醫聲論壇

醫療商業化!制度殺人!殺死醫師!聞之痛心!!

商業介入醫療之後.商人啄取不少醫療費用.又濫用醫師人力藉以謀利.造成醫師人力不足的假象.又藉口醫師人力不足大肆醫師培養名額.健保醫療實施醫院總額之後.醫師人力過剩的問題便逐漸顯現出來.

健保制度攏斷醫療.傳統醫療幾乎失去自費空間.在有限的健保醫療費用下大量過剩的醫師造成醫師收入日益減少.醫院主導下的健保醫療給付制度.佔醫師收入最主要的醫師診察費一直偏低.

藥品健保價格紊亂.台廠高價藥相對低成本.大醫院及健保藥局賺走差價.小醫院小診所申報這些藥很容易被放大核刪.醫師不敢報但是病患又有需要使用.醫師只好隱匿不報或者以他藥代替.申報與實際醫療需要有所差異.抽審放大核刪動輒移送檢調自然也造成醫師壓力.

單純的醫療.病患付出必要費用.原本就是很單純的問題.但是在商業化醫療及及未臻完善的健保制度之下.醫療變得錯綜複雜.對病患對醫師都造成傷害.

盜刷虛報費用當然不對.但是醫師過剩謀生不易.健保醫療制度偏頗是根本原因.今日不改.來日憾事將不斷發生.

(無力感) 醫師公會是否可以設專線或專人幫忙解決問題, 或如張老師一樣之心理輔導, 推薦精神科專家.

醫師的社會地位已由神->人->不如人?
當醫學生時覺得前程似錦
當住院醫師時覺得前景黯淡
當主治醫師時覺得前途茫茫
開業才知何謂萬念俱灰
只要健保還在
台灣的醫師們很難再出頭天了!
（無盡漩渦）

alexhuang50 寫: 要號召拒繳全聯會費嗎?
沒看見這些人在幹甚麼事
只收到一本直接進回收箱的三流雜誌

通訊學分那頁要先撕下來.

好快的反應;

詐領健保花招多 幫遊民開刀安排老人住院
中廣新聞網╱徐韻翔 2008-08-20 13:03
新竹仁慈醫院醫師因涉嫌詐領健保案，被檢方約談後自殺身亡，醫療院所與醫師不法申報問題再度引發關注，中央健保局表示，今年上半年共查出國內有300多家醫院診所申報異常，過去至今，不實申報的花招，從幫遊民開刀、住院天數灌水到安排安養院老人輪流住院都有，就是為了能夠多賺取一些健保申報給付費用。(徐韻翔報導)

據統計，今年1~7月份，中央健保局共查核出國內有329家醫療院所申報異常，包括大醫院小診所，中央健保局稽核室主任吳文偉表示，健保局成立以來，持續查核是否有涉及違規與違法的醫療院所，查核發現的案件，有部份是來自於民眾檢舉，其它則是由醫院定期申報的資料當中去分析，當發現異常數據時，進一步進行查核，查核時，包括總局稽核室，以及各分局查核科，專責查核人員會查明真相，適當時機會向民眾做抽訪，向醫院瞭解實際狀況。

為了賺取更多的醫療申報費用，投機的醫療院所和醫師可是花招百出，吳文偉表示，有醫院會先為遊民繳交逾期的健保費用，再把遊民帶進醫院動手術，藉此申報費用，也有與安養院「合作」的醫院，安排老人輪流住院，或是無故被割盲腸，不必動手術卻被安排開刀、住院天數灌水申報，重複刷健保卡等，為了賺錢，不肖的醫療院所可是不擇手段。

如果涉嫌違規醫療院所查經屬實，吳文偉說，中央健保局會依據與醫療院所所簽訂的合約，做適當處分，包括發函糾正、暫停合約甚至是終止合約，等於未來醫療院所不得再申請健保給付，此外，如果檢舉人是向檢調單位檢舉案件，健保局也會配合檢調單位進行查核，以期抑制不法申報歪風，避免醫療資源浪費。

超過七成診所每天看診量在卅人以下<--我也是,可是我不會A健保

MK 寫:醫ｘ會：醫師終於承認自己有在Ａ健保了...

不管醫院或診所
總額已定
就是A到同儕而不是A到健保
漲健保費是與總額有關
健保費率太低總而太少 （窮）
醫療院所經營困難
是終極原因
但是
不能直接做連結造成民眾誤解

各報文章的標題都是寫"醫院制度"殺人
但是他提到是"健保制度和醫院制度"

現在是怎樣,直接跟健保有關的都省略掉就是了
還是這樣的標題不夠吸引人?

kcfc 寫:

MK 寫:醫ｘ會：醫師終於承認自己有在Ａ健保了...

不管醫院或診所
總額已定
就是A到同儕而不是A到健保
漲健保費是與總額有關
健保費率太低總而太少 （窮）
醫療院所經營困難
是終極原因
但是
不能直接做連結造成民眾誤解

是A到同儕沒錯
問題是民眾連總額
是什麼碗糕都搞不懂
身為一縣醫師公會理事長
出來這樣講
實在十分不妥

聽說是 KMC M77 學長. （窮）

慟!! 願學弟安息......

每個月申請額給八成左右,淡季也一樣.寧願倒閉改行,也不願A健保.醫師這行高風險,
薄利.A個幾萬元,何苦來哉.

jesuischinoise 寫:超過七成診所每天看診量在卅人以下<--我也是,可是我不會A健保

現在選醫學系的考生,要好好想想,以後一個月領幾萬元生活,不要抱怨,也不要因為想多幾萬收入而挺而走險,醫師是高風險低利的行業.開藥無法自主,給付要打折,少子化沒病人看.這種行業會有前景嗎. （親一個）

現在選醫學系的考生,要好好想想,以後一個月領幾萬元生活,不要抱怨,也不要因為想多幾萬收入而挺而走險,醫師是高風險低利的行業.開藥無法自主,給付要打折,少子化沒病人看.這種行業會有前景嗎. （無盡漩渦）

COLIN 寫:現在選醫學系的考生,要好好想想,以後一個月領幾萬元生活,不要抱怨,也不要因為想多幾萬收入而挺而走險,醫師是高風險低利的行業.開藥無法自主,給付要打折,少子化沒病人看.這種行業會有前景嗎. （無盡漩渦）

（無盡漩渦） （無盡漩渦） （窮）

整件事情等到現在, 只有新竹市醫師公會理事長經由媒體說的如此一番話, 真令人心寒.

全聯會介入點：恐怕只有下一期＜台灣醫界＞的＜會員動態＞

新竹縣　林 X X 退會 : 死亡

其實人無須要求過度完美 避免想不開啊

最近粉異常的陳幸妤醫師 似乎也有力求人生無污點的堅持

forester 寫:公會
全聯會
你們睡著了嗎
為何只有在每季收費時
才能感覺到你們的存在
真正會員需要關心協助時
你們都去哪了
去日內瓦吶喊加入WTO嗎
還是去高爾夫球場商討國家大事了
對不起
我覺得那是衛生署長的事
我交會費是為什麼
是為了大樹底下好遮蔭啊
不是請你們來當衛生署長的

唉
兔死狐悲
物傷其類

+1 附議

過路人 寫:好快的反應;

詐領健保花招多 幫遊民開刀安排老人住院
中廣新聞網╱徐韻翔 2008-08-20 13:03
新竹仁慈醫院醫師因涉嫌詐領健保案，被檢方約談後自殺身亡，醫療院所與醫師不法申報問題再度引發關注，中央健保局表示，今年上半年共查出國內有300多家醫院診所申報異常，過去至今，不實申報的花招，從幫遊民開刀、住院天數灌水到安排安養院老人輪流住院都有，就是為了能夠多賺取一些健保申報給付費用。(徐韻翔報導)

據統計，今年1~7月份，中央健保局共查核出國內有329家醫療院所申報異常，包括大醫院小診所，中央健保局稽核室主任吳文偉表示，健保局成立以來，持續查核是否有涉及違規與違法的醫療院所，查核發現的案件，有部份是來自於民眾檢舉，其它則是由醫院定期申報的資料當中去分析，當發現異常數據時，進一步進行查核，查核時，包括總局稽核室，以及各分局查核科，專責查核人員會查明真相，適當時機會向民眾做抽訪，向醫院瞭解實際狀況。

為了賺取更多的醫療申報費用，投機的醫療院所和醫師可是花招百出，吳文偉表示，有醫院會先為遊民繳交逾期的健保費用，再把遊民帶進醫院動手術，藉此申報費用，也有與安養院「合作」的醫院，安排老人輪流住院，或是無故被割盲腸，不必動手術卻被安排開刀、住院天數灌水申報，重複刷健保卡等，為了賺錢，不肖的醫療院所可是不擇手段。

如果涉嫌違規醫療院所查經屬實，吳文偉說，中央健保局會依據與醫療院所所簽訂的合約，做適當處分，包括發函糾正、暫停合約甚至是終止合約，等於未來醫療院所不得再申請健保給付，此外，如果檢舉人是向檢調單位檢舉案件，健保局也會配合檢調單位進行查核，以期抑制不法申報歪風，避免醫療資源浪費。

商人經營的醫療院所真的很厲害 我這輩子怎麼也學不會 ~~~~

漸飽正在下拉台灣醫療生態, 浩劫將至, 黎明前必然黑暗, 更期待光明的到來.
黎明之前必定黑暗 (壓力) (壓力)

（窮） (壓力) 準備俟機而動.

請問全聯會有幫這位醫師的忙嗎?
應該去監察院提告

什麼光? （親一個）

Ali-aa 寫: 漸飽正在下拉台灣醫療生態, 浩劫將至, 黎明前必然黑暗, 更期待光明的到來.
黎明之前必定黑暗 (壓力) (壓力)

我就是被調查局約談了6小時的醫師.全聯會有幫忙嗎.
我因病人的女兒拿去逝的父的健保卡.就被健保局認定你詐欺偽造文書罪.
除了健保局處罰,健保局同時間會把案子送調查局或檢查官.讓你一個醫師去面對
司法.我們在醫院.診所過得好好的.那受得了調查局和檢查官的驚嚇.不是乖乖認罪
還能怎樣.我們只是為了病人看病.本來就沒有犯意.詐欺所得也不多.健保局這樣弄
醫師.全聯會在之前有叫過一聲嗎.當我在調查局被像重刑犯訊問時.全聯會你在那裡.
每個醫師被健保局這樣一攪.都覺得十分憂鬱和難過.小的像我一個月都不高興.有的
以後不開刀.重者就像那位同志去自殺.因為我們醫師"士可辱,不可殺"被莫名其妙被
弄到有刑罪.這個才是重點.我一生當一個醫師.卻被健保局弄到我一生不名譽.這是
何等的汚辱.全聯會各理事長.你們有沒有想過呀.雖然現在健保局改為重大違規才送
法院.那我們這些被健保局弄死的醫師.是何等悲哀呀.

過路人 寫:好快的反應;

詐領健保花招多 幫遊民開刀安排老人住院
．．．（刪）中央健保局表示，今年上半年共查出國內有300多家醫院診所申報異常...，過去至今，不實申報的花招，從幫遊民開刀、住院天數灌水到安排安養院老人輪流住院都有，就是為了能夠多賺取一些健保申報給付費用。(徐韻翔報導).... (刪)

所以 當局的反應才是快、狠、準！
一個醫師自殺死亡之後；廣大人民　都可以心領神會：詐領健保花招才是萬惡之源啊 !

局 vs 公會 或 全聯會 K.O. out!

2008年08月20日蘋果日報

制度殺人
燒炭自殺身亡的耕莘醫院醫師林仲明，遺書指是醫院制度謀殺他；檢調指出，其控訴透露，他是被迫配合醫院制度，才會涉詐領健保費。
據衛生局人員指出，自健保局採「醫院自主管理」制度後，醫療院所都會分配到固定的健保額度，許多私人醫院常以控制薪水等方法給予醫師看診人數壓力，要求他們達到健保分配額度；看診人數較少的醫師，壓力尤大。 （窮）


小診所更難生存
衛生局人員說，以往也曾經遇到案例，醫院為了買進某特定品牌的低價藥物，藉此向健保局報高價詐領費用，因此私下要求醫師選用該品牌藥物，或者要求醫師開立處方箋時，盡量使用該藥物。
而小診所門診人數限制多，藥品管制稽查嚴格，生存更困難，迫使醫師轉往大醫院求生，卻不得不配合院方的「生存制度」，致問題重重。
記者林師民

Civil disobedience
From Wikipedia, the free encyclopedia
Jump to: navigation, search
For other uses, see Civil disobedience (disambiguation).

Rosa Parks in 1955. She became famous for refusing to obey racist regulations. Her individual action of civil disobedience started the Montgomery Bus Boycott, which is one of the largest movements against racial segregation. In addition, this launched Martin Luther King, Jr., who was involved with the boycott, to prominence in the civil rights movement.Civil disobedience is the active refusal to obey certain laws, demands and commands of a government, or of an occupying power, without resorting to physical violence. It is one of the primary tactics of nonviolent resistance. In its most nonviolent form (known as ahimsa or satyagraha) it could be said that it is compassion in the form of respectful disagreement.

Civil disobedience is one of the many ways people have rebelled against unfair laws. It has been used in many well-documented nonviolent resistance movements in India (Gandhi's social welfare campaigns and campaigns for independence from the British Empire), in South Africa in the fight against apartheid, in the American Civil Rights Movement, Jehovah's Witnesses' stand against the Nazis (1929-1945), and in peace movements worldwide. One of its earliest massive implementations was by Egyptians against the British occupation in the nonviolent 1919 Revolution.

The American author Henry David Thoreau pioneered the modern theory behind this practice in his 1849 essay Civil Disobedience, originally titled "Resistance to Civil Government". The driving idea behind the essay was that of self-reliance, and how one is in morally good standing as long as one can "get off another man's back"; so one does not have to physically fight the government, but one must not support it or have it support one (if one is against it). This essay has had a wide influence on many later practitioners of civil disobedience. In the essay, Thoreau explained his reasons for having refused to pay taxes as an act of protest against slavery and against the Mexican-American War.

Contents [hide]
1 Early uses of the term
2 Theories and techniques
3 Examples
3.1 India (Indians)
3.2 South Africa (Africans of Color)
3.3 United States
3.4 Religious examples
4 See also
5 External links



[edit] Early uses of the term
Thoreau did not coin the term "civil disobedience". However, after his landmark 1848 lectures were published in 1849, the term "civil disobedience" began to appear in numerous sermons and lectures relating to slavery in the United States. Early examples of these include:

The Gospel Applied to the Fugitive Slave Law [1850]: A Sermon, by Oliver Stearns (1851);
"The Higher Law," in Its Application to the Fugitive Slave Bill:... by John Newell and John Chase Lord (1851);
The Limits of Civil Disobedience: A Sermon..., by Nathaniel Hall (1851);
The Duty and Limitations of Civil Disobedience: A Discourse, by Samuel Colcord Bartlett (1853).
Thus, by the time Thoreau's lectures were first published under the title "Civil Disobedience," in 1866, four years after his death, the term had achieved fairly widespread usage.


[edit] Theories and techniques
aswin r





Anti-war activist Midge Potts is arrested for civil disobedience on the steps of the Supreme Court of the United States on 9 February 2005.In seeking an active form of civil disobedience, one may choose to deliberately break certain laws, such as by forming a peaceful blockade or occupying a facility illegally. Protesters practice this non-violent form of civil disorder with the expectation that they will be arrested, or even attacked or beaten by the authorities. Protesters often undergo training in advance on how to react to arrest or to attack, so that they will do so in a manner that quietly or limply resists without threatening the authorities.

For example, Mahatma Gandhi outlined the following rules, in the time when he was leading India in the struggle for Independence from the British Empire:

A civil resister (or satyagrahi) will harbour no anger.
He will suffer the anger of the opponent.
In so doing he will put up with assaults from the opponent, never retaliate; but he will not submit, out of fear of punishment or the like, to any order given in anger.
When any person in authority seeks to arrest a civil resister, he will voluntarily submit to the arrest, and he will not resist the attachment or removal of his own property, if any, when it is sought to be confiscated by authorities.
If a civil resister has any property in his possession as a trustee, he will refuse to surrender it, even though in defending it he might lose his life. He will, however, never retaliate.
Retaliation includes swearing and cursing.
Therefore a civil resister will never insult his opponent, and therefore also not take part in many of the newly coined cries which are contrary to the spirit of ahimsa.
A civil resister will not salute the Union Flag, nor will he insult it or officials, English or Indian.
In the course of the struggle if anyone insults an official or commits an assault upon him, a civil resister will protect such official or officials from the insult or attack even at the risk of his life.

[edit] Examples

Disregarding the instructions of the police a crowd is jamming a street in Leipzig to prevent neonazis from marching through town.
[edit] India (Indians)
Civil disobedience has served as a major tactic of nationalist movements in former colonies in Africa and Asia prior to their gaining independence. Most notably Mahatma Gandhi developed civil disobedience as an anti-colonialist tool. Gandhi stated "Civil disobedience is the inherent right of a citizen to be civil, implies discipline, thought, care, attention and sacrifice". Gandhi learned of civil disobedience from Thoreau's classic essay, which he incorporated into his non-violent Satyagraha philosophy. Gandhi's work in South Africa and in the Indian independence movement was the first successful application of civil disobedience on a large scale.


[edit] South Africa (Africans of Color)
This famous movement was started by Nelson Mandela. Mandela, along with Archbishop Desmond Tutu and Steve Biko advocated civil disobedience. The result can be seen in such notable events as the 1989 Purple Rain Protest, and the Cape Town Peace March which defied apartheid.


[edit] United States
Dr. Martin Luther King, Jr, and young activists in the American civil rights movement of the 1960s also adopted civil disobedience techniques, and antiwar activists both during and after the Vietnam War have done likewise. Since the 1970s, pro-life or anti-abortion groups have practiced civil disobedience against the U.S. government over the issue of legalized abortion. They have also murdered abortion doctors and fire-bombed abortion clinics.


[edit] Religious examples
Many who practice civil disobedience do so out of religious faith, and clergy often participate in or lead actions of civil disobedience. A notable example is Philip Berrigan, a one-time Roman Catholic priest who was arrested dozens of times in acts of civil disobedience in antiwar protests. Also, groups like Soulforce, who favor non-discrimination and equal rights for gays and lesbians, have engaged in acts of civil disobedience to change church positions and public policy. "Operation Rescue" was an ecumenical Christian movement exercising civil disobedience to peacefully block access to abortion clinics.


[edit] See also
Committee of 100 (United Kingdom)
Henry David Thoreau
Civil Disobedience
Mohandas Gandhi
Satyagraha
Dr Martin Luther King, Jr
Letter from Birmingham Jail
Rosa Parks, "mother of the civil rights movement"
Dalai Lama
Abalone Alliance and Clamshell Alliance, anti-nuclear power groups
Christian anarchism
Conscientious objection
Direct action
Draft resistance
Holocaust rescuers
Le Chambon-sur-Lignon, French town
Insubordination
Hunt sabotage
Nonconformism
Nonviolence
Nonviolent resistance
Rachel Corrie
Sousveillance, passive campaign against surveillance
Tax resistance
Tree sitting
Trident Ploughshares, anti-nuclear weapons group
Defiance Campaign, anti-apartheid campaign in South Africa.

[edit] External links

制度殺人！希望有關單位注重我們這群箭堡的醫奴 (壓力) (壓力) (壓力) (壓力) (壓力) (壓力)

sjchen
違法就是錯
不可以用任何理由唐塞....
就像缺錢--生活困難--->強劫.....是不對的

請參考CIVIL DISOBEDIENCE