全民健保實施五年期間重要修訂事項之探討

Abstract

全民健保實施五年期間制度的修訂，乃為求整體全民健保系統經營的延續性，本研究探討的重要修訂事項為：影響健保收入的平均眷口數因素、增加山地離島地區之醫療補助、牙醫門診總額預算、藥品部分負擔四項。 因此，將全民健保制度事項修訂的評析將之其區分為四個面向，除了修訂事項對問題的解決與否，進而探討對整體健保的實施是否具有助益性，一、修訂事項所涉及之問題性質，二、制度所作之修訂實況，三、制度修訂後的問題改善狀況，四、經部分修訂後整體制度的運作狀況。 修訂事項與整體制度運作兩者之間的關係，若以整體系統的觀念來思考，修訂事項必須有助於整體制度運作的延續性，經評析結果，修訂事項對整體制度運作的延續有所助益的為：牙醫門診總額預算制度。

The mainly revised items of NHI that is asked to run the total system of NHI to be continued. This study of the mainly revised items is： the impact of the average family members of NHI income、to increase the medical subsidy of people in mountain and isolated island areas、the outpatient global budget of dentistry、drugs cost-sharing. Therefore, We divide the NHI’s revised items into four categories. Apart from the adequacy of the revised items, we study further into the total system of NHI. 1.revised items involve with the qualities of the problems, 2.the actual conditions of the revised items, 3.the actual conditions of the system after revising , 4.the operating situation of the total system after revising. The relation between revised items and the operation of the total system is that revised items must foster the total system to be continued. After evaluating the revised items, the revised items that foster the total system to be continued is the outpatient global budget of dentistry..