我國全民健康保險政策財務之實證研究

A Financial Analysis of Taiwan's National Health Insurance Policy

劉宜君(Yi-Chun Liu)

《中國行政評論》 10卷4期 (2001/09) Pp. 129-176

https://doi.org/10.6635/cpar.2001.10(4).05

摘要

隨著國民所得提高與人口逐漸老化，各國政府無論採取何種形式的社會保險制度，均面臨醫療費用支出不斷上漲的問題，以致各國政府在改革全民健康保險政策或調整醫療支付費用制度時，主要考量均在於維持保險財務的收支平衡，以確保制度的健全發展。
有鑑於我國過去公、勞、農保等社會保險制度財務的最大缺失在於收支之間沒有關聯，以致財務虧損嚴重，同時考量到保險財務健全與否是全民健康保險政策能否穩定持續運作的關鍵因素，亦即惟有政府能夠適當地控管保險費收入來源與醫療支出，才能更進一步提供充分及適當的醫療服務。因此，本文以多元迴歸模型實證分析影響全民健康保險策財務收支平衡之因素，評估政府實施全民健康保險政策的財務管控能力，以便作為增進財務平衡與醫療服務效率之政策建議基礎。

關鍵字

全民健康保險 ； 迴歸分析法 ； 醫療費用支出 ； 保險費收入 ； 財務收支平衡 ； 門診費用 ； 住院費用

並列摘要

With the growth of national income and the aging of the population, many government have confronted more serious fiscal crisis in their national or social health insurance programs. Thus, these governments take the responsibility to control the escalation of aggregate spending on medical care in order to provide substantial and high quality medical services and also improve reasonable development of the national health insurance system.
In such ways, the key successful factor of the national health insurance program is to maintain stable financial status of the system financing. According to the principle of balance of the system financing, the study provides an empirical analysis to measure the performance of financing Taiwan’s National Health Insurance Program in using multiple regression method. Finally, the study offers research finding and policy suggestion in improving the financing performance of Taiwan’s National Health Insurance Program.

並列關鍵字

National Health Insurance ； Regression Analysis Method ； Medical Expenditure ； Premium Collection ； Outpatient Expenditure ； Inpatient Expenditure