現代醫療專業的權力基礎是建立在對於醫療知識、技術與執業的壟斷權利和工作的自主性，並且受到國家權威的支持。但是這樣受人尊崇的專業自主地位本身並不能保證其產生經濟與社會效益。由於轉型中威權國家能力的快速弱化，專業主義者的自利行為和濫權的現象在民主化變動的社會中最為常見。 因此，國家做為專業主義的支持者，特別是醫療專業的維護者，如何能對這一群以知識技能為權力基礎、工作內容高度自主的技術菁英進行制衡，規範其不因追求私利而濫用知識技能來侵害公共利益，一直是國家機關進行社會控制的難題。本文分析台灣威權統治時期的勞工保險中的醫療給付和民主化時期的全民健康保險中的藥品給付。藉由探索國家與醫療專業之間的互動關係，本研究獲致下列初步結論：第一，威權統治時期國家專斷地降低醫療給付的政策，卻無能力管控政策的執行，導致了醫療專業者濫用臨床權力以獲得不法利益的後果。第二，民主轉型時期醫療專業雖然已經獲得參與及影響醫療政策制定的途徑，但由於這樣的管道並未完全的制度化，再加上科技官僚決策模式的專斷本質，國家機關仍然足以依據自身的政策偏好訂定醫療價格政策。第三、民主化後的國家機關已經逐步地調整其傳統威權科技官僚的政策制定模
式。國家透過訴諸大眾民意與建構「破除藥價黑洞」的共識議題網絡，醫療價格政策改革達到了初步成效但令人質疑的結果。最後但同樣重要的是，民主鞏固時期的台灣國家機關訴諸更廣泛地界定公共利益的轉變。而這樣的轉變不可避免地在持續進行的健康照護制度與政策改革中，繼續形塑國家與醫療專業互動關係的內容與社會政治脈絡。

The power of the medical profession is based on autonomy and monopoly of
medical knowledge, technique, and expertise; and furthermore it’s sponsored by various governmental authorizations. However, this prestigious autonomous status of profession itself does not warrant the
production of the economic and social efficiency.The phenomenon of professional power abuse is especially eminent in the democratizing and transitional societies, where the rapidly weakening authoritative state capacity sets off professional power abuse and selfinterested actions. Hence, being a sponsor for professionalism generally and as a protector of doctoring in particular, how the state can check and balance these knowledgebased,vocational autonomous technical elites, preventing them from the abuse of public interest for the purpose of private gain, is a dilemma of social control for the democratizing state.This essay analyzes the medical pricing policy of Taiwanese healthcare insurances (former healthcare program of labor insurance and recent national healthcare insurance) under the authoritarian period and democratizing context.By probing into the interactions and the relations between the state and medical profession, this essay has reached following preliminary conclusions: First, the authoritarian state unilaterally cut down the medical payment, but did not have the capacity to oversee the policy implementation; as a result, the medical profession abused the clinic power for illegitimate profits. Secondly, the medical profession
has gained the access to medical policy making after democratization; however,this access is not yet institutionalized and the despotic nature of technobureaucratic decisionmaking,the state still able to pursue the policy preference of its own in terms of medical pricing policy.Thirdly, the democratizing state has deliberately change its authoritative
technocratic policy measure by ways of appealing to the general public and
constructing consensus issue network of “ breaking the blackhole
of drug price gap” and reached preliminary successful yet questionable results. Last but not the least; here we are witnessing Taiwanese state shifting its allegiance toward the public interest broadly defined. Such a shift will inevitably shape the content and sociopolitical context of statemedical profession relations in the ongoing reform of healthcare institution and policy.