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    Title: 比利時健康保險制度之研究
    Other Titles: A study on belgian national health insurance system
    Authors: 薛政文;Hsueh, Cheng-wen
    Contributors: 淡江大學歐洲研究所碩士班
    趙美盈;Chao, Mei-ying;苑倚曼;Yuan, Yi-man
    Keywords: 比利時;健康保險;醫療政策;社會保險;Belgium;Health Insurance;medical policy;social insurance system
    Date: 2009
    Issue Date: 2010-01-10 23:59:56 (UTC+8)
    Abstract: 世界主要工業化國家大都因為人口結構改變、平均壽命延長和少子化現象及經濟成長下降等諸因素的影響,導致社會保險給付支出劇增,面臨所謂社會保險危機,而提出社會保險改革(social insurance reform),主要包括年金制度改革與健康保險改革兩大部份,以期解決財務負擔問題;而比利時的健康保險制度可稱是全世界最先進的國家之一,社會中的成員都能夠在一定程度上得到健康保障。百年以來,歷經戰亂,經濟危機等,比利時聯邦政府均有改革措施因應;有鑑於此,研究者想進一步探討比利時健康保險制度改革因應之道,以提供台灣作為經營一個完善便民的全民健康保險政策之借鏡。

    本文採取歷史分析法與文獻分析法分析比利時健康保險制度內容、行政組織及歷史發展;根據上述研究背景與動機,歸納本研究目的如下:
    第一、探討比利時健康保險制度內涵;
    第二、探討比利時健康保險制度改革特性;
    第三、探討健康保險相關組織中財務權限劃分;
    第四、檢視台灣全民健保現制發展並與比利時作對照,對台灣全民健保提出具體建議。

    本研究發現,比利時在所謂尊重族群差異基礎上設計出中央地方分權(decentralisation)和一致共識(consensus)原則,造就出多黨政治生態,將透過選舉、政黨及利益團體等各式參與機制而後繪出健康保險制度改革藍圖,讓被保險人以及醫療服務提供者成為比利時健康保險制度真正影響關鍵;上述發現應有助於瞭解比利時健保改革政策對健康保險行政組織之影響程度,以提供台灣全民健保政策規劃者思謀正確之行政組織改革方向。
    As time goes by, the total social insurance expenses of most industrial countries over the world, have continuously increased owing to some of the following factors: the population structure changes, the extending of life expectancy, the lower birthrate, the higher medical expenses and the decrease of economy progress rate. And thus, facing a social insurance crisis, the social insurance reform was brought up: mainly towards to pension and health insurance system, in order to solve the financial burden. And Belgian National Health Insurance System is one of the most developed countries’ systems over the world: almost the entire population is protected; Moreover, over the past century, the Belgian federal government has the solutions to the system reform.

    Based on historical and document analysis, this study examined the effects of Belgian National Health Insurance (NHI) system reform for the data analysis. The major findings of this study are presented below:
    1. the content and the development of Belgian NHI;
    2. the system reform of Belgian NHI;
    3. the limits of financial authority between all the related administrative organizations;
    4. a comparison of Taiwan current NHI system and a specific suggestion.

    The result shows that, through the decentralization system and the principle of consensus, the Belgian NHI mechanism makes the health service providers and the insured the key factors to affect the medical policies procedure; and the discovery could be helpful to understand the ample idea of Belgian NHI system reform, furthermore, to stimulate the politicians towards a decent system reform scheme for Taiwan NHI.
    Appears in Collections:[歐洲研究所] 學位論文

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