簡論全民健保監理制度民主化

A Study on the Democratization of the Supervision on the National Health Insurance System in Taiwan

郝鳳嗚(Feng-Ming Hao)

《中正大學法學集刊》 14期 (2004/01) Pp. 83-111

https://doi.org/10.30094/NCCULJ.200401.0003

摘要

我國自全民健保實施後，國家以醫療服務保障為由，將原本歸屬市場經濟之醫療產業，轉為計畫經濟之範疇，並將原屬私法領域之醫療保險與醫療服務轉為國家強制管理之公共行政領域，其優劣良窳之分析與主張各有所本，但醫療業者與一般國民是否基於正確認知而接受此一制度，則不無疑問；再者，未來醫療制度之發展是否將因健保制度或國家過度干預而有不良影響；且於現代民主社會，公民參與、資訊公開與社會自治為處理公共事務之重要原則，醫療事業國家化是否有悖於民主潮流，似有審酌之必要。
本文以全民健保監理制度民主化為題，分從健保監理規範之概念分析、現行制度檢討與未來健保改制相關規範之基本原則，探討監理規範如何因應民眾之需求與環境之變遷予以調整，從而思索以監理制度為例，探討政治民主化與經濟民主化後，社會民主化之可能途徑以及法律規範因應之道。

關鍵字

全民健保 ； 監理規範 ； 社會參與 ； 民主化

並列摘要

Since the inauguration of the National Health Insurance System in Taiwan, the state, in the name of the reassurance of the qualities of medical services, has transferred the medication industry from the regime of free market to planned economy, and consequently, the regulation of medical insurances and medical services are relocated from the private law sphere to the public administration involving coercive state interventions. The pros and cons of such changes have entailed comments and analyses on all aspects, though it remains in hesitation whether the medical personnel and citizens may properly recognize and accept the system. Moreover, it should also be reinvestigated whether the practices of the National Health Insurance System or so called excessive state interventions will incur negative effects on the future developments of the medical system. In modern democratic society, citizens' participations, transparency of informations and society autonomy are important principles for managing public affairs, it is so worthy to examine whether the nationalization of the medication industry is against the tide of democracy.
The paper is studied on the democratization of the supervision on the National Health Insurance System in Taiwan. It is analyzed with conceptual analyses on the relevant supervisory laws, reviews on the basic principles governing existing National Health Insurance System and its future reforms and discussing the supervisory amendments and adaptable measures which could be proposed to achieve relative regulations to meet the public needs and environmental evolutions. And then, taking the supervision for example, to servey the possible paths and the law norms for following roads of social democracy after political and economic ones.

並列關鍵字

National Health Insurance ； Supervisory Norms ； Social Participation ； Democratization