台灣全民健康保險制度自1995年3月實施以來，涵蓋性遍及台灣地區95%以上的居民，的確解決不少重大疾病對百姓造成極大的生活困擾，讓很多因治療導致經濟負擔太重而不敢（或不肯）就醫的民眾，能放心就醫。健康照護功能包括降低痛苦、得到工作機會、改善生命品質、得到幸福，尤其國家政府負有義務保障和促進人民的健康，所以台灣實施全民健康保險，目的是疾病的風險分擔，以醫療支付為主。但因健康照護資源稀少國家要如何以適當機制的分配資源來達到社會的公平正義，這是個難題。 本文試以丹尼爾斯的論述探討如何醫療資源分配爲主軸，再研究分析國外醫療總額預算支付制度狀況及其優缺點的基礎上，深入探討我國總額預算支付制度的內容和特點，分析其實施過程中的問題，並用公義原則來分析其優缺點，並依據丹尼爾斯公平性標記論述來探討建立科學的、全面的醫療資源公平分配原則，以探討解決醫療專業者、病患、第三支付保險費者（健保局）三者之間所引起之資源分配問題。 希望藉由公義原則的有關理論的闡述、健保醫療保險與總額預算支付制度進行理論聯繫與探討基礎上，對臺灣健保醫療資源分配問題今後的發展趨向進行總結歸納，得出符合我國健保醫療保險長遠發展需要的倫理思考意見和具體建議。 Since its implement in March 1995, the Taiwan Universal Insurance System has covered more than 95% of the population. It has helped people released of the heavy burden of many of those serious diseases. So that people enjoy the benefit of medication without any fear or overburdened. The function of health care is to reduce pain, get opportunity for jobs, and improve quality of life and happiness. For, the government has the responsibility to protect and promote people’s health. Taiwan universal health insurance is a way to share medical risks and supports mainly medication. How to set up a mechanism for the distribution of scare medical resource is a great difficult problem for social justice. This thesis employs Norman Daniels theory of just health as the framework for the analysis of the distribution of medical resources, and based on the review of international systems, to probe deeper into the content and characteristics of the limited total budget system of Taiwan. We analyze the problems of its process of implement and evaluate its merits and disadvantages according to Daniels ten benchmark of fairness, to see how the three parties of the medical professional, the patients and the insurer (The Health Care Insurance Beaura. We try to build upon this study to suggest some of the needed ethical background and propose improvements that fit into the need of our health care insurance.
