查詢結果分析
來源資料
頁籤選單縮合
題名 | 社會團體對於全民健保政策參與管道與能力之探討--以總額支付制度的運作為例=The Social Groups Participation in the Policy-Making of National Health Insurance: The Global Budgeting as an Example |
---|---|
作者 | 林志鴻; 呂建德; Lin, Chih-hong; Lue, Jen-der; |
期刊 | 政大法學評論 |
出版日期 | 20031200 |
卷期 | 76 2003.12[民92.12] |
頁次 | 頁159-210 |
分類號 | 412.56 |
語文 | chi |
關鍵詞 | 制度誘導; 社會參與; 總額支付制度; 自治管理; 集體協商; Institutional building; Social participation; Global budget; Self-regulation; Collective negotiation; |
中文摘要 | 全民健保自1995年實施以來,政策參與協調上的現象常被討論到。若國家願居於參與協作之立場,設計完善制度性社會參與機制與管道,提供相關團體貢獻運作之舞臺,以制度誘導社會力參與特定公共事務之管理,應是未來我國健保可思考之方向,特別是其高度專業分化,兼具利益對立動態複雜體系特性之健保制度為然。但參與制度運作之相關社會團體除應考量全民性、弱勢保障外,也應對內整備就緒、具代表性、專業性、正當性又有專業資訊支持之充分行動能力,方能使此完善有效之制度參與機制充分發揮,協議效力有效及於對象行為,此不但將能導引使健保制度有效運作,透過協商達於共善,而且也符合未來民主化、經濟全球化之結構性變遷趨勢。本研究以我國全民健保總額支付制的運作為重點,探討健保重要政策機制運作程序及決策上的建制安排,如何在維持專業、公共福祉以及社會參與基本架構下,謀求公平性、費用控制、醫療品質提升三項總體目標的平衡。認為衡量健保行政、財務責任對等原則,在民主化社會力澎湃之未來,經濟全球化以及健保制度內利益多元對立之協調與整合之制度內、外環境變遷下,總額支付制的建構與運作為重點,聚焦於了解政策相關之行動者在健保體系中所應扮演的職能,國家機關以及其他社會行動者在未來二代健保體系的建構上各應有怎樣的分工、建制,在確保專業與實踐社會民主之前提下,結合傳統由上而下之政策取向,以及當前及未來逐漸形成由下而上之社會力,認為由國家以制度誘導,建立正當社會團體參與機制與管道,提出促使相關各造有效合作的制度安排模式,朝向國家參與組合模式之未來,應是可行之方向。 |
英文摘要 | It has been widely claimed that policy coordination and civil participation are the main problems of Taiwan's National Health Insurance (NHI) since its implementation in 1995. The authors argue that the authority of the state in NHI issues has been deeply eroded due to rapid changes in social structure, and has been pressured to reform. This article asserts that the role of the state as a decision-maker in the health care system should be within institutional and boundary conditions. Through these facilitative conditions the affected social groups could be induced to participate in the establishment of public health insurance policies while coordinating their actions through these institutional settings. Using the implementation process of global budgeting as example, the authors analyze how the state has learned to change its role form regulator to facilitator in the steering of NHI system. Aiming to enhance of self-regulating and negotiating capacity of the affected social groups (such as social welfare, employee and employer organizations, physician and hospital representative organizations), the state has set up institutional arrangements to induce these groups to cooperate. Based on the principle of self-regulation and policy reciprocity, the state should be able to achieve cost-containment, quality assurance and public accountability through these institutional arrangements. Lastly, the authors suggest that a state-led corporatism could be an alternative governance structure for NHI. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。