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題 名 | 健康保險之部份負擔制的理論基礎之探討=A Critical Examination of Theoretical Foundation for Cost-Sharing in Health Insurance |
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作 者 | 紀駿輝; | 書刊名 | 公共衛生 |
卷 期 | 23:4 1997.01[民86.01] |
頁 次 | 頁181-197 |
分類號 | 412.56 |
關鍵詞 | 部份負擔; 健康保險; 衛生經濟學; 衛生倫理; Cost-sharing; Health insurance; Health economics; Equity in health care; |
語 文 | 中文(Chinese) |
中文摘要 | 在全民健康保險制度實行後,部份負擔制成為該制度用來控制醫療服務使用以及 醫療費用上漲的一重要工具。類似的部份負擔制亦實施於有些國外的健康保險制度。本文的 目的在由經濟學理論,來探討部份負擔制的理論基礎及其假設,並對可能引起的醫療資源分 配之公正性問題加以討論。文中的討論重點在對傳統衛生經濟學之理論基礎-福利經濟學- 的假設及倫理觀,以及其影響提出批判。另一方面,本文並介紹可能取代福利經濟學來作為 衛生經濟學理論基礎的外福利經濟學,其理論與假設,及依此理論對部份負擔制的看法,以 及促進有效利用醫療資源與節制濫用的策略。根據這些理論性的研討,本文強調在制定及分 析衛生政策時,理論假設與政策目的的一致之重要。同時,作者亦對部份負擔制提出批判及 改進政策之意見,以及未來研究的方向。 |
英文摘要 | Cost-sharing has been a popular means for health insurance systems, including the newly implemented Taiwan's National Health Insurance System, to control utilization and costs. This paper critically examines the theoretical foundation and assumptions of economics and ethics that are underlying the cost-sharing system, and their implication in the equity of health care finance and delivery. Such exposition focuses on theories and assumptions of welfare economics, which is the conventional foundation of health economics. Besides criticizing welfare assumptions and ethical implications of welfare economics, this paper also presents extra-welfarism as an alternative theoretical foundation for health economics. Moreover, this paper argues that when we develop or evaluate health policies, we should be consistent in our theoretical assumption and policy objectives. In conclusion, the author criticizes the current cost-sharing system from equity's perspecive, and proposes alternative policies for promoting efficient use of health care resources and equitable distribution of health care. |
本系統中英文摘要資訊取自各篇刊載內容。