由於美國醫療糾紛層出不窮，造成平均醫療責任險金額上升，影響醫師執業意願，形成醫療體系的危機。此外，因侵權行為制度不易彌補受害者損失，又難以落實預防危難的功能，故在這波健保法案修訂時，醫療法院方案乃其中的重點替代解決途徑。希望藉由類似行政法庭的方式，不經陪審團，由受過專業醫療訓練的法官核定較為一致的賠償金，以強調對醫療糾紛受害者賠償的方式，取代針對個別醫師的非難。且因此方案有助於資料庫的建立，累積大量個案作為研習教材，以避免類似案件重複發生。而除美國醫療法院方案外，紐西蘭、丹麥和瑞典等福利大國已採行醫療照護行政補償制度，以維護病患的安全，其近年來的經驗亦值得我國關注。我國近年來重要專科人力不足的情形相當嚴重，且醫病關係日益惡化，多數醫師為避免涉入醫療訴訟，寧願選擇糾紛較少的科別或採取防衛性醫療手段，情況和美國多有類似。本文希望經由介紹美國醫療法院及各國的醫療政策，提供未來立法和醫療行政改革的參考與建議。

The increase of the medical malpractice litigations in the United States has raised the average premium of medicalmalpractice insurance into a level of historical records, making the shortage of doctors in some states. Moreover, sincethe tort system has not functioned well to compensate the injured and to prevent future medical errors, the idea of healthcourt proposals becomes one of important alternatives when the Obama administration drafted the bill of the Patient Protection and Affordable Care Act in 2009. The central conception of the proposals is an administrative court in which judges who have received specialized medical trainings can authorize the monetary amount of malpractice compensationin a way more consistently than juries. The rational of the proposals is to focus on compensating the victims of medical malpractice rather than finger pointing individual physicians who make mistakes. Furthermore, by encouraging thedisclosure of medical errors, through the proposals a database of medical error cases will be built up to prevent therecurrence of identical medical error events. In addition to the U.S. health court proposals, some welfare states such asNew Zealand, Denmark, and Sweden have adopted administrative compensation systems in order to protect patients’ safety. Their recent experience is worth of our attention. In the recent years, the medical system in Taiwan is troubled by the shortage of manpower in some important special fields and the deteriorating of doctor-patient relationship. Many physicians would rather choose the special fields with less possibility of legal dispute or practice defensive medicine.This article discusses the related issues surrounding the proposals of health court and the experience of the welfarestates for the reference and recommendations of future legislative amendments and health care reforms.