臺灣長照法制之財源辨析：社會保險制? 稅收制?—— 借鏡日本法的再思考【本期企劃】 試閱
Rethinking the Financing Resources of Taiwan’s Long-term Care Services Law : Social Insurance System? or Tax-funded System? －Implications from Japanese Law
目前我國65歲以上高齡人口約有449萬人，高齡人口占總人口比率將在明（2025）年突破20%，邁入超高齡社會。然而，延續現行長期照顧服務法（下稱長服法）所定課稅收入作為主要長照財源的方式，是否足以支應可預見將來日益增加之國民長照需求的支出規模？或說為擴展長照服務的多元財源結構，倡議我國長照制度應從稅收制改為社會保險方式之呼聲，迄今未曾間斷；而近日衛生福利部更提出了結合兩者之雙財源制度的規劃可能。無論何者，正好也帶來了重新省思我國長照財源籌措方式的契機。是以，本文將先分析現行長服法下長照財政構造及其收支面所蘊含的公平負擔意涵。其次，梳理現行長照基金財源之組成及其近年收支現況，檢討我國現行長照法制財源籌措之現況與課題；接著，扼要說明籌措社會給付財源之規律規範，兼輔以日本法制的比較觀察，檢討長照給付財源之籌措方式，究應採取稅收制？抑或社會保險制？另在取捨兩者之際所應斟酌要素為何？
Currently we have over four hundred and forty-nine thousand people age above 65 years old. As the structuring of population aging, the ration of senior citizens will be over twenty percent next year, 2025 becoming the society of seniors. The existing long term care service’s main income resource came from taxation. Do they have enough resource to meet the rapidly increasing expenditures of long-term care need for the future? Or to expand the structure of resources from different and dynamic means? Consequently, the voice has never stop and is getter louder to promote the social insurance by changing the taxed funding system for the long-term care. Nevertheless, it also gives us an opportunity to re-examine the funding structures and resources for long-term care. First, we will analyze the existing the structure of long-term care and its burden of fairness. Secondly, after we understand the components of resources and recent years income and expenditures. We will review their financial and topics. We will explain the funding regulation and standard for social benefits. In the meantime, we will conduct the comparison and observation of Japan’s law system. Should we fund by taxation or social insurance system? Or what the criteria to choose between these two?
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