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題名：到國家主義之路：路徑依賴與全民健保組織體制的形成
書刊名：臺灣社會學
作者：林國明 引用關係
作者(外文)：Lin, Kuo-ming
出版日期：2003
卷期：5
頁次：頁1-71
主題關鍵詞：路徑依賴；歷史制度論；全民健保；社會保險；保險組織；Path dependence；Historical institutionalism；National health insurance；Social insurance；Administration of health insurance
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相關次數：
  • 被引用次數被引用次數:期刊(33) 博士論文(13) 專書(4) 專書論文(2)
  • 排除自我引用排除自我引用:33
  • 共同引用共同引用:670
  • 點閱點閱:744
　　　　　本文使用路徑依賴的概念來解釋為何臺灣的全民健保會建立「政府經營的單一體系」這種國際上罕見的「國家主義」組織體制。本文的分析有兩條主軸。在第一條軸線上，我分析制度起源時期所建立的「國家經營、體系分立、事權分散」的組織體制，如何限制擴大保險對象的行動選擇，而非意圖地使勞工保險建構了跨階級的連帶，另一方面卻又造成社會保險體系極端的結構分歧。在第二條線上，我分析執政菁英一貫採取的低保費政策，其自我增強的過程，如何使結構分歧的保險體系在1980年代末期陷於嚴重的財務危機。在危機中，既存組織體制存續的合理性遭致質疑，而家主義方案，因為其被賦予的效率功能，以及風險分攤效果有助於政府從財務危機中脫困，而塑為執政菁英解決危機的行動選擇。國家主義方案雖在決策過程中獲到部分國家機關和朝野立委的抗拒阻力，不甸，由於勞保體系業已形成階級的連帶，單一體系整合並未引發社會階級╱群體的衝突，因而弱化了反對的力量，另一方面，國家控制保險組織的長期歷史，也使民間經營的替代方案缺乏可信度和可行性。長期的歷史過程，創造了有利國家主義方案的行動條件。
　　　　　The concept of path dependence is used to explain the statist character of Taiwan's national health insurance program-that is, why the state decided to adopt a single plan under its centralized control that covers the entire population. At the first level, I look at the reasons why social insurance programs created in the 1950s by the authoritarian state placed constraints on the classification of occupational groups that were covered. A series of decisions in this area unexpectedly expanded the social bases of the labor insurance program and fragmented individual social insurance regimes. At the second level, I show how the self-reinforcing low premium-rate policy led to a fiscal crisis in social insurance programs in the late 1980s-the same time that a national heath insurance plan was being constructed. During the crisis, existing structures within the fragmented and administratively decentralized social insurance program were discredited and reorganized into a single state-managed plan. Claiming that there were advantages in terms of efficiency and cross-subsidization, this structure was promoted by the state elite as a means of ending the crisis. Since the previous labor insurance program had paved social bases broadly, a statist project integrating labor insurance and other occupational programs into a single health insurance plan was accepted with little conflict among social groups that could have mobilized large-scale resistance. Since Taiwan's social insurance systems had long been controlled and managed by the state, a society-managed system was not considered feasible as an alternative. Thus, historical processes created favorable conditions for the establishment of the statist plan.
期刊論文
1.林國明(20000500)。全民健保民營化的政治邏輯。臺大社會工作學刊，2，55+57-96。new window  延伸查詢new window
2.Esping-Andersen, Gösta(1985)。Power and Distributional Regimes。Politics and Society，14(2)，223-255。  new window
3.Goldstone, Jack A.(1998)。Initial Conditions, General Laws, Path Dependence, and Explanation in Historical Sociology。American Journal of Sociology，104(3)，829-845。  new window
4.Haydu, Jeffrey(1998)。Making use of the past: Time periods as cases to compare and as sequences of problem solving。American Journal of Sociology，104(2)，339-371。  new window
5.林國明(19971200)。國家與醫療專業權力：臺灣醫療保險體系費用支付制度的社會學分析。臺灣社會學研究，1，77-136。new window  延伸查詢new window
6.Evans, Robert G.(1987)。Hang Together, or Hang Separately: The Viability of a Universal Health Care System in an Aging Society。Canadian Public Policy，13(2)，165-180。  new window
7.Pierson, Paul(2000)。Increasing Return, Path Dependence, and the Study of Politics。American Political Science Review，94(2)，251-267。  new window
8.Mahoney, James W.(2001)。Path-Dependent Explanations of Regime Change: Central America in Comparative Perspective。Studies in Comparative International Development，36(1)，111-141。  new window
9.Krasner, Stephen D.(19840100)。Review Article: Approaches to the State: Alternative Conceptions and Historical Dynamics。Comparative Politics，16(2)，223-246。  new window
10.林國明(20010200)。歷史、制度與政策--臺灣醫療保險體系部份負擔與轉診方案的政策轉折。國立臺灣大學社會學刊，29，111-184。new window  延伸查詢new window
11.Hall, Peter A.、Taylor, Rosemary C. R.(1996)。Political Science and the Three New Institutionalisms。Political Studies，44(5)，936-957。  new window
12.Thelen, Kathleen(1999)。Historical Institutionalism in Comparative Politics。Annual Review of Political Science，2(1)，369-404。  new window
13.Immergut, Ellen M.(1998)。The Theoretical Core of the New Institutionalism。Politics & Society，26(1)，5-34。  new window
14.傅立葉(19931100)。臺灣社會保險制度的社會控制本質。臺灣社會研究季刊，15，39-64。new window  延伸查詢new window
15.Mahoney, James W.(2000)。Path Dependence in Historical Sociology。Theory and Society，29(4)，507-548。  new window
16.Pierson, Paul(2000)。Not Just What, but When: Timing and Sequence in Political Processes。Studies in American Political Development，14(1)，72-92。  new window
17.尹仲容(1959)。1950-1960年間美國經濟援助與臺灣經濟發展。臺灣銀行季刊，12(1)，71-82。  延伸查詢new window
18.Evans, R. G.(1992)。Canada: The Real Issues。Journal of Health Politics, Policy and Law，17(4)，739-762。  new window
19.Griffin, Larry J.(1992)。Temporality, Events, and Explanation in Historical Sociology: An Introduction。Sociological Methods and Research，20(4)，403-427。  new window
20.Isaac, L. W.(1997)。Transforming Localities: Reflections on Time, Causality, and Narrative in Contemporary Historical Sociology。Historical Methods，30(1)，4-12。  new window
21.Lieberman, E. S.(2001)。Causal Inference in Historical Institutional Analysis: A Specification of Periodization Strategies。Comparative Political Studies，34(9)，1011-1035。  new window
22.Quadagno, J.、Knapp, S. J.(1992)。Have Historical Sociologists Forsaken Theory: Thoughts on the History/ Theory Relationship。Sociological Methods and Research，20(4)，481-507。  new window
研究報告
1.田弘茂、林國明(2001)。全民健保改革方案的政策評估。臺北。  延伸查詢new window
學位論文
1.廖美(1992)。臺灣農民運動的興盛與衰落--對二○年代與八○年代的觀察(碩士論文)。國立台灣大學。  延伸查詢new window
2.林國明(1997)。From Authoritarianism to Statism: The Politics of National Health Insurance in Taiwan(博士論文)。Department of Sociology，New Haven, CT。  new window
3.Lin, Chia-Lung(1998)。Paths to democracy: Taiwan in comparative perspective(博士論文)。Yale University。  new window
4.李明璁(1996)。國家機器，政治轉型，與社會福利--以「老人年金」議題之發展為例(碩士論文)。國立清華大學。  延伸查詢new window
圖書
1.Haggard, Stephen(1990)。Pathways from the Periphery: The Politics of Growth in the Newly Industrialized Countries。Ithaca。  new window
2.行政院經濟建設委員會都市及住宅發展處全民健康保險研究計畫專案小組(1990)。全民健康保險制度規劃技術報告。臺北：行政院經濟建設委員會都市及住宅發展處全民健康保險研究計畫專案小組。  延伸查詢new window
3.Baldwin, Peter(1990)。The Politics of Social Solidarity: Class Bases of the European Welfare State, 1875-1975。Cambridge：Cambridge University Press。  new window
4.Stone, D.(1980)。The Limits of Professional Power: National Health Care in the Federal Republic of Germany。Chicago, IL：University of Chicago Press。  new window
5.Walzer, Michael(1983)。Spheres of justice: A defense of pluralism and equality。Oxford：Martin Robertson。  new window
6.Rimlinger, Gaston V.(1971)。Welfare Policy and Industrialization in Europe, America and Russia。New York：Wiley。  new window
7.Pierson, Paul(1994)。Dismantling the welfare state? Reagan, Thatcher, and the politics of retrenchment。Cambridge University Press。  new window
8.Stepan, Alfred(1988)。Rethinking Military Politics: Brazil and the Southern Cone。Princeton University Press。  new window
9.張博雅、羅紀琼、劉素芬、楊漢泉(1997)。專業奇蹟VS.民眾迷思：全民健康保險規劃紀實。臺北：桂冠圖書股份有限公司。  延伸查詢new window
10.Arthur, W. Brian(1994)。Increasing Returns and Path Dependence in the Economy。University of Michigan Press。  new window
11.Anderson, Odin W.(1989)。The Health Services Continuum in Democratic States: An Inquiry into Solvable Problems。Ann Arbor, Michigan：Health Administration Press。  new window
12.Navarro, Vicente(1994)。The Politics of Health Policy: The U.S. Reforms, 1980-1995。Cambridge：Blackwell。  new window
13.Immergut, Ellen M.(1992)。Health Politics: Interests and Institutions in Western Europe。Cambridge University press。  new window
14.Esping-Andersen, Gøsta(1990)。The Three World of Welfare Capitalism。Oxford：Polity Press。  new window
15.張茂桂、吳介民、楊靜文、陳維新(1989)。社會運動與政治轉化。臺北市：國家政策研究資料中心 (政研中心)。new window  延伸查詢new window
16.Skocpol, Theda(1992)。Protecting Soldiers and Mothers: The Political Origins of Social Policy in the United States。The Belknap Press of Harvard University Press。  new window
17.Chu, Yun-han(1992)。Crafting Democracy in Taiwan。Taipei：Institute for National Policy Research。  new window
18.March, James G.、Olsen, Johan P.(1989)。Rediscovering Institutions: The Organizational Basis of Politics。New York：The Free Press, A Division of Macmillan, Inc.。  new window
19.柯志明(20010000)。番頭家：清代臺灣族群政治與熟番地權。臺北市：中央研究院社會學研究所籌備處。new window  延伸查詢new window
20.Tilly, Charles(1984)。Big Structures, Large Processes, Huge Comparisons。New York：Russell Sage Foundation。  new window
21.March, James G.、Olsen, Johan P.(1995)。Democratic Governance。The Free Press。  new window
22.Abrams, Philip(1982)。Historical sociology。Cornell University Press。  new window
23.Gold, Thomas Barton(1986)。State and Society in the Taiwan Miracle。Armonk：M. E. Sharpe。  new window
24.Taylor, M. G.(1990)。Insuring National Health Care: The Canadian Experience。Insuring National Health Care: The Canadian Experience。沒有紀錄。  new window
25.行政院經濟建設委員會全民健康保險規劃小組(1990)。社會保險的財務危機與低保險費率政策。社會保險的財務危機與低保險費率政策。臺北。  延伸查詢new window
26.行政院衛生署(1990)。全民健康保險規劃研討會會議實錄。全民健康保險規劃研討會會議實錄。臺北。  延伸查詢new window
27.江振南(1971)。臺灣經濟發展中財政結構變動之分析。臺北：中央研究院經濟研究所。  延伸查詢new window
28.朱敬一、葉家興(1994)。臺灣的私人興學。臺灣的教育改革。臺北。  延伸查詢new window
29.汪國瑗(1982)。中華民國私立學校教職員保險制度現況。中華民國公務人員保險制度，下冊。臺北。  延伸查詢new window
30.李雲漢(1994)。中國國民黨史述。中國國民黨史述。臺北。  延伸查詢new window
31.馬超俊(1950)。社會保險與勞工生活的關係。中國國民黨現階段政治主張專題研究集，C14。沒有紀錄。  延伸查詢new window
32.張維(1982)。中華民國公務人員保險承保業務現況。中華民國公務人員保險制度，下冊。臺北。  延伸查詢new window
33.張肇平(1982)。中華民國「公務人員保險法」析論。中華民國公務人員保險制度，上冊。臺北。  延伸查詢new window
34.陽肇昌(1975)。三十年來的保險事業。臺灣光復三十年。臺中。  延伸查詢new window
35.翟璟(1982)。中華民國公務人員保險制度籌畫與建立經過。中華民國公務人員保險制度，上冊。臺北。  延伸查詢new window
36.(1994)。全民健康保險「公辦民營」可行性評估。全民健康保險「公辦民營」可行性評估。臺北。  延伸查詢new window
37.羅紀琼(1997)。顧問篇。專業奇蹟VS.民眾迷思：全民健康保險規劃紀實。臺北。  延伸查詢new window
38.Abbott, Andrew(2000)。Time Matters: On Theory and Method。Time Matters: On Theory and Method。Chicago, IL。  new window
39.(1996)。Health Policy Reform, National Variations and Globalization。Health Policy Reform, National Variations and Globalization。New York, NY。  new window
40.Beito, D. T.(2000)。From Mutual Aid to the Welfare State: Fraternal Societies and Social Services, 1890-1967。From Mutual Aid to the Welfare State: Fraternal Societies and Social Services, 1890-1967。Chapel Hill。  new window
41.Charles, C. A.、Badgley, R. F.(1999)。Canadian National Health Insurance: Evolution and Unresolved Policy Issues。Health Care Systems in Transition: An International Perspective。Thousand Oaks, CA。  new window
42.Cheng, Tun-jen、Haggard, S.(1987)。Newly Industrializing Asia in Transition: Policy Reform and American Response。Newly Industrializing Asia in Transition: Policy Reform and American Response。Berkeley, CA。  new window
43.Esping-Andersen, G.(1987)。Citizenship and Socialism: De-Commodification and Solidarity in the Welfare State。Stagnation and Renewal in Social Policy: The Rise and Fall of Policy Regimes。Armonk, NY。  new window
44.Ikenberry, G. J.(1988)。Conclusion: An Institutional Approach to American Foreign Economy Policy。The State and American Foreign Economic Policy。Ithaca, NY。  new window
其他
1.薛承泰(2004)。老人照顧老人 將是臺灣現象，http://ntu.edu.tw/~psc_news9312/120701.htm， 20041207。  延伸查詢new window
圖書論文
1.林國明(2000)。民主化與社會政策的公共參與：以全民健保為例。臺灣的社會福利運動。臺北市：巨流。new window  延伸查詢new window
2.Linz, Juan J.、Lerner, Daniel(1975)。Totalitarian and Authoritarian Regimes。Handbook of Political Science, Vol. 3: Macropolitical Theory。Reading, MA：Addison-Wesley。  new window
3.Sewell, William H. Jr.(1996)。Three Temporalities: Toward an Eventful Sociology。The Historic Turn in the Human Sciences。Ann Arbor：University Michigan Press。  new window
4.Levi, Margaret(1997)。A Model, a Method, and a Map: Rational Choice in Comparative and Historical Analysis。Comparative Politics: Rationality, Culture, and Structure。Cambridge：Cambridge University Press。  new window
5.Cheng, Tun-jen(1990)。Political Regimes and Development Strategies: Korea and Taiwan。Manufacturing Miracles。Princeton, N.J.：Princeton University Press。  new window
6.林萬億(2000)。社會抗爭、政治權力資源與社會福利政策的發展：一九八○年代以來的台灣經驗。台灣的社會福利運動。台北：巨流。new window  延伸查詢new window
7.朱雲漢(1998)。從黨國體制到支配性一黨體制：國民黨與臺灣的民主轉型。兩岸基層選舉與政治社會變遷：哈佛大學東西方學者的對話。臺北市：月旦出版社股份有限公司。  延伸查詢new window
8.陳明通、林繼文(1998)。台灣地方選舉的起源與國家社會關係轉變。兩岸基層選舉與政治社會變遷。台北：月旦出版社。  延伸查詢new window
9.林佳龍(1998)。臺灣地方選舉與國民黨政權的市場化：從威權鞏固到民主轉型(1946-94)。兩岸基層選舉與政治社會變遷：哈佛大學東西方學者的對話。臺北市：月旦。  延伸查詢new window
10.Esping-Andersen, G.、Korpi, W.(1984)。Social Policy and Class Politics in Post-War Capitalism: Scandinavia, Austria and Germany。Order and Conflict in Contemporary Capitalism。Oxford：Oxford University Press。  new window
 
 
 
 
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