- 學位論文
社會保險型之無財源強制性責任對地方財政的影響
The Impact of Unfunded Mandates of Social Insurance on Local Finance
摘要
本文從社會保險法令變遷過程及無財源強制性責任的角度切入，分析2直轄市與20縣(市) (澎湖縣、金門縣與連江縣除外)於87年至99年間的財政資料，來估算地方政府因負擔全民健康保險、農民健康保險保費補助款與發放老年農民福利津貼，對地方財政的衝擊。 本研究結果顯示台北市的全民健康保險保費補助款約占歲出總額的0.5-4.2%之間，三項法令負擔經費合計約495億元；高雄市的全民健康保險保費補助款約占歲出總額的0.4-3.7%之間，而三項法令負擔經費合計約162億元。就北部六縣市而言，占歲出總額以台北縣的2.2%最高；就中部五縣市而言，占歲出總額以彰化縣的2.1%最高；就南部五縣市而言，占歲出總額以雲林縣的2.6%最高；就花、東、南部四縣市而言，占歲出總額以屏東縣的2.1%最高。 此外，地方政府因積欠健保保費補助款與中央政府產生爭議及衝突，最後中央為杜絕爭議修改全民健康保險法，將原本應由地方政府負擔的健保保費補助款統一由中央政府負擔，顯見當初由地方政府負擔健保保費補助款的法令缺乏合理性。在農民健康保險保費補助款部分，目前由直轄市負擔30%，縣市政府只需負擔10%；在老年農民福利津貼部分，目前由直轄市負擔50%，縣市政府則不必負擔，似乎缺乏理論基礎。 本研究針對強制性責任提出一融通準則，即農民健康保險條例與老年農民福利津貼暫行條例是屬於全國性福利政策，皆由中央立法且由中央負責執行的事務，經費理應完全由中央來負擔。因此，建議速將地方政府應負擔農民健康保險保費補助款與老年農民福利津貼比照勞、健保納入中央負擔範圍。
並列摘要
This research analyzes the financial information of 22 cities/ counties from 1998 to 2010 in order to estimate the impact of national health insurance, health insurance premium subsidies for farmers, and old-age farmers’ welfare allowance on local finance. In addition, this study reviews the changing processes of the social insurance acts from the perspective of unfunded mandates. The findings showed that Taipei City’s national health insurance premium expenditure was approximately 0.4%~3.7% of the total expenditure. Three Acts sponsorship totaled approximately NT 49.5 billion. Kaohsiung City’s national health insurance premium expenditure was approximately 0.5%~4.2% of total expenditure and three Acts sponsorship totaled approximately NT 16.2 billion. Of the six northern counties, Taipei County has the highest percentage of total expenditure at 2.2%. Of the five central counties, the percent of total expenditure in Changhua County was the highest at 2.1%. Of the five southern counties, the percent of total expenditure in Yunlin County was the highest at 2.6%. Of Hualien, Taitung, and four other southern counties, the percent of total expenditure in Pingtung County was the highest at 2.1%. In addition, there was controversy and conflict between local and central governments due to owing health insurance premiums by local governments. To put an end to the dispute, central government modified the National Health Insurance Act, and the premium is borne by the central government now. Because these social-insurance related programs are legislated and administrated by the central government, it is recommended that the central government should pay full expenditures of them.