全民健保實施醫療儲蓄帳戶芻議的提存比例分析

本文探討台灣地區全民健康保險的效率問題，並分析加入醫療儲蓄帳戶後可能產生的福利效果。良好的健康保險制度必須兼顧公平性與效率性，醫療儲蓄帳戶的設立，具有降低醫療資源浪費的作用。本研究發現，全民健保若搭配醫療儲蓄帳戶，確能減少社會福利損失。而若不分高低風險類別，提存至醫療儲蓄帳戶的健保保費皆為同一比例，則高風險者自行負擔的額度會增加。若高風險者可提存較高比例之保費至醫療儲蓄帳戶，倘若低風險者之醫療需求彈性大於高風險者，兩者均不小於某個特定值時，則在財務收支平衡下，實施MSA制度能達到醫療資源最效率之使用。然而，當低風險者之醫療需求彈性大於某個特定值而高風險者之醫療需求彈性小於此特定值，則實施MSA制之結果成效不確定。
關鍵字：全民健康保險、醫療儲蓄帳戶、社會福利、效率

An Analysis of Deposit Ratio in Proposed MSA with National Health Insurance

　　　　　　　　　　　　　　　　　　　　　　　　(Chu-Shiu Li)＊(Chu-Shiu Li)

This paper examines the efficiency problem of National Health Insurance in Taiwan and discusses the welfare effect of medical savings accounts. The result shows that National Health Insurance implemented with MSA would reduce the welfare loss. Under a system of unequal deposit ratios for low and high-risk classes of individuals, if the price elasticity of demand for low-risk individuals is greater than that for high-risk individuals and both are not less than a certain level, then implementation of an MSA system can achieve the greatest efficiency of medical resources.

Keywords: national health insurance, medical savings accounts, social welfare, efficiency