我國政府長期照顧制度財源籌措與政策配套措施之探討

根據內政部統計，2017年2月底臺灣地區老年人口（65歲以上）已超過313.9萬人，占總人口比率13.33％。行政院自2007年核定至2008年開辦十年長期照顧政策(長照1.0)，2016年底開始進行新的長照2.0計畫，擴大了服務對象、項目、管理制度、資源多元化、責任管理，讓更多階層之大眾能享受到此服務。由於台灣正面臨人口高齡化與少子化現象的趨勢，該如何建構完備之長期照護制度是我國政府目前首當其衝所重視的議題，因此本研究之目的主要為針對我國長期照顧政策制度之保險制與稅收制制度來分析，是否能達成未來五年財源的穩健。並利用線性迴歸分析建立長期照顧籌措財源的各稅收函數模型，依據各項假設及限制，並進行實證分析和預測，從實證分析結果得知未來五年收入面與支出面推估之數值，針對2017～2021年的5歲以上之失能人口變動量進行費用推估，並與收入面推估數值做比較，其結果為未來第一年的稅收基金足以支應長照費用支出；但後續推估的四年數值呈現不足以支應長照費用支出。故能將各國相關長照政策結合其保險制及稅收制之優缺點審視並搭配現今政策及規範，以達到解決對整體需求者的費用及福利的議題，若只單單依一種制度來完善整體長期照顧的問題，是不能長期達到最適度，適時的將兩種制度做相關的規範，例如稅收制該如何達到財源的穩健，並搭配各項長期照顧支出的規劃擬定適切的方案；保險制則要思考該如何分配所負擔之費用，達到整體環境及自身權益的保障。

關鍵字

長期照顧政策；保險制；稅收制；費用推估

並列摘要

The Executive Yuan has approved a ten-year long-term care policy from 2007 to 2008. At the end of 2016, the new ten-year long-term care policy 2.0 project was launched, expanding the scope of service targets, projects, management systems, resource diversification, and responsibility management. Let the public of more classes enjoy this service. As Taiwan is facing the trend of population aging and declining population, how to construct a complete long-term care system is the first issue that the Chinese government is currently paying attention to. Therefore, the purpose of this study is mainly to address the insurance system and taxation of China's long-term care policy system. The system is used to analyze whether it can achieve the stability of the financial resources in the next five years. This study uses linear regression analysis to establish a tax function model for long-term care financing sources, based on various assumptions and limitations, and conduct empirical analysis and forecasting. From the empirical analysis results, we can know the value of the income and expenditure side estimates in the next five years. The cost estimation for the disability population change of 5 years and older from 2017 to 2021 is compared with the estimated value of the income side. The result is that the tax fund in the first year of the year is enough to support the long-term expenses; Estimated four-year value is insufficient to support long-term expenses. Therefore, it is possible to combine the relevant long-term policies of various countries with the advantages and disadvantages of their insurance system and taxation system, and to match the current policies and norms, so as to solve the problem of the costs and benefits of the overall demanders, and to make the two systems relevant in a timely manner. For example, how should the taxation system achieve the stability of financial resources, and formulate appropriate plans with the planning of long-term care expenditures; the insurance system should consider how to allocate the expenses incurred to achieve the protection of the overall environment and its own rights and interests.