受刑人納健保 醫療利用率破四成

[chienchun]

受刑人納健保 醫療利用率破四成

【聯合報╱記者詹建富／台北報導】
2013.03.25 11:11 am

二代健保元月上路，新制讓受刑人也可享受健保醫療。據統計，受刑人一月分門診就醫人數近三萬人，醫療利用率為四成四，亦即每十名受刑者中至少四人看診；健保給付金額約四千萬元。

法務部統計，全台各矯正機關收容的受刑人有六萬五千多人，元月納入健保後，特約醫療院所進入各監所提供門診服務。

根據健保局最新統計，元月受刑人因病就醫人數逾兩萬九千人，醫療利用率達四成四，其中門診近五萬五千人次，平均每件門診費用七百廿九元，前五大求診科別，依序為家醫科、內科、精神科、皮膚科及牙科。

受刑人因重病須到監所外戒護轉診住院治療者，元月有三百多人次，平均每件住診費近三萬元，住院前五大科別，依序為心臟血管內科、外科、內科、消化內科及感染科。

值得注意的是，受刑人未納入健保前，已有中醫師志願到全台十處監所為受刑人看診，但中醫師公會全聯會理事長孫茂峰表示，元月起卻未見健保局規畫監所內的中醫診療服務。他認為，受刑人多經濟弱勢，若過去可自費看中醫，沒理由納入健保後，反無中醫服務。

健保局副局長蔡魯指出，今年首次在監所內提供健保醫療服務，一切都在摸索，目前已將提出需求的桃園監獄和嘉義看守所，列為第一波試辦對象，近期將由中醫師公會協調鄰近醫療院所向健保局提出計畫案，經審核通過即可上路，最快五月即有中醫進駐提供服務。



全文網址: 受刑人納健保 醫療利用率破四成 | 醫二三事 | 健康醫藥 | 聯合新聞網 http://udn.com/NEWS/HEALTH/HEA16/778608 ... z2OWpDOlY0
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[李誠民]

受刑人納入健保,台灣的健保都要破產了!!!
這不是侵犯基本人權的事???,只因為執政黨要選票,不顧國民的死 活,又可賴在立法院?!又可以賴給醫界浪費醫療資源!(?可能嗎?!這是前衛生署長--楊志良的事--台大(?)公衛博士(非台大傑出校友,也非醫師!!!)
哈佛博士---馬英九先生,可以不沾鍋嗎?!最沾鍋的是你!!!--因為你是台灣領導人!!!國民黨也要亡在你手上,台灣如何不幸,也要亡國(?!--拖垮財政),;
應該公投(任何事---核四, 核安, 年金, 油 電雙漲....!!!都可以),結果代表罷免你!!!罷免國民黨!!!.............

[李誠民]

既然正規(?)的健保體系,不夠支應受刑人醫療(?)需求,那就交給中醫負責吧!?
到時候--死了 人,在來賴嗎/吧!! 至少不關我--馬英酒博士的事,因為我就任台灣領導人時,就聲明"不沾鍋"了:
你--國民還要選我(?),活該!!!還是"遇人不淑"?..........

[wipten]

就醫等於放風 ... 哪個 受刑人 不願多生病 反正免錢 又可以吹冷氣 順便....

[gary]

受刑人會說
我也要有5星級的住院病房
我願意貼差額

[李誠民]

FDA drops legal battle to introduce graphic pictures on cigarette packs
BMJ2013;346doi: http://dx.doi.org/10.1136/bmj.f1913(Published 22 March 2013)
Cite this as:BMJ2013;346:f1913
美國紐約市長彭博在本(三)月決定,在紐約販售香菸,應放在青少年不可看見的地方;;FDA卻作出”香菸盒”不可登出黑肺與死等警告…..,因為違反美國第一憲法修正案—保障言論自由…….為甚麼(Why)?................
The federal government is abandoning a legal battle to place pictures of blackened lungs and dead bodies on the front of cigarette packets……….
Shortly after the rolled out the new requirements in 2011, some of the country’s largest cigarette makers, including RJ Reynolds Tobacco, sued the agency, arguing that the labels were too broad and violated the companies’ rights under the First Amendment. A judge ruled last year that such a requirement for packaging did indeed violate First Amendment free speech protections, and an appeals court upheld that ruling.
……..New York City, Mayor Michael Bloomberg proposed new legislation this week to put all tobacco products out of sight of customers.
Bloomberg claimed that his bill would make New York the first city in the US to force retailers to keep tobacco products hidden………
The city’s deputy mayor, Linda Gibbs, said, “We know that smoking is dangerous, deadly, addictive and without a single benefit.
“As public health leaders we owe it to adults and young people alike to do everything we can to prevent New Yorkers from starting to smoke and helping those who want to quit.”


The Taxing Power and the Public's Health
Michelle M. Mello, J.D., Ph.D., and I. Glenn Cohen, J.D.
N Engl J Med 2012; 367:1777-1779November 8, 2012DOI: 10.1056/NEJMp1209648
我們不是都說美國(式)民主嗎?!美國是聯邦制,否則美國總統--歐巴馬就無法節制了嗎?!美國參院債務上限, 財政危機等,都是 民意機構節制總統的體制,還有最高法院的憲法裁定(所以憲法裁定在歐巴馬連任前一刻),否則現在做出憲法裁定,它的健保改革就可能又不同了!!!
Many observers feared that the Supreme Court decision on the challenge to the Affordable Care Act (ACA)1 would endorse a breathtaking expansion of the role of the federal government in regulating health matters. And it did — but not in the anticipated way. While enunciating limits on the commerce and spending powers, the Court opened the door for Congress to use its taxing power to achieve myriad policy objectives. The federal government may now increasingly join state and local governments in making creative use of taxes to pursue public health goals, though political obstacles障礙物 may block immediate action. Chief Justice John Roberts surprised pundits by joining the four liberal justices in upholding the individual insurance mandate in the ACA as an exercise of Congress's power to “lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States.”2 He wrote that the government has considerable power to tax “even in areas where it cannot directly regulate.”…..
The federal government has long used taxes to achieve public health goals, but in fairly limited ways. Taxes and tax penalties for individuals have generally been confined to products that cause health harms and associated social costs, such as tobacco, alcohol, firearms, and pollutants. Taxing of activities is rarer and confined to economic transactions; most recently, the ACA imposed a 10% tax on tanning-salon 曬黑沙龍services. Broader use has been made of tax penalties and incentives to influence corporations to refrain抑制 戒除from activities that threaten health, such as environmental contamination, or to engage in health-promoting activities such as subsidizing health insurance and wellness programs…….
Roberts's opinion appears to invite more targeted, assertive interventions to promote public health. For example, instead of merely taxing tobacco sales, the federal government could require individuals to pay a tax penalty unless they declare that they haven't used tobacco products during the year. It could give a tax credit to people who submit documentation that their body-mass index is in the normal range or has decreased during the year or to diabetic persons who document that their glycated hemoglobin levels are controlled. It could tax individuals who fail to purchase gym memberships……
……State and local governments, too, can pursue such strategies. Levying 徵稅 扣押taxes to achieve regulatory aims — even taxes resembling mandates with penalties — is well within their police-power authority. They've wielded this power to impose various “sin” taxes on unhealthful products, as well as in more innovative ways, such as the insurance mandate with an SRP that Massachusetts pioneered. The Court ruling makes clear that the federal government can enter territory historically dominated by the states.
Taxes are an appealing mechanism of public health regulation for several reasons. They proffer “nudges” and market-based solutions as alternatives to rigid mandates. Tax-based policies like the SRP retain an element of voluntariness, especially since lawmakers can calibrate the tax penalty to the importance of the desired behavior change. There's strong evidence that taxes affect consumption decisions. Finally, tax strategies are “win–win雙贏” for governments, either leading people to take health-enhancing steps or collecting revenue to fund health or other programs…….
……Aggressive lobbying by the beverage industry, for example, defeated a soft-drink tax proposed for inclusion in the ACA, and a blitzkrieg 閃電行動by the tobacco industry sank California's Proposition 29, which would have hiked cigarette taxes by $1.00 a pack, with revenues稅收 收入 allocated for cancer research. States, however, have sometimes had remarkable success in enacting new taxes; for example, New York passed a $1.60-per-pack increase in its cigarette tax in 2010, bringing the total state tax to $4.35 per pack, and 47 states have collectively increased their cigarette-tax rates more than 100 times in the past decade.
Although no constitutional barriers block expanded federal use of tax-based strategies, political obstacles remain. Some interventions we've outlined would never survive the political process, given prevailing戰勝 盛行 antitax sentiment感情 觀感. But such sentiment may fade as the economy recovers or become less important if Democrats regain control of the House of Representatives. Moreover, the Court decision affirms that Congress can facilitate passage of a tax by calling it something less controversial. The Court has highlighted an opportunity for passing creative new public health laws, authorized by the taxing power; this opportunity now awaits its political moment.


U.S. Governors and the Medicaid Expansion — No Quick Resolution in Sight
Benjamin D. Sommers, M.D., Ph.D., and Arnold M. Epstein, M.D.
N Engl J Med 2013; 368:496-499February 7, 2013DOI: 10.1056/NEJMp1215785
With President Barack Obama's reelection in November, the Affordable Care Act (ACA) will remain the law of the land for the foreseeable future. But since the Supreme Court ruling on the ACA, states have been grappling with the option the Court presented — whether to participate in the expansion of Medicaid eligibility to all adults with family incomes at or below 138% of the federal poverty level. In the aftermath 後果 餘波of the 2012 election, it is uncertain how this process will play out, but what the states decide will play a critical role in the future of the U.S. health care system….太多了,請有興趣的自行閱讀 參考!!!

[李誠民]

FDA drops legal battle to introduce graphic pictures on cigarette packs
BMJ2013;346doi: http://dx.doi.org/10.1136/bmj.f1913(Published 22 March 2013)
Cite this as:BMJ2013;346:f1913
美國紐約市長彭博在本(三)月決定,在紐約販售香菸,應放在青少年不可看見的地方;;FDA卻作出”香菸盒”不可登出黑肺與死等警告…..,因為違反美國第一憲法修正案—保障言論自由…….為甚麼(Why)?................
The federal government is abandoning a legal battle to place pictures of blackened lungs and dead bodies on the front of cigarette packets……….
Shortly after the rolled out the new requirements in 2011, some of the country’s largest cigarette makers, including RJ Reynolds Tobacco, sued the agency, arguing that the labels were too broad and violated the companies’ rights under the First Amendment. A judge ruled last year that such a requirement for packaging did indeed violate First Amendment free speech protections, and an appeals court upheld that ruling.
……..New York City, Mayor Michael Bloomberg proposed new legislation this week to put all tobacco products out of sight of customers.
Bloomberg claimed that his bill would make New York the first city in the US to force retailers to keep tobacco products hidden………
The city’s deputy mayor, Linda Gibbs, said, “We know that smoking is dangerous, deadly, addictive and without a single benefit.
“As public health leaders we owe it to adults and young people alike to do everything we can to prevent New Yorkers from starting to smoke and helping those who want to quit.”


The Taxing Power and the Public's Health
Michelle M. Mello, J.D., Ph.D., and I. Glenn Cohen, J.D.
N Engl J Med 2012; 367:1777-1779November 8, 2012DOI: 10.1056/NEJMp1209648
我們不是都說美國(式)民主嗎?!美國是聯邦制,否則美國總統--歐巴馬就無法節制了嗎?!美國參院債務上限, 財政危機等,都是 民意機構節制總統的體制,還有最高法院的憲法裁定(所以憲法裁定在歐巴馬連任前一刻),否則現在做出憲法裁定,它的健保改革就可能又不同了!!!
Many observers feared that the Supreme Court decision on the challenge to the Affordable Care Act (ACA)1 would endorse a breathtaking expansion of the role of the federal government in regulating health matters. And it did — but not in the anticipated way. While enunciating limits on the commerce and spending powers, the Court opened the door for Congress to use its taxing power to achieve myriad policy objectives. The federal government may now increasingly join state and local governments in making creative use of taxes to pursue public health goals, though political obstacles障礙物 may block immediate action. Chief Justice John Roberts surprised pundits by joining the four liberal justices in upholding the individual insurance mandate in the ACA as an exercise of Congress's power to “lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States.”2 He wrote that the government has considerable power to tax “even in areas where it cannot directly regulate.”…..
The federal government has long used taxes to achieve public health goals, but in fairly limited ways. Taxes and tax penalties for individuals have generally been confined to products that cause health harms and associated social costs, such as tobacco, alcohol, firearms, and pollutants. Taxing of activities is rarer and confined to economic transactions; most recently, the ACA imposed a 10% tax on tanning-salon 曬黑沙龍services. Broader use has been made of tax penalties and incentives to influence corporations to refrain抑制 戒除from activities that threaten health, such as environmental contamination, or to engage in health-promoting activities such as subsidizing health insurance and wellness programs…….
Roberts's opinion appears to invite more targeted, assertive interventions to promote public health. For example, instead of merely taxing tobacco sales, the federal government could require individuals to pay a tax penalty unless they declare that they haven't used tobacco products during the year. It could give a tax credit to people who submit documentation that their body-mass index is in the normal range or has decreased during the year or to diabetic persons who document that their glycated hemoglobin levels are controlled. It could tax individuals who fail to purchase gym memberships……
……State and local governments, too, can pursue such strategies. Levying 徵稅 扣押taxes to achieve regulatory aims — even taxes resembling mandates with penalties — is well within their police-power authority. They've wielded this power to impose various “sin” taxes on unhealthful products, as well as in more innovative ways, such as the insurance mandate with an SRP that Massachusetts pioneered. The Court ruling makes clear that the federal government can enter territory historically dominated by the states.
Taxes are an appealing mechanism of public health regulation for several reasons. They proffer “nudges” and market-based solutions as alternatives to rigid mandates. Tax-based policies like the SRP retain an element of voluntariness, especially since lawmakers can calibrate the tax penalty to the importance of the desired behavior change. There's strong evidence that taxes affect consumption decisions. Finally, tax strategies are “win–win雙贏” for governments, either leading people to take health-enhancing steps or collecting revenue to fund health or other programs…….
……Aggressive lobbying by the beverage industry, for example, defeated a soft-drink tax proposed for inclusion in the ACA, and a blitzkrieg 閃電行動by the tobacco industry sank California's Proposition 29, which would have hiked cigarette taxes by $1.00 a pack, with revenues稅收 收入 allocated for cancer research. States, however, have sometimes had remarkable success in enacting new taxes; for example, New York passed a $1.60-per-pack increase in its cigarette tax in 2010, bringing the total state tax to $4.35 per pack, and 47 states have collectively increased their cigarette-tax rates more than 100 times in the past decade.
Although no constitutional barriers block expanded federal use of tax-based strategies, political obstacles remain. Some interventions we've outlined would never survive the political process, given prevailing戰勝 盛行 antitax sentiment感情 觀感. But such sentiment may fade as the economy recovers or become less important if Democrats regain control of the House of Representatives. Moreover, the Court decision affirms that Congress can facilitate passage of a tax by calling it something less controversial. The Court has highlighted an opportunity for passing creative new public health laws, authorized by the taxing power; this opportunity now awaits its political moment.


U.S. Governors and the Medicaid Expansion — No Quick Resolution in Sight
Benjamin D. Sommers, M.D., Ph.D., and Arnold M. Epstein, M.D.
N Engl J Med 2013; 368:496-499February 7, 2013DOI: 10.1056/NEJMp1215785
With President Barack Obama's reelection in November, the Affordable Care Act (ACA) will remain the law of the land for the foreseeable future. But since the Supreme Court ruling on the ACA, states have been grappling with the option the Court presented — whether to participate in the expansion of Medicaid eligibility to all adults with family incomes at or below 138% of the federal poverty level. In the aftermath 後果 餘波of the 2012 election, it is uncertain how this process will play out, but what the states decide will play a critical role in the future of the U.S. health care system….太多了,請有興趣的自行閱讀 參考!!!

[李誠民]

新行業 : 鷹派醫師　
醫師應該是白袍的流氓　不是術仔
不知這代表甚麼意思?!願聞其詳!?

[wipten]

新行業 : 鷹派醫師　
醫師應該是白袍的流氓　不是術仔
不知這代表甚麼意思?!願聞其詳!?

階段性任務 .. 醫界缺甚麼角色就當甚麼