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題名 | 全民健康保費補助之公平性與效率性考量=Equity and Efficiency in Premium Subsidies of Taiwan's National Health Insurance |
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作者 | 葉秀珍; 詹宜璋; 王正; Yeh, Hsiu-jen; Chan, Yi-chang; Wang, Cheng; |
期刊 | 經社法制論叢 |
出版日期 | 19980100 |
卷期 | 21 1998.01[民87.01] |
頁次 | 頁347-381 |
分類號 | 412.56 |
語文 | chi |
關鍵詞 | 全民健康; 保費補助; |
中文摘要 | 由於政府之財源來自稅收,因此有關政府補助全民健康保險保費之相閞議 題事實上亦即反映「稅式」與「保費式」財源之爭議:若政府補助率愈高,即 代表「稅式」財源機制的成分愈大,反之則代表「保費式」財源機制之角色愈 重。基於此,本論文研究主旨乃在:1.評析我國目前全民健保保費補助之實施現 況;以及2.依社會學及經濟學之觀點,對政府介入醫療保險政策之功能以及補助 保費之理論基礎加以分析。本論文之結論主要如下:現有保費補助之差別比例顯 然缺乏公平性之考量,補助比例依據職業性質之分類並不能反映出個體在社會結 構中之立階,以及其擁有之社會經濟資源與相對之健康風險和醫療需要,因此補 助差異宜根據個人所得作為決定補助比例之「標準」。此外,依據本研究對醫療 資源配置三種不同意識型態之分析結困,可以得出一結論,就效率面而言,選擇 性的保費補貼方式較全面性的方式為妥。其中,選擇的準則依「所得」水準高低 實施差異性補貼,而非依身份或職業等特徵。 |
英文摘要 | Current issues related to premium subsidies from the government actually reflect the debates between tax financing and premium financing. Put it in another way, the higher the subsidy rate, the stronger the mechanism of tax financing, and the lower the rate, the stronger the mechanism of premium financing. On the basis of the above argument, this study evaluates current scheme of premium subsidies, and provides a critique on the rationale of governmental subsidization, from the perspective of sociology and economics. The major conclusion of this study can be summarized as follows: current scheme of premium subsidies has violated the principle of equity, since the differential subsidy rates based upon occupation classification can not fully reflect the hierarchical position of each individual in the social structure, nor can they reflect each individual's socioeconomic resources and medical needs. To rectify such deficiency, this study proposes to use income as the single criterion of premium subsidies. Moreover, after analyzing the allocation of health care resources based upon three different ideologies, this study concludes that selective premium subsidies are better than universal subsidies, and that the criterion of (selective) differential subsidies should be based upon one's income instead of status or occupation. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。