台灣長期照顧政策對於身心障礙者服務輸送之探究──參考澳洲身心障礙保險政策

The Influence of Taiwan’s Long-term Care Policy on Disabilities’ Service Delivery: The Case of Australian National Disability Insurance Scheme

在財政緊縮的背景下，澳洲勞工黨政府卻在2013年3月通過了全民身心障礙保險法案（National Disability Insurance Scheme），這項政策耗資巨額，全面影響澳洲身心障礙福利權益與服務輸送，也將身心障礙者的照顧服務推向「以個人為中心取向」與「市場化購買服務」。反觀台灣的身心障礙福利政策一直停留在片斷與資產調查之殘補式福利模型，因著2015年通過的《長期照顧服務法》以及《長期照顧保險法草案》，對於有照顧需求的身心障礙者，亦出現服務重疊的議題。目前澳洲的身心障礙保險法案已逐步分區實施四年餘，從原本傳統殘補式的補助模式，發展出「完全準備儲金」的強制社會保險，其相關服務輸送配套措施亦增加多樣化與選擇性，本文期待透過文獻探討對澳洲身心障礙政策有進一步的瞭解，提供台灣身心障礙照顧政策之服務輸送與改革另一個層面的省思與參考。 Taiwan’s welfare policy for people with disabilities has been discussed regarding its fragmentation and mean-tested service delivery. With the recent development of long-term care policy in response to the elderly, there also exist issues of overlapping care services for elderly and people with disabilities. This paper aimed to introduce Australian new National Disability Insurance Scheme (NDIS) as reference. Australia’s NDIS is a social insurance policy, adopting individualized funding package, instead of traditional block-funded disability service to support people with disabilities. Through literature review to understand Australia’s experience on their care policy for people with disabilities, focusing on paradigm shifts in “person-centered approach” and “marketized cash-for-care model”, it might provide the policymakers and social work professionals a conceptual framework for our policy and service reforms.