福利？市場？台灣照顧產業政策之初探

Welfare Service or Humanity Marketing? Inquiring into the Policy of the Care Industry in Taiwan

陳燕禎(Yen-Jen Chen)

《通識研究集刊》 13期 (2008/06) Pp. 77-100

https://doi.org/10.6488/JCGE.200806.0077

摘要

台灣老人照顧需求的迫切性和嚴重性，已成為當前社會政策的重要議題。所顗幾年來，政府大力推動照顧產業政策，雖看到了一些方案成果，但也發現政策與實務行動之間出現矛盾和缺口。因此本文主要以我國照顧服務服務福利及產業發展方案(Plan for the Development of the Care-Services welfare and Industry)為論述基礎，檢驗我國照顧產業政策的發展，並釐清福利服務和產業化發展的本質。現今老人照顧服務需求，確實需要以福利多元主義進行供給和市場發展為導向，但政府以「由產業照顧」為發展方向，就必須釐清福利服務和照顧產業政策的本質，兩者才不會在政策矛盾中相互糾纏，亦即國家對符合社會福利資格規範的弱勢者，其基本福利需求和照顧服務仍必須由政府擔負基本照顧的責任，透過多元部門的市場供給輸送服務，由供給者可以轉變為購買者，而且擔負照顧產業規範者的角色，如此在照顧福利服務和產業發展之間，才不會產生執行衝突或缺口。最後本文提出建議，如縮短照顧供需市場之落差、加強照顧產業相關配套、漸進式推廣「使用者付費」觀念、縮短外籍看護和居家服務之成本差異、建立照顧產業的溝通平台，以縮短政策與行動之落差和缺口，達到照顧產業政策邁向暨「市場化」又「人性化」的雙元目標。

關鍵字

福利 ； 市場 ； 照顧產業 ； 福利多元主義 ； 責信

並列摘要

In Taiwan, the lack of an adequate elderly care policy has been a pressing issue that grabs many policy makers' attention. In response, several social welfare programs were implemented and these programs seemed to be promising as they yielded some visible fruit. However, in actuality, these programs failed to reach their goals and they created a gap between program policies and their applications. To tackle on this problem, this paper attempts to illustrate the nature of the problem by inquiring into the national Plan for the Development of the Care-Services Welfare and Industry. It further differentiates the nature of welfare services from that of care industry. Then followed is the suggestion for the government to continue providing basic needs and care services for the minority entitled to social welfare. Additionally, the government can offer services via multiple channels available on the market, thereby shifting its role-play from being a provider to a purchaser. At the end, this study suggests narrowing down the gap between provision and consumption in the care market, improving side-policies for care industry, implementing ”users' payment,” reducing cost differences between foreign care-givers and home care services, and establishing a communication forum to facilitate the healthy growth of the care industry. It is hope that by eliminating the discrepancy between policies and applications of welfare programs, the goals of ”marketization” and ”humanization,” as laid out by care industry policy, can be attained.

並列關鍵字

welfare ； market ； care industry ； welfare pluralism ； accountability