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題名:全民健康保險會運作效能之評估研究:健保會委員之觀點
書刊名:社會政策與社會工作學刊
作者:劉宜君 引用關係
作者(外文):Liu, I-chun
出版日期:2016
卷期:20:1
頁次:頁85-128
主題關鍵詞:全民健康保險全民健康保險會委員會過程評估運作效能National health insurance policyNational health insurance committeeCommitteeProcess evaluationOperational effectiveness
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(2) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:2
  • 共同引用共同引用:45
  • 點閱點閱:137
自2000年開始,政府提出二代健保的改革構想,其中在組織體制最主要的變革是將「健保監理會」與「健保費用協定會」兩會合一,成立健保會,負責審議健保費率、給付範圍、決定5,000多億健保醫療費用的分配。研究目的透過文獻資料蒐集、深度訪談法,從健保會委員觀點評估健保會實際運作過程與效能,提出改善建議。研究發現健保會雖然有少數委員對於角色認知不足、會議效率有待增進、委員專業知識不對等、委員互動仍在磨合等問題。但整體而言,健保會的確擴大社會多元化參與健保政策,並完成法定任務。研究建議衛福部可建立各類型組成團體之委員聘任原則、訂定專家學者與公正人士代表的遴選委員會設置及作業要點、衛福部提供行政資源,協助委員分析健保相關資料,促進委員的專業表達能力,強化付費者代表監督能量,以及委員之間的實質對等協商能力。
Since 2000, the second generation National Health Insurance policy has focused on reforming its financial balancing mechanism. The key to reaching a balanced budget is to build a mechanism for 'integrating two committees governing premium revenues and medical expenses into National Health Insurance Committee (here after NHIC) to coordinate the decisions of revenues and expenses closer with each other.' A year-round procedure is established to connect global budget consultations, global budget negotiations, and premium rate negotiations under the integrated NHIC. However, this new mechanism's ability to achieve the reform goal must be evaluated. The research is an operational process evaluation that explores effectiveness and the possible NHIC problems from the committee members' perspectives. It also analyzes operational problems including the cognitive bias of committee members' roles, the loopholes in the operational processes and lack of professional knowledge of some members. The advantages of the committee include expanding participation and complete legislative missions. This research recommends that the government can present the appointees' principles, provide administrative resources to help members analyze healthcare-related information, and promote members' professional skills.
期刊論文
1.Farrell, C. M.(2005)。Governance in the UK Public Sector: The Involvement of the Governing Board。Public Administration,83(1),89-110。  new window
2.Alexander, E. R.(1998)。A structuration theory of interorganizational coordination: Cases in environmental management。International Journal of Organizational Analysis,6(4),334-355。  new window
3.Jeffries, Frank L.、Reed, Richard(2000)。Trust and Adaptation in Relational Contracting。Academy of Management Review,25(4),873-882。  new window
4.Konsynski, B. R.、McFarlan, F. W.(1990)。Information Partnerships: Shared Data, Shared Scale。Harvard Business Review,68(5),114-120。  new window
5.王千文、陳敦源(20120300)。形式上還是實質上的「公私協力」:全民健康保險總額支付制度個案分析。公共行政學報,42,99-137。new window  延伸查詢new window
6.江大樹(19930700)。合議制行政組織的類型分析。法政學報,1,203-239。new window  延伸查詢new window
7.王光旭(20121200)。委員會決策參與影響因素之探析--社會鑲嵌的觀點。政策與人力管理,3(2),75-117。new window  延伸查詢new window
8.Arnwine, D. L.(2002)。Effective Governance: The Roles and Responsibilities of Board Members。Baylor University Medical Center Proceedings,15(1),19-22。  new window
9.Daum, J.(2003)。Next Stop: The Governance Committee。Spencer Stuart Governance Letter,2003(Spring),59-63。  new window
10.Edelenbos, J.、Klijn, Erik-Hans(2007)。Trust in Complex Decision-Making Networks: A Theoretical and Empirical Exploration。Administration and Society,39(1),25-50。  new window
11.Huang, H.、Lobo, G.、Zhou, J.(2009)。Determinants and Accounting Consequences of Forming a Governance Committee: Evidence from the United States。Corporate Governance: An International Review,17(6),710-727。  new window
12.Li, H.、Suen, W.(2009)。Viewpoint: Decision-making in Committee。Canadian Journal of Economics,42(2),359-392。  new window
13.Malloy, Jonathan(1999)。What Makes a State Advocacy Structure Effective? Conflicts between Bureaucratic and Social Movement Criteria。Governance: An International Journal of Policy and Administration,12(3),267-288。  new window
14.Mitchell, J.(1997)。Representation in Government Boards and Commissions。Public Administration Review,57(2),160-167。  new window
15.Ottaviani, M.、Sorensen, P. N.(2006)。Professional Advice。Journal of Economic Theory,126(1),120-142。  new window
16.Spira, L. F.、Bender, R.(2004)。Compare and Contrast: Perspectives on Board Committees。Corporate Governance: An International Review,12(4),489-499。  new window
17.Totten, M. K.(2013)。A Unique Approach to Assessing Board Committee Effectiveness。Great Boards,2,2-3。  new window
18.Visser, B.、Swank, O.(2007)。On Committees of Experts。The Quarterly Journal of Economics,122(1),337-372。  new window
19.杜文苓、彭渰雯(20080300)。社運團體的體制內參與及影響--以環評會與婦權會為例。臺灣民主季刊,5(1),119-148。new window  延伸查詢new window
會議論文
1.陳敦源、羅凱凌(2012)。委員會治理:台灣全民健康保険決策參與的理論與實務。兩岸參與式治理比較研究研討會。北京:臺灣民主基金會:北京清華大學政治系。  延伸查詢new window
2.蔡翔傑、黃東益、陳麗光、陳敦源(2009)。委員會治理過程之評估--「全民健保醫療給付協議會議」的個案研究。2009台灣政治學會年會暨『動盪年代中的政治學:理論與實踐』學術研討會,玄奘大學 (會議日期: 2009年11月20日)。  延伸查詢new window
研究報告
1.陳敦源(2006)。全民健康保険監理會未來運作機制規劃之研究。  延伸查詢new window
2.陳敦源、張耀懋(2012)。建構全民健康保險會組織任務中財務收支連動運作機制之研究。臺北:行政院衛生署。  延伸查詢new window
學位論文
1.王光旭(2009)。決策的社會鑲嵌性及其影響:台灣中醫及牙醫健保總額支付委員會決策機制之分析(博士論文)。國立政治大學。new window  延伸查詢new window
2.鍾佳雯(2007)。委員會治理機制之研究--以台灣公務人員退撫基金監理委員會為例(碩士論文)。國立政治大學。  延伸查詢new window
圖書
1.Stufflebeam, D. L.、Shinkfield, A. J.(2007)。Evaluation theory, models and applications。San Francisco, CA:Jossey-Bass。  new window
2.Cornforth, Chris(2003)。The governance of public and non-profit organizations: What Do Boards Do?。Routledge。  new window
3.Alter, C.、Hage, J.(1993)。Organizations working together。Sage。  new window
4.彭文賢(2001)。組織結構。臺北:三民書局。  延伸查詢new window
5.Crawford, R. W.(1990)。On Board: Guiding Principles for Trustees of Not-for-Profit Organizations。Denver:Western States Arts Federation。  new window
6.Hirzy, E. C.(1993)。Nonprofit Board Committees: How to Make Them Work?。Washington:National Center for Nonprofit Boards。  new window
其他
1.Bader, B. S.,Knecht, P. R.(2013)。Most Commonly Asked Questions about Board Committees,http://www.greatboards.org/faqboard-committees-summer13.pdf, 。  new window
 
 
 
 
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