2015-04-162024-05-17https://scholars.lib.ntu.edu.tw/handle/123456789/672004摘要：台灣於1995年推行全民健康保險後，於醫療健康福利領域取得相當好的成果。儘管如此，健保目前面對如何在確保醫療品質提供而同時必須控制費用高漲的壓力，並且在許多社會變遷的影響因素下，致力於維持財務收支平衡。就此而言，德國做為社會保險的福利國家典範，19世紀末期所建構的健康保險是全世界第一個社會保險、也是第一個健康保險制度，一直是其他想要採行社會保險的新興福利國家，在政策學習與借鏡的主要參考制度。尤其在近年來，德國健保進行數次重大制度改革，試圖抑制基於多向複雜因素所導致之日益成長的醫療費用，也得到初步的成效。如何瞭解德國站在傳統的健康保險結構與思維的基礎上，進行大力的健保改革作法，以提供台灣健保永續發展的政策借鏡，便是本計畫欲達成的主要目的。本計畫開始先進行大量文獻閱讀，並著手蒐集國內外重要的相關健保改革內容。本領域運用檔案分析法、焦點團體、質性訪談，進行相關資料的蒐集與分析。在檔案分析法中，主要是瞭解國內以及國際學界對於德國健保改革的討論，並以之作為焦點團體及後續質性訪談之討論基礎。如何更深入理解德國近年的健保改革，探討其政策或法令依據以及問題狀況或發展需求，並與台灣的健康保險制度發展、結構、問題與改革作法及成效加以比較分析，反思德國健保改革對於台灣健保的借鑑意義，便成為本計畫的預期重要成果。<br> Abstract: One of the major challenges for the health insurance in Taiwan is to keep the balance between providing adequate healthcare while keeping its financial costs efficiently. Germany is a good example to learn from because it has the first health insurance system of the world beginning in 1883 that works well up to date. Similar to Taiwan, however, German health insurance is under the pressures of controlling the rising healthcare cost in order to keep the employers’ financial burden at a reasonable level. In the last decades, Germany has thus introduced a series of reform measures in an attempt to better cope with its potential financial problems, some of which has clearly strengthened the role of the state at the expense of the longstanding tradition of social partners’ self-administration. These reforms have thus far yielded fruits, though the issue of diminishing solidarity also raised concerns about the future of healthcare and health insurance. This project aims to capture the dynamic of health reforms in Germany, drawing on collection of relevant literature and documents, focus group interviews and expert interviews. Research results will offer valuable lessons for further health reforms in Taiwan.健康保險德國台灣健保改革Health insurancehealth reformGermanyTaiwan