法律學院: 法律學研究所指導教授: 蔡茂寅胡竣凱Hu, Chun-KaiChun-KaiHu2017-03-032018-07-052017-03-032018-07-052015http://ntur.lib.ntu.edu.tw//handle/246246/273419隨著臺灣邁入高齡化社會，長期照顧逐漸成為重大的社會政策議題。過去由家庭或個人承擔高齡者照顧責任的型態，已無法因應日益沈重的長期照顧需求，國家不得不擔負起建構長期照顧制度的責任。然而，國家財政能力有其界限，國家以有限的稅收提供長照服務，勢必難以滿足所有國民的長期照顧需求。因此，近年來各國傾向透過社會保險制度的建立，試圖改變長照費用負擔及財源結構，藉以確保長照服務能穩定被提供，但長期照顧保險究應如何設計或修正？其制度理念及理論基礎為何？均值得深入探討。 日本於2000年開始實施長期照護保險制度，採用社會保險的方式經營，並由被保險人所繳納之保險費支應保險支出所需費用，而「社會保險方式」係適用不同於其他社會保障制度的原理原則，例如：強制納保、緩和的等價性、給付權利原則等，同時在財務處理上具有自主性，背後更蘊含社會連帶及風險分擔的精神。日本長照保險自施行迄今歷經多次改革，仍未能完全解決財政危機，此段改革過程亦有值得臺灣借鏡之處。 有鑒於此，本文擬分析日本長期照護保險的發展背景，介紹制度轉折的脈絡，以及長照保險施行後的改革經驗，進一步以日本制度經驗為借鏡，對照並分析臺灣長照政策的發展歷程，評析行政院通過之長期照顧保險法草案，確認社會保險的定位，檢討保險費負擔及政府補助比例是否妥當等財政面的問題，期能為臺灣即將開辦的長期照顧保險提供參考以及未來制度改革的引導方向。Recently, Taiwan has entered the aging society. Long-term care is becoming a major social policy issue. The patterns of assuming responsibility for the care of elderly by the families or individuals in the past, has been unable to respond to the increasingly heavy long-term care needs. The government had to take responsibility for the construction of long-term care system. However, the financial capacity of the government has its limits. It is hard for the government to provide sufficient long-term care services only by limited taxes. Thus, social insurance system has been used to release the burden on the government, but how to design or revise long-term care insurance system still needs further discussion. Japan implemented the long-term care insurance in 2000. As a social insurance, the insured has to pay a premium in order to afford the expenses of insurance. Also, the financial system has to keep self-sufficient. The social insurance contains the spirits of social solidarity and risk-sharing. Although the long-term care insurance in Japan has been through several reforms, the financial problems still exist. This thesis compares the backgrounds of development of long-term care insurance in Taiwan and Japan, and further evaluates the drafts of long-term care insurance in Taiwan. Taking Japan as an example, we can lead the long-term care insurance in Taiwan to the right direction.3508780 bytesapplication/pdf論文公開時間: 2015/8/25論文使用權限: 同意無償授權高齡化社會長期照顧長期照護保險長照十年計畫社會保險Aging SocietyLong-tem CareLong-tem Care InsuranceLong-term care ten-year programSocial Insurancethesishttp://ntur.lib.ntu.edu.tw/bitstream/246246/273419/1/ntu-104-R98a21010-1.pdf