歐盟長期照顧給付協調法制之建構及挑戰

The Establishment and Challenges of the Long-Term Care Benefits Coordination System in EU

歐洲議會、歐盟理事會及歐盟執委會共同發表「歐盟社會權支柱」，提出 20 項歐盟社會權基本原則，其中社會保障及社會融合類別提及：任何人皆應享有可負擔且具一定品質長期照顧服務之權利，特別是居家式及社區式服務。在全球高齡化浪潮下，長期照顧需求對各國政府均形成壓力，歐盟為建立更加協調且永續的歐洲跨國合作模式，自 1960 年代起發展社會安全制度協調機制，並以 1408/71 規則、883/2004 規則為主要法律規範，加上歐盟法院判例法之實踐，逐漸發展出可彰顯歐盟共通價值之社會安全體系協調法制。然而社會安全制度乃社會發展脈動之具體展現，尤其長期照顧為新興社會安全領域，其建制亟需歐盟法律、法院實務操作以及會員國相互協調。2016 年歐盟提案修正 883/2004 規則，於疾病給付章節明定長期照顧給付之定義及其特別協調規範，可見長期照顧給付協調之必要性日漸受關注。本文爬梳歐盟社會安全制度協調規則演變，以及歐盟法院有關長期照顧給付案件的見解更迭，一窺歐盟社會安全給付協調機制之脈動，並著眼於長期照顧給付之特殊性，以歸納歐盟目前面臨之困境與挑戰，作為我國未來發展社會安全給付區域協調相關機制之借鑑。

The European Parliament, Council of the European Union, and European Commission announced the “European Pillar of Social Rights” built upon 20 key principles, among which is the social protection and inclusion that includes the long-term care principle: Everyone has the right to affordable long-term care services of good quality, in particular homecare and community-based services. Under the wave of an aging society across the world, the expanding demand of long-term care creates pressure on every member state government. In order to construct a more comprehensive and sustainable European international cooperation mode and set the basis for people mobility, the European Union began to develop the social security coordination system in the 1960s. While the Regulation 1408/71 and Regulation 883/2004 form the main legal system of Europe, the practice of Court of Justice of the European Union to some extent implies the common values of the European Union social security systems. While a social security system is a concrete demonstration of social evolution, it requires the EU law, case law of CJEU, and negotiations between Member States for further development. The Coordination Regulations were revised in 2016, including an attempt to codify the definition of long-term care and the special coordinate rules under the chapter of sickness benefits. Indeed, the revision of the Coordination Regulations of 2016 demonstrates that the coordination of long-term care benefits is increasingly necessary and important. This article shows the social security coordination rules of the EU and the evolution of the CJEU opinions related to long-term care benefits, and thereby looks into the implication of the EU social security coordination systems, focusing on the characteristics of long-term care benefits to understand the difficulties and challenges faced by the EU social security coordination rules. Last but not least, this article may provide insights and references to develop social security coordination systems for Taiwan in the future.