|其他題名: ||The Human Dimension: An “Action Analysis” of the Nascent Stage of the National Health Insurance|
Chen, Michael S.;Hsieh, Yu-Ling
national health insurance;grounded theory;human factors
|上傳時間: ||2016-06-20 14:58:54 (UTC+8)|
The National Health Insurance (NHI) Program of Taiwan was not, so to speak, born with a silver spoon in the mouth. Instead, many people wouldn’t bet a dime on its survival ability. The pessimistic comments on NHI were actually well-grounded. For instance, the monopolistic, public-run Bureau of NHI drew heavy fires from the economists who subscribed to the paradigm of neoclassical economics right along, and predicted that the NHI will fail in a matter of a few years for inefficiency and corruption. Yet, despite a myriad of problems just like every program like this around the world, NHI is alive and kicking and enjoying high approval rate and popularity among the people. At least NHI has not failed as predicted by some. This study begins by calling into question the validity of those “generally correct theories”, and, with a research method calling for on-the-site interviews, makes efforts to cast new paradigm for the NHI. The “grounded theory” method was chosen to draw the new explanation for the survival of the NHI program. We found that, at the nascent stage of the NHI, in addition to battered institutional arrangements, the situation was less than friendly to the NHI staff. As a newly established program, there were no routines to follow; easily to draw fires under tense conflict between various interest groups; elevated expectation on the part of the public was hard to meet; political interference was everywhere…It was the “human action” that hold the line and let the NHI take hold in the first place. The NHI staff gradually found the mission challenging and it was fulfilling to carry out this unprecedented job. And NHI was able to pull off from a myriad of crises. Yet, the NHI staff would need new visions, new knowledge, and new paradigm if the NHI program is to sail into the next decade in an even tougher environment of enduring uncertainty, increasing expectation, and worsening financial situation.
the NCCU Journal of Sociology