| Summary: | 碩士 === 國立臺灣大學 === 政治學研究所 === 101 === 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.
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