洗腎健保支出 去年逾3百億

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洗腎健保支出 去年逾3百億
http://tw.news.yahoo.com/article/url/d/ ... 2cd3o.html

（中央社記者溫貴香台北3日電）監察委員黃煌雄調查全民健保，今天公布地區醫院呼吸器與診所洗腎費用核付狀況，對洗腎費用核付情況，他感到不可思議。據調查，去年洗腎支出人口達6萬多人，支付逾300億元。

黃煌雄下午召開「我國全民健康保險總體檢案」記者會，公布北中南東與高屏等5地區，15個月來所進行的地區醫院呼吸器治療與診所洗腎現況田野調查，並公布民國94年到98年呼吸器與洗腎費用核付醫療點數的排序表，其中洗腎費用核付情況，讓他感到不可思議。

根據黃煌雄提供的診所申報及核付洗腎醫療點數資料顯示，民國95年台北地區某診所醫師人數是0，但申報了7000多萬醫療點數。健保局則解釋，這家診所的醫師為兼任醫師，非專任醫師，仍可申報醫療費用。

被詢及是否發現其中有弊端？黃煌雄表示，訪查過程中確實發現異常，但是否涉及浮報須進一步調查，預計12月將提出完整報告。

黃煌雄指出，根據健保局的資料，民國94年到98年間，呼吸器與洗腎費用合計占健保總經費的12.55%到13.28%間，每年人數達6、7萬人，支出新台幣500億元上下。

他表示，98年呼吸器支出人數約1萬人，健保局支付呼吸器的費用為240多億元；洗腎支出人數約6萬多人，支付的費用約300億元。

他指出，健保制度已不是單純財務的數字問題，而是牽涉如何在資源有限的情況下，讓資源分配符合公平正義原則；在有限資源讓健保永續經營，若不認真面對健保資源合理分配問題，健保制度岌岌可危。

黃煌雄說，田野調查過程中，許多宗教團體向他表示，台灣應嚴肅面對與考慮「無效醫療」問題，認真探討臨終關懷的相關配套與法令，在社會上形成共識，積極推行。

黃煌雄說，他樂見二代建保法案盡速實施，台灣社會應將一代健保所遺留的問題，隨著二代健保的上路告一段落，進而集中精力，認真探討健保支出的分配必須符合公平正義。

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洗腎健保若不給付 病患負擔增
http://tw.news.yahoo.com/article/url/d/ ... 2cd3q.html

（中央社記者陳麗婷台北3日電）監察委員黃煌雄調查洗腎及呼吸照護費用支出，1年占健保金額約1成，比例偏高。健保局今天表示，洗腎及呼吸照護都列重大傷病，如果不給付，反而造成家屬沉重負擔。

根據監委黃煌雄調查，呼吸照護及洗腎費用兩者占健保人數比率約0.3%，支出卻占健保金額超過1成，長期以來形成健保資源分配公平的疑慮。

健保局醫務管理組組長蔡淑鈴受訪表示，洗腎及呼吸器治療的病人，主要是因為腎衰竭或呼吸衰竭，造成需要接受血液或腹膜透析及呼吸器治療；而腎衰竭及呼吸衰竭是許多重大傷病的末期變化，重大傷病正是健保最需要優先照顧的對象。

她說，以98年健保申報資料分析，洗腎1年花費新台幣302.6億元，占健保全年醫療費用6.33%，呼吸器依賴患者所有費用1年花費242.92億元，占健保全年醫療費用4.76%，合計占健保總額醫療費用11.09%，確實是一大負擔；若健保不給付，民眾可能會因經濟關係而無法持續治療。

不過，蔡淑鈴說，為減緩呼吸器住院病患的醫療負擔，健保局支付居家呼吸器租賃及訪視費等費用，鼓勵病患回歸家庭，並於98年9月將8大末期疾患（含腎衰竭及呼吸衰竭）納入安寧住院及居家安寧療護支付範圍，希望減少健保支出。

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