社會保險法律核心問題探討-以醫療保險為例

「保險」是互助合作，以分散風險，彌補損失的制度。隨著國人平均壽命之提高以及健康意識之提升，促使國人在選擇醫療保險商品上偏向購買商業型終身醫療保險，以期能彌補全民健康保險之不足，以及防範年老時因頻繁就醫而產生的醫療負擔。因此本研究將探討一般社會大眾對於終身醫療商品之認識程度，以及對於這項商品所抱持的態度，並分析消費者行為間的關係，除了有助於瞭解目前台灣民眾醫療險的購買行為，分析結果亦可作為保險公司在行銷策略之參考。尤其以在疫情之後的時代，相關的醫療保險的保障範圍最大、內容最繁複，且攸關人民健康與生命最密切，世界各國均非常重視。中共在建政之初，醫療制度由國家包攬，由於缺乏成本概念，加上管理制度不健全，造成許多醫藥資源浪費，使國家財政難以負擔。各地在醫療改革上的重點及進度不一，且實行上都未臻完善，為配合醫療保險制度的完善，期能「在醫療保險制度改革中引入分擔機制；在醫藥衛生體制改革中引入競爭機制」。而於其醫療改革實施方式中，多處可見其參酌國外觀念與台灣全民健康保險之蹤影存在。

關鍵字

醫療保險；終身醫療保險；全民健康保險；保險公司

並列摘要

"Insurance" is a system of mutual assistance and cooperation to spread risks and make up for losses. With the improvement of the average life expectancy of the Chinese people and the improvement of health awareness, the Chinese people are inclined to purchase commercial life-long medical insurance when choosing medical insurance products, in order to make up for the shortage of national health insurance and prevent the medical treatment caused by frequent medical treatment in old age. burden. Therefore, this research will explore the general public's awareness of life-long medical products and their attitudes towards this product, and analyze the relationship between consumer behaviors. The analysis results can also be used as a reference for insurance companies in their marketing strategies. Especially in the era after the epidemic, relevant medical insurance has the largest coverage, the most complicated content, and is most closely related to people's health and life. All countries in the world attach great importance to it. At the beginning of the Communist Party of China, the medical system was taken over by the state. Due to the lack of cost concept and the unsound management system, many medical resources were wasted, making it difficult for the state finance to bear. The focus and progress of the medical reform varies from place to place, and the implementation has not been perfected. In order to cooperate with the improvement of the medical insurance system, it is expected to "introduce a sharing mechanism in the reform of the medical insurance system; introduce a competition mechanism in the reform of the medical and health system. ". In the implementation of its medical reform, there are many traces of its consideration of foreign concepts and Taiwan's national health insurance.