| Summary: | 碩士 === 東吳大學 === 會計學系 === 101 === The reforms of National Health Insurance (NHI) in the revenue side has become focus from public recently , with the case of health care finance income gradually are unable to afford the cost of health insurance , the concept of NHI premium structure recently have linked up with the Income Tax Law , so the Government must explain clearly to people the controversy related to NHI premium and Medicare taxes . The direction of the Department of Health is now actively planning 3rd generation of NHI, Director Chiu said, the direction of planning will continue to towards the Total Income of the Household design , and the discussion between the issue of the NHI revenue side and the Income Tax Law will become more popular.
This study described the situation of the development of the NHI, and the theoretical basis of social insurance, to explore the connotation of “User-pays” and "Ability to pay" principle , then locate the NHI is mainly to social insurance, and supplemented by social welfare, further, analyzing the differences between NHI premiums and income tax.
The study concluded that the operation nature of the revenue side of NHI shall first adopt the principle of “User-pays” to all insured to calculate the premiums, and second, collect the amount of premiums by the principle of “Ability to pay” .That is the difference between Income Tax. In addition, since the position of the NHI is mainly to social insurance, and supplemented by social welfare, all users should pay premiums except disadvantage groups or disables that government should pay premiums for them with concept of social welfare. In the meanwhile, the NHI's financial model is financial self-sufficiency and”Pay as you go” which is considered the method could let the NHI's financial system implemented with stability and feasibility.
Having this in mind , the study suggest that the design of NHI system should maintain the operating nature of social insurance and not combined the concept with Income Tax Law, and hope this would be the direction of 3rd generation NHI in the future.
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