dc.description.abstract | Health is as important as the survival right and freedom and it is the basic rights of citizen that government should to supply and protect. The national health care policy should aim to eliminate the primary health inequality, and close the gap of medical accessibility. Protect the basic health right of every citizen is an important issue of the new age of social equality.
Since 1995, Taiwan government has implemented the national health insurance policy for 15 years. The policy has improved the condition so that people no longer denied of medical treatment because of low social economics status. This policy lowers the difficulties of people obtaining medical examinations or treatments, and helps people getting medical service more easily. But the expansion of national health insurance payment items was too much, since it helped much more patients with rare diseases and helped the patients with low social and economic status, but the resources of national health insurance is over-drawn. Since 2002, the center of health insurance changed the medical service payment system to global budget system. The global budget system narrowed the gap of insurance revenue and reimbursement, but it was objected as the cause of the lowering of justice and appropriateness in such a capped payment system.
The crisis is the result of the waste of medical resource by medical service system or patients, at the same time. The public policy of distribution of medical resource also affects justice especially when the resource is limited. Norman Daniels emphasized ‘sound health care system is one of the element of protect social justice’, all medical policy and equipment should be judged by this hypothesis. Since the central value of medical resource distribution is social justice, it should not be considered or solved only by economic management.
This study analyzes the health care policy in a justice society by focusing on the ethical problems in Taiwan national health insurance resulted from mal-designed policy. We analyze the justice of medical resources of Taiwan national health insurance policy with Norman Daniels’ theory. As we know, the fees of national health insurance will be raised year by year, our analysis is quite in time,
In conclusion, the government and health care organization should review the long-term damage of the quality of patients’ health resulted from the inequality of the national health insurance policy, as well as the raising of insurance premium or the seemingly un-limited expansion of the payment items. Developing an equal and just health insurance policy is the most important and urgent matter for the government, and for the medical care system and all citizens. In this study, we suggest the establishment of a national bioethics commission in national care system, which would help to develop a just policy, solve the controversy about the inequality of the distribution of medical resources, and promote the long-term improvement of health in general.
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