我国台湾地区“全民健保”制度的财务困境及其解决之道——基于新制度主义视角

The Financial Crisis of the System of “National Health Insurance” in Taiwan and Its Solution——Based on the Perspective of New Institutionalism

医疗保障是公共服务的主要内容和公共财政的重要支出,其运行模式和财务状况体现着国家和地区治理体系和治理现代化的水平。我国台湾地区"全民健保"制度的财务困境对旧医保制度存在依赖,制度形成后的自我强化对财务困境具有一定的锁定效应和影响。解决这种财务困境的途径在于:制度的调整应规避"路径依赖"的陷阱,制度修订应与医疗服务内容和经济发展特点相适应,扩大制度论证环节的公民参与度,积极推进全民公共道德教育。

Medical security is the main content of public service and the important expenditure of public finance. Its op- eration mode and the financial status of medical security reflect the level of the national and the regional governance system and governance modernization. The financial crisis of the system of National Health Insurance in Taiwan is dependent on the old med- ical insurance system. The self-reinforcement after institutional formation has a certain locking effect and influence. The ways to solve this financial distress are：examine if there are any traps when ＂The three＇-in-one insurance＂ implementing, pay attention to collusion of changing policies and content of medical service and economic development, expand citizen participation, combine with education of civic morality.