全民健保應有的價值目標及操動手段

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Title:	全民健保應有的價值目標及操動手段
Other Titles:	Value, Objectives, and Manipulation Methods of the National Health Insurance in Taiwan
Authors:	曾琪雯 TSENG, CHI-WEN
Contributors:	企業管理學系管理科學碩博士班陳淼勝 CHEN, MIAO-SHENG
Keywords:	全民健保;二代健保;總額給付制度;財務管理 National Health Insurance (NHI);Second Generation Health Insurance;Global Budget System (GBS);Financial Management
Date:	2022
Issue Date:	2023-11-13 14:42:25 (UTC+8)
Abstract:	全民健康保險(National Health Insurance; NHI)應有價值是全民身心健康狀態創造的利益值;年度目標是全民健康指數欲達成的既定值。推動全民健保應有手段是：建立課徵健保費哲理以便獲得醫療資源，及操動(manipulating)醫療資源有效使用。其中位階在上目標領導位階在下手段的關係，可用中文字「正」上方「一」領導下方「止」表達。概因「一」字型具普遍寬廣義，故它同時形容全民；「止」與趾的字型不僅同音且同義，故用它形容推動全民健保力行之義。推動全民健保的核心問題為：如何設計自然運作的管理機制，使健保財務收支與醫病契合關係皆平衡。其意涵可用「道」(Dao)字型形容如下：1.道字右上兩點代表健保財務收入與支出的關係即是對立也是一體的；或代表診斷及醫療之效果(診療方式與病情的契合度)與診療效率對立統一體。2.道字緊臨兩點下水平線代表:上述兩個對立統一體須平衡。3.道字右下「自」代表自然，左邊「辵」代表運作，二者合併代表自然運作的機制。這表示「正道」是全民健保管理的自我平衡與運作的表現。透過此自我平衡與運作的機制將全民健保管理問題，製作成可具體討論型態是本文的主要內容。應用此「正道字型解析法」，詮釋目前台灣全民健保管理的是非功過，並提出有效的策略與建議，則為本文的主要研究結果。　　The National Health Insurance (NHI) of Taiwan should create benefits for society by maintaining the national health status at a high level. The country has an annual objective of achieving a specific value of the national health index. Taiwan should promote the NHI through health insurance taxation, creating easy access to medical resources, and manipulating medical resources to ensure they are used effectively. Methods are currently subordinate to objectives in hospitals, which can be shown using a Chinese character 正 (pronounced “jheng”), which comprises two other characters, 一 and 止 (pronounced “yi” and “jhih”). The character 一 denotes integrate , and is used to leadership citizens; 止 denotes the implementation of the NHI. The core problem of the NHI’s implementation is how to design a management mechanism that achieves a natural operation and a balance between income and expenditure and in the doctor–patient relationship. On the basis of pictograms and knowing, this problem can be depicted using the Chinese character 道 (pronounced “dao”) that means road. First, the two upper right marks in 道 can depict the relationship between the income and expenditure of the NHI or between the effectiveness and efficiency of diagnosis and treatments (an opposite and integrated relationship). Second, the horizontal line under the two marks in 道 indicates that balance must be achieved. Third, the 自 (pronounced “zih”) on the lower right of 道 denotes nature, and the辵 (“chuo”) on the left side of 道 denotes operation; the combination of these two characters illustrates a mechanism of natural operation. Accordingly, 正 and 道 indicate the NHI’s self-balance and operation. This paper focuses on the self-balanced and operational mechanism of the NHI, uses analyses of the shapes of 正 and 道 to explain the current management of Taiwan’s NHI, and proposes practical recommendations.
Appears in Collections:	[Department of Business Administration, Master/Ph.D Program in Management Sciences] Disserations and Theses(Master and Doctoral Program in Management Sciences)

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