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| 題名: | 英國國民健康服務體制之研究 |
| 其他題名: | A Study on the National Health Service in the United Kingdom |
| 作者: | 鄧亦汝
DENG, YI-RU |
| 貢獻者: | 國際事務與企業學系歐洲研究碩士班
張心怡
CHANG, HSIN-YI |
| 關鍵詞: | 新冠肺炎;國民健康醫療保險;社會安全;國民健康服務體制;英國
social security;National Health Service;United Kingdom;National Health Insurance (NHI);COVID-19 |
| 日期: | 2021 |
| 上傳時間: | 2022-08-18 11:21:19 (UTC+8) |
| 摘要: | 隨著工業革命及資本主義制度的不斷發展，社會事務逐漸國家化已經成為現代國家政府在內部治理上一個重要的發展趨勢。國家除了開始介入原先被視為是屬於私領域的經濟生產、分配等領域外，也邁向建立有系統的社會安全體系與服務，例如勞工最低薪資、社會保險制度、普及式的醫療保健制度等。其中，普及式醫療保健制度的建立可說是建構當代福利國家的重要基石之一。進入二十世紀後，歐洲許多國家陸續出現為人民提供部分或全面的社會服務體系，早在1911年，英國便制定了《英國國家保險法》（National Insurance Act 1911），發展出提供低收入勞工使用的社會保險，1946年時更正式立法通過《國民健康服務法》（NHS Act 1946），由政府編列預算，提供國民大部分為免費之各類醫療服務，1948年正式開辦｢國民健康服務｣（National Health Service）。我國自1995年始正式實施為全民提供醫療保健服務的全民健康保險（National Health Insurance, NHI），期間也常因健保財務短絀而不時掀起有關費率調整、體制改革的諸多討論，雖然英國的國民健康服務體制（National Health Service, NHS）與台灣的全民健康保險在制度上不盡相同，但兩者同樣在財務、人力與醫療服務上面臨相當程度的挑戰，特別近來因受Covid-19疫情衝擊而病患大增，進而導致此類健保體系出現能量不足的困境。為此，本論文從歷史的角度探討英國國民健康服務體制的變遷，首先針對歐洲社會安全制度與理念的發展做一探討，以為英國建立國民健康服務體制提供理論面向的背景基礎；其次探究英國國民健康服務體制的發展、監管機制與實際運作模式；最後則分析英國國民健康服務體制所面臨的問題、挑戰與政府的改革措施，希望藉此能為我國全民健康保險制度提供相關的改革方向與建言。
With the continuous development of the industrial revolution and the capitalist system, the gradual nationalization of social affairs has become an important development trend in the internal governance of modern national governments. Alongside to the states' gradual intervention into the areas of economic production and distribution that were originally regarded as private sectors, the states' governance are also expanding towards the establishment of a systematic social security system and services, such as minimum wages for labor, social insurance systems, universal health care systems, etc. Among them, the establishment of a universal medical care system can be said to be one of the important cornerstones of constructing a contemporary welfare state. Entering into the twentieth century, many European countries have successively emerged to provide partial or comprehensive social service systems for their people. As early as 1911, the United Kingdom enacted the National Insurance Act (National Insurance Act 1911), which developed to provide low-income laborers. In 1946, the National Health Service Act (NHS Act 1946) was formally passed through legislation in 1946. The government budgeted and provided most of the citizens with free medical services. In 1948, the “National Health Service” was officially launched (National Health Service). Since 1995, Taiwan officially implemented the National Health Insurance (NHI), which provides medical and health services for all people. During this period, due to the shortcomings of health insurance finance, many discussions about rate adjustments and system reforms have been raised from time to time. Although the UK's National Health Service (NHS) and Taiwan's National Health Insurance are not the same in terms of the system, the two both face considerable challenges in financial, human, and medical services, especially due to the recent Covid-19 epidemic. The impact has caused a large increase in patients, which has led to the dilemma of insufficient energy in this type of health insurance system. To this end, this thesis explores the changes in the British National Health Service system from a historical perspective. Firstly, it discusses the development of European social welfare systems and concepts, so as to provide a theoretical background basis for the establishment of a national health service system in the United Kingdom; secondly, it explores the United Kingdom the development, supervision mechanism and actual operation mode of the national health service system; finally, it analyzes the problems, challenges and government reform measures facing the British national health service system, hoping to provide relevant reform directions and reforms for the national health insurance system for Taiwan. |
| 顯示於類別: | [國際事務與企業學系(亞太研究碩士班,公共政策研究碩士班,歐洲研究碩士班)] 博碩士論文-歐洲研究碩士班
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