- 學位論文
私立醫療機構改制醫療社團法人之探討
A Study on the Reforms of Private Hospitals to Medical Incorporations
摘要
2004年醫療法新增醫療社團法人制度，提供符合特定條件的私立醫療機構可以轉型為醫療社團法人契機，並能解決原先私立醫療機構以醫師個人名義登記，不具法人資格、無法永續經營等問題，可透過多角化經營及適度的架構規劃，有效降低租稅負擔，並收永續經營之利，更能募集資金擴大經營規模，有利其醫療資源整合，故運用法人制度來釐清私立醫療機構的所有權與經營權是必要的。 本研究旨在針對私立醫療機構與醫療社團法人之租稅問題，及私立醫療機構所面臨之管理經營問題作探討，經參酌相關之書籍、期刊及論文等文獻，加以分析彙整後，首先得到之結論為當私立醫療機構改制為醫療社團法人後，原屬執行業務所得將變為營利所得，醫療社團法人盈餘依法得予分配，適用兩稅合一及未分配盈餘加徵10%，又因商機擴大，資源整合且引進新投資人等專業經營管理團隊效益明顯，對私人醫療機構不啻為開闖事業之新局，雖其仍涉有相關之土地增值稅、所得稅及營業稅等有關稅負問題，但此稅負問題，實務上可透過未來醫療社團法人投資及營運架構之適當規劃，有效降低其稅負負擔，期望能提供其他私立醫療機構轉型為醫療社團法人之參考，與建議政府再思考目前私立醫療機構多抱持觀望態度不願進行組織變革之問題所在。
並列摘要
The system of Medical Corporate Aggregate, which was a new section added into The Medical Law in 2004, provides a private medical institution which meets specific criteria with an opportunity to transform into a medical corporate aggregate. It also solves the problem that private medical institutions have no corporate status and no capacity of sustainable operation due to the registration under personal names of doctors. A medical corporate aggregate may effectively reduce its tax burden through diversified businesses and appropriate structure planning and take advantage of sustainable operation. Furthermore, it may raise more capital to expand its business, which facilities integration of medical resource. Therefore, it is necessary to use the corporate system to clarify the ownership and management rights of private medical institutions This study aims to probe tax problems relevant to private medical institutions and medical corporate aggregates and management issues that private medical institutions face. After referring to and analyzing and summarizing relevant books, periodicals and papers, the study finds that after a private medical institution is transformed into a medical corporate aggregate, the original professional practice income becomes income from profit-seeking. Then earnings from the medical corporate aggregate can be distributed under laws. Tax integration and 10% surtax on undistributed earnings are applied to the medical corporate aggregate. Furthermore, because of increase of business opportunities, resource integration,and significant effectiveness of the professional management team, such as introduction of new investors,it is a new chance for the private medical institution to expand its business. Although there are some tax issues, such as land value-added tax, income tax and business tax, the burden from taxes in question can be effectively reduced in practice by investment from future medical corporate aggregates and appropriate planning of operating structure. It is expected that the discussion herein can provide useful references for private medical institutions to be transformed into medical corporate aggregates and suggestions for the government to reconsider the crux of the problem that private medical institutions are unwilling to undertake organizational transformation.