我國長期照顧制度的費用估算與財務處理

The Projections of Expenditures and Financing for Long-Term Care in Taiwan

鄭清霞(Ching-Hsia Cheng) ； 鄭文輝(Peter Wen-Hui Cheng)

《臺大社會工作學刊》 15期 (2007/10) Pp. 167-218

https://doi.org/10.6171/ntuswr2007.15.05

摘要

為回應台灣地區長期照顧需求加速增加的趨勢，公共部門亟需建立可永續經營的長期照顧制度，以減輕需照顧者及其家庭的負擔，提升需照顧者的生活品質。本文主要目的在於估算社會保險制與稅收制之長期照顧費用規模，並進一步討論其財務規劃原則與財務處理方式。主要發現如下：(1)我國長期照顧需要人口將由2006年的66萬人，上升至2031年的126萬人。(2)2006-2031年間，社會保險制長期照顧費用中推估約占GDP 的0.52-0.62%；稅收制長期照顧費用中推估則約為GDP之 0.31-0.56%；(3)就政府的負擔分析，保險制較低，2006-2031 年間約為215至496億元之間，但稅收制則為330-1123億元。(4)為顧及長期照顧制度財務的穩健性，部分準備提存是較理想的作法。社會保險制建議每10年調整一次費率，稅收制則採行5年平衡基金。

關鍵字

長期照顧 ； 費用估算 ； 財務處理

並列摘要

To meet the rapidly increasing need of long-term care in Taiwan, the government is urgently called to develop a formal public long-term care system, which may lessen the care burden of the family and also upgrade the quality of care. This study aims to project the long-term care expenditure and to investigate the important issues related to the design of the financial system of long-term care for social insurance and tax-funded system.
The major findings from this study are four-fold： (1) People with disability is expected to almost double from 660 thousands to 1.26 millions during 2006-2031;(2) Projected long-term expenditures as the percentage of GDP, according to medium estimate, are between 0.52-0.62% during 2006-2031 for social insurance, and 0.31-0.56% for tax-funded system；(3) On the other hand, the projected burdens on the government are expected to be lower under social insurance, between 21.5-49.6 billion NT dollars during 2006-2031, than those under tax-funded system, between 33-112.3 billion dollars for the same period. (4) Fluctuating sizes of generations create variations in tax rates. To facilitate the soundness of finance, pre-funding is a suggested cure for this variation. We suggested that the social insurance rate may be adjusted every ten years for social insurance and the tax rate may be adjusted every five years for tax-funded system.

並列關鍵字

long-term care ； financing system ； expenditure projection

參考文獻

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