全民健康保險補充財源初探

A Pilot Study on Supplemental Revenue Sources for National Health Insurance

郭振雄(Jenn-Shyong Kuo) ； 何怡澄(Yi-Cheng Ho) ； 林翠芳(Tsui-Fang Lin)

《台灣公共衛生雜誌》 31卷4期 (2012/08) Pp. 314-325

https://doi.org/10.6288/TJPH2012-31-04-03

摘要

本文藉由回顧文獻及討論相關法令研修議題，尋找全民健康保險可能之補充財源，並探討這些財源的可行性與合理性。本文建議政府考慮開徵或加徵有害物質健康福利捐。此外，將部分奢侈稅稅收做為全民健康保險之補充財源有劫富濟貧的作用，與社會保險之重分配目標不謀而合。最後，考量肥胖、博弈及汙染活動對健康產生的醫療外部成本，將肥胖稅、博弈稅與健康相關之汙染稅收專用於日益成長的醫療費用，有其合理性。在面臨調整保費費率不易，保險給付範圍不斷擴大的情況下，尋求補充財源為規劃我國全民健康保險財務政策不可避免的趨勢。

關鍵字

全民健康保險 ； 補充財源

並列摘要

The aim of this paper was to explore potential sources of revenue for National Health Insurance (NHI). Potential revenue sources considered were earmarked taxes on various substances including cigarettes, alcoholic beverages and betel nuts. A fat tax, a green tax, a luxury tax and a gambling tax were also considered. We reviewed the literature in this area of research, examined relevant financing policies in other countries, and discussed the benefits and costs associated with the proposed revenue sources. We suggest that the government raise the tax rates on tobacco and alcohol consumption to finance NHI. In addition, the government can tax sin goods such as betel nuts and sugar-sweetened beverages. In light of the negative externalities associated with gambling and pollution activities, the government can use parts of the green tax and the gambling tax to finance NHI. Finally, a luxury tax is also a good financing alternative due to its redistributive nature. We contend that, due to NHI's growing financial burden, it is imperative to find supplemental sources of revenue.

並列關鍵字

National Health Insurance ； supplemental revenue sources

參考文獻

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