從數位憲政與數位信任看我國健保資料庫的爭議與使用

Applying Digital Constitutionalism and Digital Trust for Taiwan National Health Insurance Database Governance

2022年8月12日出爐的憲法法庭判決，為纏訟十年的健保資料庫二次利用爭議，劃下一個休止符。但對健保資料庫在內之健康資訊的治理模式辯論，卻才是正式拉開序幕。 對此，本文認為立法者應從醫療數位轉型之觀點出發，以數位信任（Digital Trust）之透明、安全、問責、忠實義務與利益共享等概念，來回應傳統資訊隱私權中，自主控制路徑中的種種困境。 同時，面對跨國企業掌握之平台經濟與監控資本主義，歐盟如何運用數位憲政主義（Digital Constitutionalism）概念，來建構一套數位權力分立及司法審查，也深植我們參考。 要如何運用以上概念，儘速建置一個可受民眾信任的健保資料治理機制，將會是權責機關刻不容緩的重責大任。

The Taiwan Constitutional Court ruling on August 12, 2022, marked a milestone of a decade of dispute for secondary uses of data from the National Health Insurance Database. While the ruling is final, however, debates on developing a health data governance framework have just started. This paper argues, from the digital transformation of medical care perspective, that legislators should respond to the various difficulties in the current data control model under the traditional information privacy law, by applying the concept of Digital Trust, for transparency, security, accountability, fiduciary duty, and benefit sharing. Also, facing current trends of the platform economy and surveillance capitalism controlled by multinational big tech, how the EU scholars use the concept of Digital Constitutionalism to construct a set of digital separation of powers and judicial review is a must-see reference. How to establish a good and trustworthy data governance mechanism for Taiwan National Health Database by using the concepts of digital trust and digital constitutionalism is an urgent and critical responsibility for the competent authorities.