以所得總額為費基徵收健保費對所得分配面的影響

The Redistribution Effect of Income Based National Health Insurance Premium

張凱鈞(Kai-Chun Chang)

指導教授 ： 林翠芳

國立臺北大學/公共事務學院/財政學系/碩士(2010年)

摘要

現行的全民健康保險保費徵收以「薪資所得」為費基，造成了保費負擔的水帄以及垂直不公帄。本研究的主要目的在於模擬二代健保規定中，以「家戶所得總額」為費基的規劃，利用民國88年至95年主計處家庭收支調查的資料，模擬二代健保的保費分配，研究此規定對保費負擔公帄性之影響。本文之研究方法利用了Kakwani指數、AJL模型及迴歸分析。 本研究主要結論如下：
第一， 健保保費費基若由一代健保的「薪資所得」設算為二代健保「家戶所得總額」，即使在保費上下限相當有利於富有家戶的情況下，仍然達到改善原先保費過度累退分配之目的。
第二， 二代健保的保費模擬中，若不設立保費上下限，保費負擔達到最累進的分配，而隨著保費上限的降低，保費的分配將趨向累退。
第三， 二代健保的保費模擬中，縱然保費之上限有利於富有家戶，仍改善同樣所得分位內，保費負擔落於薪資階級之水帄不公帄。

關鍵字

二代健保 ； 所得分配 ； Kakwani指數

並列摘要

The household's premium of national health insurance (NHI) in Taiwan is based on the household's salary income. This arrangement results in both horizontal and vertical inequalities. The second-generation national health insurance (G2) reform in Taiwan proposes to use the household's gross income as the base of premium. The purpose of this thesis is to use the Survey of Family Income & Expenditure data and study whether the premium reform can make the distribution of the premium burden fairer. This study uses Kakwani index, AJL model, and regression analysis to explore the impact of G2 premium reform on income distribution in Taiwan. The following are the conclusions of this study. (1) The premium system of G2 can make the distribution of premium burden fairer than the original one, even though the ceiling of the premium is very low. (2) If there are no premium floor and ceiling, the distribution of premium burden will be the most progressive. With the ceiling decreasing, the distribution will become more regressive, but the distribution is still fairer than the original one. (3) The premium system of G2 can improve the distribution of the burden between different occupations in the same income level.

並列關鍵字

second generation health insurance ； income distribution ； Kakwani index

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