ƙananan farashi na "Bronze" a ƙarƙashin ObamaCare yana ɗaukar irin wannan ƙima mai yawa. Wato, da siffofi na wajibi Dole ne waɗannan tsare-tsare su kasance da su don samun ƙwararrun Tsarin Kiwon Lafiya (QHP) akan Kasuwannin ACA don haka su cancanci kari na haraji da raguwar raba farashi yana gudana kuma yana gudana kamar rafin Tennyson:
- Batun Garanti: Dole ne a ba da tsare-tsare kowane mai nema ba tare da la'akari da matsayin lafiya, jinsi, ko wasu dalilai (babu rubutun likita).
- Babu Keɓancewar Yanayin da Ya Gabata ko Tsawon Lokacin Jira: Dole ne a fara ɗaukar hoto don abubuwan da suka gabata. rana daya ba tare da ware ko jinkirtawa ba.
- Muhimman Amfanin Lafiya (EHB) dole ne ya rufe duk nau'ikan ka'idoji 10 tare da ƙimar gaske a cikin kowane:
- Ayyukan marasa lafiya na gaggawa
- gaggawa da sabis
- arin
- Kulawar haihuwa da jarirai
- Lafiyar hankali da sabis na rashin amfani da abubuwa (ciki har da kula da lafiyar ɗabi'a)
- Magunguna masu ba da magani
- Sabis da na'urori masu gyarawa da gyarawa
- Ayyukan dakin gwaje-gwaje
- Sabis na rigakafi da lafiya da kula da cututtuka na yau da kullun
- Ayyukan yara, gami da kula da baki da hangen nesa
- Ƙimar Gaskiya (Matakin Ƙarfe) Biyayya: Waɗannan buƙatun suna auna adadin matsakaicin kuɗin likita don daidaitaccen yawan jama'a da shirin ya biya bayan duk abin da aka cire daga aljihu, inshorar haɗin gwiwa, da biyan kuɗi. Ana nuna matakan da nau'in tushen ƙarfe wanda manufar ke biyan ƙarin kashi mafi girma na jimlar farashin magani:
- Bronze ≈ 60%
- Azurfa ≈ 70%
- Zinariya ≈ 80%
- Platinum ≈ 90%
- Bayan rabon da ke sama, duk da haka, akwai ƙarin cikakken iyaka da ake kira Matsakaicin Iyakar Fita Daga Aljihu wanda ba za a iya wuce ta gaba ɗaya a cikin raba farashin hanyar sadarwa (wanda ba za a iya cirewa + haɗin-biyan kuɗi + coinsurance ba). Wadannan iyakoki na 2026 a halin yanzu $10,150 don tsare-tsaren mutum da $20,300 don tsare-tsaren iyali.
- Don haka, a cikin yanayin shirin Bronze inda jimillar kuɗin magani ya kai $100,000 saboda matsanancin rashin lafiya, zaman asibiti, ko tsarin jiyya mai tsada, shirin zai biya dala 60,000 kuma mai cin gajiyar $40,000. Amma matsakaicin iyaka zai iyakance biyan masu cin gajiyar zuwa kusan rabin wancan ko $20,300.
- Kuma idan gidan yana da dala 80,000 na daidaitaccen babban kudin shiga a ƙarƙashin dokar yanzu iyakar ƙimar kuɗin da zai kasance 6% ko $4,800. Mahimmanci duk sauran za a shawo kan Uncle Sam.
- Babu Iyakar Dalar Shekara-shekara ko Ta Rayuwa akan Muhimman Fa'idodin Lafiya
- Sabis na rigakafi tare da Raba Kuɗi na Zero. Duk shawarwarin USPSTF “A” & “B”, rigakafin ACIP, sabis na rigakafin mata na HRSA, da sabis na kula da yara na Bright Futures dole ne a rufe su kafin a cire su tare da biyan kuɗi na $0 yayin cikin hanyar sadarwa.
- Ƙimar Ƙimar Al'umma / Ƙuntatacce Mahimman Kima: Ƙirar ƙima na iya bambanta kawai ta:
- Shekaru (3:1 rabo max)
- Amfanin taba (1.5:1 rabo max)
- Yankin kima na yanki
- Girman iyali
→ Babu bambanci ta yanayin lafiya, jinsi, sana'a, da sauransu.
- Pool Haɗari Guda: Tdole ne mai bayarwa ya haɗa duk masu rajista na QHP na kasuwa (a-da-da-canza) zuwa cikin wurin haɗari guda ɗaya don dalilai na ƙima.
- Isar da Sadarwar Sadarwa & Ka'idodin Mai Ba da Mahimmanci na Al'umma: Dole ne tsare-tsare su haɗa da isassun lamba da nau'in masu samarwa, da mafi ƙarancin kaso na Ma'aikatan Al'umma Mahimmanci (asibitocin da ke ba da ƙarancin kuɗi, FQHCs, Ryan White, da sauransu).
- Amincewa: Dole ne NCQA, URAC, ko wani jikin da aka gane na HHS ya amince da tsare-tsare akan daidaitawar haɗari, haɓaka inganci, da sauransu.
- Bambanci Mai Ma'ana/Rashin Wariya: Tsare-tsare daga mai bayarwa ɗaya dole ne ya bambanta da juna mai ma'ana; babu wariyar da ba ta dace ba dangane da shekaru, nakasa, ko buƙatun lafiya da ake tsammani.
- Tsara Tsare-tsaren Fa'ida: Idan Kasuwa yana ba da daidaitattun zaɓuɓɓuka (mafi yawan jihohi suna yin don 2026), QHP dole ne ya dace daidai akan abubuwan cirewa, haɗin-biyya, matakan magunguna, da sauransu, idan mai bayarwa ya zaɓi bayar da daidaitaccen tsari.
Shirin da ya gaza kowane ɗayan waɗannan buƙatun ba za a iya siyar da shi akan Kasuwar ACA ba kuma ba za a iya karɓar ƙididdigan haraji na ƙima ko ragi na raba farashi ba - ko da HSA-cancantar, mai rahusa, ko wani abu mai kyau. Wannan shine dalilin da ya sa tsare-tsare na gajeren lokaci, ƙayyadaddun lamuni, tsare-tsaren ƙungiyoyi, da sauransu, kusan ba su cancanci tallafi ba.
Kamar yadda za mu fadada a cikin Sashe na 2, sakamakon hauhawar farashin waɗannan buƙatun yana da yawa, kuma matsin lamba na siyasa don samun waɗannan tsadar tsadar rayuwa ta Uncle Sam ba shi da ƙarfi. Don haka Trump yana kan wani abu da gaske: Ba kowane Ba'amurke kuɗin daidai da Medicare, Medicaid, ObamaCare, ko shirye-shiryen ma'aikata kuma bari kasuwa ta kai hari kan hauhawar farashi, sharar gida, wuce gona da iri, da wauta da aka gina a cikin tsarin na yanzu!
A halin yanzu, a nan akwai faɗakarwa mai ɓarna don Sashe na 2. A cikin shekaru 64 da suka gabata, daidaitawar hauhawar farashin kaya (2024 $) kashe kuɗin kula da lafiya a Amurka ya haɓaka ta 18X, daga dala biliyan 283 a shekarar 1960 zuwa dala tiriliyan 5.127 a shekarar 2024. Kuma a kan kowane mutum, ribar da aka samu ya zarce. 10X, ku. daga game $1,500 a 1960 zuwa fiye $15,000 a yau (sake cikin 2024 $), yayin da rabon GDP ya fashe daga 5.2% zuwa 18.9%.
Wato jirgin dakon kaya na kiwon lafiya da ya gudu yana buƙatar dakatar da shi kuma nan ba da jimawa ba. Lallai Trump yana sosa bishiyar da ta dace.
Trump zai yi tattalin arzikin Amurka kwata-kwata idan ya tsaya kai da fata kan harin da ya kai kan Inshorar Lafiya ta Fake. Bayan haka, shi ne tushen tushen tsarin kula da lafiyar hauhawar farashin kayayyaki na Amurka - don haka yana buƙatar fallasa shi sosai kuma da ƙarfi.
Don farawa, lokacin da kuka keɓe fitar da kuɗi don binciken lafiya, haɗin gwiwa, shirye-shiryen isar da lafiyar jama'a kai tsaye, da makamantansu daga dala tiriliyan 5.267 na jimillar kashe kuɗin kiwon lafiyar Amurka, a halin yanzu akwai kusan kusan $ 3.7 tiriliyan na ciyarwa don sabis na kula da lafiya na sirri da tsare-tsare, kamar yadda aka nuna a teburin da ke ƙasa. Amma duk da haka kaso mai tsoka na wannan kashe kuɗi na kula da lafiyar mutum yana shiga ta masu biya na ɓangare na uku duk da cewa kuskuren Trump na kwanan nan ya hana masu cin gajiyar haƙƙin -
…… ..TATTAUNAWA DA SIYA KANSU, MAFI KYAU, INSHARA. WUTA GA MUTANE! BABU ABINDA ZAI ZUWA GA MANYAN, FAT, KAMFANONIN ARZIKI MAI ARZIKI, WADANDA SUKA YI ARZIKI DA ARZIKI, KUMA SUKA KASHE AMERICA DON ISA.
A gaskiya, cikakke 82% or $ 3.0 tiriliyan na kashe kuɗaɗen kula da lafiya (2024) ta masu biya na ɓangare na uku. Mafi mahimmanci, kodayake ana kiran waɗannan masu biyan kuɗi akai-akai a matsayin masu siyar da "inshorar likita", suna ba da inshora da suna kawai. Kamar yadda muka faɗa a cikin Sashe na 1, yawancin waɗannan daloli na ɓangare na uku ana bayar da su ta hanyar haƙƙin gwamnati ko wuraren biyan kuɗi na jama'a masu zaman kansu da na ma'aikata waɗanda ba sa saita farashi bisa tsarin haɗarin likita, don haka ba sa sanya masu cin gajiyar farashin sabis ɗin da matsayin lafiyar su da ayyukansu ke samarwa.
Don haka, kashe kuɗin kula da lafiyar ma'aikata na shekara ya kai $10,934 ga kowane mai cin gajiyar amma kawai $2,018 na wannan yana wakiltar kuɗin da ba a cikin aljihu ba don ƙima, abubuwan cirewa, da kuma biyan kuɗin da masu amfani suka sha. Masu amfani da kiwon lafiya ba su taɓa gani, ji ko samun ra'ayi mafi hazo game da $8,916 daidaitawa.
Yanzu, ko wannan $8,916 balance kowane mai cin gajiyar da aka biya ta hanyar wuraren waha yana sanya kamfanonin inshora su zama masu wadata, kamar yadda Trump ya yi ikirari, ko kuma ofisoshin gwamnati mai kiba, kamar yadda masu ra'ayin rikau na siyasa ke karbar haraji, hakika yana kusa da batun.
Abin da ke da mahimmanci shi ne sabanin lamarin a kowace kasuwa na tattalin arziki, masu amfani da kiwon lafiya ko masu ba da sabis ba sa ganin farashi da farashin sabis da kulawar da ake bayarwa ko ta hanyar su. Saboda haka, ba su da wani abin ƙarfafawa na tattalin arziki don amsa alamun kasuwa. Wato, yin siyayya a kusa idan sun kasance masu amfani da farashi ko don inganta farashinsu / shawarwarin sabis dangane da masu fafatawa idan sun kasance masu samarwa.
Notes:
- Kowane Amfani $ = Jimlar Kashewa /# na jimlar masu amfana
- OOP/Amfani $ = Mai Amfani OOP /# na jimlar masu amfana
- OOP% = Mai Amfani OOP / Jimlar Exp (gaba ɗaya 18.4%)
- Jimlar masu cin gajiyar 336.8M ya haɗa da ~7M dual-cancantar ƙidaya sau biyu
- Yana rufe kula da lafiyar mutum kawai; cikakken NHE = $5.267T (sauran $1.58T = sauran masu biyan kuɗi + wadanda ba na sirri)
Teburin da ke sama ya bayyana cewa 55% ko $ 2.26 tiriliyan na kashe kuɗin kula da lafiyar ma'aikata ya biyo bayan manyan haƙƙoƙin gwamnatin gargajiya guda biyu-Medicare da Medicaid. Duk da haka duka waɗannan manyan wuraren ba da tallafi na gwamnati kusan ba su da kyau ga mabukaci. Mutane miliyan 147 (cibiyoyin biyu na masu cancanta miliyan 7) waɗanda suka ci gajiyar waɗannan haƙƙoƙin ba su taɓa ganin lissafin likita ba ko kuma sun sami kuɗin kuɗi, sai dai don ƙaramin kuɗi a cikin yanayin Medicare.
A cikin yanayin Medicaid, a zahiri, sama da masu cin gajiyar Medicaid miliyan 84.5 ne waɗanda suka biya. kusan babu wani abu daga aljihu don ayyukansu. Kamar yadda aka nuna a ƙasa, kuɗin waje na aljihu don haɗin gwiwar Medicaid da sauran cajin ya kai daidai 1.1% na jimlar kuɗin Medicaid ko $118 ga kowane mai cin gajiyar kowace shekara. Sabanin haka, mai biyan gwamnati na ɓangare na uku yana ɗaukar sama $10,844 kowane mai cin gajiyar farashi. Rabo kenan 92:1 bisa asusun Uncle Sucker da sauran mataimakansa na jiha da kananan hukumomi.
Ee, asalin Medicaid an kafa shi azaman nau'i na biyan kuɗin shiga na nau'in nau'in kudin shiga don masu karamin karfi. Amma yanzu cikakken kashi 25% na yawan jama'ar Amurka Medicaid ne ke rufewa, kuma a wannan yanayin yana samun kulawar lafiya kyauta. Abinda kawai ke riƙe farashin, ƙimar amfani, da farashi shine farashin bureaucratic da amfani da abubuwan sarrafawa waɗanda adadinsu ya kai ga kayan aiki mara ƙarfi wanda baya ɗaukar ƙarancin hauhawar farashin kayayyaki.
Don shakku, a nan ne matakin farashi, adadin masu cin gajiyar Medicaid, da farashin kowane mai cin gajiyar a zahiri tun daga 1980. Za a iya samun ɗan shakku daga wannan bayanan cewa kula da lafiya kyauta shine injin hauhawar farashin kaya kamar babu sauran.
A iya sanina, jimillar rajista ya karu daga ƙasa da miliyan 20 a cikin 1980 zuwa lokacin annoba na kwanan nan na kusan miliyan 100. A lokaci guda, farashin dala akai-akai (2024 $) ya haura daga $4,857 ga kowane mai cin gajiyar a 1980 zuwa $10,959 a 2024.
Lokacin da masu amfana suka tashi kusan ninki biyar kuma farashin kowane mai amfana ya karu da kashi 2.2X a cikin shekaru 45, jimlar fitar da kaya ta tashi sama. Don haka, kudin Medicaid na "runaway" na dala biliyan 95 a kowace shekara wanda gwamnatin Reagan ta kai hari a 1981 ya riga ya kai dala biliyan 173 ta 1990 da dala biliyan 578 a jajibirin dokar ObamaCare a 2010.
Tun daga wannan lokacin, saboda faɗaɗa cancanta da fa'idodi masu sassaucin ra'ayi, juzu'i da farashin dala akai-akai sun kusan ninki biyu zuwa miliyan 85 da dala biliyan 926, bi da bi. Sa'an nan kuma, a ƙarshe ba za a yi izgili da dokokin lissafi ba.
A cikin shekaru 44 da suka gabata yawan kashe kuɗin Medicaid na dala ya ƙaru a 5.31% kowace shekara ko ninki biyu 2.7% GDP na gaske a kowace shekara. Don haka kamar yadda mutumin ya ce, al'amuran da ba su dawwama suna tsayawa.
Abin da kayan kyauta ke yi. Trump ya buga ƙusa a kai, ko da bai yi daidai da Medicaid ba lokacin da ya ba da "ikon kashe kuɗin magani ga mutane" ukase a farkon wannan makon.
Notes:
- Ƙirar ƙima daga bayanan MACPAC FY (kimanin kalanda); 2023/2024 an daidaita shi zuwa CMS NHE ($872B 2023, $926B 2024 proj.).
- Masu amfana: Matsakaicin rajista na shekara-shekara (M).
- Ƙimar gaske ta ƙare zuwa 2024 $ ta amfani da CPI-U (2024=313.689).
- Tsayayyen rubutu don kwafi.
A zahiri, POTUS yakamata ya kasance yana da Medicare a hankali, shima. Babu shakka babu wani fannin “inshora” da aka rubuta ta likitanci game da shi.
Da farko, kashi 84% na dalar Amurka tiriliyan 1.1 na kudin sa na shekara-shekara ana ƙididdige su. kudaden gwamnati kai tsaye ga dillalai. Saboda haka a fili masu amfani suna da 'yanci don gudu $ 920 biliyan ƙimar sabis da caji a cikin 2024 ba tare da ainihin gani ba game da farashin dubun-dubatar abubuwa da aka yi wa Medicare a madadin masu cin gajiyar miliyan 66.
Bugu da ƙari, har ma da $ 180 biliyan na kashe-kashen aljihu da masu cin gajiyar Medicare ke ɗauka ba su isar da bayanai masu ma'ana sosai game da farashin sabis da sakamakon kuɗi na ƙimar amfani mai yawa ko jiyya na Cadillac da zaɓuɓɓukan sabis. Wannan saboda cikakken dala biliyan 150 na adadin da masu cin gajiyar suka cinye sun kasance na Sashe na B (dala biliyan 130) da Sashe na D (dala biliyan 20) “kudaden inshora.”
Bugu da ƙari, babu alamun inshora komai game da waɗannan masu biyan kuɗi masu ƙimats. Na biyun su ne kawai tsarin kasafin kuɗi na sabani waɗanda aka ƙera don rage farashin likitoci da farashin sayan magani akan asusun gwamnati na gabaɗaya, kuma sun bambanta sosai dangane da farashi akan lokaci. Yadda ya kamata, ƙimar kuɗi wani nau'i ne na harajin masu cin gajiyar wanda ba shi da alaƙa da farashi da adadin Sashe na B da Sashe na D sabis da ake cinyewa.
Dangane da haka, kawai ainihin amfani da tushen farashi ga duka dala tiriliyan 1.1 na biyan kuɗin Medicare shine kusan. $ 30 biliyan darajar haɗin-biyya da deductibles ɗin da masu cin gajiyar suka sha a cikin 2024. Wato, kawai 2.7% Ana ba da kuɗaɗen fitar da kuɗin Medicare ta hanyar da ke isar wa masu amfani da kowane ma'ana a duk tasirin kuɗin da ba a cikin aljihu na sabis ɗin likita da ake amfani da su ba.
Don duk dalilai masu amfani, sabili da haka, manyan abubuwan da ake kashewa don Medicare kuma sun kai “kaya kyauta” a matakin masu cin gajiyar.
Idan ya zo ga ma'auni na wuraren biyan kuɗi na ɓangare na uku, ɓangaren aljihu na jimlar kuɗin yana da yawa sama da ƙarƙashin manyan haƙƙoƙin kula da lafiya na gwamnati biyu. A cikin yanayin ObamaCare, masu cin gajiyar miliyan 21.3 sun biya dala biliyan 120 ko kashi 56% na farashi a cikin 2024.
Amma dala biliyan 54 na karshen na ObamaCare Exchange ne na “inshorar inshora”, net of premium credits. Wannan yana nufin tasirin da ba a cikin aljihu ba ga masu amfani ya kasance aikin samun kuɗin shiga ne, ba amfani da sabis na kiwon lafiya ba ko kowane ma'anar kuɗin da aka rubuta na likitanci na fakitin ɗaukar hoto na tilas wanda aka tilasta musu su saya akan musayar don samun ƙima mai ƙima.
Hakazalika, a cikin yanayin kashe dala tiriliyan 1.4 na sabis na likita wanda masu cin gajiyar shirin kiwon lafiya miliyan 155 suka jawo, kawai. 25% a zahiri an biya ta masu cin gajiyar.
A gaskiya, don haka, ainihin aikin dalar Amurka tiriliyan 1.6 na kasuwa wanda ObamaCare da Tsare-tsaren Ma'aikata ke rufe an tsara su sosai don rage ilimin mabukaci game da farashin kula da lafiyarsu da kuma kare su daga tasirin da halayensu da zaɓin su ke da shi akan jimillar farashi, kamar yadda za mu ƙara girma daga baya.
An sake bugawa daga Stockman's sabis na sirri
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David Stockman, Babban Malami a Cibiyar Brownstone, shine marubucin litattafai da yawa akan siyasa, kudi, da tattalin arziki. Shi tsohon dan majalisa ne daga Michigan, kuma tsohon Daraktan Ofishin Gudanarwa da Kasafin Kudi na Majalisa. Yana gudanar da shafin nazari na tushen biyan kuɗi ContraCorner.
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