論1970-80年代臺灣醫政關係一種統治觀點的析評

Political Policy Considerations for Changing the Medical System in Taiwan during 1970 to 1980: An Examination on Government Intervention and Its Effects

台灣在1970一80年代的威權體制中，呈現出特殊的統治框架，這是因應當時國內外局勢變動的影響，致使「台灣化」成為國家統治的焦點和正當性根源。因此就醫政關係而官，醫療努攤被置入國家統治的一環，而醫療體系的發展也蘊含著政權落實台灣經營的一個統治圖像。為探討這般統治圖像，本文係以政治介入醫療之相關論述、政策、及權力，作為三條分析軸線，來對此時期台灣的醫政關係進行考察。本文發現，在威權體制的「台灣化」訴求下，醫療政治化已然是醫療場域中的普遍景象，亦即「政治發展醫療」和「醫療服務政治」已形成一體的兩面，這是此時期醫政關係的特殊之處，同時亦開啟了台灣「國家醫療」的發展雛型。然就分析策略來說，本文因採統治觀點的切入模式，以致文中較偏向政治控制而少論及民問醫療體制的社會力反制，這是本文的局限，但也是本文議題探討上的先行設定。

During 70s’ to 80s’when Taiwan was operated under an authoritarian system, “Taiwanization” became the political focus and the base of the political legitimacy to tackle with the domestic and international changes then. To meet the political-medical relationship, medical system had to be interwoven to the national governing system. The development of the health care system indicated that the political power was settling itself down in Taiwan at that time. To investigate the political influence on the health care system, the present study aimed to compare and analyze the two systems from three aspects, namely, existing literature, the political policy, and the political power. It showed that the health care system was greatly directed and affected on a large scale by the political situation, the Taiwanization, under the authoritarian system. That is, “the politics directing the health care” and “the health care served the politics” became two sides of a coin,and both of them created the prototype of the “national health care system”. With regard to the analysis strategy, the present study adopted a government viewpoint so that it mainly discussed the political control and rarely touched the issue of the combat of the medical care system. This is the limitation of the present study but it is also the presumption of the discussion.