Za Medicaid Cire rage Jiyya Zɓk.
Dandalin Opioid shine matsala mai girma a Amurka. Daga 1999 zuwa 2015, ko daga magungunan kwayoyi ko kuma daga kayan aikin rashin lafiya kamar heroin, fiye da rabin mutane mutane sun mutu daga wani abu mai ban mamaki. Cibiyoyin Kula da Magunguna da Magungunan Medicaid (CMS) sun ruwaito cewa mutane 91 ne ke mutuwa a kowace rana daga mummunan zalunci, sa mu a kan hanya don mutuwar 32,400 a shekara ta 2017.
Medicaid yana taka muhimmiyar rawa wajen magance buri. Tare da ɗaya daga cikin Amirkawa biyar da suka dogara ga Medicaid don bukatun lafiyar su, wace irin sabis ne shirin ke ba da kuma waɗannan ayyukan zasu ci gaba idan jam'iyyar Jamhuriyar Republican ta sami nasara wajen shafe Dokar Kulawa mai Kyau , ta Obamacare?
Maganin Opioid yana Duk Aiki
Maganar Opioid ba kawai matsalar matsala ba ce. Wannan matsala ta kasa.
An kashe mutane fiye da dubu biyu a kan kogin Overdose a shekara ta 2014. Ohio da California sun fi fama da mutuwar mutuwa fiye da 2,000 a kowace, yayin da New York, Florida, Illinois, Texas, Massachusetts, Pennsylvania, da kuma Michigan kowannensu ya kai fiye da 1,000 mutuwar da aka ruwaito .
Kamar yadda cin zarafi na opioid ba yanki ba ne, Medicaid ba'a iyakance ga jihohi ba. Ma'aikatar Medicaid, yayin da jihohi ke gudanar da su ta fasaha, an biya kuɗin ta hanyar tarayya. Gwamnatin tarayya ta kafa ƙananan ka'idoji ga wanda ya cancanci Medicaid kuma abin da ya kamata a haɗa shi a cikin shirin.
Dokar Dokar Kula da Lafiya ta Amurka , kamar yadda aka ambaci shi a cikin wakilan majalisar wakilai na Amurka, ya ba da shawarar samar da babbar hanyar maganin Medicaid. Kwamitin, wanda yanzu ake kira Dokar Sashin Kula da Kulawa tagari, yana jiran zabe a majalisar dattijan Amurka kafin ya zama doka. Idan ya wuce, doka ta iya canza abin da ke da amfani ga lafiyar jiki - ciki har da ayyukan kiwon lafiya na tunanin mutum da kuma jiyya - an rufe ku ta inshorar lafiya.
Wannan ya hada da Medicaid.
Biyan maganin Opioid
Dokar Kulawa mai Kulawa ta buƙaci cewa jihohin da ke shiga cikin ƙwayoyin Medicaid suna amfani da kayan amfani da maganin cuta. Duk da haka, dokar ta ba da sassauci kuma ta yarda kowace jihohi ta yanke shawarar wane sabis ɗin da suke so su sake biya.
Dokar Amincewa da Kula da Kulawa tagari zai kawo karshen yaduwar maganin Medicaid kuma ya dakatar da magani don magance buri.
Akwai nau'o'i daban-daban na jiyya don ɗauka:
- Ayyukan masu fita daga waje (ciki har da farfadowa na rukunin, farfadowa na mutum, da kuma sabis na goyan baya)
- Ayyuka masu tsada
- Ayyukan baƙuwar kwanciyar hankali da dogon lokaci
- Inpatient kula da detoxification
Wani binciken a cikin Lafiya ya tantance jihohi don cin zarafin daga 2015 zuwa 2016. Abin sha'awa, masu bincike sun gano cewa ɗaukar hoto ba shine mafi girma a jihohin da ke da magani na Medicaid ba .
Kasashe goma sha uku da Gundumar Columbia sun rufe duk ayyukan, kuma jihohi 26 sun kalla ɗaya sabis a kowane mataki na magani. Jihohi tara ba su samar da maganin Medicaid ba saboda duk wani abu da ake yi wa maganin cin zarafi a cikin matakai biyu ko fiye.
Duk da haka, bayar da waɗannan ayyuka ba ya nufin suna da sauƙin samun dama.
Kusan rabin jihohin da ake buƙatar irin tsari da aka amince da su kafin a amince da su kafin su biya bashin kulawa na asibiti. Jihohi tara sun kara da cewa yawan kuɗin da za'a iya amfani da shi a kan ayyukan maidawa.
Yin maganin maganin Opioid tare da Magunguna
Mafi magungunan da ake amfani da su don magance maganin opioid su ne buprenorphine (sunan Suboxone), methadone, da kuma naltrexone (sunaye masu suna Depade, Revia, da Vivitrol). Kowace magani yana ɗauka ga masu karɓa na opioid a cikin kwakwalwa don aiwatar da sakamako:
- Buprenorphine: Buprenorphine tana tsammanin za a fi son shi saboda farfadowa domin yana da tsawo cikin jiki. Hakan ya hana tasirin euphoric wanda ke tattarewa da yawa, kuma yana da rabi mai rai daga 24 zuwa 42 hours.
- Methadone: Methadone wani shinge ne wanda yake taimakawa wajen rage karfin zuciya. Duk da haka, kamar sauran opioids, zai iya haifar da dogara ga jiki. An yi amfani da ƙwayar ƙwayar ƙarfe ta hanyar amfani da farfadowa kuma ana iya yaye shi a tsawon lokaci. Yawan rabi mai sauƙi ne, yana daga 8 zuwa 59 hours.
- Naltrexone: Ana nufin Naltrexone ya rage karfin buƙatar ƙwayar cuta kuma a wasu lokuta ana amfani dasu don shawo kan shan barasa. Rabin rabi shine tsawon karfe 4 zuwa 13.
Harkokin Kula da Lafiya ta nuna cewa kowace jihohi da kuma Hukumomin Columbia sun rufe buprenorphine, kuma jihohi hu] u da hu] u sun rufe naltrexone. Har ila yau, ɗaukar hoto don saduwa, ba ta da kyau. Kasashe 32 ne kawai suka ƙunshi ɗaukar hoto don ƙwayar cuta a cikin shirin Medicaid.
Hakazalika da sabis na bada shawarwari da kulawa, izinin farko ya taka muhimmiyar rawa wajen ɗaukar magunguna. Yawancin jihohi suna buƙatar izini na farko don buprenorphine yayin da uku na cikinsu suna buƙatar buƙatun.
Abin takaici ne lokacin da kake tunani game da shi. Mutanen da suke neman taimako don cin zarafi na opioid suna hana damar yin amfani da sauri idan sun fi so. Tsayawa a jiyya shine ainihin abinda zai iya haifar da su sake dawowa.
Samun kudi ya Kashe zuwa Medicaid
Jiragen Medicaid don magance annobar kasa ba abu ne mai ban mamaki, ba idan an yanke kudade ga shirin ba. Abin takaici, wannan shine abin da zai faru.
Idan Dokar sulhuntawa tagari ya zama doka, ƙaddamarwar Medicaid kamar yadda muka san shi a karkashin Dokar Kulawa da Kulawa za ta daina zama. Abubuwan da ake buƙata don haɗawa da maganin mugun abu kamar yadda ɓangare na shirin Medicaid zai tafi.
Ko da jihohin da ba su shiga yaduwar maganin Medicaid ba zasu shafi. Wannan shi ne saboda kudade na gargajiyar zuwa shirin Medicaid zai canza. Maimakon gwamnatin tarayya ta daidaita abin da kowace jihohi ke kashe dollar a dollar, Dokar Ma'anar Sakamakon Kula da Kula da Kulawa tagari zai ƙayyade jihohi ga biyan kuɗi . Wato, kowace jihohi za ta sami adadin kuɗin da ya dace daga gwamnati bisa yawan mutane a kan Medicaid a wannan jiha.
Bisa ga Babban Ofishin Budget na Kasuwanci, wannan canji na kudade zai kashe dala biliyan 772 daga Medicaid ta 2026.
Wannan zai sanya nauyi ga jihohi don samun ƙarin tallafi idan an kasa iyakokin ƙasashen su. An sa ran cewa jihohi da dama zasu buƙatar yanka sabis na Medicaid don su zauna a cikin motsi. Abin baƙin ciki, ayyukan kiwon lafiya na tunanin mutum da kuma maganin jiyya yana iya zama na farko da zai tafi.
Kalma daga
Babu wata hujja cewa dokar Amintattun Kulawa da Kula da Kula da Kulawa tagari zai rage damar yin amfani da ayyukan kiwon lafiya na tunanin mutum. Ba kome ba idan kun kasance a kan Medicaid, tsarin kula da lafiyar mutum, ko inshora mai tallafin aiki. Canje-canje a cikin abin da waɗannan shirye-shiryen zasu ɗauka, watau, canje-canje ga amfanin lafiyar lafiyar, zai shafi abubuwan da za ku karɓa kuma zai sa ya fi ƙarfin wa waɗanda ke fama da jaraba don samun taimakon da suke bukata.
> Sources:
> Grogam CM, Andrews C, Ibrahim A, et al. Ƙididdigar Ƙididdigar Bincike A cikin Magunguna na Medicaid Don Amfani da Maganin Yin amfani da Magungunan Kwayoyi da Opioid Yi amfani da Magunguna. Health Aff. Disamba 2016 35 (12): 2289-2296. Doi: 10.1377 / hlthaff.2016.0623
> HR 1628 . Ofishin Majalisar Dattijan Amurka. https://www.budget.senate.gov/imo/media/doc/SENATEHEALTHCARE.pdf. An buga Yuni 22, 2017.
> HR 1628, Dokar sulhu da kyau ta 2017. https://www.cbo.gov/publication/52849. An buga Yuni 26, 2017.
> Rigakafin Rigaka & Gyaguni: Opioid Overdose - Magana game da annoba. Cibiyoyin Cibiyar Kula da Cututtuka na Cututtuka da Rigakafin Lafiya. https://www.cdc.gov/drugoverdose/epidemic/index.html. Updated Yuni 21, 2016.
> Rodriguez CH. Magunguna na Medicaid don maganin Yara Yara. Shafin yanar gizon Kaiser Health News. http://khn.org/news/medicaid-coverage-for-addiction-treatment-varies-dramatically/. An buga Disamba 6, 2016.