Maziko Osungira Thanzi (Health Maintenance Organization) (HMO)

Mmene Kusamaliridwa Kuthandizira Kumathandizira Phindu Lathanzi Labwino

Monga wogulitsa mankhwala, mosakayika mwamvapo HMO kale. Ndipotu izi ndizimene zimatchuka kwambiri pazinthu zonse zamagetsi. Kodi HMO imachokera kuti? Nazi mbiri yakale ya mtundu uwu wa antchito opindula. Mu 1973, The Health Maintenance Organisation Act inasintha ndondomeko ya Public Health Service Act ya 1944, ndipo idasintha momwe njira zathanzi zidzakhalire ku America ndi kuzungulira dziko lapansi.

Kodi Health Maintenance Organization ndi chiyani?

HMO sizovuta kwambiri. Pansi pa malamulo a tsopano a US, HMO imatanthauzidwa ngati bungwe la boma kapena lachinsinsi limene limakwaniritsa zonsezi:

1. amapereka chithandizo chofunikira ndi zowonjezera kwa anthu ake
2. ili bungwe ndipo likugwiritsidwa ntchito movomerezeka ndi boma

Choncho, HMO ndi bungwe lomwe liri ndi cholinga chokhalira kupereka mwayi wolingana ndi ntchito zothandizira zaumoyo popatsana nawo mamembala akugwirizana ndi mawu ena. Nthawi zambiri, izi ndi mgwirizano wokhalabe pakati pa anthu ogulitsa omwe adakambiranapo kale za ntchito zotsika mtengo, komabe akusungabe khalidwe la chisamaliro. Owapatsa ameneŵa ayenera kukwaniritsa miyezo yapamwamba kuti agwirizane ndi makanema ndipo ayenera kusunga makadi abwino, kotero ndipambana kupambana kwa ogula. Nthaŵi zambiri, HMO imathandiza chisamaliro cha chithandizo chamankhwala chopewa chithandizo, zomwe ndizo zomwe ogwira ntchito zaumoyo amalimbikitsa.

Izi zimayenda bwino ndi mapulogalamu a mgwirizano wa makampani ndikupatsanso chithandizo chachipatala kwa anthu ena.

Ma HMO onse amafufuzidwa mosamala ndi mabungwe angapo a boma, kuphatikizapo Dipatimenti iliyonse ya State ya Health yomwe ikugwira ntchito. Ma HMO anawotchedwa kumapeto kwa zaka za m'ma 1990 pamene adapeza kuti anthu omwe akukonzekera mapulani sakupeza yankho labwino ndi chisamaliro.

Kuchokera apo, kasamalidwe ka HMO kakhala kakuyamika chifukwa cha kayendetsedwe ka zipangizo zamagetsi zomwe zimayendetsa kasamalidwe ka data ndi njira zolembera.

Kodi ma HMO amapindulitsa bwanji?

Ma HMO adakali njira imodzi yowonjezereka yosamalira thanzi omwe abwana amapereka, pa zifukwa zingapo.

• Zimakhala zosavuta kusamalira chifukwa cha ndalama zowonjezera zomwe zimapangidwira.
• Malingaliro sakhala ovuta kwambiri kwa omwe apanga mapulani chifukwa amadziwa kuti gawo lawo ndi lotani, kuphatikizapo ofesi yothandizira.
• Ma HMs nthawi zambiri amakhala otsika mtengo wothandizira olemba ntchito ndi mamembala pa moyo wa zolinga.
• Matenda a madokotala ndi malo osowa zaumoyo amayang'anitsitsa mosamala kwambiri, kotero anthu omwe akukonzekera mapulani adziwa kuti akupeza chisamaliro chotheka.
• Malingaliro odalirika azachipatala amalamulidwa ndi kuvomereza kwa HMO isanachitike, ndipo izi zimatetezeranso ogula ku chinyengo.

Kodi Ma Trends mu Health Care Market ndi otani pa ntchito ya HMO?

Malinga ndi akatswiri a zachipatala, zovuta kuchoka kuzinthu zamakono zowononga zaumoyo zakhala zikulimba pazaka makumi awiri zapitazo. Dipatimenti ya Ogwira ntchito ku United States imalangiza kuti ndalama zothandizira ntchito zimakhala zogwirizana ndi 96 peresenti yazinthu zothandizira zaumoyo zoperekedwa ndi ogwira ntchito apakati ndi akulu mu 1984 ndipo zaka makumi awiri pambuyo pake iwo amawerengera osachepera 15 peresenti ya inshuwalansi ya umoyo wothandizira.

Ndondomeko zothandizira zaumoyo zimapitirirabe m'malo mwa mapulogalamu akale a zaumoyo.

Makampani ambiri amapereka magawo atatu omwe amapindula nawo ogwira ntchito, limodzi ndi angapo ali ngati gawo la intaneti ya HMO. Imeneyi ndi njira yabwino kwambiri yothetsera inshuwalansi ya thanzi komanso kukhala ndi khalidwe la chisamaliro. Ma HMO akupitirizabe kukhala olimbikitsa chisamaliro mu malonda a inshuwalansi lero.