摘要
台湾地区全民健康保险制度历经“一代健保”和“二代健保”两个阶段。“一代健保”建构单一的健康保险体系、强制民众参与健康保险、借鉴社会保险型保障模式、创设总额支付制度。相较“一代健保”,现行的“二代健保”保险范围更广泛、保费缴纳更合理、保险服务更优质、就医体验更便捷。推动“二代健保”创新的运行逻辑是全民参与健康保险、“中央健康保险署”节约控制保险资源、制度设计合理化和医疗技术专业化,以及“健保云端系统”提供全方位信息共享。“二代健保”获得台湾地区民众较高的满意度,但其定位、保费负担、服务支出、信息存储安全等面临实践困境。应倡导以人为本的价值理念、加强基层医疗服务和信息化水平,特别要积极推进两岸医疗产业融合发展,进一步完善台湾地区全民健康保险制度。
Taiwan s universal health insurance system has gone through two stages:"the first-generation health insurance"and"the second-generation health insurance"."The first-generation health insurance"builds a single health insurance system,compels people to participate in health insurance,introduces a welfare insurance model,and creates a total payment system.Compared with"the first-generation health insurance",the current"second-generation health insurance"has wider insurance coverage,more reasonable premium payments,better insurance services,and more convenient medical treatment experience.The operational logic of promoting the innovation of"the second-generation health insurance"is the universal participation in health insurance,the"Central Health Insurance Agency"to save and control insurance resources,the rationalization of system design and medical technology specialization,and the"Health Insurance MediCloud System"to provide comprehensive information sharing."The second generation health insurance"has achieved high satisfaction of the Taiwan region residents,but its positioning,premium burden,service expenditure,information storage security are also facing practical difficulties.We should advocate the concept of people-oriented values,strengthen the level of primary medical services and informatization,especially actively promote the integrated development of medical industries across the Taiwan Straits,and further improve Taiwan s universal health insurance system.
作者
曾思菲
ZENG Sifei(Putian College,Research Center of Xi Jinping Thought on Socialism with Chinese Characteristics for a New Era,Putian 351100,Fujian,China)
出处
《闽台关系研究》
2024年第4期92-104,共13页
Studies on Fujian-Taiwan Relations
关键词
台湾地区
全民健康保险制度
“健保云端系统”
Taiwan
universal health insurance system
"Health Insurance MediCloud System"
