自從健保開辦以來，的確造福了不少民眾，但現今因為健保局財政困難.docVIP

醫學系二年級 B101095009 劉彥廷 JOHN Q. (迫在眉睫)－醫師誓詞下的醫療制度與衝突 摘要： 　　現在許多大醫院都有設所謂的自費門診（ｅｘ：台大的景福門診），其中一個問題需要探討：「特需門診」所謂的VIP門診，即以自費的方式多付錢，能由知名的醫生教授診療，或是不需排隊優先看診福利。（用全民健保的個人需掛號排隊）。研究此制度它存在的必須性及是否違背醫師誓詞裡醫生不得選擇其病人。 　　醫療是種服務嗎？醫學生在向希波克拉底宣誓之後成為醫師，現行制度該如何面對處理才不會違反對病人的利益。研究VIP門診的需要性，探討出醫院、醫師、經濟弱勢者、富人與政府各方面的觀點，並設法找出平衡解決之道。 內容： 　　自從健保開辦以來，的確造福了不少民眾，但現今因為健保局財政困難，而實行的總額制度金額的緊縮，產生了許多問題，因為總額使大醫院有看越多病人而越虧錢的情況，致使一些教學級醫院紛紛開辦所謂的自費門診（也可以說是VIP門診、富人門診、特需門診等），及拓展各種自費項目另闢財源，以平衡健保總額下不足的虧損，例如台大景福門診掛號費訂為一千元，繳交部分負擔費三六○元。無論到了什麼地方，也無論需診治的病人是男是女、是自由民是奴婢，對他們我一視同仁，為他們謀幸福是我惟一的目的。我將不容許有任何宗教、國籍、種族、政見或地位的考慮介乎我的職責和病人之間形成就醫障礙經濟弱勢的病患很難在工作中抽空看病，卻因為付不起高貴的自費門診掛號費，只能和大批病患在門診外苦苦等候。健保現在的制度，是介於社會福利和商業保險之間對富人來說是非常不公平的 　　雖然現在的醫療科技日新月異，但我相信最終的目的都是為了促進人類福祉的，無論如何，在距離希波克拉底時代遙遠的今天，我們仍然是遵從著他的中心思想的。 附錄： 一、(英) Hippocratic Oath I swear by Apollo, Asclepius, Hygieia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment, the following Oath. To consider dear to me, as my parents, him who taught me this art; to live in common with him and, if necessary, to share my goods with him; To look upon his children as my own brothers, to teach them this art. I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone. To please no one will I prescribe a deadly drug nor give advice which may cause his death. Nor will I give a woman a pessary to procure abortion. But I will preserve the purity of my life and my arts. I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art. In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or with men, be they free or slaves. All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not t