長照險複製健保 最後還是由全民埋單 – 中時電子報
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長照險複製健保 最後還是由全民埋單
2015年06月05日 04:10
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長照保險費實例試算
攸關長照保險經濟命脈的《長照保險法》昨政院拍版通過,其中保費自負比例,雇主由原先規畫的6成降至4成,政府則由1成升至3成,民眾自負3成不變,然而政府與民眾是一體的,政府多自付的2成,拿的還是納稅人的錢,政院力圖法案能獲支持順利過關,最後還是由全民埋單。長照保險財源的收入,完全參考健保,但依據健保的財務經驗,過去政府常因為預算拮据不斷積欠健保費,健保署最後只能先向銀行借錢周轉,借貸金額一度高達千億,後二代健保修法,明訂健保政府支付比率不能低於36%,但行政院主計處為36%要怎麼算,到現在還與健保署未達成共識,雙方認定的費用差距高達110億,顯示政府對於社福保險的支出並不穩定,恐影響財源運作。
長照險複製健保 最後還是由全民埋單 - 中時電子報
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長照險複製健保 最後還是由全民埋單
2015年06月05日 04:10
中國時報
魏怡嘉/特稿
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長照保險費實例試算
攸關長照保險經濟命脈的《長照保險法》昨政院拍版通過,其中保費自負比例,雇主由原先規畫的6成降至4成,政府則由1成升至3成,民眾自負3成不變,然而政府與民眾是一體的,政府多自付的2成,拿的還是納稅人的錢,政院力圖法案能獲支持順利過關,最後還是由全民埋單。長照保險財源的收入,完全參考健保,但依據健保的財務經驗,過去政府常因為預算拮据不斷積欠健保費,健保署最後只能先向銀行借錢周轉,借貸金額一度高達千億,後二代健保修法,明訂健保政府支付比率不能低於36%,但行政院主計處為36%要怎麼算,到現在還與健保署未達成共識,雙方認定的費用差距高達110億,顯示政府對於社福保險的支出並不穩定,恐影響財源運作。
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長照保險雇主負擔部分大降2成,40億的缺口全由政府來承擔,未來隨著保費的調漲,這個缺口只怕會愈來愈大。雖然政院表示會挪用房地合一稅等稅收,因稅無法指定特定用途,房地合一稅收入無法確保年年都可足額提供長照保險費用所需,尤其社福的分配一直處於弱勢,如過去政府寧將錢去蓋蚊子館,也要積欠健保費,所以未來難保政府欠費的戲碼不會上演。沒有足夠的財源,長照之路將崎嶇難行,恐淪為空心蘿蔔。此外,健保收費對象以職業分類為6類15目,一直為外界所垢病不公平,認為應以收入高低為計費基礎,而不是職業類別,後來開辦了補充保險費,還是沿用職業分類收取,加大了不公平性,因而至今仍爭議不斷,各界認為應改採較為公平的家戶總所得計算,極力催生第三代健保。但此次的長照保險法,並沒朝改革的方向思考,完全複製健保,健保所洐生的不公平問題,長照收費也概括全收,不公平的老問題,依舊存在新的長照保險法中,令人遺憾。,