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    政大機構典藏 > 法學院 > 法律學系 > 期刊論文 >  Item 140.119/109132


    Please use this identifier to cite or link to this item: https://nccur.lib.nccu.edu.tw/handle/140.119/109132


    Title: 揮別俾斯麥模式社會保險制度？ 從德國聯邦憲法法院幾則判決評析 德國近二十年健保制度改革方向
    Other Titles: Far from Bismarckian Social Insurance? -An Observation of Twenty Years of German Healthcare Reforms with a Review of the Relevant Decisions of the German Federal Constitutional Court
    Authors: 孫迺翊
    Sun, Nai-Yi
    Contributors: 法律系
    Keywords: 德國法定健康保險;健保改革;競爭;附加保費;共同自治
    German statutory health care insurance;health care reform;competition;supplementary premium;joint selfgovernment
    Date: 2016-09
    Issue Date: 2017-04-24 10:23:56 (UTC+8)
    Abstract: 德國法定健康保險制度近二十年來歷經多次重大改革，現行制度已不同於以往以保障受薪階級為主、採多元複數之社會自治組織形式、強調階級認同與社會互助等圖像，取而代之者為全民強制保險配合商業保險社會法化、導入保險人間競爭機制、聯邦層級組織單一化、一般保費費率單一化搭配附加保費由各保險人再自主決定等制度特徵。本文就此詳加介紹，並探討上述改革措施引發的憲法疑義，包括商業保險締約自由之限制、競爭機制是否弱化社會互助及醫療服務指令民主正當性不足等問題。最後，再就德國與臺灣健保制度所面臨的憲法爭議進行簡要分析。
    German statutory health care insurance (Die gesetzliche Krankenversicherung) has undergone important changes over the last twenty years. Today its framework is fairly different from the traditional Bismarckian model, which is characterized by identity and solidarity among employees and management manifested in plural self-governmental bodies. The current health care system is constructed by the following means: legal instruments, including the obligation for all citizens to be insured by public or private insurers, with free choice of public insurers-the sickness funds (Krankenkasse) for insured persons which leads to more competition among sickness funds; centralization of the plural federal self-governmental and joint self-governmental bodies; introduction of a uniform contribution rate for all sickness funds connected with supplementary premiums for individual one. This article will provide an overview of paradigmatic changes of the German health care reform over the last twenty years, and of the relevant legal issues, including the constitutionality of compulsory insurance accompanied by legal modifications of private health care insurance contracts, the consistency of competition mechanisms in the social insurance scheme with the constitutional principle of social welfare state, and the democratic legitimacy deficit of the medicinal directives issued by the Federal Joint Committee (gemeinsamer Bundesausschuss). Finally this article will conduct a comparative analysis of the constitutional debates over Taiwan`s National Health Insurance and its 2011 reforms in light of the different legal frameworks and the social, economic and political challenges of each system.
    Relation: 歐美研究, 46(3), 373-442
    Data Type: article
    Appears in Collections:[法律學系] 期刊論文

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