臺灣博碩士論文加值系統

本文基於購買私人健康保險，是為了極大化個人的預期效用理論，採用Probit regression model，且利用民國八十三年和民國八十五年的台灣地區家庭收支調查（SFIE）資料，作為私人健康保險購買決定要素在全民健保開辦的前後期比較（全民健康保險於民國八十四年開辦）。
購買私人健康保險的決定因素中，地區因素以及個人特徵和家庭特徵變數都佔有極重要的影響。此外另一個重要的發現是，全民健康保險的實施造成私人健康保險的購買減少，也就是全民健保與私人健康保險呈現替代關係。本文的研究發現，地區醫療資源不同且發展程度不一的情形下，會影響到個人購買醫療保險的決定。而全民健康保險實施之後，女性、政府受雇人員以及教育程度較高者與其對照組相對購買較多的私人健康保險。個人的婚姻狀況、年齡也都與健康保險的購買決定有顯著的關聯。此外家庭人口數以及家庭所得越多者，在全民健康保險之前後的比較中，都是較可能購買私人醫療保險。

We explore the factors influencing the demand for private health insurance in Taiwan. In order to realize the relationship between National Health Insurance (the introduction of National Health Insurance System in 1995) and private health insurance, 1994 and 1996 Surveys of Family Income and Expenditure data were used in this research. Besides, we also put both years data together to get indirect impacts between NHI and private health insurance. Probit regression is used to examine the socio-economic variables affecting the probability of private health insurance purchased.
In conclusion, it’s confirmed that there are significant regional differences in purchasing private health insurance, especially people who live in north region are more likely to purchase private health insurance. Geographical location is an important factor of affecting the probability of buying private health insurance. Moreover, individual characteristics, such as martial status, gender, age, education all influence the probability of purchasing private health insurance. Married and female are more likely to buy private health insurance than their counterparts. Because People who are 65-year-olds and above are more easier to be eliminated from private health insurance market, they are more unlikely to have private health insurance. Family size and family income have positive impacts on determinants of buying private health insurance. Finally, we also examine the relationship between private health insurance and National Health Insurance. The results show that National Health Insurance has a negative effect on having private health insurance.

第一章 緒論 3
第一節 研究動機與目的 3
第二節 研究方法 11
第三節、文章架構 13
第二章 文獻回顧 14
第一節 相關文獻 14
第二節 醫療保險 21
第三章 理論模型與實證模型之設定 29
第一節 理論基礎 29
第二節 實證方法及資料 32
（1）實證方法 32
（2）實證資料 34
（3）變數敘述和預期假設 36
第四章 實證結果 46
第一節 八十三年與八十五年之迴歸分析結果 47
1-1區域分別 47
1-2個人特徵 48
1-3家庭單位特徵 51
第二節 合併八十三年與八十五年之迴歸結果 52
2-1 全民健康保險實施之影響 52
第五章 結論與建議 57
第一節 結論 57
第二節 檢討和未來研究 58
參考文獻： 60
中文部分 60
英文部分 63

英文部分
1. Asenso-Okyere, W., Osei-Akoto, I., Anum, A., ＆ Appiah, E. (1997). Willingness to pay for health insurance in a developing economy. A pilot study of the informal sector of Ghana using contingent valuation. Health Policy, 42, 223-237.
2. Besley, T., ＆ Coate, S., 1991. Public provision of private goods and redistribution of income. American Economic Review 81, 979-984.
3. Besley, T., Hall, J., ＆ Preston, I. (1998). Social Security and Health Care Consumption: A Comparison of Alternative Systems, Private and public health insurance in the UK. European Economic Review, 42, 491-497.
4. Besley, T., Hall, J., ＆ Preston, I. (1999). The demand of private insurance: do waiting lists matter? Journal of Public Economics, 72, 155-181.
5. Chen, C., Liu, T., ＆ Chen, L. (2003). National health insurance and the antenatal care use: a case in Taiwan. Health policy,64(1), 99-112.
6. Cheng, S. ＆ Wang, J. (1999). Demand for Private Health Insurance and Its Effect on Health Care Utilization in Taiwan. Proceedings of Taipei International Conference on Health Economics, 1-13.
7. Dewar, D. (1998). Do those with more formal education have better health insurance opportunities? Economics of Education Review, 17(3), 267-277.
8. Diehr, P., Madden, C. W., Martin, D. P., Patrick, D. L. & Mayers, M. (1993). Who enrolled in a state program for the uninsured: Was there adverse selection? Med Care, 31, 1093-1105.
9. Ettner, S. (1997). Adverse selection and the purchase of Medigap insurance by the elderly. Journal of Health Economics, 16, 543-562.
10. Friedman, M. & Savage, L.J. (1948). The utility analysis of choices involving risk. J. Political Economy, 56, 279-304.
11. Greene, W. (2000). Econometric Analysis. Fourth Edition.
12. Gujarati, D.N. (1988). Basic Ecomometrics. Second Edition.
13. Hall, J., Lourenco, A.de.R. ＆ Viney, R. (1999). Carrots and sticks-The fall and fall of private health insurance in Australia. Health Economics, 8(8), 653-660.
14. Harmon, C. ＆ Nolan, B. (2001). Health insurance and health services utilization in Ireland. Health Economics, 10(2), 135-145.
15. Hopkins, S. ＆ Kidd, M. (1996). The determinants of the demand for private health insurance under Medicare. Applied Economics, 28, 1623-1632.
16. Jaquette, J. (1993). The family as a development issue. In G. Young, V. Samarasinghe, & K. Kusterer (Eds.), Women at the center, development issues and practices for the 1990s (pp. 45-62). West Hartford, CT: Kumarian Press.
17. Levin, C., Ruel, M., & Ahiadeke, C. (1999). Working women in an urban setting: Traders, vendors, and food security. World Development, 27(11), 1977-1991.
18. Liu, T., ＆ Chen, C. (2002). An analysis of private health insurance purchasing decisions with national health insurance in Taiwan. Social Science ＆ Medicine, 55(5),61-80.
19. Liu, T., Chen, C. & Chen, L.(2002). The impact of National Health Insurance on Neonatal Care and Childhood Vaccination in Taiwan, 17(4), 384-392.
20. Long, S.H., Marquis, M.S., ＆ Rodgers, J. (1998). Do people shift their use of health services over time to take advantage of insurance? Journal of Health Economics, 17, 105-115.
21. Maddala, G..S. (1992). Introduction to Econometrics. Second Edition.
22. Manning, W., Morris, C., ＆ Newhouse, J. (1987). Health insurance and the demand for medical care: Evidence from a randomized experiment. American Economic Review, 77(3), 251-277.
23. McCall, N., Driver, S., Bauer, E., & Knickman, J. (1997). The partnership for long-term care: Who are the partnership policy purchasers? Medical Care Research and Review, 54(4), 472-489.
24. McCall, N., Mangle, S., Bauer, E., & Knickman, J. (1998). Factors important in the purchase of partnership long-term care insurance. Health Services Research, 33(2), 187-203.
25. Ngui, M., Burrows, C. & Brorown, K. (1990). Health insurance choice: an econometric analysis of ABS health and health demand insurance surveys. In Selby Smith, C. (ed.) Economics and Health: 1989 Proceedings of the Eleventh Australian Conference of Health Economists, Public Sector Management Institute, Monash University, Melboourne.
26. Nyman, J.A. (1999). The value of health insurance: the access motive. Journal of Health Economics, 18, 141-152.
27. Propper, C. (1989). An econometric analysis of the demand for private health insurance in England and Wales. Applied Economics, 21, 777-792.
28. Propper, C. (1993). Constrained choice sets in the U.K. demand for private medical insurance. Journal of Public Economics, 51, 287-307.
29. Rhine S.L.W., ＆ Ng Y.C. (1998). The effect of employmenr status of private health insurance coverage: 1977 and 1987. Health Economics, 7/1, 63-79.
30. Sen, A. (1990). Gender and cooperative conflicts. In I., Tinker(Ed.), Persistent inequalities: Women and World development(pp. 123-150). New York: Oxford University Press.
31. Shea, D. G. & Stewart, R. P. (1995). Demand for insurance by elderly persons: private purchase and employer provision. Health Economics, 4, 315-326.
32. Shmueli, A. (1998). Supplemental health insurance ownership in Israel: An empirical analysis and some implications. Social Science and Medicine, 46(7), 821-829.
33. Sindelar, J. L. (1982).Differential use of medical care by sex. Journal of Economics, 17, 229-252.
34. van de Ven, Wynand, P. M. M. & Bernard, M. S. van Praag (1981). The demand for deductibles in private insurance: a probit model with sample selection. Journal of Econometrics, 17, 229-252.
35. Von Neumann, J., Morgenstern, O. (1944). Theory of games and economic behavior. Princeton University Press, Princeton, NJ.
36. Wickramasinghe, A. (1993). Women’s roles in rural Sri Lanka. In M. Janet, & V. Kinnaird (Eds.), Different places, different voices: Gender and development in Africa, Asia, and Latin America (pp. 159-175). New York: Routkedge.
37. Willcox, S. (1991). A health risk? Use of private insurance. National Health Strategy Background Paper no. 4, March.
38. Wolfe, J.R. & Goddeeris, J. H. (1991). Adverse selection, moral hazard and wealth effects in the Medigap insurance market. Jurnal of Health Economics, 10, 433-459.
中文部分
1. SunnyNet保險網，http://www.sunny.org.tw/ins/subject/health.htm，有了全民健保還需要商業性保險嗎?，03/18/03。
2. 中央健康保險局，http://www.nhi.gov.tw/04personal/personal_41.htm#41_9，03/17/03。
3. 中央健康保險局 (1996)，「全民健康保險統計」，中央健康保險局。
4. 中央健康保險局 (2000)，「全民健康保險統計」，中央健康保險局。
5. 中央健康保險局 (1996)，「全民健康保險業務手冊」，中央健康保險局。
6. 中央健康保險局 (2000)，「全民健康保險業務手冊」，中央健康保險局。
7. 中華民國人壽保險業務統計年報，1979。
8. 中華民國人壽保險業務統計年報，1998。
9. 中華民國人壽保險業務統計年報，2001。
10. 毛碧玲，1995，淺談全民健康保險與商業保險，台北市醫師公會會刊，13(6)，第12-20頁。
11. 白明昭、陳靜雯、吳瓊華，2000，民國八十五年觀察年度個人醫療保險與重大疾病保險經驗發生率探討，壽險季刊，第115期，第49-97頁。
12. 民國九十年台灣地區特定死因除外簡易生病表提要分析，台灣內政部全球資訊網，http://www.moi.gov.tw/W3/stat/Life/90死因提要分析.htm - date: 2002/12/24。
13. 朱澤民，2002，全民健康保險財務收支發展及因應改革方案芻議--取消現行保險對象分類方式，以各類所得總額為計算保費之費基，主計月刊，557，第14-23頁。
14. 行政院主計處 (2000)，「家庭收支調查」，行政院主計處。
15. 住院醫療費用保險單示範條款。
16. 何艷宏，1995，在全民健保制度下對商業性互補醫療險最適需求的決定模式，保險專刊，42，第119-137頁。
17. 何艷宏，1996，在全民健康保險制度下民眾對互補醫療險需求的模擬分析研究，保險專刊，43，第166-176頁。
18. 吳乾源，1998，全民健保實施後對商業性保險的影響，復興學報，第217-232頁。
19. 周麗芳、陳曾基，2000，探討全民健康保險改革方案：「健康儲蓄帳戶」，台灣醫界，43(8)，第38-40頁。
20. 郝充仁、周林毅，2001，台灣地區人壽保險需求之實證估計，壽險季刊，第122期，第38-53頁。
21. 財政部保險司89年年報，http://www.insurance.gov.tw/watch/89year/newmain.asp，12/31/02。
22. 財政部保險司90年年報，http://www.insurance.gov.tw/watch/90year/index.asp，12/31/02。
23. 陳雲中，1992，論全民健康保險與商業性健康保險之互補關係，保險專刊，30，第6-22頁。
24. 陳秋瑩等，1999，臺灣地區民眾使用中醫門診服務的因素之調查，中國醫藥學院雜誌，8(1)，第77-87頁。
25. 陳聽安，1996，英國的私人健康保險與國民健康服務，保險專刊，46，第1-21頁。
26. 傅立葉，1995，福利國家公／私部門的互動：台灣私人保險與社會保險關係的初步探討，中國社會學刊，18，第117-152頁。
27. 莊榮霖，2002，全民健保對老人財務負擔及醫療需求影響的實證分析，研考雙月刊，26(1)，第85-96頁。
28. 陳欽賢、劉彩卿，2002，全民健保保費預收之可行方案研究，保險專刊，18(1)，第38-60頁。
29. 張加恩，1994，加拿大全民健保的借鏡，保險專刊，35，第102-105頁。
30. 傷害保險單示範條款。
31. 傷害醫療保險給付附加條款。
32. 蔡偉德講、張羽伶摘錄整理，2000，全民健康保險對醫療市場的影響，競爭政策通訊，4(6)，第12-18頁。
33. 劉彩卿、吳佩璟，2001，全民健保下病患在各醫療層級間的就醫選擇－台北市小兒科病患為例，醫務管理期刊，2(2)，第87-108頁。
34. 劉彩卿、陳欽賢，2001，研析在全民健保制度下影響臺北都會區民眾就診之因素，經濟研究，37(1)，第69-92頁。