論台灣民主發展中的醫政關係

On the Relationship between Medical Care and Politics in the Democratic Development of Taiwan

葉永文(Yun-Wen Yeh)

《臺灣民主季刊》 2卷4期 (2005/12) Pp. 99-126

https://doi.org/10.6448/TDQ.200512.0099

摘要

邁向民主道路的台灣社會，多元化與民意政治展現了不同以往的「國家與社會」景象，亦即國家與政權不再同形構，而是提升為含括政治和社會的整體。這樣的民主過程也影響了此時期台灣的「醫政關係」。檢視1980年代中期以來的醫政關係，可發現「國家與社會」呈示著兩幅圖像，一幅是國家醫療持續擴大對社會介入的圖景，另一幅則展現醫療社會在抗拮政治時的蓬勃圖景。此外，在醫療與政治的抗拮圖景中，卻也能襲現醫療被政治化和政治被醫療化的錯綜複雜。這些皆構成民主化過程中的台灣醫政關係之形貌。然從醫政關係的討論中，係能彰顯台灣民主發展的諸多問題，如醫療體系的政治化情景便可對照出台灣社會的泛政治化偏向。倘若這屬民主化過程的不成熟境況，則便已標示出台灣的民主道路尚有一段距離要走。

關鍵字

醫療政策 ； 醫政關係 ； 國家醫療 ； 政治民主 ； 統治

並列摘要

Taiwan's society is on the path towards democracy. In Taiwan's diverse society, public opinion reveals different understandings of the ”state-society” nexus. Consequently, the concept of the state and political power are delineated from each other. The process of democratization affects the relationship between politics and the medical care system. Examining the relationship between politics and medical care in the 1980s, we can detect two concurrent trends in the relationship between ”state and society”: first, national medical care intervened in society; second, the medical community resisted the influence of politics. Therefore, politics and medical care are interwoven and affect each other. These relations between medical care and politics in Taiwan were all features of Taiwan's democratization process. The present discourse on the relation between politics and medical care also indicates that many problems still remain unresolved as Taiwan's democracy progresses. For example, the political influence on medical care demonstrates that social issues tend to be over politicized in Taiwan. If this is a sign that democratization still remains immature, it also indicates that ”real democracy” is still far away from us.

並列關鍵字

medical policy ； medical care and politics relations ； national health care system ； political democracy ； government

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