從「零和競爭」到「價值取向競爭」——臺灣血液透析市場分析與破壞式策略建議

Abstract

藉由深度的S-C-P分析，本研究分析了臺灣血液透析市場的現況，並進一步發現政府政策是形成臺灣血液透析市場的市場結構、市場行為及市場績效的關鍵因素。此外，本研究更發現，目前臺灣的血液透析市場陷入了零合競爭的情況，在零合競爭下，產業內一方的收益來自於犧牲另一方的利益，換句話說，臺灣透析產業陷入了成本轉嫁的惡性循環，透析服務者、透析患者及政府皆藉由轉嫁成本至他方來提高自身利益。 為了改善目前的現狀，本研究提供了兩個策略概念：（1）退出策略——退出目前由全民健保局所控制的產業環境，並創立一個不受健保局規範的新競爭環境；（2）競爭重心轉移策略——將競爭重心由原本的「成本轉嫁」轉換成「價值提升」。 本研究基於前述的兩個策略概念提出一個具體策略——引進居家夜間血液透析（home nocturnal hemodialysis），居家夜間血液透析對透析服務者、透析患者及社會整體的優點在研究中進一步的分析，本研究也將探討目前實施居家夜間血液透析所受到的限制。

Through a thorough S-C-P analysis of dialysis industry in Taiwan, this research provides an in-depth picture of the industry. It further identifies that government policy is the key determinant of the overall industry structure, market conduct as well as market performance. Unfortunately, this research also reveals that the current industry is in zero-sum competition where one industry player’s gain is at the other’s expense. All industry players, including dialysis service providers, dialysis patients and government are trapped in the cost-shifting vicious circle with little hope to step out. To the very situation, this research proposes two strategic concepts to improve the current phenomenon: (1) the option out strategy—withdrawing from game under NHI’s control and start a new game field free from NHI regulation and planned economies; and (2) competition focus switching strategy—switching the focus of competition from cost reduction to patient’s value creation. One concrete strategic recommendation has been made in the later part of the thesis—home nocturnal hemodialysis serving both for the purpose of optioning out and competition focus switching. The advantages of HNHD, to dialysis service providers, to the patients and to the overall society as well, are analyzed in details. The current restrictions to execute HNHD in Taiwan are also discussed in the research.