全民健保健康科技給付管制之研究Study on the Coverage Regulation of Health Technology in National Health Insurance

摘要
全民健保制度內，健康科技是否給付，攸關被保險人權益甚鉅，釋字524號重申法律保留與授權明確原則，期能確保全民健保的給付，合乎民主法制的要求。除了依上述原則檢視現行健康科技給付管制的健保法令外，面對高度專業行政的健保制度以及支付制度的變革，形式上的法律保留、授權明確的要求，顯然不足以降低民眾對健康科技給付決策的疑慮。建立一個獨立而專業的健康科技評估制度，可有助於提升健康科技給付決策的正當性。
關鍵字：健康科技、釋字524號、法律保留、授權明確、給付管制、健康科技評估
Abstract
The coverage of health technology in National Health Insurance is concerned with the welfare of all citizens. The J. Y. Interpretation No.524 pointed out that “the rights or obligations relating to the insurance should be clearly defined and regulated by the doctrine of legal reservation, the doctrine of legislative delegation”. This paper reviews the coverage regulations of health technology according to the rules set out in the Interpretation No.524. Moreover, highly professional administration in National Health Insurance and the change of payment system enable the public to question the coverage decision of health technology. To set up an independent and professional system for health technology assessment may help the justice of the coverage decision.
Keywords: health technology, J. Y. Interpretation No.524, the doctrine of legal reservation, the doctrine of legislative delegation, coverage regulation, health technology assessment