德國法定健康保險制度之探討－以2010年底之修法為中心

A Study of the German Statutory Health Insurance-Based on the Legislative Updates December 2010

林谷燕(Ku-Yen Lin)

《弘光人文社會學報》 15期 (2012/07) Pp. 72-91

https://doi.org/10.29933/SHSS.201207.0004

摘要

屬於生命風險的疾病，往往不是多數人個人經濟能力得獨立支撐，因疾病以致無法工作所帶來的收入停頓，也可能使生病者及其家屬經濟陷入困境，為因應此等風險，德國從法定健康保險、私人健康保險及公務員補助金，甚至社會救助等制度，提供此等事故發生之支出。這項健康保險主要建立在社會連帶基礎上，透過實物與服務給付提供，滿足被保險人之需求，並藉此達到不同家庭間之負擔衡平、不同世代之衡平、以及收入不同之被保險人間的風險衡平及健康與生病者間的互助衡平。然日益增加的健保財政負擔，導致2010年12月底的健保修法。除提高保險費率外，對於附加保險費之調整，以達成多元保險人間之社會衡平，亦為此次修法重點。本文以文獻閱讀方式，介紹該健保內容，並探討新法實施近一年來所產生的問題，提供我國關於德國健保內涵之新資訊。

關鍵字

德國 ； 法定健康保險 ； 德國社會法法典第五篇

並列摘要

Disease belongs to the ordinary risks of life. However, many people are not able to cover the costs of disease management on their own. What is more, disease may lead to incapacity to work and, thus, to loss of income. In Germany, these risks are covered by the statutory health insurance. Its basic principle is solidarity. It serves the needs of the insured through in-kind and in-service benefits. It is designed to achieve family equalization, generation equalization, salary equalization and solidarity equalization. In view of the rising expenses, the contribution rate and the supplemental contribution have been changed in the new statutory health insurance law end of the year 2010. The present paper is based on the method of literature review. It shall offer to the Taiwanese the new information about Germany's statutory health insurance; it presents its content and the problems of the law from the day after coming into effect.

並列關鍵字

Germany ； statutory health insurance ； the book V of the social code