健保永續發展藍圖──健保會的運作與改革

National Health Insurance (NHI) is part of the executive power of the Ministry of Health and Welfare (MOHW). But it is structured according to the principle of separation of power to a certain extent. The National Health Insurance Committee (NHIC) as the legislative branch is in charge of governance. Although the NHIC embodies the spirit of citizen participation, due to the high professional threshold of the knowledge and information of health insurance policies, not everyone can fully comprehend the policy content right away. As a result, there are problems of professional asymmetry and meeting inefficiency. This article is based on the results of the research project, “The direction and challenges of the reform of Taiwan National Health Insurance’s system and laws from the perspectives of the development of the health insurances of other countries” (M08E8271), funded by the MOHW in 2019. The objective of the article is to explore the future blue prints for the innovation of the NHIC in order to facilitate the sustainable development of NHI. Through domestic and international comparative studies and the implementation of Delphi technique, the research proposes three potential paths: 1. Maintain status quo; 2. Expand the functions of NHIC to include the negotiation of reimbursement schedules of medical services and pharmaceuticals; 3. Modify the missions of the NHIC