1 3 7 11 11 11 11 13 13 14 17 19 21 21 26 30 31 33 34 38 41 44 48 52 55 58 62 64 66 69 73 77 86
GDP 80-89 15 GDP 79-86 15 85-89 17 84-89 22 2.1 79-87 14 2.2 84-89 16 2.3 85-89 18 2.4 85-89 18 2.5 90 -115 19 2.6 90-115 20 3.1 84-88 22 3.2 84-89 23 3.3 84-89 24 3.4 86-89 25 3.5 84-89 26 3.6 84-89 27 3.7 84-89 27 3.8 84-89 28 3.9 84-89 28 3.10 84-89 29 3.11 30 4.1 31 4.2 32
70 8.77 1 3 . 3 7 8 4 - 8 9 GDP 5.27-5.44 84-89 247.5 3.9 8.7 4.8 7.1 1.6
84 33.02 89 39.10
3.6
8.9
89 30.2
70%
2 0 0 1
1980
(Donaldson and Gerard, 1993; Hoffmeyer and McCarthy, 1994; Saltman and
Figueras, 1997; 2001) 2.1 ( 85-87 ) 8.77% ( 81-83 ) 13.37% 11.53% 7.56% 4 17.90% 11.47% 6.5 8.96% -0.84% 10 GDP ( 79-83 ) 4.2% 4.99% 0.8 5.34% 0.35 ( 85-89 ) 5.27-5.44%
GDP 45% 40% 15% GDP 2% 2.77% 52% 56% 35% 9% GDP 5.3-5.4 OECD 7.8% GDP 2000
87 89 2.2 247.5 84-88 4.13% 4.25% 1.36 0.78 85 1 1.1 85 10 0.95 87 3 0.88 0 . 7 8 4.65%
2-2 85-89 3.9 8.7% 4.8 7.1% 1.6 2.2 85 87 88 86 6.6% 88 5.6% 89 0.5% 2001 ( ) 85-87 2-3 88 88 0.8 89 7.4% % 1. 85 85 84 2. 3. 0.78 4. 84-88 5. 85 89 4.15% 5.49% 6.55% -2.41% -1.06%
88 2.3 85-86 87-88 88 89 85 88 88 89 2.4 85-86 85 0.81% 86 3.33% 1.36 1.1 85 1 0.95 85 10 3.72% 4.57% 2.2 %
2.94% 2.09% 87 88 5% 8 7 3 0 . 8 8 6.01% 3.83% 1.03 0.72 88 89 1.9% 88 3.43% 89 6.7% 2.5 88 25 90-115 6.2-7.4% GDP 0.6-1.4 0.6-0.7 GDP 90 2.9% 115 2.6% 2 . 7 - 2 . 8 % 5 . 2 % 4.6% 4.9% 1995 14.6% 7% 4.8% 4.1% 1.6-3.7 2000 : 1. 90 4.25% 2. 0.97 3. 90 GDP 0
( ) % 2.6 110 0.3 1-1.2% 2-3% 2.1-2.3%
88 1.36 0.78 3.1 84-88 4.13% 0.78 4.65% 0.52 84-89
30.24% 28.98% 36.74% 27.89% 26.79% 33.01% 33.02% 39.1% 3.2 84-89 84-88 4.42% 2.83% 3.82% GNP 6.27% 2.2 0.78 (90 1 ) 0.88 84-88 4.5 0.37
1 . 8 5 8 9
1.82% GNP 5.16% 35%
55 45
(lump-sum tax) (poll
tax) 85 12.71% 3.64% 3.5 2001 1999 %
1998 2000 ( ) ( ) (16,500 ) ( 31.7%) ( ) ( ) ( ) ( ) ( ) 87 7 3.3 ( ) 3 3.45-3.78 3.3 70% 5% 3.4 86-89 8 8 8 7 . 5 %
8.9% 1.12% 2.0% 70 2.2% 0.1% ( ) 3.5 97.7% 93.88% 41.83% 37.75% 1 = - + + -2 88 12 3
3.6 35
%
1. 89 5
88 3.7 84-89 84-88 1. 2. 89 7 84 3-12
85 13.88 15.44 89
15 ( )
3.8 84-89
84-86 64.71%
3.9 89 30.2% 15.53% 3.10 84-89 88 86 84 2000
( )
50~60% ( )
( )
( ) ( ) ( ) ( ) ( ) 15,840 55,400 3.61 ( )
( ) 16,500 19,200 ( ) 1. (1) (2) 2. 3. ( ) 1. 2. 1.
2.
87 56.4% 12.6% 28% 28.4% 12.6%+56.4% 28%=28.4% 10% 40% 100% 100% 60% 30% 40% 70%
1. 2. 30% 60% 70% 88 80% 30% 6.8 58.51 49.19 6.68 2.64 6.91 72.22 0.88 127 462 88 133 957
1 2 3
6 4.25%
100
100
87 3 89 0.88
OECD ( ) 45% ( ) 77.8 60.72 48.64 46.55 233.73 42.02%
35% ( ) ( ) ( ) ( ) ( )
60% 70%
(30%) (10%)
(40%) (70%) (100%)
(100% 70%) (40%)
84 3 89 4 3 9 1 . 5 8 58.8% 2582.29 41.2% 355.52 8.09% 286.64 80% 67 143 46.97% 41.1%
(1992) (1994) (1996) (1996 84 33 35 88 8 1 100 20
A D ( 24 ) E Z ( 25 156 ) 50 AA 100 AA 156 50 100 ( ) 50
1.
87 87 7 89 7 90 7 1 2 1 2 3 4 5 6 7
gatekeeper
infrastructure
1998
reference price
international reference pricing therapeutic reference pricing
reference price
1
2
(16.1%) GDP GDP 5.5% GDP 3% OECD OECD 1999
OECD
(egalitarian) (libertarian)
( L e G r a n d a n d R o b i n s o n , 1 9 8 4 ; M a y n a r d a n d Williams, 1984; Culyer, 1980; Wagstaff et al., 1994; 1998)
(1999) 12 (124,874 ) 25,000 1996 1999 1997 1999 1999 1 9 9 9 K a k w a n i = -0.090 Kakwani=-0.119 Kakwani=-0.204 1999 Kakwani -0.280
50% Kakwani=0.277 3 7 . 7 % Kakwani=0.028 50% =-0.002 Kakwani=-0.204 -0.280 1999 =-0.134
= - 0 . 1 2 8 1999 0.122 0.056 1999 0.032 1999 1999 1999 1999 3.35 3.15 3.40
20%
0.57 0.56 0.60
0.65 0.67
Medisave
GDP 3% OECD
15% 10%
1. 1996 2. 1994 3. 2001 4. 2001 5. 1992 6. 1999 7. 1998 8. 1998 2001 9. 2001 10. 1998 21 347-81 11. 1999 12. 1999 13. 2 0 0 0
14. 2001 1999-2000 15. 1992 16. 1996 17. 1998 39-70 18. 2000
19. Culyer, A. J. 1980 The Political Economy of Social Policy. Oxford: Martin Robertson.
20. Donaldson, C. and Gerard, K. 1993 Economics of Health Care Financing: The Visible Hand. New York: St. Martins Press.
21. van Doorslaer, E., Wagstaff, A. and Rutten, F. (eds.) 1993 Equity in the
Finance and Delivery of Health Care: An International Perspective.
Oxford: Oxford University Press.
22. Hoffmeyer, U.K. and McCarthy, T.R. 1997 Financing Health Care. Dordrecht, Netherlands: Kluwer Academic Publishers.
23. Lairson, D. R., Hindson, P. and Hauquitz, A. 1995 Equity of Health Care in Australia. Social Science Medicine, 41, 475-82.
24. Le Grand, J. and Robinson, R. 1984 The Economics of Social Problems, London: Macmillan.
25. Maynard, A. and Williams, A. 1984 Privatisation and the National Health Service. In J. Le Grand and R. Robinson (eds.), Privatisation
and the Welfare State, London: Allen and Unwin.
26. Saltman, R.B. and Figueras, J. (eds.) 1998 European Health Care Reform:
Analysis of Current Strategies. World Health Organization Regional
27. Wagstaff, A., van Doorslaer, E. and Paci, P. 1994 Equity in the Finance a n d D e l iv e r y o f H e a l t h C a r e : S o m e Te n t a t iv e C r o s s - C o u n t r y Comparisons. in McGuire,A., Fenn,P. and Mayhew,K.(eds.) Providing
Health Care: The Economics of Alternative Systems of Finance and Delivery, 141-71. New York: Oxford University Press.
109 3 2653-4401 www.nhri.org.tw 91 2 1 1 120 www.sanmin.com.tw 0765234-8 (02)2508-4000 386 (02)2500-6600 61 (02)2361-7511 GPN:1009100276 ISBN: 957-01-0501-1 -- 1 -- 91 ISBN 957-01-0501-1( ) 1. 2. 563.741 91001823
