全民健康保險停保、復保制度檢討–法律與政策觀點

Translated title of the contribution: Suspension and Resumption of Coverage in Taiwan's National Health Insurance: A Critical Review from Legal and Policy Perspectives

Research output: Contribution to journalArticle

Abstract

In Taiwan's National Health Insurance, the insured can apply for suspension of coverage when she or he plans to stay overseas for over six months. When the person returns to Taiwan, the coverage shall resume automatically. However, a person who travels overseas for less than six months and returns to Taiwan at an earlier date shall revoke coverage suspension upon the day when he/she arrives at Taiwan and make up the premium payment.
The suspension and resumption of coverage system has some legal and policy problems: 1. The National Health Insurance Act never authorizes the government agency to enforce such a system; 2. The system distorts fair and equal distribution of burden in social insurance; 3. The related rules prescribed by the government agency are complicated and confusing, leading to many peoples' complaints and legal disputes with the government. For preserving fairness/equality and eliminating social loss form administrative burden and disputes, we suggest the abolition of suspension and resumption of coverage system. Besides, we also suggest some measures for improving the existing system.
Original languageTraditional Chinese
Pages (from-to)395-416
Journal保險專刊
Publication statusPublished - 2017

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health insurance
Taiwan
coverage
government agency
overseas
social insurance
human being
premium
complaint
fairness
equality
travel
act

Keywords

  • National Health Insurance Act
  • Social insurance
  • Suspension and resumption of coverage
  • Equality
  • Fairness
  • Distributive justice

Cite this

全民健康保險停保、復保制度檢討–法律與政策觀點. / 何建志; 李崇僖.

In: 保險專刊, 2017, p. 395-416.

Research output: Contribution to journalArticle

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title = "全民健康保險停保、復保制度檢討–法律與政策觀點",
abstract = "全民健康保險於民國84年施行以來,即有出國停保及復保制度,但全民健康保險法並未明文授權辦理,僅規定於施行細則。在法理上,停保、復保制度違反法律保留原則。在政策上,出國停保、復保程序繁瑣,耗費行政機關及人民時間、人力並時而引發爭議,由平等原則、分配正義及社會成本效益而言不值得繼續維持出國停保、復保制度。在這項制度尚未廢除前,本文也針對現行實務提出改進措施建議,以預防人民與健保機關之爭議。",
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