Theo ldi cua Bid McCollum, dd, viec Tdng thd'ng Obama mud'n them Tdng chudng ly bang Florida, "Vu kien se chUdng trinh BHYT nha nqdc vao he giiip Cbinh quyen lien bang hieu r i n g thdng[r]
(1)CHAU MY NGAY NAY SO 03-2010 63 THONG TIN LUAT CAI CACH Y TE - CHIEN THANG GIAN • N A N V A D A Y NGOAN MUC CUA • • TONG THONG OBAMA V ao 22/3/2010, sau nhiing cuoc tranh luan day cang thang tai Ha vien, Du luat cai each y te My Tong tho'ng Obama de xuat da dUdc Ha vien My thong qua vdi ty le sit vdi 219 phieu thuan va 212 phieu chong Day dUdc coi la chie'n thang quoc noi quan nhat ke tif ong Obama nham chifc Tdng tho'ng Co the noi, viec Du luat cai each y te My dUdc thong qua da mang lai mot sU thay ddi kha 16n xa hoi My, nhat la doi vdi so' dong nhiing ngifdi dan My den thdi diem hien tai van chUa duoc hUdng bao hiem y te Du luat dUdc ddi v6i nhiing thay ddi chfnh sach y te ldn nhat vong thap ky qua tai My ThUc te cho thay, viec ban hanh Luat Cai each y te la rat can thie't doi vdi so' dong xa hoi My, nhat la luc he tho'ng cham soc y te cua My dang CO nhiing vifdng mic kha 16n can duoc giai quye't My hudng tdi la ngUdi My tudi tif 65 trd len, nhiing ngUdi thu nhap thap, tre em, phu nii mang thai va ngUdi khuyet tat, cUu chie'n binh Theo so' lieu tif Van phong tho'ng ke My, ifde tinh 46,3 trieu ngUdi nam 2008, va nam 2009 la khoang 32 trieu ngUdi tong dan so' 300 trieu dan d My khong eo BHYT (tuy r i n g nhiing so' lieu ke tren da bao gom khoang hdn trieu ngUdi khong phai la cong dan My va hdn 10 trieu ngUdi eo thu nhap hdn 50.000 USD/nam) NhUng-nhiing sd lieu ke tren se la bang chifng hutu ieh eho nhiJng ngUdi img ho cai each BHYT noi rang he tho'ng BHYT khong tdi dUde vdi da so' ngUdi dan My, va vi le n6 can dUde thay doi My, chi phi cham soc sifc khoe cho ca nhan tang nhanh dang bao dong Nude My nam 2007 da ehi khoang 2,2 ty USD, chie'm 16,2% eua GDP, gan nhu gap doi binh quan eua cac nUdc phat trien Vai net ve he t h o n g cham soc y te cong nghiep khac danh cho van de eham cila My soc y te Hau qua la cang eo nhieu Khong nhu nhieu qud'c gia phat trien ngUdi My-khdng the eo du kinh phi cho khac, he tho'ng cham soc y te d My mang viee dong BHYT Dieu dan tdi viec mot net dac trUng rieng D6 la My khong hang ehuc trieu ngUdi My khdng co bao CO he tho'ng eham s6e y te den tat ca moi hiem hoac eo chang dUde bao hiem dUdi ngUdi dan Hau he't ngUdi dan c6 dUde bao miJe Va tat nhien, nhiJng ngUdi hiem y te (BHYT) thong qua nhiJng ngudi gap van de gi ve sifc khoe thi le dUdng chu eua ho, nhien ciing co ngu'di ky nhien la ho phai tU moc hau bao chi true tiep vdi cac cong ty bao hiem tU tra cho moi chi phi ve y te Theo tho'ng ke nhan Viec ngUdi dan co nhan dUdc sU eua eac nha nghien ciiu, ed den mot n i a cham sdc sifc khoe tif he thd'ng y te hay so' nhiing ngUdi bi pha san d My khong, dieu thuoe vao viec ea nhan chiu hau qua mot phan tif ehi phi y te ma e6 ddng BHYT hay khdng p d i tqdng ho da phai chi tra Cdn ddi vdi Chinh phu ma chifdng trinh cham sdc va ho trd y te d My, chi phi tang ciing dong nghia vdi viee (2) 64 SO 03-2010 CHAU MY NGAY NAY Chinh phii dang ehi cang nhieu hdn phi bao hiem se dUdc gia*^ di dang ke, thi cho cham sdc va hd trd y te DUde biet, dang Cdng hda lai cho r i n g chUdng trinh hien Chinh phu My dang chi cho bai BHYT nha nUdc hinh se khie'n cho chUdng trinh tang tif 4% eua GDP nganh BHYT tU nhan bi loai bd, ma dieu nam 2007 len den 7% nam 2025 va 12% dd, theo Nghi si Rockefeller: chang khac nam 2050 Vdi so'ngan saeh kha ldn dxiOc nao mdi goi cac cdng ty BHYT t\i nhan tieu dimg cho linh viic y te da khien cho tie'p tuc tim each tan thu tif tiii tien cua ehi phi cham sdc y te trd phan ldn ngUdi dan nhat tham hut ngan sach My Va cudi cimg vao 22/3/2010, vdi 219 phie'u thuan va 212 phie'u chd'ng Ha Chang difdng gian nan ctia Dvf luat vien My ciing da thdng qua Du luat cai each y te va gifi nd de'n Tong thd'ng DUdc coi la trung tam chUdng Barack Obama de ky luat Theo trinh ddi ndi nam dau cam quyen cila luat mdi nay, BHYT se dUde ap dung ddi Tdng thd'ng Obama, Du luat cai each y te My tri gia 871 ty USD, vdi nhiing chang vdi 95%) ngUdi dan My dUdi 65 tudi Luat dUdng day nhoc nhan eho ban than mot ea'm cac cdng ty bao hiem tif chdi bdi Du luat de cd dUde sU thdng cua cua ca thudng ddi vdi nhiJng benh ma ngUdi dan da mac trUdc luat cd hieu liic Ke tif Thifdng vien lan Ha vien My toan bd dan My se phai mua bao Dii luat diidc thong qua hiem y te va hq se bi phat ne'u khdng Dii luat cai each y te cua My Nha mua Phan ldn sd' tien mua bao hiem y te Tring hau thuan n h i m muc dich md se dUdc dung de hd trd nhiJng gia dinh ed rdng dich vu cham sdc y te cho khoang 31 trieu ngUdi, ddng thdi khd'ng che' chi phi thu nhap dudi 88.000 USD/nam chi tra va cai thien chat lUdng cham sdc sifc khde phi tdn y te Chinh phu ciing se ban hanh va nhu vay, nang ty le ngqdi dan dUdc mot sd' sac thue mdi nham vao tang ldp giau xa hdi hudng bao hiem len khoang 95% Vao sang sdm 24/12/2009, vdi 60 Vd cupc chien bang - lien bang phie'u thuan va 39 phie'u chd'ng, ThUdng Tuy Du luat da dUdc thdng qua va vien My da ehinh thifc thdng qua Du luat Tdng thdng da ky lenh ban hanh nhUng cai each y te, bat chap sii chd'ng ddi quyet nd dang phai ddi mat vdi nguy ed bi kien liet eua dang Cong hda Viec thdng qua Chinh quyen eua nhieu bang tai My da du luat eho thay sii chia re ThUdng khdi kien Tdng thd'ng ky ban vien mqi vien eua dang Dan hanh luat Vu kien chil ye'u dUdc tap chu deu bd phieu img hq, phe trung vao dieu khoan cila dao luat mdi, dang Cong hda deu bd phie'u chd'ng dd la quy dinh ngUdi dan se bi phat tien Du luat tren dUdc dang Dan chu va neu khdng mua bao hiem Mot sd' bang d dang Cong hda dam phan sud't may thang My dang xem xet k h i nang thdng qua cho de'n nd dUdc ThUdng vien thdng mot dao luat n h i m vd hieu hda dieu qua Cae vien eua dang Dan chu khoan cila dao luat mdi "Trong heh khang dinh du luat se giiip giam ehi phi y sif cila chiing ta chUa bao gid Chinh phu te My len tdi 127 ty USD vdng 10 lien bang dUde trao quyen yeu cau dan nam dau va 650 ty USD 10 nam mua hang hda hay dich vu" Ken tiep theo Ve phia dang Cdng hda, hq eho Cuccinelli, Tdng chudng ly bang Virginia, r i n g diJ luat la kha dat dd Them vao phat bieu Theo ldi cua Bid McCollum, dd, viec Tdng thd'ng Obama mud'n them Tdng chudng ly bang Florida, "Vu kien se chUdng trinh BHYT nha nqdc vao he giiip Cbinh quyen lien bang hieu r i n g thdng bao hiem ma theo dng la nham bang Florida se khdng de quyen cdng dan muc dich cho ngUdi dan cd them sii liia va quyen tif chu cua bang bi phdt Id chon va cac cdng ty bao hiem tU nhan se khoac khdng dUdc tdn trqng" Bang budc phai tang cudng canh tranh, qua dd da nop ddn kien len Tda an lien bang vdi (3) CHAU MY NGAY NAY SO 03-2010 ndi dung: Nhiing quy dinh eua luat mdi da xam pham den chu quyen cua eae bang budc cac bang phai chi nhieu ty USD de md rdng quyen bao hiem y te eho ngUdi ngheo Ciing nhu bang Florida, nhieu bang khac d My ciing da de ddn kien len Tda an lien bang nhu bang Alabama, Colorado, Idaho, Michigan, Nebraska, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Louisiana va Washington Gdp them vao sU chd'ng ddi nay, nhutng nghi si cua dang Cong hda the se buy bd luat mdi ne'u gianh dUdc the da so' tai Ha vien va ThUdng vien cae cupc bau cif giiJa ky vao thang 11 tdi Sii tranh cai ve ndi dung cua dao luat hay thUe chat la mau thuan ldi Ich cdng ddng vdi ldi ieh cua eae tap doan bao hiem y te tU nhan, dang dUde du luan the gidi rat quan tam Luat mdi cua My se cdn rat gian nan dUdc mang ap dung tren thUc te bdi tif nd dUde Tdng thd'ng Obama de 65 xuat cho de'n nd dUdc dUa de thdng qua hai lan tai Qudc hdi My va sau dUdc ky ban hanh, da gap rat nhieu sU chd'ng ddi tif nhieu phia, nhat la tif phia dang Cong hda Tif ban gd'c cua dU luat eho tdi ban eudl da ed mot sd thay ddi ap lUe den tif phia "dang Cong hda Theo nguyen van ban gd'c, Chinh phu My mud'n toan bd chUdng trinh BHYT se nha nUdc quan ly, nhien ban luat mdi vifa dUde ban hanh thi quy dinh da dUde sUa ddi, chap nhan bao hiem y te eong song song tdn tai eimg bao hiem y te tU nhan Tuy nhien, phia dang Cong hda ciing chUa chiu difng lai d dd, hg cdn mud'n rang can phai thay ddi them mot so' ndi dung du luat nham khdng lam thiet hai eho cac tap doan bao hiem tU nhan • Le Lan Anh tong hop Vien Nghien ciiu Chau My GIOI THIEU VE LIEN MINH BOLIVAR CHO • CHAU MY (ALBA) ^^f^ Hdi nghi thUdng dinh eae i^l nguyen thu qud'c gia va chinh phil ^ • J ^ cua Hiep hdi cac qudc gia vimg Caribbean lan thif III d Isla Margarita vao thang 12/2001, theo ddng sang kie'n cua Cuba Fidel Castro va Tong thdng Venezuela Hugo Chavez, da de xuat lap mdt lien minh giiia eae qud'c gia My Latinh va Caribbean vdi muc tieu tang cUdng sii doe lap eua My Latinh thdng qua hdi nhap kinh te - xa hdi va chinh tri cua khu vUe Lien minh se boat ddng tren cd sd tii cd, hd trd lin n h i m giai quye't cae van de khu viic va cung phat trien Dau tien, hen minh diiOc dat ten la "the Bolivarian Alternative for the Americas" - Su liia chon Bolivar danh cho chau My (ALBA), mdt sU liJa chon n h i m thay the Khu vUe Tu thUdng mai ciia ehau My My de xuat (FTAA) Sau nam, ALBA da chinh thife dUde lap va md dau vdi mot hiep dinh giiJa Venezuela va Cuba tai Havana vao 14/12/2004 Ke tif sU khdi dau nam 2004, lien minh da phat trien len, dai dien eho tdng dan so' thudc lien minh la hdn 75 trieu ngUdi Cac qud'c gia vien ALBA gdm: Cuba, Venezuela, Bohvia (2006), Nicaragua (2007), Dominica (2008), Honduras (2008), Ecuador (2009), Saint Vincent & Grenadines (2009), va Antigua & Barbuda (2009) NhiJng nUde vien khdng chinh thife nhUng dUdc mdi tham dii eac cudc hdi ngbi eua lien minh la Haiti va Uruguay Ngay (4)