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標題: 健康權與醫療費用總額支付制度之研究
A Study on the Relationship between the Right of Health and Global Budget System of the National Health Insurance
作者: 蘇政宏
Su, Cheng-Hong
Contributors: 李玉君;吳明孝
李恵宗
中興大學
關鍵字: 健康權;全民健康保險;總額支付制度;醫療費用
right of health;national health insurance;global budget system;medical expenditure
日期: 2010
Issue Date: 2012-09-04 13:55:37 (UTC+8)
Publisher: 科技法律研究所
摘要: 健康權從許多國家憲法或國際公約上均可視其以追求身心健康完整之狀態為目的,我國從84年開始施行全民健康保險,而全民健康保險之意旨以增進全體國民健康、提供醫療保健服務為目的,全民健康保險之運行則有賴穩定的財務營運與良好的醫療費用支付制度為基礎,我國因沿襲公、勞保時所採行之論量計酬制度而導致醫療費用支出逐年上漲,遂於民國87年從牙醫開始施行總額支付制度,醫院亦於民國92年施行總額支付制度。總額支付制度在醫療費用控制上有一定之抑制效用,但對於醫療機構亦有相當之影響,在總額預算上限制與浮動點值下,直接影響醫療院所之營運狀態與人民就醫便利性及醫療品質之保障。我國大法官解釋第472號解釋中確立強制納保為實現國家照護人民健康之義務,而總額支付制度之施行對於人民之健康權是否有侵害之可能,或對於人民維持尊嚴之健康條件有無保障之實益,均為本研究探討之目的。健康權以身心健康完整為目的,總額支付制度施行對於醫療機構或人民在醫療服務與相關措施下,有無侵害人民健康權之可能性或有無繼續施行之必要,在未來可以加以檢視其正當性與實質合理性。希望藉由此問題之探討,可以增加人民對於自身健康權之權利意識,以保障人民之健康權益。
From many states constitution or international conventions can visible the right of health depending on the pursuit of a state of complete physical and mental health, since the inauguration of National Health Insurance (NHI) in Taiwan in 1995, the purpose of the NHI is enacted to promote the health of all nationals, to administer national health insurance and to provide health services, the operation of the NHI depend on the stability financial operating and well medical payment system to support. In Taiwan, the Fee For Service scheme from Government Employee's Insurance and Labor Insurance systems is adopted that results in the medical expenses increased yearly. The global budget system not only have remarkable effect on control medical expenditure but also have considerable impact on medical institutions. Under the global budget cap policies and floating value, it directs impact on the state of hospitals operation and the medical convenience of the people and the protection of the quality of medical care. Judicial Yuan Interpretation No. 472 establish that the NHI has the obligation to place all the people under its protection through the adoption of a compulsory system, whether the implementation of global budget system have possibilities of infringing people's rights to health or have the protection beneficial to maintain the dignity of the people health, both the purpose of this study.
The purpose of the right to health was a state of complete physical and mental wellbeing, the medical institution and the people both under the great impact of the implementation of global budget system, the relevant measures of the global budget system have possibilities of infringing people's rights to health or continue to implement it necessary, we can inspect its legitimacy and essence of rationality in future. By studying on this issue, the consciousness of the right to heath can be enhanced so as to protect the rights and interests to people's health.
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