以保險費為自負額之改革對健保財務影響之分析

本文的主要目的在以消費者選擇理論為基礎，配合被保險人全戶的醫療利用及綜合所得稅資料，以檢定被保險人不再繳交保險費，而將目前所繳交的保險費移做全戶門診自負額的做法，是否能達到解決全民健保財務赤字的目標，以及對於社會整體醫療資源及社會福利的影響。在各種可能的所得彈性、價格彈性及平均掛號費的組合下，我們發現，實施該建議方案之後，門診次數減少的幅度約佔總門診次數的4.6%至17.6%，健保局所增加的財務負擔佔全部門診醫療費用的14.5%至17.1%。換言之，該方案雖能抑制醫療資源的使用，但是無法解決全民健保的財務問題。另外，我們的研究也發現，實施該方案之後，社會福利將會減少。

關鍵字

自負額；全民健保

並列摘要

Recently, motivated by the huge financial deficit of NHI, some specialists propose a program trying to reestablish the financial solidity of NHI. The main idea of this program is to use the insurance premium of a household as its deductibles. The purpose of this research is to employ the consumer choice theory to test whether the proposed deductibles can solve the current financial problem of the NHI and to study its impacts on the health resources utilization and on social welfare. The data sets used include information of the health care utilization and expenditures. For various combinations of income elasticities, price elasticities and average registration fees, we find that the reduction of outpatient visits varies from 4.6% to11.1% of the total outpatient visits. However, the increase in the financial burden of Bureau of the NHI (BNHI) is between 14.5% and 17.1% of the total outpatient expenditures. It implies that the proposed deductibles make the financial problem of BNHI even worse.

並列關鍵字

Deductibles ； NHI

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