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uk travel blog 在 Jの背包旅行 Facebook 八卦

Jの背包旅行 By Jの背包旅行

2018-07-15 19:37:06 有 1,565 人按讚
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【#旅行投稿分享】芬兰🇫🇮 7天6夜冬天❄️☃️亲子游，机票住宿吃喝玩乐全包才RM7750😍#还包括一晚玻璃屋哦！

芬兰每位成人总花费约RM 7750
**RM 4.90 = €1

【🇫🇮Sim Card篇📱每人RM 41】
💲RM 82 (Hotspot enable所以一张可以两个人用)
https://hello1010.my/uk-europe-cu-2gb

【🇫🇮旅游保险篇🏥每人RM 76】
💲RM 304

【🇫🇮飞机票篇✈】
💲每人来回RM 3568
✈Thai Airways RM 8276
✈British Airways £ 550 = RM 3084
✈Finnair € 595 = RM 2915

【🇫🇮租车篇🚘】
💲每人RM1064
Helsinki € 270 = RM 1346
Rovaniemi € 431 = RM 2131
Petrol € 159 = RM779
总数除4个人因为车子很大足以载四位成人加行旅~
租车网址: https://www.avis.com/en/home

【🇫🇮食物篇🍽 】
💲每人RM284
€174 = RM853
只除3个人因为两个女儿只吃一个成人的份~

➖➖➖➖➖➖➖➖➖➖
【🇫🇮行程篇🤳】
💲每人€526 = RM2577
Day 1: ✈
💓KL - Heathrow
💓Heathrow - Helsinki
💓入住Mukava Maja Majatalo
http://www.booking.com/Share-jL7P5i
€148 两晚 = RM737

Day 2: Helsinki
💓Temppeliaukio Church
门票每人€3 = RM15
💓Senate Square

Day 3: ✈ + 🚘
💓Helsinki - Rovaniemi (1个小时飞机)
💓Rovaniemi - Giellajohka (4个小时车程)
💓入住Giellajohka (挪威边界) https://www.agoda.com/giellajohka/hotel/kaamanen-fi.html…
€264 两晚 = RM1300
👐建议大家从Helsinki直飞Ivalo，
不用飞Rovaniemi先，
那样就不用驾那么久车，
芬兰冬天夜晚来得早，
路几乎是没有路灯，
很暗。。。。很暗。。。
驾车需要花费很大的精力，
但是有失也有得，
我们在这段车程看到近约1个小时的北极光~

Day 4: 🚘Ivalo
💓Husky sledge
成人 €125 = RM612
小孩 €67.50 = RM330
💓Reindeer safari
成人 €100 = RM490
小孩 免费

Day 5: 🚘玻璃屋
💓Giellajohka - Arctic Snow Hotel (5个小时车程)
入住Arctic Glass Igloo玻璃屋
http://www.booking.com/Share-daVB70
€619 一晚 = RM3030
👐幸运的我们在一抵达玻璃屋就遇见北极光，
加上没有下雪所以晚上躺在床上是看到超级多星的

Day 6: 🚘Rovaniemi
💓Santa Claus Village
与圣诞老人合照: €40 = RM200
💓Reindeer Sledge
€40 = RM200
入住The Blueberry Studio
https://www.airbnb.com/rooms/4546109
€120 一晚 = RM594

Day 7: ✈
💓Rovaniemi - Helsinki
💓Helsinki - Heathrow

➖➖➖➖➖➖➖➖➖➖
【作者：@shierly yshai】
>>更多详细攻略可浏览作者部落客：
http://ni88.blogspot.com/2018/06/blog-post.html

#芬兰 #冬天 #欢迎私聊投稿
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Facebook: https://m.facebook.com/JBackpacktravel
Travel Blog: Jbackpack.blogspot.com
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uk travel blog 在 高雄好過日 Facebook 八卦

高雄好過日 By 高雄好過日

2018-11-06 19:20:08 有 1,562 人按讚
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#由實證研究看癌症治療一口價可行性
-基於本土資料的觀光醫療效益分析
文：陳信諭 醫師

壹、前言

中國國民黨高雄市長候選人韓國瑜先生提出政見中，特別強調「觀光醫療」一環，在受訪時，他特別指出：要推動「全亞洲最便宜的治療癌症還有醫療美容」，「我國際掛牌，價格直接訂出來」，「鼻癌、鼻咽癌120塊美金、乳癌200塊美金、眼睛割雙眼皮50塊美金」。

眾所皆知，市長候選人於正式場合發表政策看法，背後均應有幕僚團隊的詳盡研究與分析，數據亦應經過查證。韓國瑜候選人事隔兩個月，經過認真研究後，雖再次指出：「如果大家不滿意價格，眼睛割雙眼皮可以提高到1萬元美金。」

然而，醫療相關政策與果菜市場批發叫賣顯有差異，不該隨意喊價，而其價格亦不是由輿論或選民滿不滿意來決定。迄今為止，韓國瑜候選人尚未收回「癌症觀光醫療」的政策，亦尚未提出最新治癌全球掛牌價碼。

因此，本文將根據嚴謹的本土和國外數據分析，來探討「癌症觀光醫療一口價」的合理成本與可行性。

貳、癌症醫療成本分析

我國實施全民健保已有23年，累積大量的數據，從健保資料庫分析中，便可了解台灣治療各類癌症，在各階段健保成本支出的不同。

以2014年高醫等團隊發表的健保資料庫論文為例 [1]，從1996-2007年收集141,772例乳癌、大腸直腸癌、肝癌、肺癌、胃癌分析。在2007年，從診斷到初始治療（12個月內）乳癌的健保花費為8347美金，大腸直腸癌為8113美金，肺癌為10681美金，而胃癌為10780美金。以乳癌而言，單單是「初始治療」，不論是化學治療（3650美元）、放射治療（6310美元）、手術治療（478美元），每一項的花費都遠超過200元美金的國際掛牌價。而我們知道，健保價格已經是經過政策性壓縮，200美元基本上無法進行任何有意義的癌症治療，甚至連診斷成本都不足。

而2016年成大團隊進一步分析健保資料庫[2]，以終身治療成本（lifetime cost）而言，乳癌需要28,180 美金，鼻咽癌男性需要29,809美金；女性需要30,225 美金。而以乳癌來說，光是每一生活品質調整人年（Quality Adjusted Life Years; 簡稱QALY），乳癌就需要2054美金成本。男性鼻咽癌病患每個QALY更需要3578元美金成本，均遠遠高於200元。

若我們進一步利用1996-2007年間治癌健保費用上漲趨勢推算，11年內治癌成本便上升了40-70%[1]。若以美國NIH推估之治癌費用上升模型預估，預估10年後成本可能再提升27%[3]，回推治療每名病患花費的健保總支出將超過百萬台幣。

根據調查，近12年，可注射癌症藥物花費經通膨調整後，仍上升18%[4]。而隨著標靶藥物不斷推出，新藥成本也持續上揚，舉例而言，2015年FDA核准的幾個新藥，一個月藥價便要1萬美金～6萬5美金。若我們要提供國際品質的治療（包含個人化基因診斷與治療等），但又要堅持「癌症一口價」的方式，可說是全世界絕無僅有，財務上完全不可行的方式。

有趣的是，中國因人力成本較低，且患者不一定都能接受到完整治療，因而癌症治療費用也較低。舉例而言，根據《刺絡針》發表的回顧論文，中國治療每個新增乳癌案例的花費是1216美元[5]，而該國沿海省份為2835美元[6]。雖該國醫療品質參差不齊，但仍比韓候選人的價格高了6-14倍之多。且這是在該國醫師平均年薪僅有13,764美元（換算台幣月薪約34K）[7]的情況下達到的。

韓國瑜候選人刻意把治療費用壓低到乳癌200美元，是否是要刻意吸引中國客群，賤賣台灣優質醫療？或是想壓低台灣醫師薪水至與中國同等或更低？其背後動機雖然不明，但仍明顯脫離常理。

參、觀光醫療的分類與我國推動現狀

韓候選人團隊指出，觀光醫療是一個有「創意」的政見。然而，不論就國內外案例來說，均非如此。甚至觀光醫療已是台灣和高雄推行已久的政策。根據衛福部「國際醫療管理工作小組」指出，於2007年起，行政院以「醫療服務國際化旗艦計畫」進行推動臺灣國際醫療服務，由衛生福利部委託臺灣私立醫療院所協會執行「醫療服務國際化推動計畫」，包含「特殊醫療」與「觀光醫療」兩部份。特殊醫療以台灣強項的高技術性手術或療程為主，觀光醫療則是串聯旅遊、醫療院所輔助旅遊業者開發養生、健檢、醫美行程，使國際旅客接受醫療服務同時間享受臺灣優質觀光環境。至2016年，已累積近163萬服務人次，產值達823億台幣[8]。以高雄而言，在地不少醫療院所，如義大醫院也已成立國際醫療工作中心，結合集團飯店、觀光、專業醫療資源。在遊客到院前就提供完整諮詢、治療計劃、辦好政見和安排旅宿。亦可安排在地觀光，後續空中醫療轉送聯繫等服務[9]。

另外，11年前中央推動國際醫療標語為「 醫療走出去，病人走進來」，跟目前韓候選人口號就極為相似。若說創意不過是停留在11年前而已。

如果我們進一步分析觀光或旅遊醫療（Medical tourism）概念，可大致分為旅客從醫療較落後處，到醫療先進處尋求較佳治療的模式；以及從經濟較發達，醫療成本較高處，到成本較低廉處尋求便宜治療的模式。後者是目前較多國家，如泰國、馬來西亞、韓國強調的「觀光醫療」。而根據前述，衛福部也將兩者明確以「特殊醫療」與「觀光醫療」分隔。

根據一篇綜合研究指出，觀光醫療最多的是不孕症、美容手術、減肥手術、牙醫治療等範疇。而就醫意願會受醫療品質、等待時間與花費成本等影響[10]。而部分國家則也已發展出專門的強項，例如匈牙利的減肥手術，波蘭的牙醫，就頗受西歐富裕國家歡迎。而泰國的變性手術或南韓的整形手術也是知名案例。

整體而言，如癌症此類重症醫療，並不屬於觀光醫療範疇，甚至因考量併發症及各類特殊條件，在特殊醫療模式中，也不可能使用「國際掛牌一口價」營運。而不論是哪個觀光醫療成功國家，發展觀光醫療的先決條件都在於營運成本的平衡。根據本研究利用pubmed等資料庫搜尋，並無在重症醫療上大量虧損，而透過觀光業補貼的案例。

韓國瑜候選人團隊指出，醫療觀光客可以透過「到夜市消費」等方式，達成促進經濟效果。姑且不論重症癌症病人與家屬到夜市消費的意願，根據本研究實地考察，高雄六合國際觀光夜市，相似產品的確能達成「國際掛牌，一口價」的標準。本團隊實際考察，在2018年10月30日晚間11點30分時，六合夜市東西各有一家雞排店營業，雞排均是一塊70元。若以平均虧損100萬元台幣計算。約要購買14285片雞排，營業額才能到100萬。而根據不同來源指出，賣雞排毛利率在20-50%左右，因此更需要賣28570~71425片雞排才能打平單獨一位患者的損失。以一家攤位日賣200片雞排就算生意尚不錯下[11]，約需不眠不休工作將近一年才能弭補治療一位患者損失，經濟效益極低。

肆、結論

韓國瑜候選人的觀光醫療政策存在嚴重問題，主要包含：
1. 成本效益分析的不可行。
2. 特殊醫療與觀光醫療的概念混淆。
3. 抄襲11年前我國已執行之政策，但缺乏額外的政見內容。

此政見缺乏創意，亦欠缺專業，包含許多隨口而出的臆測數據，若韓國瑜候選人即其團隊的行政能力如此，可能會造成高雄醫療業百億以上的經濟損失，同時也難以創造任何新的經濟機會。

伍、參考文獻

1.Li, T. Y., Hsieh, J. S., Lee, K. T., Hou, M. F., Wu, C. L., Kao, H. Y., & Shi, H. Y. (2014). Cost trend analysis of initial cancer treatment in Taiwan. PloS one, 9(10), e108432.

2.Hung, M. C., Lai, W. W., Chen, H. H., Lee, J. C., Lin, Y. J., Hsiao, J. R., ... & Wang, J. D. (2016). Cost effectiveness of cancer treatment in Taiwan. Journal of the Formosan Medical Association, 115(8), 609-618.

3.Mariotto AB, Yabroff KR, Shao Y, Feuer EJ, Brown ML (2011) Projections of the cost of cancer care in the United States: 2010–2020. J Natl Cancer Inst 103: 117–128.

4.Burki, T. K. (2017). Rising cancer drug costs in the USA.The Lancet Oncology, 18(11), e652. doi:10.1016/s1470-2045(17)30805-7

5.Fan, L., Strasser-Weippl, K., Li, J. J., St Louis, J., Finkelstein, D. M., Yu, K. D., ... & Goss, P. E. (2014). Breast cancer in China. The lancet oncology, 15(7), e279-e289.

6.Zhao XY, Zhang X, Tang Y, Tang JH. (2009). Analysis on the hospitalization expense of breast cancer operation patients and its influencing factors. Chinese Health Economics, 28, 41–43.

7.Zhang, C., & Liu, Y. (2018). The salary of physicians in Chinese public tertiary hospitals: a national cross-sectional and follow-up study. BMC health services research, 18(1), 661.

8.衛生福利部國際醫療管理工作小組(https://www.medicaltravel.org.tw/Article.aspx?a=18&l=1)

9.義大醫療財團法人國際醫療工作中心
（http://www.edahealthcare.com/AboutUs-CIPS.aspx）

10.Hanefeld, J., Smith, R., Horsfall, D., & Lunt, N. (2014). What do we know about medical tourism? A review of the literature with discussion of its implications for the UK National Health Service as an example of a public health care system. Journal of travel medicine, 21(6), 410-417.

11. 阿甘創業加盟網，開店創業加盟賣炸雞排店擺攤實務經驗談
（http://ican168blog.pixnet.net/blog/post/18860922-賣香雞排成本與獲利實務經驗談）

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《高雄好過日》協會，為 2016 年 3 月在高雄發起的青年組織，並於 2017 年 6 月 18 日正式登記成為協會。好過日成員們來自高雄各個地區、有著不同的職業及成長背景。 　 《高雄好過日》希望高雄「過好日」之前，必須先要「好過日」。協會以「城市想像」與「在地實踐」為兩大主軸，融入「公眾參與」、「永續發展」、「社會自由」等核心概念，用在地視角談高雄議題，從外國工業城市轉型尋找高雄可行的出路，並致力成為民間與政府的對話平台。​
《高雄好過日》協會，2016 年在高雄發起的青年組織， 2017 年 6 月 18 日正式登記為協會。 定期定額捐款：https://pse.is/EMGGJ
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uk travel blog 在 Jの背包旅行 Facebook 八卦

Jの背包旅行 By Jの背包旅行

2018-10-01 21:49:54 有 919 人按讚
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【#旅行投稿分享】芬兰🇫🇮 7天6夜冬天❄️☃️亲子游，机票住宿吃喝玩乐全包才RM7750😍#还包括一晚玻璃屋哦！

芬兰每位成人总花费约RM 7750
**RM 4.90 = €1

【🇫🇮Sim Card篇📱每人RM 41】
💲RM 82 (Hotspot enable所以一张可以两个人用)
https://hello1010.my/uk-europe-cu-2gb

【🇫🇮旅游保险篇🏥每人RM 76】
💲RM 304

【🇫🇮飞机票篇✈】
💲每人来回RM 3568
✈Thai Airways RM 8276
✈British Airways £ 550 = RM 3084
✈Finnair € 595 = RM 2915

【🇫🇮租车篇🚘】
💲每人RM1064
Helsinki € 270 = RM 1346
Rovaniemi € 431 = RM 2131
Petrol € 159 = RM779
总数除4个人因为车子很大足以载四位成人加行旅~
租车网址: https://www.avis.com/en/home

【🇫🇮食物篇🍽 】
💲每人RM284
€174 = RM853
只除3个人因为两个女儿只吃一个成人的份~

➖➖➖➖➖➖➖➖➖➖
【🇫🇮行程篇🤳】
💲每人€526 = RM2577
Day 1: ✈
💓KL - Heathrow
💓Heathrow - Helsinki
💓入住Mukava Maja Majatalo
http://www.booking.com/Share-jL7P5i
€148 两晚 = RM737

Day 2: Helsinki
💓Temppeliaukio Church
门票每人€3 = RM15
💓Senate Square

Day 3: ✈ + 🚘
💓Helsinki - Rovaniemi (1个小时飞机)
💓Rovaniemi - Giellajohka (4个小时车程)
💓入住Giellajohka (挪威边界) https://www.agoda.com/giellajohka/hotel/kaamanen-fi.html…
€264 两晚 = RM1300
👐建议大家从Helsinki直飞Ivalo，
不用飞Rovaniemi先，
那样就不用驾那么久车，
芬兰冬天夜晚来得早，
路几乎是没有路灯，
很暗。。。。很暗。。。
驾车需要花费很大的精力，
但是有失也有得，
我们在这段车程看到近约1个小时的北极光~

Day 4: 🚘Ivalo
💓Husky sledge
成人 €125 = RM612
小孩 €67.50 = RM330
💓Reindeer safari
成人 €100 = RM490
小孩 免费

Day 5: 🚘玻璃屋
💓Giellajohka - Arctic Snow Hotel (5个小时车程)
入住Arctic Glass Igloo玻璃屋
http://www.booking.com/Share-daVB70
€619 一晚 = RM3030
👐幸运的我们在一抵达玻璃屋就遇见北极光，
加上没有下雪所以晚上躺在床上是看到超级多星的

Day 6: 🚘Rovaniemi
💓Santa Claus Village
与圣诞老人合照: €40 = RM200
💓Reindeer Sledge
€40 = RM200
入住The Blueberry Studio
https://www.airbnb.com/rooms/4546109
€120 一晚 = RM594

Day 7: ✈
💓Rovaniemi - Helsinki
💓Helsinki - Heathrow

➖➖➖➖➖➖➖➖➖➖
【作者：@shierly yshai】
>>更多详细攻略可浏览作者部落客：
http://ni88.blogspot.com/2018/06/blog-post.html

#芬兰 #冬天 #欢迎私聊投稿
ᔕᑌᗷᔕᑕᖇƖᗷE ᒍᗷᗩᑕƘᑭᗩᑕƘ旅行频道✈️
——————————————❤︎
Facebook: https://m.facebook.com/JBackpacktravel
Travel Blog: Jbackpack.blogspot.com
Instagram: Instagram.com/juiern
Youtube: https://goo.gl/eZFfMs

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Jの背包旅行

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活着就是要坚持实践梦想 如果你也和我一样疯旅行 就关注J背包吧！ Exploring never stop✈️
分享小J旅行点点滴滴，特色景点和住宿， 还可以参考旅游达人们的游记哦~～
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uk travel blog 在 Oppa Thuchy Youtube 的評價

Oppa Thuchy By Oppa Thuchy

2017-09-23 19:00:01 有 348,928 人看過 有 4,581 人喜歡
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ไปตัดผม.. รถเกือบชนกลางลอนดอน! | LONDON VLOG
1 วันในลอนดอน ไม่ได้เที่ยวเยอะอย่างที่คิดนะ

มาดูการใช้ชีวิตแบบเด็กนักเรียนลอนดอนกัน ว่าวันๆผมทำอะไรบ้าง 555
เพลงอาจจะเยอะไปนิส แต่อยากให้ดูกันแบบ "เพลินๆ" นาจาา

แจกพิกัดร้านตัดผมจ้ะ: www.jubileehairsalon.co.uk


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Email: oppathuchy@gmail.com
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post-title
Oppa Thuchy

About author
?"OCHYMY FOREVER"? ช่อง Lifestyle เน้สนุก มัน ฮา แค่คุณยิ้มและหัวเราะ ผมก็สุขใจแล้วครับ Oppa ?Instagram : https://www.instagram.com/oppathuchy ?Fanpage : https://www.facebook.com/oppathuchy ?Facebook : https://www.facebook.com/thuchyhandsomeandcool ?Twitter: https://twitter.com/oppathuchy Ajumma ❤️Instagram : https://www.instagram.com/namnung.p ❤️Fanpage : https://www.facebook.com/ajummanammy ❤️Facebook : https://www.facebook.com/profile.php?id=100009197442657 ❤️Twitter: https://twitter.com/ajummanammy ติดต่อโฆษณา หรือ Sponsor ได้ทาง Email: [email protected] Line: @OppaThuchyManager
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uk travel blog 在 PEACHII Youtube 的評價

PEACHII By PEACHII

2015-03-02 01:13:58 有 256,967 人看過 有 2,006 人喜歡
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IG: sacross | Twitter: iamsacross | Snap: sacross.peachii

post-title
PEACHII

About author
ordinary | creator | english language | food | travel | lifestyle | Thai based in London ???? Facebook #สตีเฟ่นโอปป้า: http://www.facebook.com/sacrosspeachii Facebook ภาษาอังกฤษ/เรียนต่ออังกฤษ: http://www.facebook.com/gouni.th Instagram: http://www.instagram.com/iampeachii Twitter: https://twitter.com/impeachii ---------------------------------------------
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uk travel blog 在 PEACHII Youtube 的評價

PEACHII By PEACHII

2015-05-30 16:06:35 有 196,435 人看過 有 2,778 人喜歡
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คลิปสั้นขำๆ มาลงเอาใจสาวๆนิดนึงนะคะ แซ่บมั่งไม่แซ่บมั่ง ดูขำๆไม่ดราม่าเนอะ ^^

post-title
PEACHII

About author
ordinary | creator | english language | food | travel | lifestyle | Thai based in London ???? Facebook #สตีเฟ่นโอปป้า: http://www.facebook.com/sacrosspeachii Facebook ภาษาอังกฤษ/เรียนต่ออังกฤษ: http://www.facebook.com/gouni.th Instagram: http://www.instagram.com/iampeachii Twitter: https://twitter.com/impeachii ---------------------------------------------
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社群媒體上有些相關的討論：

uk travel blog 在 England Itinerary - Travel - Pinterest 的八卦


England Itinerary: Where to Go in England by Rick Steves Travel Route, Uk ... Must see places for a trip to Wales | Helena Bradbury | Travel Blogger | From. ... <看更多>

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