二代健保改革

Second-Generation National Health Insurance Reform

全民健保開辦後，大幅增加民眾就醫的可近性，獲得極高之民眾滿意度，全民健保實施多年後也出現許多的問題，包括就醫次數的增加及醫療費用的快速成長，健保財務的不健全導致健保收支不平衡等。因此，自2001 年起政府啟動「二代健保」的改革工作，邀請各領域之專家學者針對全民健康保險制度之設計與運作進行分析與檢討，前後歷經12 年的努力終於完成健保法的修法。本文將回顧促使健保改革的壓力、二代健保改革之經過及重點改革方向，討論全民健康保險法修法內容與前述二代健保規劃內容之差異，以及健保局具體落實在行政措施上之情形。

The accessibility of health care has been greatly improved since the implement of the National Health Insurance program in Taiwan. Although there is high public satisfaction, many problems appeared, such like the rapid growth in healthcare visits and costs as well as the imbalance between revenues and expenditures, after years since the initiation of the program. Therefore, the government launched its reform for the "Second-generation National Health Insurance" in 2001 and finally enacted the amendment in 2011. The purpose of this article is to review the pressure leading to reform, the process adopted, and the directions for reform recommended by the task force. This review especially focuses on the differences among the original National Health Insurance program, the task force's recommendations, and the 2011 amendment of the National Health Insurance Law.