台灣防疫政策的歷史制度分析

The epidemic prevention policy of Taiwan by applying historical institutionalism

王開弘(Kai-Hong Wang)

指導教授 ： 孫煒

國立臺灣大學/社會科學院/政治學研究所/碩士(2006年)

https://doi.org/10.6342/NTU.2006.00047

摘要

本研究主要嘗試對我國防疫政策進行歷史制度論的操作（包括防疫史發展分期、防疫制度抉擇、防疫制度的建構與制度影響等），試圖以一個簡單的理論模型來解釋我國防疫政策是如何在受到歷史的遺緒、利益相關行動者的競合及各種機遇的交錯互動下，所產生的一次又一次的制度抉擇與轉折。並於經歷前述詭譎多變的制度遺緒或變遷的影響下，於2003年的SARS疫情事件中，冷酷的將台灣防疫制度的種種問題整個揭露出來。本研究發現SARS 發生後，防疫政策不單未產生轉折，反而繼續在「路徑依賴」的軌道上，延續著醫療專業與財團緊密結合的邏輯繼續深化。更甚者恐是擁有醫療專業霸權者，利用人們對未明疫病的恐慌及憑恃民眾對醫療專業的隔閡，無視政府財政的有限，將防疫整備需求刻意放大，並導入商業利益當中。透過歷史的回溯，本研究將SARS期間政策失靈現象，歸因於國家管制力量在防疫政策上的不當退卻及醫療利益行為人、政治經濟優勢力量結盟進駐所導發的必然結果。歷史制度主義途徑對這類涉及各歷史時期間政治、經濟、社會及文化交相影響的議題探討最為合宜。由於我國以往在公共衛生的研究中，較缺乏以政治經濟學作為研究途徑；在防疫體制的相關研究中，更少見以制度作為研究重點。本論文抱著拋磚引玉的心情，提出了一個政治經濟學的模型，期待藉由本論文的提出，吸引更多衛生政策研究對此研究途徑的重視。

關鍵字

防疫政策 ； 歷史制度論 ； SARS

並列摘要

The main idea behind this study is to analyze the epidemic prevention policy of Taiwan by applying historical institutionalism. Whereas our basic approach is trying to understand how such a policy of Taiwan has so far been affected by historical events, benefits created by competitions, and other circumstances of all matters. In 2003, during the period of severe acute respiratory syndrome (SARS) outbreaks, it manifested all kinds of issues that made significant impacts on the existing disease prevention policy of Taiwan. However, since the major SARS crisis was over, no government officials have taken any action to rewrite the prevention policy. Moreover, things have been moving along on the “path dependent” track, which results in a situation that medical professional consortiums cooperated tightly together. The worse scenario is monopoly. The medical professionals tend to manipulate the public and make them fear due to lack of medical knowledge, totally ignore government financial limitation and try to enlarge the needs for disease prevention resources, which shift the entire matter to a business like setting. Though going back to history, this study concludes that the government authority has hold back the rights to stand up for its people by restraining collaboration between medical professionals and their consortiums. Historical institutionalism approach is supposed to be perfect for discussion of an issue involving politics, economy, society and culture throughout a period of time. However, there have not been many studies on public health discussed from the Political Economy point of view, and nor any preventive policy debated from the perspective of the government system. By establishing initiation, proposing a new concept, the research on how history and other factors affecting the creation of new healthcare policy hopefully will be valued in the near future.

並列關鍵字

The epidemic prevention policy ； historical institutionalism ； SARS

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