全民健保政府補助款對跨世代財政負擔的影響

本研究使用世代會計法，以跨世代財政負擔觀點，評估政府健保補助款支出及健保局為因應財務持續短絀的各項調整措施，對跨世代財政負擔的影響。評估結果顯示，台灣目前的財政政策確實會造成跨世代財政負擔不平衡，健保補助款是造成不平衡的原因之一。模擬分析顯示，健保局年調降平均眷口數與調升保險費率，對跨世代財政負擔不平衡皆無明顯影響。為維持健保收支平衡，未來若允許平衡保險費率持續調升，相較於訂定費率調高上限，更會擴大跨世代不平衡程度。
關鍵字：全民健保、政府補助款、淨稅負、跨世代財政負擔

Intergenerational Fiscal Burden Impact of Government Subsidy on National Health Insurance in Taiwan

　　　　　　　　　　　(Kung-Cheng Lin)＊(Steven Zongshin Liu)＊(Shenhua Yu)

Employing the generational accounting approach, this study aims to evaluate the effects of National Health Insurance (NHI) subsidies and the NHI bureaus policy adjustments due to persistent financial deficits on the intergenerational fiscal burden. The results indicate that current fiscal policies in Taiwan result in intergenerational fiscal burden imbalance, and NHI subsidies contribute to the imbalance. Simulation results show that policies to reduce the average number of dependents and increase the premium rate would not widen the intergenerational imbalance. Notably, to balance the NHI budget, proposals to continuously increase premium rates will aggravate the degree of intergenerational imbalance more than proposals to set a premium rate ceiling.
Keywords: national health insurance, government subsidy; net tax payments; inter-generational fiscal burden