健保體制下特約醫事服務機構之管理──初評釋字第753號解釋【月旦時論】 試閱
The Management of the Designated Medical Service Agency in the Institution of Health Insurance ─ Comment on the Interpretation No. 753
全民健康保險制度開辦至今已逾20年,釋字第753號係第八個解釋。該號解釋作成後,各大媒體紛紛以標題「醫院、藥局詐領健保費遭裁罰不違憲」進行報導,然而本文認為,該號解釋係從媒體角度看待「詐領健保費」問題,若立於醫事機構負責人之角度觀察,則未必能如釋字第753號一般獲得合憲之結論。健保特約之內容攸關全民生存權與健康權,應有法律或法律具體明確授權之命令為依據,本文逐一整理解釋理由書所羅列之爭點,並就法律授權是否明確、全民健康保險醫事服務機構特約及管理辦法是否逾越母法授權,以及停約抵扣與重複處罰是否有違比例原則等問題加以評析。
There was the health insurance in the past two decades and the interpretation No. 753 is the eightieth about it. After being decreed, many median report it under the title “Fraud of Insurance by Hospital and Pharmacy is not Indictable Offence against the Constitution.” Even though the Interpretation No. 753 solved the problem of frauds of insurance with the view of the medium, it still not necessarily had the constitutionality at all, if it started with the person responsible for the medical institution. Due to the designated medical service is tangent to the right of life and of health, it should depend on the laws and orders based on the principle of the explicit delegation. In this article are Organizations of the legal issues in the interpretation and Analyses with the criterions whether the legal empower was clear and definite, whether the regulations exceeded the empower of the superior law and whether the deduction with stopping the contract and the repeated punishments against the proportionality principle.
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