釋字550號解釋之法律經濟分析

The Economic Analysis of Constitutional Interpretation No.550

我國自民國84年開辦全民健康保險以來，基於全民健康保險制度所產生之憲法上疑義屢屢發生，全賴司法院大法官依據全體社會之福祉以解釋相關憲政疑義。依據全民健康保險法第27條規定地方政府應按比例補助全民健康保險之保費，台北市政府於民國91年針對上述條文認為其侵害憲法所保障之地方自治權而聲請釋憲，並由司法院大法官作成釋字550號解釋，認為相關立法並未違憲，並引起學說上極大之爭議。 本文以下擬先介紹相關條文及釋字550號解釋，並整理聲請釋憲者與大法官之見解。其次探討基於全民健康保險法所生之保險費之性質為何，以作為討論之開端。繼而就相關之法律概念所具有之定義加以介紹，並探討釋字550號之真正爭議乃在於如何權衡全民健康保險之社會制度與地方自治制度保障兩者間價值之輕重。 然後再基於前面業經分析之法律概念為基礎，繼續以法律經濟分析中有關經濟外部性之理論，來探討相關健保費由中央完全負擔或地方負擔兩種不同制度間之利弊；並得出應由決策者負擔全部費用較符合經濟效率要求之結論，而此同時在法律概念也符合憲法上政治責任之要求。 Since the enforcement of national health insurance in 1995, several constitution related issues have been raised. They were solved and interpreted by the justices from the Judicial Yuan on the basis of social welfare. According to the article 27 of the national health insurance law, the local government should subsidize the premium per rata. Taipei municipal Government asserted such pro rata distribution violated its constitutional right of autonomy, and filed a petition to the Grand Justices for constitutional interpretation. The Grand Justices set up the constitutional interpretation No.550 and found that the provision indispute didn't violate the constitutional law, and yet has been aroused extensive academic debate around researchers and scholars on the rightfulness of the interpretation. First of all, this article will intruduce to the readers the constitutional interpretation No.550, and the nature of the premium of the national health insurance thereon. Secondly, the article will indicate that the primary issue of interpretation No.550 is how to balance the interests of the system of the whole people health insurance and that of the autonomic right. On thebasis of the former explication of the legal concepts, this article will go futher to continues study the benefits and loses under separate system that the premium is completely subsidized by the central government and that which is jointly subsidized by the local and the central government per rata. This article will conclude that the former system is more efficient and more in comformity with constitutionally political responsibility.