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    题名: 台灣的公民社會與醫療改革
    作者: 劉梅君
    贡献者: 勞工所
    关键词: 公開透明;健康保險;責信;醫療改革
    transparency;health care reform;accountability;national health insurance
    日期: 2012-09
    上传时间: 2016-07-13 14:32:39 (UTC+8)
    摘要: 享譽國際的臺灣健保制度，的確終結了臺灣家庭因病而貧的悲劇，幾近百分之百的覆蓋率，低廉的保費，以及包山包海的醫療服務，使得健保成為臺灣引以為傲的社會保險制度。但這個臺灣之光背後，卻也掩藏不住二、三十年來臺灣醫療生態所經歷的極大變化，例如：醫療產業成了資本競逐的商品市場，醫療院所趨向大型化致使地區醫院急速萎縮，健保論量計酬的支付制度造成不同專科領域消長以致出現「五大皆空」的危機，健保財政頻亮紅燈，這種種結構性問題均使得臺灣醫療環境面臨難以永續的挑戰，改革成為迫在眉睫的當務之急。臺灣醫療改革基金會在這個巨大艱難的改革社會工程中，從初始面臨的質疑與嘲諷，到今天的理解，甚而公私協力攜手，一步步推進制度的改進，讓醫療回歸以人為本的初衷，重建醫療本應具有的公共性與公義價值。本文著重側寫臺灣醫療改革基金會在12年來幾個關鍵的改革足跡，特別是對於政府責信及資訊公開透明的要求一直是改革行動的核心，除了再現基金會每個改革行動的審慎嚴謹與議題選擇的思考策略，也藉此為臺灣的公民社會留下彌足珍貴的一頁紀錄。
    The internationally renowned Taiwan health insurance helps families to be able to receive medical care without falling into poverty. With its 100% coverage rate, low premium and free access to all kinds of medical service, Taiwan health insurance is a glory of this nation and has won high esteem from the international society. However, there are major structural changes that jeopardize our health care environment. For instance, medical service has been commodified in pursuit of profits; medical organizations are expanding to gain better market share and receive higher insurance payment; ‘fee for service’ payment leads to the shrinkage of certain medical professions that used to be honored by medical professionals; frequent budgetary deficits put health insurance in crisis. Those structural problems expose Taiwan health care environment to sustainability crisis. Therefore, the Taiwan HealthCare Reform Foundation aimed to restructure the health care system to honor patient-based principles by proposing reform plans and collaborating with public as well as private sectors. The paper overviews the key steps this foundation took over the past 12 years with special focus on issues of accountability and transparency. This overview not only captures the strategic thinking behind every key reform issue, but also serves as an important chapter in which health reform efforts in Taiwan have gained wide recognition and support.
    關聯: 第三部門學刊, 18, 51-59
    数据类型: article
    显示于类别:[勞工研究所] 期刊論文

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