CNN說要美國學習臺灣健保，美國醫師慘了。

[mhc130588]

札卡利亞以台灣的健保為例指出，台灣是一個強健的自由市場經濟體，在1990年代中期設計健保制度時參考了許多既有的模式，選擇了全民投保的模式，不是讓幾家民間保險公司 承擔這項工作，而是創造「單一保險人」（single insurer）方式，作為台灣版的健保雛型。

札卡利亞說，台灣全民健保的結果是讓所有人都能加入健保，以極低的成本享有高品質的醫療服務。台灣在健保上的支出只占GDP7%，但美國卻花了17%。

札卡利亞也以瑞士的健保為例指出，20年前，瑞士的健保制度和美國一樣，就是由民間保險業者負責處理民眾投保，造成瑞士民眾不願意購買健保。後來瑞士政府以公投通過法 令，規定每個人都必須購買健保，這就很類似美國總統歐巴馬一心要推動的健保改革方案。

瑞士在健保上的支出占GDP的11%，且民眾每年都可以改變健保方案，民眾對健保系統的整體滿意度相當高。

[yuhung2000]

瑞士在健保上的支出占GDP的11%，且民眾每年都可以改變健保方案，民眾對健保系統的整體滿意度相當高

照樣造句:
台灣在健保上的支出只占GDP7%, 且民眾每年都可以改變健保方案，民眾對健保系統的整體滿意度相當高..... （無盡漩渦） (不要啊)

[lupin]

美國醫師不會像台灣醫師這般好欺負。
未來新標題：
CNN說台灣醫師要學習美國醫師抗爭方式，xxx慘了。

[hsu]

http://open.nat.gov.tw/OpenFront/report ... =C09401484

不知道這些台灣官員出國考察的目的是幹嘛？

[kwojohn]

http://open.nat.gov.tw/OpenFront/report ... =C09401484

不知道這些台灣官員出國考察的目的是幹嘛？

名為考察出差...實為觀光旅遊... （無盡漩渦）

[歐伊斯特拉夫]

國情不同

[Easyplayer]

札卡利亞以台灣的健保為例指出，台灣是一個強健的自由市場經濟體，在1990年代中期設計健保制度時參考了許多既有的模式，選擇了全民投保的模式，不是讓幾家民間保險公司 承擔這項工作，而是創造「單一保險人」（single insurer）方式，作為台灣版的健保雛型。

札卡利亞說，台灣全民健保的結果是讓所有人都能加入健保，以極低的成本享有高品質的醫療服務。台灣在健保上的支出只占GDP7%，但美國卻花了17%。

札卡利亞也以瑞士的健保為例指出，20年前，瑞士的健保制度和美國一樣，就是由民間保險業者負責處理民眾投保，造成瑞士民眾不願意購買健保。後來瑞士政府以公投通過法 令，規定每個人都必須購買健保，這就很類似美國總統歐巴馬一心要推動的健保改革方案。

瑞士在健保上的支出占GDP的11%，且民眾每年都可以改變健保方案，民眾對健保系統的整體滿意度相當高。

直說是拖拉斯就好....
說穿了就是要實施醫療共產主義....

說的更白....
政府也不想國民活太久....
沒錢一直支撐社福支出....
人民別活那麼久就好....

[haowu15]

讚啦,力推

唯有美國醫師的大力反彈
才有機會讓我們的委屈被公佈

[lijen]

札卡利亞以台灣的健保為例指出，台灣是一個強健的自由市場經濟體，在1990年代中期設計健保制度時參考了許多既有的模式，選擇了全民投保的模式，不是讓幾家民間保險公司 承擔這項工作，而是創造「單一保險人」（single insurer）方式，作為台灣版的健保雛型。

札卡利亞說，台灣全民健保的結果是讓所有人都能加入健保，以極低的成本享有高品質的醫療服務。台灣在健保上的支出只占GDP7%，但美國卻花了17%。

札卡利亞也以瑞士的健保為例指出，20年前，瑞士的健保制度和美國一樣，就是由民間保險業者負責處理民眾投保，造成瑞士民眾不願意購買健保。後來瑞士政府以公投通過法 令，規定每個人都必須購買健保，這就很類似美國總統歐巴馬一心要推動的健保改革方案。

瑞士在健保上的支出占GDP的11%，且民眾每年都可以改變健保方案，民眾對健保系統的整體滿意度相當高。

這段文字有問題
醫療保健支出≠健保
健保大約只佔了整體醫療保健支出的一半；其他民間和自費等等醫療行為占了約一半
所以說台灣在健保的支出，只佔了GDP的3%~4%

http://www.doh.gov.tw/CHT2006/DM/DM2_p0 ... oc_no=6601

93年國民醫療保健最終支出6,647億元中，以全民健保醫療保健支出(應付醫療給付數＋行政管理費)共3,759億元占56.6%最多；其次為家庭自付醫療保健支出2,168億元或占32.6%；政府部門511億元或占7.7%。
http://www.doh.gov.tw/statistic/data/%E ... %BC%8D.pdf

[tonyhsu]

這是ZAKARIA GPS討論的原文影像出處，有空的同仁都應該聽完就可以知道裡面問題一堆。
http://globalpublicsquare.blogs.cnn.com ... ry/health/

這是影片裡面開宗明義提到的比較圖，看好了，是over ranking 和Health Expenditure 的比較，排名七個國家，台灣？抱歉根本沒在裡面。也就是說GPS這節目只拿台灣的『便宜』來說嘴，論醫療品質根本排不上名。
http://www.commonwealthfund.org/Publica ... Healt.aspx

有幾點他也沒提到，花費低原因有很多，老年人口比例比美國低，移植醫學比美國比例少，這些都是台灣費用還沒竄高的原因，不是一個single payer system就能夠一筆帶過的。像亞洲All numbers per million population腎，肝，心，每百萬人口移植數分別是3,0.3,0.03,相較比美國是52,19,8分別是17倍，63倍，266倍，所以台灣醫療費用低這塊也該算進去。
http://en.wikipedia.org/wiki/Organ_transplantation

剛看了台灣移植醫學會的網站，這類資訊根本沒有，只有一堆進修課程的時刻表而已，當遇到要和官方或國外媒體講述論點的時候經常沒有自己版本的數據可以引用，我覺得這也是台灣醫界在面對問題時只能被動參考新聞報導的弱點。

[kwojohn]

上聯：美國歡喜傾銷以富瘦肉精狂牛症肉品

下聯：台灣湧泉回報以世界第一之全民健保

橫批：看誰先倒

[Easyplayer]

話說回來....
這只是要漲健保所貼的業配....
美國敢這樣搞....??

[tonyhsu]

剛剛去CNN回覆了，希望大家有空也能多過去發聲，讓事情真相讓老美也知道一下。

I am M.D. in Taiwan. It’ s nice to know the discussion about Taiwan’s Healthcare on your show. But I must point out some viewpoints about Taiwan’s Healthcare are not true actually. “Single payer system” is not the only reason of the low cost of health expenditure in Taiwan now. For example,the percentage of ageing population and their associated costs in Taiwan is far less than those in US. And the percentage and costs in transplantation in Taiwan is also far less than US. (For example, the number for heart transplantation per million population in USA is 8, and Asia average is only 0.03, which is more 200 times.)
Moreover, there are over 200 hospitals(around 25% of total hospitals) in Taiwan are closed after the start of Health Insurance in 1995, and nowadays there are around 25% of doctors leaving the Healthcare system for cosmetics business due to many difficulties. Of course you can still say the costs in Taiwan are still low than US, but they will costs more soon in the future.

[lupin]

剛剛去CNN回覆了，希望大家有空也能多過去發聲，讓事情真相讓老美也知道一下。
.

英文不好或沒時間的醫師，不用寫那麼多，直接寫：
"I am a doctor from Taiwan.I XXXX the TMD healthcare system."

[alexhuang1961]

就算美國實施健保 那是用美金計酬
美國醫師公會非常強勢
光這點就夠啦!
台灣那個能叫醫師公會 專門出賣會員權利

[auricle]

美國變成共產國家了 ! （無盡漩渦）

[leonhong]

CNN全文叫做Cao Ni Ma，本來就是可以不用太相信的。

https://www.google.com/#hl=zh-TW&safe=o ... 72&bih=858

這，就是CNN

[bryan]

美國醫師不會像台灣醫師這般好欺負。
未來新標題：
CNN說台灣醫師要學習美國醫師抗爭方式，xxx慘了。

1.沒錯

2. Yes, we can!

[bryan]

上聯：美國歡喜傾銷以富瘦肉精狂牛症肉品

下聯：台灣湧泉回報以世界第一之全民健保

橫批：看誰先倒

葉師父文武兼修

[bryan]

剛剛去CNN回覆了，希望大家有空也能多過去發聲，讓事情真相讓老美也知道一下。

I am M.D. in Taiwan. It’ s nice to know the discussion about Taiwan’s Healthcare on your show. But I must point out some viewpoints about Taiwan’s Healthcare are not true actually. “Single payer system” is not the only reason of the low cost of health expenditure in Taiwan now. For example,the percentage of ageing population and their associated costs in Taiwan is far less than those in US. And the percentage and costs in transplantation in Taiwan is also far less than US. (For example, the number for heart transplantation per million population in USA is 8, and Asia average is only 0.03, which is more 200 times.)
Moreover, there are over 200 hospitals(around 25% of total hospitals) in Taiwan are closed after the start of Health Insurance in 1995, and nowadays there are around 25% of doctors leaving the Healthcare system for cosmetics business due to many difficulties. Of course you can still say the costs in Taiwan are still low than US, but they will costs more soon in the future.

大大加油 (眼汪汪)

[bryan]

就算美國實施健保 那是用美金計酬
美國醫師公會非常強勢
光這點就夠啦!
台灣那個能叫醫師公會 專門出賣會員權利

大老們我沒有說這句話哦
(郎母系挖台ㄟ)

但是我力推這句話

[bryan]

CNN全文叫做Cao Ni Ma，本來就是可以不用太相信的。

https://www.google.com/#hl=zh-TW&safe=o ... 72&bih=858

這，就是CNN

本來就是
老美御用發聲筒

[tonyhsu]

如果我沒看錯CNN的影片（裡面也只有這個談到台灣）http://globalpublicsquare.blogs.cnn.com ... alth-care/
裡面『完全沒有』提到甚麼驚人低成本，甚麼高品質結果。只有一句是這樣講的：Not surprisingly, they had the lowerest health care cost in the world, and up there among the best in terms of the outcome, but they only spent 7 percents of their economy of and we spent 17. 翻成中文是：『不令人意外的，他們有世界上最低的健康照護花費，以這條件來看結果是最好的，他們只花了7%的經濟費用而我們是17%。』台灣的媒體很愛在翻譯的時候加上字句給自己臉上貼金。

[tonyhsu]

如果我沒看錯CNN的影片（裡面也只有這個談到台灣）http://globalpublicsquare.blogs.cnn.com ... alth-care/
裡面『完全沒有』提到甚麼驚人低成本，甚麼高品質結果。只有一句是這樣講的：Not surprisingly, they had the lowerest health care cost in the world, and up there among the best in terms of the outcome, but they only spent 7 percents of their economy of and we spent 17. 翻成中文是：『不令人意外的，他們有世界上最低的健康照護花費，以這條件來看結果是最好的，他們只花了7%的經濟費用而我們是17%。』台灣的媒體很愛在翻譯的時候加上字句給自己臉上貼金。

[image]

CNN全文叫做Cao Ni Ma，本來就是可以不用太相信的。

https://www.google.com/#hl=zh-TW&safe=o ... 72&bih=858

這，就是CNN

本來就是
老美御用發聲筒

CNN還是目前世界上最接近真實跟最有效率的新聞電子媒體

[dtemer92]

其實啊，也不用別人吃飯我們喊燒，過度替美國醫生緊張
CNN不過就是個媒體，如同台灣的TVBS，或者無線三台，中天之類的
美國媒體言論自由，CNN稱讚台灣健保，那是CNN記者的自由

究其然
美國的醫療環境與台灣有相當的差異

例如，
USA的家庭醫師轉診制度很健全
平常看病是採取約診制 (而非像台灣掛了號, 在門口排隊等叫號)
急診採取封閉式急診，
候診病人跟家屬，或者其他閒雜人會被隔離在醫療區以外，
也不可能讓你URI，AGE就一直掛號然後衝進去罵醫生這麼久不叫號

倘若美國真的實行全民健保
這些制度，可預知大概不會有所改變
倘若美國真的實行全民健保，甚至總額預算
我猜測還是會比較偏向加拿大，英國或者其他歐美國家的健保，不可能無限壓榨醫師
（總額用盡了醫師就可以放假之類的）
美國的醫師也不可能乖乖向台灣醫師一樣被壓榨

另外, 美國區分出了private跟public hospital
資本主義自由經濟的美國國度
不可能容忍把公私立醫療機構通通納入健保範圍，畢竟這不符合美國立國精神
頂多是public hospital被納入，
會仍然保有private hospital的自由市場空間

[stockk]

這案子早被美國國會踢掉

選舉又來賣弄一次??

[Ocean]

美國醫師那麼好搞的話
早就比台灣更早全民健保實施了 (眼汪汪)

[lupin]

CNN 上到目前為止所有台灣醫師的回應:

#
PP

I am from Taiwan.
Taiwan's Health care has a lot of problems.
Don't be stupid.
Maybe It's cheap for patients.
It's quite expensive for healthy people.
March 19, 2012 at 1:48 am | Reply
#
Harry Lin

I am a Taiwanese doctor practicing in Taiwan. The Taiwanese healthcare system is far from such a perfect model depicted in the show. For me as a healthcare recipient, the government makes me and my employer pay close to 7& of my monthly salary for compulsive coverage, that's on top of the 20-40% income tax that I have to pay. For me as a healthcare provider, the government's payout is so pitiful that each doctor in private practice has to see about 30 patients a day just to break even. Example: The government pays less than $3 US dollars per Urine Catheterization performed (cost of Foley tube & urine bag included), and later on if the government (acting as both auditor & final arbitrator) determines that the procedure was not "necessary", it fines the doctor $300 (100 times the amount) for this single disputed charge alone. One would think that the government would have no trouble containing healthcare cost with stringent measures like that, but no, the healthcare system generates a deficit every year that has to be remedied by ever-increasing premiums. The reason: The system is unable to control misuse & waste by patients who think healthcare is dirt cheap.
March 19, 2012 at 2:28 am | Reply
#
A Doctor From Taiwan

I am M.D. in Taiwan. It’ s nice to know the discussion about Taiwan’s Healthcare on your show. But I must point out some viewpoints about Taiwan’s Healthcare are not true actually. “Single payer system” is not the only reason of the low cost of health expenditure in Taiwan now. For example,the percentage of ageing population and their associated costs in Taiwan is far less than those in US. And the percentage and costs in transplantation in Taiwan is also far less than US. (For example, the number for heart transplantation per million population in USA is 8, and Asia average is only 0.03, which is more 200 times.)
Moreover, there are over 200 hospitals(around 25% of total hospitals) in Taiwan are closed after the start of Health Insurance in 1995, and nowadays there are around 25% of doctors leaving the Healthcare system for cosmetics business due to many difficulties. Of course you can still say the costs in Taiwan are still low than US, but they will costs more soon in the future.
March 19, 2012 at 3:40 am | Reply
#
John M.

I felt compelled to say thank you, for bringing some good people to light in your reporting. The people that you mentioned who are showing the results and failures of our current system (also some available changes that can be made). These facts and results are apalling and yet almost no one is doing anything to make a difference. The items that your reporting mentions, need action to eliminate the deficiencies, and make some changes to our system. The time for action is long overdue Thank you to the people that participated in your broadcast. Mr. Zakaria your report is well recieved and much appreciated..
March 19, 2012 at 3:47 am | Reply
#
TaiwanGuyInUS

I didn't give up my Taiwan nationality just in case that I have to retire in Taiwan.
The way Taiwan does it, is that they keep cost low.

Organized medicine and doctor have to charge fee according to the guide book. You can't be rich becoming a Taiwan doctor. Taiwan doctor are not in million dollar student loan either after their training.
There is no insurance company taking profit. The government is the insurer.

Everything is digitized. Everyone has an ID card which link to networked database. All patients' billing history, record go with them in their ID card. They are able to keep administrative cost down to 6~7% of the total cost as oppose to in US, 22%.

Drug company makes less money also. The drug of the choice is typically effective and its cost within reason.

Everyone has to join and the government subsidize the premium for the poor.
It works great. My father lives in US and he goes back every year for annual check up.

On the upside, US medicine has better quality, but only the adequate insured ultra poor and ultra rich can afford them. lolz Everyone else has to go bankrupt. lolz
March 19, 2012 at 11:26 am | Reply