日本的勞災保險制度：對台灣職災保險改革的啟示

Commentary: long-term effects of early Tai Chi on exercise tolerance, anxiety, depression, and quality of life in hospitalized patients with chronic obstructive pulmonary disease

目標：台灣職災補償法規範散亂繁複，造成職災勞工的補償權益無法確保、雇主責任無法 落實。鑑於台灣與日本國情文化接近，本研究旨在深入探討日本勞災保險制度，作為台灣制度 改革借鏡。方法：本研究蒐集並回顧日本勞災保險相關文獻，包含中文或日文的論文、專書、 政府官方資料等，並依據下列架構分析、比對資料：(1)制度沿革、(2)法源與行政組織、(3)納 保人口、(4)財源與保費、(5)給付內容、(6)認定機制。結果：日本勞災保險依據《勞動者災害 補償保險法》，由中央勞動基準局及地方勞動基準監督署主管，涵蓋全體受僱勞工，由雇主全 額支付保費，給付內容包含職災勞工及家屬所需各層面。職業傷病認定過程由勞動檢查官主 導。結論：參考日本勞災保險經驗，台灣職災補償制度應整合並制定專法、擴大保險涵蓋範 圍、精算合理費率、提昇給付內容，同時亦應簡化職業傷病申請與認定流程，由勞檢單位積極 介入協助，以確保職災勞工的補償權益。

Objectives: Workers' compensation in Taiwan is complicated, and it is regulated by various laws; this results in inadequately guaranteed workers' rights to compensation and easy escape from employers' responsibilities. Considering the cultural and socioeconomic similarities between Taiwan and Japan, we examined the institutional arrangements and recognition procedures of the Industrial Accident Compensation Insurance (IACI) of Japan to suggest directions for institutional reform in Taiwan. Methods: The literature about IACI in both Japanese and Chinese including journal articles, books, and official publications was reviewed. Data were analyzed and compared in terms of: (1) institutional evolution, (2) legal basis and administrative organizations, (3) insured population, (4) premiums and financing, (5) benefits, and (6) mechanisms for recognition. Results: IACI in Japan was established on the basis of the IACI Act, and is supervised by the Labor Standards Bureau and prefectural Labor Standards Inspection Offices. All employed workers are covered, and premiums are fully paid by employers. Various types of benefits are provided to the injured workers and their families. The recognition process of occupational injuries and diseases is handled by labor inspection officers. Conclusions: Learning from the experience of IACI in Japan, we believe that a new law is needed to integrate the workers' compensation systems in Taiwan. Coverage should be expanded, the insurance rates should be adjusted reasonably, and benefits should be increased. In addition, the compensation procedures and recognition mechanisms should be simplified and actively assisted by labor inspectors in order to guarantee workers' compensation rights.