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題名:健保欠費、中斷與2003年健保特赦條款
書刊名:臺大社會工作學刊
作者:蔡貞慧 引用關係林美雀
作者(外文):Tsay, Jen-huoyLin, Mei-chiue
出版日期:2010
卷期:21
頁次:頁115-152
主題關鍵詞:全民健保未納保者轉出保費補助保費欠費National health insuranceThe uninsuredDisenrollmentPremium subsidyPremium arrears
原始連結:連回原系統網址new window
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  • 共同引用共同引用:30
  • 點閱點閱:44
有鑑於全民健保實施以來,健保欠費或健保中斷者人數攀升,健保局於2003年實施為期一年之「健保特赦條款」,本研究運用健保局行政資料分析該方案參與者之特性,檢視該方案是否真正照顧到弱勢族群。研究結果顯示205,754人或107,272戶之參與者,以15~44歲、男性、失業者為居多數,通常被排除在現有社會救助體系之外。此外,透過5%之樣本戶所得資料分析,結果指出參與者樣本之經濟劣勢程度與現有低收入戶相近,屬近貧階級。然而,參與者之持續欠費與無力負擔延緩積欠的保費,顯示該方案雖保障一時之就醫可及性,卻未解決貧窮邊緣戶長期無法繳納健保費的困境。此外,本研究也發現有超過一成的方案受益家戶實無經濟困難之虞。因此,本研究建議一方面有必要放寬全民健保保費補助之經濟門檻,另一方面應對於以人口、家庭、社會特性為目標人口的保費補助設有經濟門檻之配套,甚或全面改以經濟門檻為單一補助資格標準。
In respect to an increasing number of enrollees who dropped out the National Health Insurance (NHI) program due to premium arrears, the Bureau of National Health Insurance enacted a 1-year premium relief program for the economically underprivileged people in 2003. Eligible beneficiaries could apply for either premium waiver or installment according to their economic status. This study aims to analyze the characteristics of program participants using the NHI administration data. The results show that 205,754 individuals or 107,272 households were mainly aged between 15-44, male, unemployed, those who were conventionally excluded from formal social assistance systems. In addition, by analyzing the tax information of sample (5% of households), the results indicate that a majority of the program participants were marginally above the poverty line, and hence, they were not qualified as low-income to be exempted from the NHI premium. Moreover, although this 1-year program had protected this near-poor population's temporary access to care from 2003 to 2004, the outstanding arrears and new premium payments will continue to accumulate after the termination of this relief program. Clearly, they won’t be able to afford such a large financial burden. Therefore, a more generous and long-term premium subsidy policy, instead of a short-term relief program, is critical for the near poor. Besides, the results show that over 10% of sampled households were quite affluent in contrast with the household income of the general population. Therefore, the study suggests that the premium subsidy criteria should be either exclusively income-tested or income-tested in complement to a categorical arrangement for specific population groups.
期刊論文
1.林志鴻、陳俊全(20051200)。全民健保體制下弱勢族群照護措施之檢討與財源籌措。臺灣社會福利學刊,4(2),1-47。new window  延伸查詢new window
2.呂建德(20030900)。與弱勢者的團結--尋找全民健保中的正義基礎。臺灣社會研究,51,51-94。new window  延伸查詢new window
3.鄭清霞、鄭文輝(20050600)。我國社會保險被保險人財務負擔與政府補助之探討。臺灣社會福利學刊,4(1),51-93。new window  延伸查詢new window
4.李玉君、張瑞君(20070300)。全民健保法對經濟弱勢者醫療保障規定之評析。國立臺灣大學法學論叢,36(1),157-208。new window  延伸查詢new window
5.邱永仁(2003)。社會福利還是社會保險?兼論健保大赦條款。臺灣醫界,46(4),45-47。  延伸查詢new window
6.葉秀珍、詹宜璋、王正(19980100)。全民健康保費補助之公平性與效率性考量。經社法制論叢,21,347-381。  延伸查詢new window
7.Kelton, C. M. L., Levitt, M.,、Pasquale, M. K.(2006)。Barriers to SCHIP enrollment: A cross-county study of the State Children's Health Insurance Program in Pennsylvania。Politics & The Life Sciences,24(1/2),22-31。  new window
8.Phillips, J. A., Miller, J.E., Cantor, J.C.,、Gaboda, D.(2004)。Context or composition: What explains variation in SCHIP disenrollment?。Health Services Research,39(4),865-886。  new window
9.Seccombe, K., Newsom, J.,、Hoffman, K.(2006)。Access to health care after welfare reform。Inquiry,43(2),167-178。  new window
10.Swartz, K.(1994)。Dynamics of people without health insurance: Don't let the numbers fool you。Journal of the American Medical Association,271(1),64-6。  new window
11.林季平(2008)。〈影響加入台灣全民健保的社會經濟不均等要素〉。《社會政策與社會工作期刊》,12(2),91-122。  延伸查詢new window
12.葉秀珍(1997)。失業期間中斷保險之保險費籌措方式之探討。中央健康保險局86年度委託研究計畫。  延伸查詢new window
13.林季平(2008)。影響加入台灣全民健保的社會經濟不均等要素。社會政策與社會工作期刊,12(2),91-122。new window  延伸查詢new window
14.健保局(2008)。全民健康保險統計。  延伸查詢new window
15.Kelton, C. M. L.、Levitt, M.、Pasquale, M. K.(2006)。Barriers to SCHIP enrollment: A cross-county study of the State Children's Health Insurance Program in Pennsylvania。Politics & The Life Sciences,24(1/2),22-31。  new window
16.Phillips, J. A.、Miller, J. E.、Cantor, J. C.、Gaboda, D.(2004)。Context or composition: What explains variation in SCHIP disenrollment?。Health Services Research,39(4),865-886。  new window
17.Seccombe, K.、Newsom, J.、Hoffman, K.(2006)。Access to health care after welfare reform。Inquiry,43(2),167-178。  new window
18.Swartz, K.(1994)。Dynamics of people without health insurance: Don't let the numbers fool you。Journal of the American Medical Association,271(1),64-66。  new window
研究報告
1.陳孝平、葉秀珍、鄭文輝、郝鳳鳴(2003)。《全民健保財務制度如何因應景氣波動》。  延伸查詢new window
2.葉秀珍(1997)。《失業期間中斷保險之保險費籌措方式之探討》。  延伸查詢new window
3.王俊程、陳鴻基(2001)。《運用資料挖掘技術協助健保財務管理:以承保中斷及繳費不正常資料挖掘為例》。  延伸查詢new window
4.林季平、林昭吟(2002)。《調查、推估、分析未參加全民健保者原因》。  延伸查詢new window
5.林季平、林昭吟(2002)。調查、推估、分析未參加全民健保者原因 (計畫編號:D0H91-NH1004)。臺北:中央健康保險局。  延伸查詢new window
6.陳孝平、葉秀珍、鄭文輝、郝鳳鳴(2003)。全民健保財務制度如何因應景氣波動。  延伸查詢new window
7.王俊程、陳鴻基(2001)。運用資料挖掘技術協助健保財務管理:以承保中斷及繳費不正常資料挖掘為例。  延伸查詢new window
學位論文
1.阮琇茹(2003)。全民健保保險對象中斷投保管理機制之探討(碩士論文)。國立中正大學。  延伸查詢new window
2.劉美芳(2002)。全民健保未投保者輔導策略之研究-以中央健保局中區分局為例(碩士論文)。逢甲大學。  延伸查詢new window
圖書
1.行政院衛生署(1997)。全民健康保險實施二年評估報告。台北:行政院衛生署。  延伸查詢new window
其他
1.社會司(2008)。歷年最低生活費一覽表,http://sowf.moi.gov.tw/10/9104-1.htm, 20080704。  延伸查詢new window
2.東森新聞報(2004)。單親媽媽求助無門?健保局推動經濟困難者納保優惠專案,http://www.nownews.com/2004/05/10/91-1628091.htm, 20100407。  延伸查詢new window
3.健保局(2008)。中央健康保險局業務執行報告97年度4月份:附表30各級政府97年1月至3月補助弱勢保險對象一覽表,http://www.nhi.gov.tw/webdata/AttachFiles/Attach_11532_2_承保附表97年1至3月弱勢保費表-承保附表30.pdf, 200807011。  延伸查詢new window
4.陳美珍(2008)。減稅綁選票,http://udndata.com/ndapp/Print?id=4239548, 20080313。  延伸查詢new window
5.勞保局(2008)。2008年勞工保險統計年報,http://www.bli.gov.tw/sub.aspx?a=9A9%2fnNSbos4%3d, 20090423。  new window
6.經濟日報(2008)。政院灑錢8億大赦弱勢健保戶,http://udndata.com/ndapp/Print?id=4235881$d20080313。  延伸查詢new window
7.劉見祥(2003)。台灣社會經濟發展與醫療衛生發展:醫療保險發展,http://www.tcchm.org.tw/public/Attachment/51242054271.pdf, 20080617。  延伸查詢new window
8.衛生署(2004)。「經濟困難民眾納保優惠專案」已全部執行完成,21萬人受惠,http://www.doh.gov.tw/CHT2006/DM/DM2_p01.aspx?class_no=25&now_fod_list_no=5978&level_no=2&doc_no=33457, 20080701。  延伸查詢new window
9.王武郎(2008)。真省錢助弱勢好過政策買票,http://udndata.com/ndapp/Print?id=4237038, 20080313。  延伸查詢new window
10.民生報(2004)。納保優惠專案6月5日截止,貧困者若符資格快申請,http://web2.cc.nctu.edu.tw/~hcsci/protect/inf/2004/0307.htm, 20100407。  延伸查詢new window
11.林佳瑩(2003)。許全民一個真正的健保特赦吧!,http://old.npf.org.tw/PUBLICATION/IA/092/IA-C-092-030.htm, 20080624。  延伸查詢new window
12.張翠芬(2009)。健保大溫暖8千貧戶欠費勾銷。  延伸查詢new window
 
 
 
 
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