| 摘要: | 本論文研究之內容共分為五章，第一章為「緒論」，介紹本論文之研究背景與動機、研究目的、研究方法、研究範圍與章節架構等說明。
第二章為「兩岸社會保險制度」，由社會法治國之存立展開論述，探討社會法治國下之社會安全制度及社會保險之關聯性，並就社會保險制度之退休金保險、全民健康保險、失業保險、職業災害保險和照護保險加以闡明，同時對於大陸地區社會保險制度之基本養老保險、基本醫療保險、工傷保險、失業保險、生育保險…等加以論述，比較及歸納兩岸之間社會保險制度之差異。
第三章為「兩岸社會保險之健康醫療保險及長期照護制度之比較」，臺灣之健康醫療保險制度以全民健康保險為主，大陸地區醫療保險依保險對象可分為城鎮職工醫療保險、城鎮居民醫療保險及新型農村合作醫療，與臺灣早期以勞工保險、公務人員保險、農民保險制度較為相似。首先就健康醫療保險之目的與功能予以說明，其次對於臺灣與大陸地區健康醫療保險之保險對象、保險財務、保險給付及醫療體系等方面進行比較，並加以整理及歸納，提出研究見解。
其次，就長期照護制度與健康保險之銜接進行論述，並蒐集歸納臺灣現行制度中與長期照護服務相關之法令，如老人福利法、身心障礙者權益保障法、精神衛生法及全民健康保險法等內容加以說明。再者，介紹臺灣於2015年5月15日立法院三讀通過《長期照顧服務法》之長照服務及長照體系內容，並藉由籌措長期照顧服務制度之財源時，進而推展長期照護保險。最後，介紹大陸地區長期照護保險制度之發展，歸納比較兩岸長期照護制度之差異。
第四章為「司法院大法官相關解釋研究」，本章就司法院釋字第472、524、550及701號解釋，說明全民健康保險法對於強制納保、繳費滯納金之規定、不給付內容之明確性、責成地方政府補助保費及身心失能無力自理生活須長期照護者之所得列舉扣除等議題分析歸納其結論。
第五章為「結論與建議」，經比較兩岸社會保險之健康醫療保險制可知兩岸之醫療體系均採分級制度，兩岸保險財務之管理及來源方式亦屬大同小異，其差異並不明顯；惟於承保範圍方面，臺灣採全民強制納保方式較大陸採強制與自願並行之方式為優，且臺灣之醫療保險給付範圍遠大於大陸之基本醫療給付。於兩岸長期照護制度方面，臺灣已實施「長期照顧十年計畫」，由各縣市政府提供長期照顧服務，並2015年5月15日立法院三讀通過《長期照顧服務法》，較大陸以《老年人權益保障法》為主之長期照護制度較為廣泛。最後就長期照護保險未來之立法方向提出說明。
This thesis includes five chapters. ChapterⅠ, Introduction, is going to present the background, motivation, purposes, method, scope and the structure of the study.
ChapterⅡ- Social Insurance of Taiwan and China. The first section is discussing the Social Security System and Social Insurance relative to Das soziale Staatsziehl. The second section is introduce The Social Insurance of Pension Insurance, Health Care Insurance, Unemployment insurance, Occupational Accident Insurance, Long-Term Care Legal System in Taiwan and China.
ChapterⅢ- Compared with the Health Care of Social Insurance and Long-Term Care Legal System between Taiwan and China. The first section is introduce and compare with the Health Care of Social Insurance between Taiwan and China. The second section is introduce the Long Term Care Act go through the entire three-reading procedure in the Legislative Yuan at 15 May 2015. The third section is discussing the Senior Citizens Welfare Act, People with Disabilities Rights Protection Act, Mental Health Act, National Health Insurance Act relative to Long-Term Care Legal System and compare with the China.
ChapterⅣ-The Study of The Judicial Yuan Interpretation No. 472、524、550 and 701. The first section is discussing the issues of compulsory national health insurance and the imposition of an overdue charge by The Judicial Yuan Interpretation No. 472. The second section is discussing the issues of some provisions of the National Health Insurance Act inconsistent with the doctrine of legal reservation by The Judicial Yuan Interpretation No. 524. The third section is discussing the issues of the National Health Insurance Act constitutional in requiring that local governments contribute to the subsidy for premium payable by people residing in their respective administrative regions for the national health insurance program executed by the central government by The Judicial Yuan Interpretation No. 550. The forth section is discussing the issues of limiting the itemized deductions of medical expenses for long term care of disabled persons to expenses paid to health care providers prescribed in the Income Tax Act by The Judicial Yuan Interpretation No. 701.
ChapterⅤ- Conclusion. Compared with the Health Care of Social Insurance between Taiwan and China, the medical service system and insurance finance were the same. But the National Health Insurance is compulsory social insurance and the benefits were including of illness, injury, or maternity. Compared with the Long-Term Care Legal System between Taiwan and China, the Executive Yuan of Taiwan had approved Long-Term Care for 10-year Plan in April 2007, and the Long Term Care Act approved by Legislative Yuan at 15 May 2015, but the Long-Term Care Legal System in China was limited at old man. At last, propose some suggestions for Long Term Care Insurance. |
