Kula da lafiyar jama'a

Kula da lafiyar jama'a
Bayanai
Iri	government agency (en)
Aiki
Bangare na	public finance (en)

Maɓuɓɓugan kuɗaɗen kuɗaɗen lafiya ta ƙasa

Kiwon lafiya da jama'a ke ba da kuɗi wani nau'i ne na kuɗaɗen kula da lafiya da aka tsara don biyan kuɗin duk ko yawancin buƙatun kiwon lafiya daga asusun da jama'a ke gudanarwa. Yawancin lokaci wannan yana ƙarƙashin wani nau'i na lissafin dimokuradiyya, 'yancin samun damar yin amfani da shi wanda aka tsara a cikin dokokin da ke aiki ga dukan jama'ar da ke ba da gudummawa ga asusun ko samun fa'ida daga gare ta.

Asusun na iya zama amana marar riba wanda ke biyan kuɗin kiwon lafiya bisa ga ƙa'idodin gama gari waɗanda membobin suka kafa ko ta wata hanyar dimokuradiyya. A wasu ƙasashe, gwamnati ko wata hukuma ta gwamnati ce ke kula da asusun don amfanin al'umma baki ɗaya. Wannan ya bambanta shi daga wasu nau'o'in inshora na likita masu zaman kansu, ' yancin samun damar yin amfani da su wanda ke ƙarƙashin kwangilar kwangila tsakanin mutum mai insured (ko mai tallafa musu) da kamfanin inshora, wanda ke neman samun riba ta hanyar sarrafa kudaden kuɗi tsakanin masu ba da kuɗi. da masu ba da sabis na kiwon lafiya.

Lokacin da haraji shine hanyar farko ta samar da kuɗin kula da lafiya kuma wani lokacin tare da inshorar dole, duk mutanen da suka cancanta suna karɓar matakin murfin ɗaya ba tare da la'akari da yanayin kuɗin su ko abubuwan haɗari ba.

Iri-iri na jama'a tsarin

Yawancin kasashen da suka ci gaba suna da tsarin kiwon lafiya na wani bangare ko cikakken tallafi na jama'a. Yawancin ƙasashen masana'antu na yammacin duniya suna da tsarin inshorar zamantakewa bisa ka'idar haɗin kai na zamantakewa wanda ke rufe mutanen da suka cancanta daga ɗaukar nauyin nauyin nauyin yawancin kudaden kiwon lafiya, wanda aka ba da kuɗin haraji a lokacin rayuwarsu ta aiki.

Daga cikin ƙasashe masu tallafin jama'a na kiwon lafiya akwai hanyoyi daban-daban na kudade da samar da sabis na likita. Ana iya ba da kuɗin tsarin daga kudaden shiga na gwamnati na gaba ɗaya (kamar a Kanada, United Kingdom, Brazil da Indiya ) ko ta hanyar tsarin tsaro na zamantakewa na gwamnati (kamar a Ostiraliya, Faransa, Belgium, Japan da Jamus ) tare da keɓantaccen kasafin kuɗi da haraji ko gudunmawa. Hakanan adadin kuɗin kulawar da aka rufe ya bambanta: a Kanada, duk kulawar asibiti gwamnati ce ta biya, yayin da a Japan, marasa lafiya dole ne su biya kashi 10 zuwa 30% na kuɗin zaman asibiti. Ayyukan da tsarin jama'a ke bayarwa sun bambanta. Misali, gwamnatin Belgium tana biyan mafi yawan kudaden kula da hakora da ido, yayin da gwamnatin Ostireliya ke daukar nauyin kula da ido amma ba kula da hakora ba.

Za a iya gudanar da magani da ba da kuɗin jama'a da gwamnati ta bayar, kamar yadda yake a cikin ƙasashen Nordic, Portugal, Spain, da Italiya ; a wasu tsarin, kodayake, ana ba da kuɗin magani a bainar jama'a amma yawancin masu ba da asibiti ƙungiyoyi ne masu zaman kansu, kamar a Kanada. Ƙungiya da ke ba da inshorar lafiyar jama'a ba lallai ba ne gwamnatin jama'a, kuma kasafin kudinta na iya zama ware daga babban kasafin kudin jihar. Wasu tsarin ba sa samar da kiwon lafiya na duniya ko taƙaita ɗaukar hoto zuwa wuraren kiwon lafiyar jama'a. Wasu ƙasashe, kamar Jamus, suna da ƙungiyoyin inshorar jama'a da yawa waɗanda ke haɗe ta hanyar tsarin doka gama gari. Wasu, irin su Netherlands da Switzerland, suna ba da izinin masu inshorar riba masu zaman kansu su shiga.

Kiwon lafiya mai hawa biyu

  Kusan kowace babbar ƙasa da ke da tsarin kula da lafiya na jama'a kuma tana da tsarin daidaitaccen tsari na masu zaman kansu ga marasa lafiya waɗanda ke da inshorar likita masu zaman kansu ko kuma su kansu suna biyan kuɗi. A cikin waɗancan jahohin, waɗanda ke iya biyan kuɗi suna samun damar samun magani da jin daɗi waɗanda ƙila ba za su samu ga waɗanda suka dogara ga tsarin jiha ba.

Tun daga farkon tsarin NHS (1948), asibitocin jama'a a Burtaniya sun haɗa da "gadaje na jin daɗi" waɗanda galibi za su kasance dakunan dakunan da aka fi dacewa da su cikin kwanciyar hankali, da kuma ɗakuna masu zaman kansu a wasu asibitocin inda ake samar da ƙarin abubuwan more rayuwa. Marasa lafiya da ke amfani da waɗannan gadaje suna cikin asibitin NHS don yin aikin tiyata, kuma ana gudanar da ayyuka gabaɗaya a cikin gidan wasan kwaikwayo iri ɗaya kamar aikin NHS da ma'aikata iri ɗaya amma asibiti da likita suna karɓar kuɗi daga kamfanin inshora ko majiyyaci. Waɗannan gadaje na jin daɗi ba su wanzu a cikin duk tsarin da jama'a ke bayarwa, kamar a Spain. Hukumar ta NHS kuma tana biyan asibitoci masu zaman kansu don daukar nauyin tiyata a karkashin kwangila.

Tattaunawar siyasa

 

Binciken kasa da kasa na 2006 kan yadda mutane masu alhakin ke tunanin gwamnati ce don tallafin kiwon lafiya

Kasashe da yawa suna neman daidaiton ma'auni na inshorar jama'a da masu zaman kansu, tallafin jama'a, da kuma biyan kuɗi daga aljihu.

Yawancin kasashen OECD sun aiwatar da gyare-gyare don cimma manufofin manufofin tabbatar da samun damar kiwon lafiya, inganta ingancin kiwon lafiya da sakamakon kiwon lafiya, ware matakin da ya dace na sassan jama'a da sauran albarkatu ga kiwon lafiya amma a lokaci guda tabbatar da cewa an samar da ayyuka a cikin arha mai inganci da tsadar farashi (daidaituwar tattalin arziki). Matakan da yawa, kamar ingantattun hanyoyin biyan kuɗi, sun inganta haɓakar tattalin arziƙin da ke fuskantar masu samarwa. Duk da haka, gabatar da ingantattun abubuwan ƙarfafawa ta hanyar yanayi mai fa'ida tsakanin masu samarwa da masu inshora ya tabbatar da wahala.

Wani bincike na Harvard na 2009 da aka buga a cikin Jarida ta Amurka na Kiwon Lafiyar Jama'a ya gano fiye da mutuwar 44,800 a kowace shekara a Amurka saboda rashin inshorar lafiyar Amurkawa, kwatankwacin mutuwa daya a kowane minti 12. Ƙari da yawa, yawan adadin mutane a Amurka, ko masu inshora ko marasa lafiya, waɗanda suka mutu saboda rashin kulawar likita an kiyasta a cikin bincike na 1997 zuwa kusan 100,000 a kowace shekara.

Duba kuma

 

• Lafiyar duniya
• Manufar lafiya
• Tsarin lafiya
• Dokar lafiya
• Kula da lafiya idan aka kwatanta da nau'ikan tallafin jama'a daban-daban
• Inshorar lafiya ta ƙasa
• Ra'ayin jama'a game da sake fasalin kiwon lafiya a Amurka
• Kula da lafiyar mai biyan kuɗi ɗaya
• Maganin zamantakewa
• Inshorar zamantakewa
• Kula da lafiyar duniya
• Ma'aikatar Kiwon Lafiya ta Burtaniya

Kara karantawa

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• Devereaux PJ, Heels-Ansdell D, Lacchetti C, et al. (June 2004). "Payments for care at private for-profit and private not-for-profit hospitals: a systematic review and meta-analysis". CMAJ. 170 (12): 1817–24. doi:10.1503/cmaj.1040722. PMC 419772. PMID 15184339.
• Doctors support universal health care: survey, Reuters, March 31, 2008 (first reported in Annals of Internal Medicine).
• Krauss, C. As Canada's Slow-Motion Public Health System Falters, Private Medical Care is Surging, New York Times, February 26, 2006.
• Woolhandler S, Himmelstein DU (August 1999). "When money is the mission—the high costs of investor-owned care". N. Engl. J. Med. 341 (6): 444–6. doi:10.1056/NEJM199908053410611. PMID 10432332.