頁籤選單縮合
| 題 名 | 人口結構與健保虧損=The Aging Population and NHI Financial Deficit |
|---|---|
| 作 者 | 吳維修; | 書刊名 | 藥學雜誌 |
| 卷 期 | 28:4=113 2012.12[民101.12] |
| 頁 次 | 頁11-17 |
| 分類號 | 412.56 |
| 關鍵詞 | 人口老化; 醫療需求; 健保虧損; 政府補助; 醫療服務; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 台灣低廉、涵蓋率高的健保,令許多國家稱羨,但近年已有虧損之狀況,未來潛在的虧損如何及是否可以解決,值得探討。台灣的人口結構,自 2011年起進入快速老化的階段,使用醫療資源較多的 65歲以上人口,未來 10年所增加的人數,將比過去 20年的總成長人數 110萬人多出 30萬 (27%)人, 40年後則將增至今日 248萬人的 2.8倍 689萬人,因此未來醫療需求大幅增加,為趨勢所在。主要負擔健保財務收入的 15-64歲人口數,卻將由目前的 1,713萬人,下降至 40年後的 1,028萬人。故未來直接來自薪資相關的健保收入不容樂觀,試算之後必需由政府負擔的潛在健保給付差額應該是在每年 1,300-3,600億之間。造成現今健保虧損的主因是政府補助不足,實際補助僅約 21%,遠低於法定應負擔比例,使台灣醫藥產業被健保給付擠壓至瀕臨崩盤,血汗醫院造成服務意願低、護士荒、重要科別缺乏新進醫師、藥品退出市場等現象,讓台灣的醫藥環境充滿昏暗的未來。能解決問題的方法是,政府足額補助所需的醫療需求,恢復老化社會所該帶來的醫療產值增加,進而帶動社會經濟成長,促進醫藥人員的服務意願,並從經濟成長中以稅收回收所補助的金額,使整體環境由負面循環轉向正面循環。 |
| 英文摘要 | Taiwan's low cost and high coverage National Health Insurance (NHI) has been admired by most of the advanced developed countries in the world. However, the financial deficit issue has happened in the past few years. The extent of the potential financial deficits in the future will be analyzed and the possible solution will also be proposed. Taiwan's population structure is entering a rapidly aging phase started from 2011. Ten years later, the total growth in the aging (> 65 years old) population, which represent a group of high consumption of medical care, will have additional 0.3 million (27%) more than the total growth in the past 20 years. Forty years later, the aged population will growth 2.8 times to 6.89 million people, hence the medical need and the expenditures should be increased tremendously accordingly. While the population that account for the National Health Insurance income, aged 15 to 64 years old, will decrease from today's 17.1 million people to forty years later's 10.3 millions. Hence, the calculated potential National Health Insurance financial deficits will be around 130-360 billion TWD annually in the future. The main cause of the financial deficit today is the Government subsidiary was far less than required by the law. Currently, the reimbursement is only 89% of the applied amount of the consumed medical care. Under a situation that the medical expenditures is already too low in Taiwan, the squeezed reimbursement had caused the nearly collapsed of the medical system, the long working time and low pay environment lead to low morale of the Medicare personnel – lacking of nurse, no new residency in major specialist such as Internal Medicine, Surgery, Pediatrics, Obstetrics, Emergency Room and Anesthetist. And also a lot of medicines withdrew from the market due to the too low reimbursed prices. The only way to turn such a negative cycle to a positive cycle might be the Government to invest enough resources to restore the medical industry growth which should originally be contributed by the increased aging population. With such step, the invested resources will stimulate the economic growth bring by the medical needs, consequently the increased rewards will stimulate the working willingness of the medical personnel and also stimulates the development of new medicines. Finally, the Government could recover it investments from the taxes of the economic growth brought by the medical investments and the foreseeable aging population could have better medical care in the future. |
本系統中英文摘要資訊取自各篇刊載內容。