我國全民健康保險的所得重分配效果：1995~2000

Income Redistributional Effects of Taiwan's National Health Insurance, 1995-2000

蔡貞慧(Jen-Huoy Tsay)

《社會政策與社會工作學刊》 8卷1期 (2004/06) Pp. 221-250

摘要

過去研究指出，全民健保收入在各所得水平間呈不利窮人的累退分配，惟，累退現象逐年趨緩。本研究運用1995至2000年主計處家庭收支調查，進一步觀察健保醫療給付受益的分配情形，並檢驗全民健保收支相抵後的所得重分配效果。研究結果指出：(1)全民健保醫療給付在各所得水平間呈均等分配，同時，其有利於窮人的累進分配程度逐年提升。(2)考量全民健保收支淨歸宿後，低所得者的淨效益為正值，並且，所得愈低，淨效益值越大，反之，高所得者的淨效益傾向為負值，並且，所得愈高，淨效益值愈小；同時，高低所得組之間的差異逐年擴大。(3)比較全民健保收支淨效果後的所得分配與稅前所得分配的吉尼係數差異，全民健保明顯改善所得分配，並且，改善程度逐年提高。

關鍵字

全民健康保險 ； 醫療給付 ； 收支淨歸宿 ； 所得重分配

並列摘要

Previous studies have indicated that the distribution of national health insurance (NHI) contributions was regressive to income, whereas the regressivity was decelerating annually. Applying the 1995-2000 Survey of Family Income and Expenditure, this study further examines the distribution of NHI medical payments across income levels and the income redistributional effects of NHI after taking account of its net fiscal incidence analysis. The results show that medical payments were equally distributed across income levels, with increasing progressivity annually. When offsetting medical payments with contributions, low income people tend to have a positive net benefit, while high income people tend to have a negative net benefit. The differences of net benefits between the poor and the rich increased year by year. Furthermore, in terms of the Gini coefficient, the income distribution, taking into account the net fiscal incidence of NHI, indicates a more equitable result in contrast to a pre-tax income distribution. This improvement of income distribution caused by NHI also grew annually.

並列關鍵字

national health insurance ； medical payments ； net fiscal incidence ； income redistribution

參考文獻

湯澡薰、郭乃文、張維容(2002)。醫護科技學刊。

蔡貞慧、周穎政(2002)。臺灣全民健康保險的醫療支出重分配效果，1995~2000。台灣公共衛生雜誌。21，373-379。

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