Household Composition and Inequality in Health Care Financing in Taiwan, 1995-2000

家戶組成與台灣健康照護財務負擔的公平性，1995-2000

蔡貞慧(Jen-Huoy Tsay)

《經濟論文叢刊》 31卷4期 (2003/12) Pp. 483-505

https://doi.org/10.6277/ter.2003.314.4

摘要

本研究運用1995-2000家庭收支調查檢驗台灣自1995年實施全民健康保險以來健康照護財務負擔在家戶之間分配的公平性。該調查資料已包括有家戶全民健保、商業健康保險的保費支出及自付醫療費用。至於政府補助全民健保保費部分則依據兩組賦稅歸宿假設而設算出各家戶的賦稅負擔。本研究首先以全部家戶所得高低排序來計算健康照護支出的不均度指數，之後，再根據兩組分別調整家戶大小及家戶等成人數後的所得排序重新計算不均度指數。結果發現三組不同所得定義下排序所計算出的不均度指數差異極大，顯示家戶組成是影響健康照護財務負擔分配的因素，同時，其對不同財源的影響也不同，值得進一步研究。

關鍵字

家戶組成 ； 全民健康保險 ； 所得分配 ； 賦稅歸宿

並列摘要

By using the 1995ñ2000 Survey of Family Income and Expenditure, this study examines changes in the distribution of health care financial burdens among households since the enactment of National Health Insurance (NHI) in 1995. The survey provides household information on health insurance premiums and out-of-pocket health care expenditures. The government subsidy to the NHI was allocated to each household based on two sets of tax incidence assumptions. This study first used total household income to rank households' economic well-being and derive an income inequality index. The study also conducted sensitivity analyses on robustness of the income distribution and income inequality index using both adjusted household size and adult equivalent household income. The large variation in inequality indices observed from using different measures of household economic well-being implies that household composition might affect the distribution of the health care financing burden and its impact might vary over health care financing sources.

並列關鍵字

household composition ； national health insurance ； income distribution ； tax incidence

參考文獻

蔡貞慧 Tsay, Jen-Huoy、 周穎政 Chou, Yiing-Jenq(2002)。臺灣全民健康保險的醫療支出重分配效果，1995-2000 Redistributional effects of health care expenditures under the national health insurance program in Taiwan, 1995-2000。臺灣公共衛生雜誌 Taiwan Journal of Public Health。21(5)

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