8 9 瑏瑠瑏瑡瑏瑢 1. 瑏瑣瑏瑤瑏瑠瑏瑡瑏瑢瑏瑣瑏瑤 p See Frank A. Sloan Experience Rating Does It Make Sense

Size: px

Start display at page:

Download "8 9 瑏瑠瑏瑡瑏瑢 1. 瑏瑣瑏瑤瑏瑠瑏瑡瑏瑢瑏瑣瑏瑤 p See Frank A. Sloan Experience Rating Does It Make Sense"

卒钱
7 years ago
Views:

1 * ** DOI /j. cnki. fxpl * 11YJC GD10XFX10 CLS2012D144 ** http / / news. qq. com / a / / htm

2 8 9 瑏瑠瑏瑡瑏瑢 1. 瑏瑣瑏瑤瑏瑠瑏瑡瑏瑢瑏瑣瑏瑤 p See Frank A. Sloan Experience Rating Does It Make Sense for Medical Malpractice Insurance 80 Am. Econ. Rev

3 法学评论 2014 年第 4 期环境中能够潜心技术的提高和研究化解医患矛盾缓解紧张的医患关系瑏瑥引入保险这种分散风险消化损失的经济制度成为一种必然的选择瑏瑦从此层面而言强制医疗责任保险有助于创造良好医疗环境因为强制医疗责任保制度医务人员可以放手治疗获得第一手临床资料善尽谨慎注意义务潜心总结临床经验推动疑难杂症处理方案的形成提高医疗水平和技术正是通过大量临床实践在解决各类疑难病例的过程中使年青生涩的医学生成长为优秀的临床医生或其他类型的医务人员同时因保险公司的介入医务人员与繁杂的医疗纠纷相隔离有时间和精力去思考医学上尚未解决的难题推动医学发展 3. 医学需要借助强制医疗责任保险实现人类代际医疗公平交强险平衡的是车辆所有者或使用者与交通事故的受害者之间的利益其无需也不必关注当代与后代之间的利益冲突但强制医疗责任保险则不仅必须关注医务人员与受害患者权益的衡平也必须关注人类代际之间利益的衡平发展医学的终极目的是治疗患者保护人类健康因此患者乃至患者以外大众权益的保护是强制医疗责任保险制度的最终目的医学发展一定程度是基于个案患者权益的牺牲有些医学问题需要数代人付出健康甚至生命的代价才能够完成和解决如癌症艾滋病等都是无数研究人员临床工作者和患者前后接力攻克或正在攻克的医学难题当人类面对此类超越个体乃至人类代际的医疗风险时医务人员无法独自承担患者个体更是无力承担此类风险已经超越个体的能力范畴需要体现社会公平和正义的强制医疗责任保险制度在全社会范围内分担以使人类获得持续发展瑏瑧因此事关民众医疗安全和社会稳定的强制医疗责任保险其不仅关涉保险合同当事人和直接关系人保险人投保人被保险人等还包括保险合同以外的其他潜在患者也关涉人类后代交强险与强制医疗责任保险在制度产生原因目的等方面存在重大差别二者的制度构建也应不同交强险目的为弥补受害者损失甚至补充设立道路交通事故社会救助基金以救助受害者因此其制度内容主要包括保险费率保险费缴纳主体保险事故等但强制医疗责任保险则不仅为保护患者更是为医务人员创造良好职业环境为医学发展以及人类代际健康公平因此强制医疗责任保险制度既应衡平医患权益也应衡平人类代际健康利益其制度内容除了补偿受害患者利益还应内含促进医疗技术提高医疗损害减少的制度机制侵权责任法对医疗侵权采过错责任原则尽管同时规定适用推定过错的三种情形即医疗机构已经违反法律行政法规规章及其他有关诊疗规范的规定或隐匿或拒绝提供与纠纷有关的病历资料或伪造篡改或销毁病历资料而使患者遭受损害但这其实是过错责任的直接适用其过错已为自己行为所证明无需裁判机构再行推定瑏瑨侵权责任法的规定无疑将极大地调动医务人员探索未知领域的积极性但也意味着在现有法律调整范围内如果没有相应配套制度因医务人员探索未知领域而遭受的损害或风险将由患者承担此于患者极不公平以过错为调整基础的侵权法无法完成对医疗损害的填补也无法分散医疗风险更无法衡平人类代际健康公平瑏瑩侵权法对医疗损害行为的调整存在以下缺陷 1. 侵权法中医疗损害责任的承担以过错为基础没有深入探究过错责任与风险责任的重大差别瑐瑠我国侵权法对医疗行为的调整受传统侵权法过错责任的逻辑支配混淆了因医疗风险所致损害与传统过错所致损害的调整模式过错处理的是不法行为之责任而风险责任应对的是不幸事件之损害分配瑐瑡瑏瑥参见杨秀仪卢瑞芬台湾地区医疗伤害责任保险之实证研究台湾行政院科学委员会专题研究计划成果报告 2000 年 8 月第 66 页瑏瑦参见李玉泉保险法法律出版社 2003 年版第 8 页瑏瑧参见前注瑏瑣吕群蓉文第 183 页瑏瑨参见吕群蓉医务人员医疗行为侵权归责原则之评析载法律适用 2010 年第 5 期瑏瑩参见强美英医疗损害赔偿分担机制初探载河北法学 2010 年第 9 期瑐瑠参见朱岩风险社会与现代侵权责任法体系载法学研究 2009 年第 5 期瑐瑡参见叶金强风险领域理论与侵权法二元归责体系载法学研究 2009 年第 2 期 114

4 瑐瑢瑐瑣瑐瑤瑐瑥瑐瑦 2. 瑐瑧瑐瑨瑐瑩瑑瑠 3. 瑐瑢瑐瑣瑐瑤瑐瑥瑐瑦瑐瑧瑐瑨瑐瑩瑑瑠瑐瑠瑐瑡 115

5 瑑瑡瑑瑢瑑瑣 1. 瑑瑤瑑瑥瑑瑦瑑瑧瑑瑡瑑瑢 4 瑑瑣 4 瑑瑤 See J. D. Jacobson Medical Malpractice and the Tort System JAMA vol p 瑑瑥 See S. Y. Tan The Medical Malpractice Crisis Will No-Fault Cure the Disease University of Hawaii Law Review vol p 瑑瑦瑑瑧

6 瑑瑨瑑瑩瑒瑠瑒瑡瑒瑢瑒瑣瑒瑤 2. 1 瑒瑥 2 瑑瑨 See Paul C. Weiler Reforming Medical Malpractice in a Radically Moderate - and Ethical - Fashion DePaul L. Rev. vol p 瑑瑩 See Paul C. Weiler Fixing the Tail The Place of Malpractice in Health Care Reform Rutgers Law Review vol p 瑒瑠 See J. O'Connell An Alternative to Abandoning Tort Liability Elective No-Fault Insurance for Many Kinds of Injuries Minnesota Law Review vol p 瑒瑡 See Kenneth Thorp Fixing Medical Malpractice Through Health Insurance Enterprise Liability Harvard Law Review Vol pp 瑒瑢瑒瑣瑒瑤瑒瑥 A

7 瑒瑦瑒瑧 Abstraction The allocation of medical damage liability is the fundamental contradiction between doctors and patients. Although the compulsory medical liability insurance system and the traffic compulsory insurance belong to the compulsory insurance but the two are very different. The traffic compulsory insurance came from the medical risk by patients and medical staff which is a liability insurance system of the redistribution to medical damage liability and medical risk in order to equity and regulate to doctor-patient contradiction. Medical damage liability belongs to tort liability law. But the adjustment of China's tort law on medical damage liability limited liability barriers which cannot compensate the patients of medical damage. The consequences tense to relationship between doctors and patients which medical risk cannot be dispersed and medical resources enjoy unfair among people of different generations. So we should build compulsory medical liability insurance system on the foundation of no-fault compensation liability which government and patients should participate in the insurance aiming to realize the connection of medical liability insurance and tort law. Key Words Medical Risk No-fault Compensation Liability Compulsory Medical Liability Insurance 118 瑒瑦瑒瑧

P134 ~ P329 ~ P P 瑏瑡 P P 瑏瑢 P197 ~ 198 2

P134 ~ P329 ~ P P 瑏瑡 P P 瑏瑢 P197 ~ 198 2 2016 6 Jun. 2016 33 3 JOURNAL OF ZAOZHUANG UNIVERSITY Vol. 33 NO. 3 100006 1940 1941 1942 1943 * K265 A 1004-7077 2016 03-0001 - 13 1938 8 17 3 P1 ~ 3 1 4 P346 ~ 348 2 1939 6 1940 6 7 5 P18 1940 6 * 2016-04

8 9 瑏瑠 瑏瑡 瑏瑢 1. 瑏瑣 瑏瑤 瑏瑠 瑏瑡 瑏瑢 瑏瑣 瑏瑤 p See Frank A. Sloan Experience Rating Does It Make Sense

8 9 瑏瑠瑏瑡瑏瑢 1. 瑏瑣瑏瑤瑏瑠瑏瑡瑏瑢瑏瑣瑏瑤 p See Frank A. Sloan Experience Rating Does It Make Sense