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医疗保障是公共服务的主要内容和公共财政的重要支出,其运行模式和财务状况体现着国家和地区治理体系和治理现代化的水平。我国台湾地区“全民健保”制度的财务困境对旧医保制度存在依赖,制度形成后的自我强化对财务困境具有一定的锁定效应和影响。解决这种财务困境的途径在于:制度的调整应规避“路径依赖”的陷阱,制度修订应与医疗服务内容和经济发展特点相适应,扩大制度论证环节的公民参与度,积极推进全民公共道德教育。
Medical insurance is the main content of public services and an important expenditure of public finance. Its operation mode and financial status embody the national and regional governance systems and the level of modernization of governance. The financial predicament in the system of “National Health Insurance” in Taiwan of our country depends on the old medical insurance system. Self-strengthening after the system is formed has a certain locking effect and impact on financial distress. The way to solve this kind of financial distress lies in: the adjustment of the system should avoid the trap of “path dependence”, the revision of the system should be compatible with the content of medical service and the characteristics of economic development, expand the degree of citizen participation in institutional argumentation, and actively promote public moral education.