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題名 延長退休對健保收入的影響
The impact of deferred retirement age on the revenue of national health insurance
作者 李璿
貢獻者 連賢明<br>Lien, Hsien-Ming
李璿
關鍵詞 人口老化
延長退休
健保收入
Aging population
Deferred retirement
National health insurance revenue
日期 2017
上傳時間 2-Oct-2017 10:20:01 (UTC+8)
摘要 隨著人口結構老化、戰後嬰兒潮人口即將面臨退休年紀,台灣健保財務採用隨收隨付制度,將面臨健保支出因為人口老化與科技進步提升,健保收入因為大量人口退出勞動市場而萎縮,使得健保財務入不敷出。民國106年6月27三讀通過的公務人員退休資遣撫卹法法案,台灣年金制度改革對於延後退休將勢在必行,欲藉由延長退休,改善台灣勞動市場供給情形,進而增加年金收入。本文旨在透過健保資料庫,了解延後退休政策對健保收入將帶來的增加效果,同時考慮不同的年齡設定、退休年數以及眷口數下的影響。結果發現在穩健推估的情況下,延長退休對健保收入可以帶來約至少170.59億至244.49億元的收入,若以105年度的5,618億健保收入來說,延長退休的影響效果約佔3.04%至4.35%的健保收入,顯示確有增加效果,但並未十分顯著。此外,102年規定被保險人屬於公、民營事業機構退休後無職業者,應先以眷屬身分依附配偶或子女投保,本文研究顯示當政策實行後,退休後在地區人口投保的被保險人人數減少約40%,並且增加了當年度的眷屬平均投保薪資,使得當年健保收入提高約6,284萬元,反映民眾在健保制度當中,職業選擇情形的普遍以及可能帶來對健保財務的傷害與不公平。因此,未來的退休政策應將退休年齡對於全民健保財務收入的不同影響納入考量。
Since Taiwan’s national healthcare insurance (NHI) is pay-as-you-go, technological development and changes in the demographic structure due to the aging population, have led to a rapid increase in healthcare expenditure. However, national health insurance revenue has shrunk as baby boomers approach retirement age. On June 27 2017, Taiwan’s Legislative Yuan passed the pension reform bill, aimed at increasing the pension fund by deferred retirement. This study uses the NHI research database, to determine the impact of deferred retirement on national health insurance revenue under different factors such as age, years of retirement, and number of dependents. The results suggest that under a steady estimation, the impact of deferred retirement on national health insurance revenue is NTD 17.0-24.45 billion a year, which is about 3.04-4.35% of the total national health insurance revenue of NTD 561.8 billion in 2016, indicating an increase thereof. Nevertheless, the impact of deferred retirement on national health insurance revenue is moderate. On the other hand, the healthcare policy changed in 2013. When insured public servants retire, they should be insured under their spouse, son, or daughter on priority rather under the district office. The results of the policy changed indicate a 40% reduction in people insured under district offices and an increase of NTD 62.84 million in national health insurance revenue. Since insurers can choose their insurance status, national health insurance revenue is eroded because people can receive different treatments under different statuses. Consequently, the retirement policy should take the impact on national health insurance revenue into consideration.
參考文獻 行政院主計處(2016),104年受僱員工動向調查,國勢普查處,台北
行政院國家發展委員會(2016),中華民國105至150年人口推估,行政院,台北。
吳春樺、王劼、林文德(2014),提早退休對醫療費用之影響,台灣衛誌,33(1),51-62。
李大正、楊靜利、王德睦(2011),人口老化與全民健保支出:死亡距離取向的分析,人口學刊,43,1-35。
國家衛生研究院(2017),檔案譯碼簿,衛生福利部,台北
教育部(2016),師資培育統計年報,師資培育及藝術教育司,台北
連賢明(2008),如何使用健保資料進行經濟研究,經濟論文叢刊,36(1),115-143。
陳孝平(2013),從「二代健保」的實施回顧其規劃與立法,2013年兩岸三地社會福利學術研討會-社會政策與社會品質,中國浙江,浙江大學。
陳寬政、林子瑜、邱毅潔、紀筱涵(2009),人口老化、疾病擴張、與健保醫療費用,人口學刊,39,59-83。
銓敘部(2016),105年銓敘部統計年報,銓敘部,台北
衛生福利部中央健康保險署(2017),2015年全民健康保險統計動向,衛生福利部,台北。
總統府國家年金改革委員會(2017),國是會議全國大會報告,總統府,台北。
韓幸紋(2013),從學理及行政執行面探討保險對象補充保險費課徵之問題,台灣衛誌,32(1),6-17。
Byongho Tchoe, and Sang-Ho Nam. (2010). Aging Risk and Health Care Expenditure in Korea. International Journal of Environmental Research and Public Health, 7, 3235-3254.
Edward L. Schneider, and Jack M. Guralnik. (1990). The aging of America impact on health care costs. JAMA, 263(17), 2335-2340.
Kyung-Rae Hyun, Sungwook Kang and Sunmi Lee. (2016). Population aging and healthcare expenditure in Korea. Journal of Health Economics, 25, 1239-1251.
Lovink MH, Persoon A, van Vught AJ, Koopmans RT, Schoonhoven L, and Laurant MG. (2015). Physician substitution by mid-level providers in primary healthcare for older people and long-term care facilities: protocol for a systematic literature review. Journal of Advanced Nursing, 71(12), 2998-3005.
Minchung Hsu and Pei-Ju Liao. (2015). Financing national health insurance: the challenge of fast population aging. Taiwan Economic Review, 43(2), 145-182.
Minchung Hsu, Xianguo Huang, and Somrasri Yupho. (2015). The development of universal health insurance coverage in Thailand: Challenges of population aging and informal economy. Social Science & Medicine, 145, 227-236.
Kerstin Nilsson, Anna Rignell Hydbom, and Lars Rylander. (2016). How are self-rated health and diagnosed disease related to early or deferred retirement? A cross-sectional study of employees aged 55-64. BMC Public Health, 16, 886-894.
OECD (2016), Society at a glance 2016.
Orazio Attanasio, Sagiri Kitao, and Giovanni L. Violantec. (2007). Global demographic trends and social security reform. Journal of Monetary Economics, 54, 144-198.
Sean A.P. Clouston, Nicole Denier. (2017). Mental retirement and health selection: Analyses from the U.S. Health and Retirement Study. Social Science & Medicine, 178, 78-86.
Tiffany Hui-Kuang Yu, David Han-Min Wang, and Kuo-Lun Wu. (2015). Reexamining the red herring effect on healthcare expenditures. Journal of Business Research, 68, 783-787.
Zweifel P, Felder S, Meiers M. (1999). Ageing of population and health care expenditure: a red herring? Journal of Health Economics, 8(6), 485-496.
描述 碩士
國立政治大學
財政學系
104255021
資料來源 http://thesis.lib.nccu.edu.tw/record/#G0104255021
資料類型 thesis
dc.contributor.advisor 連賢明<br>Lien, Hsien-Mingzh_TW
dc.contributor.author (Authors) 李璿zh_TW
dc.creator (作者) 李璿zh_TW
dc.date (日期) 2017en_US
dc.date.accessioned 2-Oct-2017 10:20:01 (UTC+8)-
dc.date.available 2-Oct-2017 10:20:01 (UTC+8)-
dc.date.issued (上傳時間) 2-Oct-2017 10:20:01 (UTC+8)-
dc.identifier (Other Identifiers) G0104255021en_US
dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/113309-
dc.description (描述) 碩士zh_TW
dc.description (描述) 國立政治大學zh_TW
dc.description (描述) 財政學系zh_TW
dc.description (描述) 104255021zh_TW
dc.description.abstract (摘要) 隨著人口結構老化、戰後嬰兒潮人口即將面臨退休年紀,台灣健保財務採用隨收隨付制度,將面臨健保支出因為人口老化與科技進步提升,健保收入因為大量人口退出勞動市場而萎縮,使得健保財務入不敷出。民國106年6月27三讀通過的公務人員退休資遣撫卹法法案,台灣年金制度改革對於延後退休將勢在必行,欲藉由延長退休,改善台灣勞動市場供給情形,進而增加年金收入。本文旨在透過健保資料庫,了解延後退休政策對健保收入將帶來的增加效果,同時考慮不同的年齡設定、退休年數以及眷口數下的影響。結果發現在穩健推估的情況下,延長退休對健保收入可以帶來約至少170.59億至244.49億元的收入,若以105年度的5,618億健保收入來說,延長退休的影響效果約佔3.04%至4.35%的健保收入,顯示確有增加效果,但並未十分顯著。此外,102年規定被保險人屬於公、民營事業機構退休後無職業者,應先以眷屬身分依附配偶或子女投保,本文研究顯示當政策實行後,退休後在地區人口投保的被保險人人數減少約40%,並且增加了當年度的眷屬平均投保薪資,使得當年健保收入提高約6,284萬元,反映民眾在健保制度當中,職業選擇情形的普遍以及可能帶來對健保財務的傷害與不公平。因此,未來的退休政策應將退休年齡對於全民健保財務收入的不同影響納入考量。zh_TW
dc.description.abstract (摘要) Since Taiwan’s national healthcare insurance (NHI) is pay-as-you-go, technological development and changes in the demographic structure due to the aging population, have led to a rapid increase in healthcare expenditure. However, national health insurance revenue has shrunk as baby boomers approach retirement age. On June 27 2017, Taiwan’s Legislative Yuan passed the pension reform bill, aimed at increasing the pension fund by deferred retirement. This study uses the NHI research database, to determine the impact of deferred retirement on national health insurance revenue under different factors such as age, years of retirement, and number of dependents. The results suggest that under a steady estimation, the impact of deferred retirement on national health insurance revenue is NTD 17.0-24.45 billion a year, which is about 3.04-4.35% of the total national health insurance revenue of NTD 561.8 billion in 2016, indicating an increase thereof. Nevertheless, the impact of deferred retirement on national health insurance revenue is moderate. On the other hand, the healthcare policy changed in 2013. When insured public servants retire, they should be insured under their spouse, son, or daughter on priority rather under the district office. The results of the policy changed indicate a 40% reduction in people insured under district offices and an increase of NTD 62.84 million in national health insurance revenue. Since insurers can choose their insurance status, national health insurance revenue is eroded because people can receive different treatments under different statuses. Consequently, the retirement policy should take the impact on national health insurance revenue into consideration.en_US
dc.description.tableofcontents 壹、 緒論 8
貳、 文獻回顧 12
一、 人口老化 12
二、 延長退休 16
參、 制度介紹 19
一、 全民健康保險制度 19
二、 退休制度 24
肆、 研究方法與變數選擇 33
一、 基本資料介紹與設定 33
二、 選擇的變數 44
伍、 研究結果 47
一、 延長退休對健保收入的影響 47
二、 不同變數下延長退休的影響 49
三、 被保險人投保第六類與否對延長退休的影響 50
四、 小結 55
陸、 研究限制 56
柒、 結論 59
捌、 參考文獻 61
玖、 附錄 64
一、 STATA程式碼 64
二、 公、民營被保險人退休定義與實際比較 70
zh_TW
dc.format.extent 1455914 bytes-
dc.format.mimetype application/pdf-
dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0104255021en_US
dc.subject (關鍵詞) 人口老化zh_TW
dc.subject (關鍵詞) 延長退休zh_TW
dc.subject (關鍵詞) 健保收入zh_TW
dc.subject (關鍵詞) Aging populationen_US
dc.subject (關鍵詞) Deferred retirementen_US
dc.subject (關鍵詞) National health insurance revenueen_US
dc.title (題名) 延長退休對健保收入的影響zh_TW
dc.title (題名) The impact of deferred retirement age on the revenue of national health insuranceen_US
dc.type (資料類型) thesisen_US
dc.relation.reference (參考文獻) 行政院主計處(2016),104年受僱員工動向調查,國勢普查處,台北
行政院國家發展委員會(2016),中華民國105至150年人口推估,行政院,台北。
吳春樺、王劼、林文德(2014),提早退休對醫療費用之影響,台灣衛誌,33(1),51-62。
李大正、楊靜利、王德睦(2011),人口老化與全民健保支出:死亡距離取向的分析,人口學刊,43,1-35。
國家衛生研究院(2017),檔案譯碼簿,衛生福利部,台北
教育部(2016),師資培育統計年報,師資培育及藝術教育司,台北
連賢明(2008),如何使用健保資料進行經濟研究,經濟論文叢刊,36(1),115-143。
陳孝平(2013),從「二代健保」的實施回顧其規劃與立法,2013年兩岸三地社會福利學術研討會-社會政策與社會品質,中國浙江,浙江大學。
陳寬政、林子瑜、邱毅潔、紀筱涵(2009),人口老化、疾病擴張、與健保醫療費用,人口學刊,39,59-83。
銓敘部(2016),105年銓敘部統計年報,銓敘部,台北
衛生福利部中央健康保險署(2017),2015年全民健康保險統計動向,衛生福利部,台北。
總統府國家年金改革委員會(2017),國是會議全國大會報告,總統府,台北。
韓幸紋(2013),從學理及行政執行面探討保險對象補充保險費課徵之問題,台灣衛誌,32(1),6-17。
Byongho Tchoe, and Sang-Ho Nam. (2010). Aging Risk and Health Care Expenditure in Korea. International Journal of Environmental Research and Public Health, 7, 3235-3254.
Edward L. Schneider, and Jack M. Guralnik. (1990). The aging of America impact on health care costs. JAMA, 263(17), 2335-2340.
Kyung-Rae Hyun, Sungwook Kang and Sunmi Lee. (2016). Population aging and healthcare expenditure in Korea. Journal of Health Economics, 25, 1239-1251.
Lovink MH, Persoon A, van Vught AJ, Koopmans RT, Schoonhoven L, and Laurant MG. (2015). Physician substitution by mid-level providers in primary healthcare for older people and long-term care facilities: protocol for a systematic literature review. Journal of Advanced Nursing, 71(12), 2998-3005.
Minchung Hsu and Pei-Ju Liao. (2015). Financing national health insurance: the challenge of fast population aging. Taiwan Economic Review, 43(2), 145-182.
Minchung Hsu, Xianguo Huang, and Somrasri Yupho. (2015). The development of universal health insurance coverage in Thailand: Challenges of population aging and informal economy. Social Science & Medicine, 145, 227-236.
Kerstin Nilsson, Anna Rignell Hydbom, and Lars Rylander. (2016). How are self-rated health and diagnosed disease related to early or deferred retirement? A cross-sectional study of employees aged 55-64. BMC Public Health, 16, 886-894.
OECD (2016), Society at a glance 2016.
Orazio Attanasio, Sagiri Kitao, and Giovanni L. Violantec. (2007). Global demographic trends and social security reform. Journal of Monetary Economics, 54, 144-198.
Sean A.P. Clouston, Nicole Denier. (2017). Mental retirement and health selection: Analyses from the U.S. Health and Retirement Study. Social Science & Medicine, 178, 78-86.
Tiffany Hui-Kuang Yu, David Han-Min Wang, and Kuo-Lun Wu. (2015). Reexamining the red herring effect on healthcare expenditures. Journal of Business Research, 68, 783-787.
Zweifel P, Felder S, Meiers M. (1999). Ageing of population and health care expenditure: a red herring? Journal of Health Economics, 8(6), 485-496.
zh_TW