| Summary: | 碩士 === 中原大學 === 企業管理研究所 === 96 === In order to improve our citizenly health, the National Health Insurance (NHI) policy was officially implemented in Taiwan on March 1995. Even if NHI had high satisfaction, the insurance premium bases harden into stone; tariff was not easy to adjustment; the demand for medical treatment increased and the trading process was inefficiently all of them were causing the financial deficit. The study use system dynamics research process and Vensim software to build the relationship between insured, insurer and medical institution. Using the model develop the workable policy to mitigate the financial pressure. This study focus on three purposes: (1) building NHI financial predict model by system dynamics, (2) probe the main reason to lead the deficit, (3) predict the workable development for NHI finance, (4) using model stimulation to find out workable policy for mitigating the financial presses.
This study chosen three policies to stimulate: (1) increase insurance tariff, (2) increase co-payment, (3) increase deductible in out-patient department. According to the aging population society are coming, the insured population decreasing and the family dependants increasing year in and year out so that the revenue from insurance would not have very significant growth. If increase the medical cost from patient then will decrease the medical demand, the medical institution will decrease drug using then lighten the “black hole” influence from drug expenses. Raise medical demander’s responsible to restrain the medical expense increasing are helpful to mend financial deficit. Because of Taiwan have special frame to NHI, the policy adjustment often become political machine then the policy simply has short run effect there are no significant improvement in the long run.
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