| dc.description.abstract | The purpose of NHI is stated clearly from the very beginning that ＂promoting the health of all citizens, for national health insurance, as to provide health care services＂ of the National Health Insurance Act. National Health Insurance aims to provide the public with basic health care protection. To achieve this goal, medical expenses must go through a universal health care network to improve the accessibility of the population’’s access to medical services, and proper control of health care expenditure growth in the financial income is necessary to eliminate financial barriers to people and maintain appropriate fairness.
In the light of bioethical perspective to rationality of social system, we must deeply consider what John Rawls says: ＂justice is the primary value of the social system, as truth is the primary value of the system of thought＂, due to the constraints of the limited resources, how policies or social system establish a health care system of resource allocation reach a fair and equal justice thinking, and when the ability to obtain a reasonable practice for the health care system is critical to the problem.
With the advocacy and implementation of World Health Organization, health is the prevalent human rights that have become the universal values of contemporary society. Daniels further extended Rawls’’ justice theory to the areas of health care, and provided a Rolls Justice Health Care (Just Health Care) theory in order to maintain catholic average opportunity (fair in equality of opportunity) for the basic principles of health care; he demonstrated that according to the fair and equal opportunity, the society should base on the moral principles to do the health care because the health conditions are influential to individuals’ competitiveness to possess fair equality. Therefore, the community has an obligation to meet each individual’’s basic health needs. We further describe how the social health care policy fairly distributes the medical resources.
This thesis conducts ethical debate for Taiwan’’s current implementation of the second generation of health care caused by improper system design; and a just society should be provided with health care policy in the light of philosophical theory. Based on Daniels theory of justice, applying theory of ten benchmarks of fairness to an ideal health care system should have justice. Due to the disputes caused by second-generation health care system, and conflicts or contradictions between policy implementation surface and the moral level, we carry on bioethics’ point of view as a route and hope to build a health system that truly meets social equity, fairness, and justice, and thus benefit all healthy life of citizens.
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