菸品健康福利捐預算分配的公平性

目的　瞭解2003年和2004年香菸健康捐的預算分配與實際執行狀況，並探討其是否符合社會公平的精神。方法　蒐集各承辦單位現有的健康福利捐之經費資料，再探討各業務的社會公平性，主要考量為是否將健康捐用於吸菸民衆，或是其他健康與經濟地位的弱勢族群。結果　菸品健康福利捐總額約為每年100億，其中健保醫療費用約70億，社會福利、菸害防制、衛生保健各約10億，而前二者基本上符合社會公平的精神。菸害防制項目預算執行的重點為補助地方政府、菸害防制宣導、戒菸教育服務體系三項計畫，佔菸害防制經費的90%(2003)和86%(2004)。衛生保健項目補助地方政府和國家防癌計畫兩項計畫，佔衛生保健經費的53%(2003)和56%(2004)。菸害防制項目符合公平原則的計畫包括與戒菸直接或間接相關，或與疾病防治直接相關的計畫。衛生保健項目由於對象為一般民衆，容易造成公平原則的模糊。結論　健康捐用於健保醫療費用並未違反社會公平性，但菸害防制與衛生保健經費分配部份仍有公平原則模糊的疑慮。

關鍵字

公平性；政府預算；健康福利捐；菸品

並列摘要

Purpose. To explore the distribution of taxes derived from the sale of tobacco allocated for health and social welfare in Taiwan. Methods. Data regarding the distribution of revenue from the sale of tobacco products in Taiwan budgeted for health and social welfare were collected from relevant government departments. The adequacy of the allocation of tax revenue was evaluated based on the following equity criterion: the distribution of tax revenue is to the advantage of the least favored according to social and health status. Results. Tax revenue from the sale of tobacco apportioned for health and social welfare accounted for approximately USD 300 million annually in 2003 and 2004. Of these funds, 70% was allocated to cover health care expenditures, 10% was for general social welfare, 10% was for tobacco bans and restrictions, and 10% was for health education and promotion. Approximately 86% to 90% of the budget for tobacco bans was allocated to local governments, advertising and education systems, and 53% to 56% of the budget for health promotion was allocated to local governments and cancer prevention programs. Conclusion. According to the equity criterion defined in this study, the tax revenue allocation for health care expenditures and general social welfare is adequate. However, the adequacy of tax revenue allocation for tobacco bans and health education requires further evaluation.

並列關鍵字

equity ； revenue allocation ； tax revenue ； tobacco

國際替代計量

菸品健康福利捐預算分配的公平性

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