論給付行政之公私協力

Abstract

國家為解決資本主義所衍生之社會問題，發展出社會安全體系，尤其強調社會保險政策，國家積極介入以弭平社會關係中之衝突與不平等，由於現代社會之高度複雜性，國家必須有計畫性地解決社會問題及引導社會發展。生存照顧已成為現代法治國家之必要行政任務，帶動行政法學上對給付行政之探討，有別於國家與市民間之單方垂直關係，協力概念為國家高權所無法涵蓋，必須賦予法律規範並從體系性思考，將給付行政與社會法領域結合，有助於回應民眾對社會福利之需求，國家亦以給付行政提供各項社會給付內容。 現代國家所面臨之社會給付增加，為因應財政負擔窘境及增進行政效率，國家與社會關係之轉變將為「公私協力」及「合作國家」之模型，透過合作、協商之方式處理現代社會所面臨之問題。在合作國家中，已不再強調國家之中心地位，而增加「私人」方面參與之可能性，在「公私協力」下結合「自主規制」，國家於一定法規範框架下，得容許私經濟主體自行為「社會自主規制」，儘管如此，國家仍負有促進、監督之責，非全然放任市場自由運作；另一方面，國家任務當然也不再侷限於履行責任，而有各種可能之責任型態包括國家擔保責任，為維繫公益之必要性與連續性，有必要重新確認國家責任內涵。 我國對於給付行政內容泛指有關社會保險、社會救助、生活必需品之供給等措施而言，主要基於國家負有生存照顧義務，給付行政之性質，端視國家之法制構造而定。本文研究重點在於以全民健保與規劃中的長照保險之給付行政事項，探討憲法基礎理論及法律關係，並盤點分析各項行為形式，分析公私協力與行政合作內涵在憲法結構及法律規範下之容許性；除學理上探討外，亦探討爭議審議案件、法院判決及大法官解釋具有代表性的實際案例。 面對世界各國普遍之人口老化及少子化、勞動力減緩及醫療費用上漲之問題，社會保險是人民的保障還是人民的負擔？凡此皆須檢視給付行政之妥適性及社會保險面臨必須改革議題，值得未來再深入探究。To solve social problems derived from capitalism, nations developed social security system which emphasizes social insurance to alleviate conflicts and inequality in the society. Due to the highly complication of modern society, nations must systematically resolve social problems and motivate social progress. Living attendance has become essential administration to modern nations of laws. Different from the vertical relationship between nation and citizens in Administrative Law, Public Private Partnership functions beyond national power, combines benefit administration and Social Laws, and properly responds citizens’ needs to social welfare. Nation provides social welfare in all kinds of form through benefit administration. Modern nations are now facing growing financial burden and administrative inefficiency in social welfare. Accordingly, the relationship between nation and the society would transform into Public Private Partnership and Cooperative Nation and countries can resolve social problems through collaboration and negotiation. In Cooperative Nations, government is not the only power center and private sectors have more opportunities to contribute. Under the frame of Social laws, government could grant private economies to perform Self-Regulation. Nonetheless, on one hand the government is still responsible for market operation supervision and motivation; on the other hand, government’s responsibility includes not only obligation fulfilment but also national guarantee, benefit sustainability and continuity to reassure national responsibility. Government Benefit Administration in Taiwan includes social insurance, social benefit, and necessity supply, which is based on the creed that nation is answerable to Living Attendance. As for the features of Government Benefit Administration, it depends on the law. This dissertation is based on long-term insurance Benefit Administration in Taiwan Health Insurance System to further discuss fundamental theory of the constitution and law, analyze behavioral models, and evaluate the permit of Public Private Partnership and Administration Cooperation under enforcement and regulation of the constitution and laws. Apart from theory discussion, this dissertation also examines related cases, judicial cases, and judicial deliberation from the supreme court. With global population aging, declining birth rate, labor shortage, and rising medical expenses, is social insurance guarantee or burden to people? To observe more, we must investigate the righteousness of Government Benefit Administration and reformation of social insurance. This topic is worth more pursuit and discussion in the future.