地方政府分擔全民健保費之爭議與處理--以臺北市政府聲請釋憲案為例

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Title:	地方政府分擔全民健保費之爭議與處理--以臺北市政府聲請釋憲案為例 The Controversy and Solution of Local Government's Sharing the Cost of NHI Program: Exampled by the Taipei City Government's Petition for Constitutional Interpretation
Authors:	陳滄海
Contributors:	臺北市立教育大學社會暨公共事務學系
Keywords:	全民健保保費
Date:	2002
Issue Date:	2009-07-13 16:16:27 (UTC+8)
Abstract:	中文摘要　　　　　全民健康保險法規定直轄市及縣市政府應依比例分擔部分被保險人之保險費，引發地方自治團體拒繳保險費之連鎖反應。本案因涉及中央與地方權限劃分，以及地方財政自主等諸多制度與學理之爭議，臺北市政府乃聲請大法官解釋，以圖解決系爭問題。　本文就憲法及有關法規，分就地方政府聲請釋憲適格與否之程序問題，以及地方自治之法理，探就地方政府分擔全民健保費的實際。經由研究認為，在本質上，全民健康保險乃屬全國一致性之規範，從而國家應責無旁貸地負起政策及執行之責任。然鑑於全民健保具有社會保險之意涵，由是，地方自治團體亦不能置身度外，在憲法及相關法律規範下，相當程度分擔健保費用，自無悖於憲政法理。所可議者，基於中央與地方合作的伙伴關係，若欲地方分批相關費用，當須讓地方有協力參與政策討論，甚或徵詢地方議會之同意。而全民健康保險法逕由中央強迫地方分擔費用之舉，無寧有破壞地方自治根本精神之虞，堪值檢討改善。英文摘要　　　　　The National Health Insurance (NHI) Law stipulates that the local government should share proportionally the insurance fee of health care, which has caused a chain reaction of payment denial﹒ With regard to various disputes over the system and scholarly theory, such as the division of functions between the central and local governments and the local financing powers, the Taipei City Government has sought for a constitutional interpretation of the NHI Law to the Grand Justices of the, Judicial Yuan. This article, from constitutional and lawful points of view, looks into the reality of local government's sharing the cost of NHI program, in respect of the rightfulness of petitioning for constitutional interpretation by the local government and the related theory of autonomy. This study finds out that since the NHI program is nationwide in substance, it is clear that the central government is responsible for the policy and execution. While the NHI program also falls into the category of social insurance, hence the local government has its share to contribute that is, its reasonable ratio stipulated by law is no contradiction to the Constitution. However, what leaves room to dispute is that based upon the cooperative partnership of the central and local governments，the local government should have had the opportunities to take part in the policy making process, and asked for the local council's approval if necessary. The fact that NHI Law "forcefully" imposes part of insurance fee on the local government could undermine the fundamentals of autonomy and is worthy of further deliberation and improvement.
Relation:	臺北市立師範學院學報, 33, .p,219-233
Appears in Collections:	[Department of Social and Public Affairs] Periodical Articles

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