Sezvo varwere vachiwedzera kuvimba nevamiriri uye mabasa avo, hutano hwehutano hweUnited States hwakagadzira izvo Dr. Robert Pearl anodana "pfungwa dzepakati".
Pakati pevagadziri nevatengi, iwe unowana boka renyanzvi dzinofambisa kutengeserana, kufambisa iwo uye kutumira zvinhu nemasevhisi.
Vanozivikanwa sevarevereri, vanobudirira mune ingangoita indasitiri yese, kubva kune real estate nekutengesa kune zvemari uye mafambiro masevhisi.Pasina varevereri, dzimba nehembe zvaisazotengeswa.Pachave pasina mabhanga kana nzvimbo dzekuchengetera pamhepo.Nekuda kwevamiriri, madomasi anorimwa kuSouth America anounzwa nechikepe kuNorth America, opfuura netsika, anozopedzisira ave muchitoro cheko uye anopedzisira apinda mudengu rako.
Varevereri vanozviita zvese nemutengo.Vatengi nenyanzvi dzezvehupfumi havabvumirani pamusoro pekuti vanopindirana vari tupukanana tusina kukosha kuhupenyu hwazvino, kana zvese zviri zviviri.
Chero bedzi gakava richiramba riripo, chinhu chimwe chine chokwadi: vamiriri vehutano hweUS vakawanda uye vari kubudirira.
Vanachiremba nevarwere vanochengeta hukama hwemunhu uye vanobhadhara zvakananga vamiriri vasati vapinda.
Mumwe murimi womuzana remakore rechi19 airwadziwa nepfudzi akakumbira kushanyirwa nachiremba wemhuri yake, uyo akaita nzvero yomuviri, kuongorora chirwere, uye mushonga wemarwadzo.Zvose izvi zvinogona kuchinjana nehuku kana mari shoma.Murevereri haadiwe.
Izvi zvakatanga kuchinja muhafu yekutanga yezana remakore rechi20, apo mari uye kuoma kwekutarisira kwakava nyaya kune vakawanda.Muna 1929, apo musika wemasheya wakaputsika, Blue Cross yakatanga semubatanidzwa pakati pezvipatara zveTexas nevadzidzisi venzvimbo.Vadzidzisi vanobhadhara bhonasi yemasendi makumi mashanu pamwedzi kubhadhara rubatsiro rwechipatara rwavanoda.
Mainishuwarenzi broker ndiye anotevera murevereri mukurapa, achiraira vanhu nezvezvakanakisa zvirongwa zveinishuwarenzi yehutano nemakambani einishuwarenzi.Makambani einishuwarenzi paakatanga kupa mabhenefiti emishonga muma1960s, maPBMs (Pharmacy Benefit Managers) akabuda kuzobatsira kudzora mutengo wezvinodhaka.
Varevereri vari kwese kwese munzvimbo yedhijitari mazuva ano.Makambani akaita seTeledoc neZocDoc akagadzirwa kubatsira vanhu kuwana vanachiremba siku nesikati.Offshoots ePBM, akadai seGoodRx, ari kupinda mumusika kuti ataurirane nezvemitengo yezvinodhaka nevagadziri uye mafemasi akamiririra varwere.Masevhisi ehutano hwepfungwa akaita seTalkspace neBetterHelp amuka kuti abatanidze vanhu navanachiremba vane rezinesi rekupa mishonga yepfungwa.
Aya mapoinzi mhinduro anobatsira varwere kufamba zvirinani masisitimu ehutano husina kushanda, zvichiita kuti kutarisirwa uye kurapwa kuve nyore, kuwanikwa, uye kukwanisika.Asi sezvo varwere vachiwedzera kuvimba nevanopindirana nemasevhisi avo, zvandinodaidza kuti pfungwa dzepakati dzakashanduka muhutano hweAmerica.
Fungidzira kuti wawana mutswe wakareba pamusoro penzira yako.Iwe unogona kusimudza asphalt, kubvisa midzi pasi uye kuzadza nzvimbo yose.Kana kuti unogona kuhaya mumwe munhu kuti agadzirire nzira.
Pasinei neindasitiri kana nyaya, vamiriri vanochengeta "kugadzirisa" mafungiro.Chinangwa chavo ndechekugadzirisa dambudziko rakamanikana pasina kufunga nezve anoperekedza (kazhinji maumbirwo) matambudziko ari shure kwaro.
Saka kana murwere akatadza kuwana chiremba, Zocdoc kana Teledoc inogona kubatsira kuronga nguva.Asi makambani aya ari kufuratira mubvunzo muhombe: Sei zvakaoma kuti vanhu vawane vanachiremba vanotengeka pakutanga?Saizvozvo, GoodRx inogona kupa makuponi kana varwere vasingakwanise kutenga zvinodhaka kubva kuchitoro chemishonga.Asi kambani iyi haina basa kuti sei vanhu vekuAmerica vachibhadhara zvakapetwa kaviri pamagwaro sevanhu vari kune dzimwe nyika dzeOECD.
Hutano hweAmerica huri kuramba huchidzikira nekuti vayananisi havasi kugadzirisa matambudziko aya makuru, asingagadziriswe.Kushandisa mufananidzo wezvokurapa, murevereri anogona kuderedza mamiriro ezvinhu anotyisidzira upenyu.Havaedzi kuvaporesa.
Kuti zvive pachena, dambudziko nemishonga haisi kuvapo kwevamiririri.Kushaikwa kwevatungamiriri vanoda uye vanokwanisa kudzoreredza hwaro hwakakanganisika hwekutarisira hutano.
Muenzaniso wekushaikwa kwehutungamiriri iyi "mubhadharo-we-sevhisi" yekudzorera modhi yakapararira muUS hutano hwehutano, umo vanachiremba nezvipatara vanobhadharwa zvichienderana nehuwandu hwesevhisi (bvunzo, marapirwo, uye maitiro) avanopa.Iyi "mari paunoshandisa" nzira yekubhadhara ine musoro mumaindasitiri mazhinji emakambani.Asi mukutarisira utano, migumisiro yacho yave ichidhura uye inopesana.
Mukubhadhara-per-service, vanachiremba vanobhadharwa zvakanyanya pakurapa dambudziko rekurapa pane kuridzivirira.Vanofarira kupa kutarisirwa kwakawanda, kungave kunowedzera kukosha.
Kutsamira kwenyika yedu pamubhadharo kunobatsira kutsanangura kuti nei mitengo yehutano yeUS yakakwira zvakapetwa kaviri sekukwira kwemitengo mumakore makumi maviri apfuura, nepo tarisiro yehupenyu haina kushanduka panguva imwe chete.Parizvino, US iri kusara kumashure kwedzimwe nyika dzakabudirira muhutano hwekiriniki, uye huwandu hwekufa kwevana naamai hunopetwa zvakapetwa kaviri kune dzimwe nyika dzakapfuma.
Iwe unogona kufunga kuti vashandi vehutano vaizonyara nekukundikana uku - vaizosimbirira kutsiva iyi isingashande yekubhadhara modhi neimwe inotarisisa kukosha kwekuchengetwa kwakapihwa kwete kuwanda kwekutarisirwa kwakapihwa.Hauna kunaka.
Iyo yekubhadhara-ye-value modhi inoda kuti vanachiremba uye zvipatara vatore njodzi yemari yemhedzisiro yekiriniki.Kwavari, shanduko yekubhadhara prepay yakazara nenjodzi yemari.Saka pachinzvimbo chekutora mukana iwoyo, vakatora pfungwa yepakati, vachisarudza shanduko diki dzekuwedzera kuderedza njodzi.
Sezvo vanachiremba nezvipatara vachiramba kubhadhara mutengo, makambani einishuwarenzi akazvimirira uye hurumende yemubatanidzwa vanoenda kubhadharira-ku-kuita zvirongwa zvinomiririra yakanyanyisa yepakati pfungwa.
Aya mapurogiramu ekurudziro anopa mubayiro vanachiremba nemamwe madhora mashoma pese pavanopa basa rekudzivirira.Asi nekuti kune mazana ehumbowo-hwakavakirwa nzira dzekudzivirira chirwere (uye chete shoma shoma yemari yekurudziro iripo), isiri-yekurudziro nzira dzekudzivirira dzinowanzo furatirwa.
Murangariro wemurume-wepakati unobudirira mumaindasitiri asina kushanda zvakanaka, anonetesa vatungamiriri uye achitadzisa shanduko.Naizvozvo, nekukurumidza iyo US hutano indasitiri inodzokera kune yayo hutungamiriri pfungwa, zviri nani.
Vatungamiri vanotora nhanho mberi uye kugadzirisa matambudziko makuru nezviito zvakashinga.Vepakati vanoshandisa mabhandi-aids kuvanza.Kana chimwe chinhu chisina kumira zvakanaka, vatungamiri vanotora mutoro.Mafungiro emurevereri anoisa mhosva pane mumwe munhu.
Zvakafanana nemishonga yekuAmerica, nevatengi vezvinodhaka vachipomera makambani einishuwarenzi kudhura kwakanyanya uye hutano husina kunaka.Uyewo, kambani yeinishuwarenzi inopomera chiremba pane zvose.Vanachiremba vanopomera varwere, vanodzora uye makambani ezvekudya nekukurumidza.Varwere vanopomera vavanoshandira uye hurumende.I denderedzwa rakashata risingaperi.
Zvechokwadi, kune vanhu vakawanda mumhizha yehutano-maCEO, zvigaro zvemabhodhi evatungamiri, vatungamiri vemapoka ezvokurapa, uye vamwe vakawanda-vane simba uye kukwanisa kutungamirira shanduko yekuchinja.Asi pfungwa yemurevereri inovazadza nekutya, inodzikisira kutarisa kwavo, uye inovasundira kune diki diki kuvandudzwa.
Matanho madiki haana kukwana kukurira kuwedzera uye kupararira kwehutano matambudziko.Chero bedzi mhinduro yehutano inoramba iri duku, migumisiro yekusaita ichakwira.
Hutano hweAmerica hunoda vatungamiriri vakasimba kuti vapwanye pfungwa dzepakati uye kukurudzira vamwe kuti vatore danho rakashinga.
Kubudirira kunoda kuti vatungamiri vashandise mwoyo yavo, huropi, uye musana - iwo matatu (dimikira) nzvimbo dzeanatomical dzinodiwa kuunza shanduko.Kunyangwe anatomy yehutungamiriri isingadzidziswe muzvikoro zvekurapa kana zvehukoti, ramangwana remushonga rinotsamira pazviri.
Zvinyorwa zvitatu zvinotevera munhevedzano ino zvichaongorora ayatomy uye kutsanangura matanho angatorwa nevatungamiriri kushandura hutano hweAmerica.Danho 1: Bvisa pfungwa dzepakati.