通常在談論健康照護的公平性時，主要分成垂直公平與水平公平兩種。在健康照護財務面的垂直公平意指有較高所得或經濟能力者，應支付較高的保費；水平公平意指，有相同所得或經濟能力者，應支付相同的保費。在健康照護提供面的垂直公平意為有不同需要者，應有不同的治療；水平公意為有相同需要者，應有相同的治療。然而由於提供面的垂直公平較難界定其程度，故多數學者在提供面僅談水平面，而本研究亦採相同的論點來分析被保險人在保費負擔與其醫療費用支出之公平性問題。 本研究資料係採用鄭文輝教授等在1996、1997年研究之原始資料，包括85年度的健保承保檔、醫療利用紀錄檔及財稅資料中心之綜合所得稅檔。利用逐步迴歸或probit二分法迴歸方式進行保險對象自付保費負擔與其醫療費用支出之間的公平性探討。 本研究實證結果簡述如下： 一、在被保險人自付保費負擔公平性方面，存在違反垂直公平或水平公平的情況，可能之原因如下： 1.投保金額分級表的上下限差距過小，使所得愈高，其保費增加的比例形成累退。 2.在投保金額分級表中每一等級仍有上下限之規定。 3.三類投保金額過低，與其所得分配差異過大。 4.眷口數計費採論口計費，而通常所得愈低，眷口數有愈多的現象，故論口計費將使得所得較低者之保費負擔加重或同樣所得水準者，負擔不相同的保費情形。 5.各類目均適用同一費率，且同一類目之自付比率均相同，無法有效發揮所得重分配效果。 二、個人醫療費用支出的差異及其與保費或所得高低之間的公平性 1.門診費用受到所得因素影響，個人所得愈高，門診費用有愈高的現象；且因為重症而就醫者仍為少數，以其他一般症狀就醫者仍占多數。 2.重症患者或罹患十大死因患者，多以所得較低或保費較低者居多，顯示全民健保的開辦，確實為較低收入者或較弱勢族群減輕就醫上之財務負擔。 3.由於男性罹患重症之比率較女性高，故雖然女性的門診次數與費用較男性高，但在個人總醫療費用上均以男性較高，可能與其生活、就醫習慣有關；而隨著年齡的增加，個人醫療利用情形與費用均逐漸增加，但對於中壯年人口之男性而言，個人醫療費用有逐漸上升趨勢，值得注意。 故對我國全民健保之政策性建議，為使所得重分配的效果得以發揮，在保費負擔方面，建議提高投保金額分級的上下限差距，且縮短等級之間的上下限，分級數愈多，愈能表現出公平性；眷口數計費改採論被保險人計費；三類投保金額與自付比率應調高。在醫療費用分配方面，為抑制所得較高或保費負擔較多者對醫療資源的不當利用，本文建議改採定率部分負擔、改善城鄉醫療資源分配，保障內容改採保大不保小，抑制不必要及小額的醫療支出，讓社會保險的自助、互助及他助精神得以發揮。 未來期能利用數年的歷年資料，來分析個人或家戶在時間上之所得、保費負擔與醫療費用支出三者之間的分配情形，以更能深入瞭解政策之改變，帶來之效果。 / Equity is widely acknowledged to be an important policy objective in the health care field. The principle comes in two versions: a horizontal version (persons in equal need should be treated the same) and a vertical version (persons with greater needs should be treated more favourably the those with lesser needs). The purpose of this study is to investigate the equity between the insurees’ premium burden and their medical care expenditures in Taiwan's National Health Insurance Scheme. The sample combines two sets of data, which are data for the insured and their dependents’ premiums and medical expenditures of utilization obtained from the Bureau of NHI ; individual income tax return data obtained from the Data Processing Center of the Ministry of Finance. According the data, we will be able to use the regression model of stepwise and probit methods to analysis the purpose of this study. The major findings are twofold: First, at present the regulations in the premium exists the horizontal and vertical the inequity, so the system can't bring the income replaecment, About medical dilvery, NHI is favorable person lower-income. To achieve ability to pay, the gap between the upper and bottom of insured payroll-related amount class should be lengthened. And to lighten the burden of insuree with dependents. Second, in the medical delivery deductible amounts paid by beneficiaries will be changed from fixed amounts to fixed rate to control the wasting medical resource.

Section 27(1)(a) of the Constitution of the Republic of South Africa, 1996, entrenches everyone's right of access to health care services. The purpose of this dissertation is to determine the manner in which this right must be interpreted and implemented in order to alleviate poverty to the optimal extent possible, in South Africa. As a point of departure, the relationship between poverty and health, as well as the theoretical basis of poverty, is addressed in terms of soft law. Thereafter, the theoretical basis of the right of access to health care service is analysed and explained from both an international and a South African perspective. This is followed by an investigation into international law. The manner in which the United Nations International Covenant on Economic, Social and Cultural Rights is interpreted and implemented and whether or not this contributes to poverty alleviation, is investigated. This is followed by an analysis of the right in terms of the Constitution and case law. Particular attention is paid to the manner in which the courts interpret the right of access to health care services. It is then determined whether the state is implementing the right in such a manner as to contribute to the optimal alleviation of poverty, in South Africa. Finally, a conclusion is reached and recommendations are made as to ways in which the right can be interpreted and implemented to reduce poverty to the optimal extent possible, in South Africa. / Thesis (LL.M.)--North-West University, Potchefstroom Campus, 2010.

Section 27(1)(a) of the Constitution of the Republic of South Africa, 1996, entrenches everyone's right of access to health care services. The purpose of this dissertation is to determine the manner in which this right must be interpreted and implemented in order to alleviate poverty to the optimal extent possible, in South Africa. As a point of departure, the relationship between poverty and health, as well as the theoretical basis of poverty, is addressed in terms of soft law. Thereafter, the theoretical basis of the right of access to health care service is analysed and explained from both an international and a South African perspective. This is followed by an investigation into international law. The manner in which the United Nations International Covenant on Economic, Social and Cultural Rights is interpreted and implemented and whether or not this contributes to poverty alleviation, is investigated. This is followed by an analysis of the right in terms of the Constitution and case law. Particular attention is paid to the manner in which the courts interpret the right of access to health care services. It is then determined whether the state is implementing the right in such a manner as to contribute to the optimal alleviation of poverty, in South Africa. Finally, a conclusion is reached and recommendations are made as to ways in which the right can be interpreted and implemented to reduce poverty to the optimal extent possible, in South Africa. / Thesis (LL.M.)--North-West University, Potchefstroom Campus, 2010.

With the advent of the new National Health Act, health care in South Africa is at a critical point as this will be the first time in history that a National Health Insurance is being implemented in this country. Globally National Health Insurance has been around for more than a hundred years, however some countries with long established national health schemes are currently grappling with funding issues surrounding their health systems. South Africa should take note of these issues as it embarks on this journey. The objective of this study was to perform a literature review on how South Africa’s National Health Insurance can be funded taking cognisance of the history of the country and experiences of other countries. It is imperative for each country to achieve optimal health care funding to ensure the success and long-term sustainability of National Health Insurance. The analysis of the problems experienced by other countries revealed that balancing the three main funding options namely, allocated from the national revenue fund, user charges and or donations or grants from international organisations, is critical as the funds needed in a system to achieve coverage at an affordable cost is dependent on the current state of health care in a country. Considering South Africa’s history and current inequality in society and health care it is clear that the majority of funding for the National Health Insurance should be supplied by the national revenue fund. The required funds can either be raised by increasing existing taxes or introducing a new tax specifically aimed at financing the National Health Insurance. The use of user charges is important however, although not purely for a revenue collection point, but from a cost control point of view as well. Some studies have revealed that the lack of user charges results in a misuse of the system. / Financial Accounting / M. Phil. (Accounting Science)

The creation of the National Health Service is treated, analytically and historically, as a planning process involving major changes in the social organisation of health as a part of the larger set of social and economic reconstruction policies undertaken by the wartime Coalition and postwar Labour governments. Definitions of 'health' are considered as relative both to social expectations and ideology, and to theoretical models of the organisation of health services. These models are identified with certain socio-political agents or interests in the providing and consuming of health services: professional groups, public and private authorities, non-professional workers, and the public. The models of the health service advocates and of the medical profession are considered as reference points. A framework is presented for the analysis of the representation of these interests, by the state, in the planning and operation of the NHS, and as beneficiaries of its services. Through a detailed historical consideration of internal health service planning documents of the major interests, including the medical profession, the health service advocates representing the Labour party and trade unions, and recently released documents of the Ministry of Health and the Coalition and Labour Cabinets, the interaction of the interests with the two governments and with each other is traced, and the reconciliation by the state of the health service models proposed by them is analysed. It is argued that the changes wrought in the social organisation of health in Britain can be described according to certain principles of the organisation of pre- and post-NHS health services: principles of public access, structure of services, structure of administrative control and structure of planning representation. Tne major interests were represented differentially by the state with respect to each of these criteria; similarities and differences between the approaches of the two governments to the representation of interests are examined, and it is concluded that, although the health service advocates and the public benefited from a free and universal scheme, the public and non-professional health workers enjoyed considerably less representation than the medical profession in the particular services provided by the NHS and in its planning and administration.

Text in English / South Africa is currently in the process health care reform as the Government has undertaken the task of providing universal health care to all South Africans through the implementation of the National Health Insurance Scheme (NHI). This study took an in-depth look at the history and progression of the post-1994 South African health care policy, and applied the Power Resources Theory to the political economy of the current health care reform process in South Africa. Through a comparative study of the pivotal elements in the phases of health reform in Canada and Sweden this study drew lessons for the design and implementation of universal public health care provision in South Africa. This study found that a strong culture of care, strong political will, active civil society participation and a focus on equality as opposed to poverty in the creation of policy is essential to a successful implementation of universal health care. / Sociology / M.A. (Sociology)

本論文對於醫療市場的生產績效研究，係由兩篇獨立的學術研究報告所組成，研究重點在於利用非參數資料包絡分析方法 ( nonparametric DEA approach )，估計醫院的生產技術，以衡量醫院的技術效率及不同年度間之生產力變動，進而分析不同醫院間，生產績效差異的主要原因。本論文所採用的研究方法與探討的主題，不同於國內既有的相關文獻。 第一部分：生產不確定性與醫院效率 本部分主要探討在醫院面對不確定性時的效率評估。一般而言，醫院有兩種生產上的不確定性來源：醫師或醫院的診療結果所導致的生產不確定性；及消費者對醫療服務需求的不確定性 (Arrow, 1963)。當醫院面對生產不確定性時，醫院效率將與廠商如何處理不確定性問題有關，亦即，當廠商事前規劃愈縝密，未來可能的產出失靈水準愈低，則其生產效率表現愈佳。本文利用民國 82 及 83 年（準）醫學中心與（準）區域醫院資料，模擬醫院在面對生產不確定性時，各種可能的產出失靈水準，以chance constrained DEA 模式 (Land, Lovell and Thore, 1993) 估算醫院的隨機技術效率，並與傳統、確定性的DEA模式所得到之結果，做一比較。 Chance constrained DEA模式與傳統DEA模式的不同，在於前者估計出的生產前緣，並不總是包絡所有的樣本點，亦即，允許某廠商之產出超越生產前緣或說允許產出失靈可能性之存在，而後者則否。實證結果發現，在chance constrained DEA模式下，私立醫院的技術效率高於公立醫院，且呈現統計顯著性的差異，但兩者間的差異隨著醫院事前準備程度的提高而縮小；而傳統DEA模式也顯示，私立醫院的技術效率確實顯著地高於公立醫院。此外，若產出失靈水準夠低，則chance constrained DEA模式的效率值與傳統DEA模式的效率值，兩者間的分配會呈現統計顯著性差異。 在面對生產不確定性時，欲提升公立醫院的生產效率，應提高廠商事先規劃的程度，才能與私立醫院之生產效率並駕齊驅。一般而言，廠商事先準備的程度高低，與醫院本身的特性有關，因此，欲改善公立醫院緩衝產能的準備程度，以降低產出失靈水準，有必要進行體制層面的改革，亦即，從進行人事變革、財務之授權與彈性化等方向開始做起，如此應可提高公立醫院的生產效率。 第二部分：全民健康保險制度與醫院生產力變動 全民健保實施後，民眾對醫療服務的可近性提高，醫院間的市場結構改變，因此，醫院生產力與效率的提升，成為眾所關切的焦點。為瞭解醫院在全民健保實施後，資源是否有效配置，本部分利用民國 82 至 86 年醫學中心、區域醫院與地區醫院等大小型醫院資料，以範疇DEA模式估計Malmquist生產力變動指標，並將之分解為技術變動、純技術效率變動、及規模效率變動等三項變動來源。 實證結果發現，從82至86年醫院整體平均效率而言，CRS（VRS）生產技術下的平均效率為 66.00%（74.87%），表示不論大小型醫院，平均而言，皆存在技術不效率的情形。再者，在民國84年，亦即全民健保實施的年度，其效率水準明顯較其他年度為低，其餘年度的效率水準都相對較高，此一結果意謂，政策干擾對於醫院效率表現的影響，是短期性的。另外，小型醫院皆較大型醫院不效率，兩者的效率差異呈現統計顯著性；以權屬別而言，不論是大型醫院或小型醫院中的私立醫院，其生產效率均優於公立醫院，且兩者的效率差異呈現統計顯著性。而透過迴歸分析顯示，全民健保實施、權屬別之虛擬變數、佔床率、平均住院日、及以醫院產出衡量的集中度指標等，是影響醫院生產效率的重要因素。 從Malmquist生產力變動（　et al., 1994）來看，平均而言，82-86年間醫院生產力成長率約在 -3.06 % 左右。就生產力變動來源而言，技術成長率（-2.74 %）與整體效率成長率（-0.33 %）均為負，而技術變動則是阻礙生產力成長的主要原因。此外，若以醫院整體效率變動來源來看，平均而言，整體效率退步是由於規模效率變動所致（-0.74%）。 此外，本文著重在　et al.(1994)、Ray and Desli (1997) 及Grifell and Lovell (1998) 三種定義下的Malmquist生產力變動指標之比較。研究結果發現，Grifell and Lovell (1998) 的一般化Malmquist生產力指數，並沒有正確衡量廠商的生產力變動及其變動來源項。而利用Kruskal-Wallis檢定結果發現，三個模式中的生產力變動差異，並不具統計顯著性，而變動來源項（技術變動與規模效率變動）亦顯示相同的結果。 / This dissertation is focused on the efficiency and productivity studies of hospitals in Taiwan. It includes two independent academic papers. The primary intention is to introduce the newly developed ideas in the measurement of efficiency and productivity, rather than to create new ones. The utilization of these ideas has not, however, been discussion in print. And some of the arguments we used and brought together are new regarding to the literature of hospital efficiency and productivity measurement. Utilizing the non-parametric data envelopment analysis (DEA) approaches, efficiency scores and productivity change indexes were estimated. Efforts were made to explain the difference of productivity performance among individual hospitals. Nevertheless, the methods we used and the economic approach behind them distinguish this study from other empirical studies of the medical market. Part I　 Market Uncertainty and Hospital Efficiency This part of the dissertation is focused on the measurement of efficiency of hospitals, incorporating uncertainty. There are stochastic variations in production relationships for hospitals. Generally speaking, the uncertainty of hospitals comes from two major sources: the natural uncertainty of medical cares; and the uncertainty of demands for medical cares (Arrow, 1963). Given the uncertainty in the medical market, the efficiency of hospitals hinges on how decision-makers deal with it. Undoubtedly, an optimal planning of the output buffers improves the efficiency performance. Using the hospital survey data in 1993 and 1994, and employing the chance constrained DEA model (Land, Lovell and Thore, 1993), the stochastic efficiency indexes of public and private medical centers and regional hospitals were estimated. Compared with deterministic frontier enveloping a given set of sample observations all the time, the chance-constrained frontier envelops them most of the time. That is, the chance constrained DEA allows the possibilities of output failure. Imposing different values of output failure probability, the estimation results were compared with the traditional (deterministic) DEA models. The empirical evidences of the chance constrained DEA model showed that, on average, private hospitals performed significantly better than public hospitals. This result matches with the result of the traditional DEA model. With Mann-Whitney U test, we compared the distributions of efficiency indexes under chance constrained DEA and deterministic DEA models. The test results showed that the difference between these two different models is statistically significant given a higher probability of output failure. These results imply that the nature of risk and the manipulation for risk are different for public and private hospitals. We also find that that the efficiency performance of public hospitals could be improved by the increasing of its reserve capacity. Part II　 National Health Insurance and Hospital Productivity Change In this part of the dissertation, we examine the impact of NHI on hospitals, and trace the sources of hospital productivity growth in Taiwan. To pursue our goal, we employ a data consisting of 157 medical centers, regional hospitals and district hospitals over the period 1993 to 1997, and resort to the Malmquist productivity index to measure total factor productivity change. The index could be decomposed into three components: technical change, pure technical efficiency change and scale efficiency change. The estimation technique used in the study is the deterministic non-parametric DEA approach. The results we find are revealing and suggestive to the public and the government in order to promote and assure the efficient delivery of quality health care. The average efficiency scores are 66.00% (74.87%) for CRS (VRS) technology and it means that there are substantial efficiency losses for the sample hospitals during the study period. The efficiency score of the hospitals as a whole in 1995 (the beginning year of NHI) was much lower than the other 4 years' efficiency scores. A censored Tobit regression analysis is used and identifies that NHI policy, ownership, rate of bed occupancy, average length of stay and the output-specific concentration level were all the significant determinants of technical efficiency. Empirical results indicate that most medical care regions became more output-specific concentrated. Total factor productivity on average deteriorated at an annual rate of -3.1%, and it was dominated by substantial technical regresses at an annual rate of -2.74%. The small hospitals were severely affected by NHI. Furthermore, within large and small hospital groups, the difference in technical change was statistically significant, but the differences in TFP and the associated components between ownership were not. Special attention was paid to compare　 et al.(1994), Ray and Desli (1997) and Grifell and Lovell (1998) approaches to decomposing the Malmquist productivity index. Empirical results indicate that the first 2 approaches yield accurate productivity changes, while GL doesn't. However, they produce almost the same magnitude of average TFP. In addition, no significant differences in the measured technical change and efficiency change were found among the three approaches.

Text in English / South Africa is currently in the process health care reform as the Government has undertaken the task of providing universal health care to all South Africans through the implementation of the National Health Insurance Scheme (NHI). This study took an in-depth look at the history and progression of the post-1994 South African health care policy, and applied the Power Resources Theory to the political economy of the current health care reform process in South Africa. Through a comparative study of the pivotal elements in the phases of health reform in Canada and Sweden this study drew lessons for the design and implementation of universal public health care provision in South Africa. This study found that a strong culture of care, strong political will, active civil society participation and a focus on equality as opposed to poverty in the creation of policy is essential to a successful implementation of universal health care. / Sociology / M.A. (Sociology)

保險代位之本質，可說是整個保險代位體系之核心所在。本文乃以保險代位之本質—亦即求償模式為重心，對於保險代位之相關問題，依序加以討論。本文首先自保險代位存在之法理、以及學說上對其之批評加以分析、並提出回應。在保險代位之求償模式方面，我國傳統以來循大陸法系之傳統，採取法定債權移轉理論，而與英美法有所不同；英美法之架構近年來漸受學說之重視，甚至對其有所爭議，故實有釐清之必要。本文乃對英美保險代位之本質、架構加以探索，並對其與擬制信託之融合詳加分析，以求釐清其法律關係。除了英美以外，本文亦對其他主要國家之立法例詳加分析，並歸納為大陸法系與英美法系兩大系統。而中國大陸與台灣均屬於繼受法之地位，關於保險代位求償模式、名義等，亦可見受不同立法例所影響之軌跡；其許多條款與學說見解亦有疑義，值得我國引以為戒。於分析英美法與各國立法例，並審酌我國之背景後，本文乃嘗試對我國提出「保險代位求償模式相對論」—即原則上仍採取法定債權移轉理論，但在保險人與被保險人有特定具體之特約時，則可約定採取英美法之模式、或是自行約定其他求償模式。 另外，關於不足額保險、而應負責之第三人資力不足時，保險人與被保險人之間受償順序之問題，本文將由傳統的法釋義學方法出發，藉由對立法例、實務與學說見解的分析，以重新思考相關的法理基礎。本文也將使用法律經濟分析的方法，以經濟模型重新考量代位求償過程中可能的因素，重新驗證被保險人優先受償模式對於被保險人的效用。就結論而言，在損失填補原則的架構下，被保險人優先受償模式仍應為最適的解決方案。但此原則應有以法規或嚴格意定予以排除、修正之空間。在判斷順序上，可依三階段判斷：先檢視法規有無特別規定，再檢視當事人間是否有特別約定，若均無再適用被保險人優先受償模式以分配之。 對於特別保險—如全民健康保險法、勞工保險條例、強制汽車責任保險法等中之代位體系，本文亦加以分析，並同樣認為於適當之類型中，本文之保險代位模式求償相對論亦應可加以適用。在再保險與保險代位之適用問題上，本文肯認保險人對第三人之求償無庸扣除再保險之給付。而對於再保險是否、如何適用於保險代位，本文則認為可以三階段判斷之：首先，就再保險之類型為判斷；再判斷原保險人是否欲向第三人求償；如再保險之類型適合、又原保險人不欲向第三人求償時，則應允許再保險人向第三求償。最後，總結全文提出結論；並分三階段對於我國法提出相關建議，以供未來進一步之參酌。 / The nature of subrogation can be regarded as the core of the subrogation system. This research put stress on the nature of subrogation which was the subrogation. Regarding the related problems of subrogation, they will be discussed orderly. The article firstly starts to analyze from the existence of subrogation and the criticism for the theory to provide the responses. In the aspect of the way how subrogation operates, our country traditionally follows the Continental Law System to adopt the “legal assignment theory” which is different the Anglo-American Law System. The structure of Anglo-American Law System is stressed by the theory and is very controversial. Consequently, it is necessary to figure out the truth. This research is aimed at exploring the nature and structure of common law subrogation theory and analyzes other integration of the constructive trust to figure out the law relationship. Except for Anglo-American countries, this research also analyzes the lawmaking of other countries and induces the two main systems which are Continental Law System and Anglo-American Law System. Mainland China and Taiwan belong to the status of Succession Law. Regarding the subrogation and nominal, it can be seen that the orbit is affected by different ways of lawmaking. Understandings of many clauses and theories are still uncertain. Our country should learn a lesson from it. With analyzing the ways of lawmaking of common law and each country, and considering the background of our country, the research attempts to address the “relativity theory of insurance subrogation” to our country. In principle, it still adopts legal assignment theory. However, when the insurer and insured have specific agreement, they can negotiate to adopt the Anglo-American model or make other subrogation model by themselves. Other problems can arise with regard to payment priority between the insurer and the insured, particularly in cases of underinsurance and when the responsible third party has insufficient funds to make up the difference. The present study takes the traditional rechtsdogmatik approach as its starting point, analyzing legislative precedents, practical aspects and academic theories to re-examine the underlying legal principles. The paper also makes use of economic analysis of law techniques, employing economic models to reconsider the factors that may be involved in the subrogation process, and re-examining the efficacy of the insured-whole doctrine from the point of view of the insured. The main conclusions reached are that, within the framework created by the principle of indemnity, the insured-whole doctrine is still the optimal solution; however, there may be situations in which the insured-whole doctrine must be rejected or modified in light of legal or regulatory requirements or strict interpretation. Determination can be made in three stages. Firstly, the relevant laws and regulations should be examined to determine whether any special provisions apply. Then, an examination should be made to determine whether any special agreements exist between the parties concerned. If no special legal or regulatory provisions apply and no special agreements exist, then the insured-whole doctrine can be applied. For the subrogation systems in special insurances—for examples, the National Health Insurance, Labor Insurance, and Compulsory Automobile Liability Insurance, the research also analyzes them and considers that in the proper type, the relativity theory of insurance subrogation can be adopted. About the problems about reinsurance and subrogation, this research admits that insurer asks for subrogation for the third party not need to deduct from settlement of reinsurance. For reinsurer and how to apply to the subrogation, the research considers that it can be judged from three stages. If the type of reinsurance is suitable and the original insurer does not want to claim against the third party, it should be allowed that the reinsurer can claim against the third party directly. Finally, the research makes the conclusion and provides related suggestions to the law of our country to be viewed as the future reference.

隨著IC卡的使用，它正深深地影響著我們的未來生活方式，其應用發展趨勢也是值得我們重視的課題。本研究主要從「IC智慧卡成為主流的資訊載具」、「我國內政部、衛生署、交通部及財政部等中央各部，對IC卡之應用發展各擁管轄範圍且各自發展」、「民間業者各自引進或發行電子現金儲值卡」等三方面，說明其可能造成的結果及相關重要課題，以作為本研究之動機。 本研究從我國IC卡應用發展相關文獻中，搜集和本研究主題較相關者，提出IC卡票證整合、IC卡安全整合機制及IC卡規模經濟等值得研究課題，以作為進行IC卡應用發展趨勢研究之參考。 對於IC卡目前應用發展現況，本研究主要說明政府推動國民卡的沿革、政府推動自然人憑證的沿革、政府推動健保IC卡沿革及交通IC票卡目前應用發展，以利了解我國IC卡目前應用發展現況。 針對交通IC票卡，本研究說明北、中、南各地區電子票證IC智慧卡應用發展，包括悠遊卡、台中ｅ卡通、Taiwan Money Card等，後續說明IC票卡規格發展及交通IC票卡系統架構發展，以更深入了解交通IC票卡目前應用發展現況。 本研究針對IC卡應用發展問題，進行更深入的分析，主要論述面向，包括技術面(IC卡規格、IC卡系統架構) 、法令面(IC卡法令規定)、經營管理面(含IC卡管理組織、發行、經營模式)等方面，以發掘問題，分析問題及提出解決策略。 本研究針對所提出之解決策略，予以聚焦，以提出更關鍵的解決策略，包括：(一)技術面：1.建立IC卡共同憑證。2.建立IC卡安全認證。3.建立IC卡整合架構。(二)法律面：1.修改銀行法及交通運輸相關法規中不合IC卡現有運作之規定。2.增訂電子票證法規。(三)經營管理面：1.建立規模經濟發卡量。2.建立IC卡發卡機構經營模式。 3.建立憑證認證機構公信力。4.建立IC卡資訊交換中心。 本研究針對三個構面，提出核心解決策略為「一卡通用」及其整體解決架構及實施步驟，且對整體解決策略之構想方案，提出IC卡卡片規格整合矩陣架構圖，以找出更為適當的IC卡規格方案，該矩陣架構圖，以「共同憑證一卡整合」及「多憑證一卡整合」二構面為縱軸，及「IC卡規格中不存放各類別資料」和「IC卡規格中存放各類別資料」二構面為橫軸，提出四種IC卡片規格整合架構，並列出其優缺點，經研析後，本研究建議初期以具有共同憑證及各類別憑證但不存放各類別資料之架構，作為一卡通用整合規格初期架構，稱為「IC卡共同多憑證不存放各類別資料一卡整合」，最後本研究提出長期一卡通用願景，以「IC卡共同憑證不存放各類別資料一卡整合」為目標。 本研究之結論為：1.我國各類別IC卡規格各行其道，未有整合前瞻性。2.各產業IC卡系統運作架構未整合，導致我們卡滿為患。3.IC卡應用發展於法律面應積極訂定「交通運輸業電子票證法」。4.「非銀行不得發行現金儲值卡」已超越母法規定應修法。5.IC票卡發行機構透過銀行發卡可享有發卡權利金等商機。6.建立IC票卡資訊中心作為全台IC票卡整合運作中心。7.IC票卡業者透過整合可增加發卡量，共創雙贏。8.IC卡於技術面應發展整合技術，以達成一卡通用目標。9.IC卡一卡通用宜建立IC卡資訊交換中心及憑證整合認證中心。10.IC卡一卡通用宜建立整體解決架構之實施步驟。11.IC卡一卡通用卡片規格整合可建立矩陣架構圖，以利分析。12.IC卡一卡通用共同憑證之運作於技術上為可行方案。 最後建議未來可持續探討之課題：1.IC卡一卡通用宜建立認證API(Application Programming Interface)程式介面及標準作業程序。2.IC卡一卡通用宜建立憑證整合認證中心及資訊中心之經營模式。3.IC卡一卡通用宜評估對IC卡產業及憑證認證產業之衝擊。 / A study of trends in the applications and developments of IC cards The IC card is being used widely and it will deeply affect our future living mode. Therefore, trends in its applications and developments have become important subjects of study. This research explores the possible outcome and related important subjects for the utilization of IC card, based on the following three propositions. 1. The IC card is one of the modern world’s primary information media. 2. Government units such as the Ministry of the Interior, the Ministry of Transportation and Communications, the Ministry of Finance ROC, the Department of Health and the Executive Yuan ROC all have jurisdiction over the development and control of development and potential applications of the IC card. 3. Private enterprises have introduced or developed electronic cash-stored cards. The information related to the research subject was collected from the relevant literatures in regard to the applications and developments of IC card in Taiwan, presenting the current safety and integration mechanism of IC ticket cards and the economical magnitude of IC card use, which are both topics that should be taken into consideration in the study of the applications and developments of IC cards. Based on the current situation of the applications and developments for IC cards, the main purpose of this research is to show the evolution of IC cards promoted by the our government, including National Card, Citizen Digital Certificate IC Card, National Health Insurance IC Card, as well as current applications and developments of the Transportation IC Card, in order to help understand the current situation for the applications and developments for existing IC cards in Taiwan. In the Transportation sector, this research shows the applications and developments of various IC smart cards in north, central and south Taiwan, i.e. Easy Card, Taichung e-Cartoon Ticket Card and Taiwan Money Card. It also shows the development of the specification for IC Ticket Cards as well as the development of Transportation IC Cards’ systematic infrastructure, in order to help understand the present situation for the applications and developments of a Transportation IC Card. This research is an analysis of IC card’s applications and developments, covering technical issues (specification and systematic framework of IC card), legislation issues (laws and regulations for IC Card), management issues (operation and administration, release and business model for IC cards), so as to discover and analyze the possible problems as well as propose solutions. Focusing on strategies for finding solutions, presenting more critical strategies for IC Cards, consisting of: 1. Technical: (1) To establish a common certificate (2) To establish safety authentication (3) To establish integration infrastructure 2. Legislation: (1) To revise the Banking Law as well as the laws and regulations relating to public transportation, which are not suitable for the existing operations (2) To revise and augment the laws and regulations for electronic tickets 3. Management: (1) To establish an economic circulation of scale (2) To establish the management pattern for card-issuing organization (3) To establish public credibility for a certificate authentication organization (4) To establish information interchange center To consolidate the above-mentioned three areas, this research proposes a core strategic solution – the concept of “one card for common use (All-in-One Card)” along with integrated solution scheme and operation steps. In addition, for an overall solution strategic plan, in this research it also presents a matrix composition for the integration of specifications to discover a more applicable specification scheme for the IC card. The matrix composition is proposed in four types of framework of specification integration with a file of advantages/disadvantages, based on the concept of X, Y coordinate system – X axis being “One Card integrated with Common Certificate” and “One Card integrated with Multi-Certificates”, Y axis being “No data deposited in the IC card specification” and “All sorts of data deposited in the IC the card specification”. Through detailed research and analysis, it is suggested that at the primary stage, to create the “One card for common use” with an integration of “Common Certificate and Multi-Certificates but no data depositing in the IC card specification”, which is called “One card with common and multi-certificates but no any data deposited in the specification.” The long-term goal will be to achieve “One card with common certificate only and no data deposited in the card specification” for long-term use. Conclusions: 1. In this country, various IC cards have their own specifications and there is still no prospect for integration. 2. The IC card system being used by different industries is still not being integrated, so the market is full of different IC cards. 3. The enactment of the “law on electronic tickets” should be pursued more vigorously for the IC card applications and developments. 4. The stipulation of “A non-bank may not issue a stored value card” might have overtaken the stipulation of “Banking Act”. It should be amended. 5. So long as the IC Ticket Card agency issues IC cards through a bank, the agency will possess the business opportunity of charging the bank a card-issuing fee. 6. To establish an IC Ticket Card information center to integrate the operation of the many IC ticket cards using in Taiwan area. 7. It will be a win-win situation, if IC ticket card operations can be integrated, and this will increase card-issuing quantity as well. 8. On the technical front, integration technology for IC cards should be developed in order to achieve the goal of an “All-in-One Card”. 9. An “IC Card Information Interchange Center” and an “Authentication Center of Certificate Integration” for the “All-in-One Card” should be established. 10. A standardized operational procedure should be established for an overall solution to the “All-in-One IC Card”. 11. The integration of the specifications of the “All-in-One IC Card” can be done through a matrix composition to assist analysis. 12. Technically, an “All-in-One IC Card” with “Common Certificate” is a feasible plan. In the end, this research also offers suggestion on valuable topics that can be the subject of continued discussion in the future: 1. “All-in-One IC Cards” should have an authentication with API (Application Programming Interface) program as well as a standard operational procedure. 2. A business model for “IC Card Information Center” and “Authentication Center of Certificate Integration” should be established. 3. An evaluation of the impact on the IC card industry and the certificate authentication industry should be made.