台灣實施長期照護財務機制之研究 -逆向抵押貸款探討

Abstract

「年老」是幾乎每個人都會面臨的課題，隨著生活品質提高、環境衛生改善、甚至生物科技進步，在此趨勢下，長期照護更突顯其重要性。許多已開發國家受到結婚率下滑、生育率降低、醫療技術進步、完善的醫療資源及生活水準提升等因素影響，人口結構呈現快速老化現象。台灣亦不例外，已無法全然由家庭負擔責任。隨著老年人口比例逐年增加，台灣已逐漸進入高齡少子化社會，因此老年人口的長期照護也逐漸成為社會問題。由於目前市場銷售的商業長期看護保險價格高昂，並非一般人所能負擔，且台灣目前也僅以社會救助方式及全民健保支應小部分長期照護相關給付，面對未來大量的長期照護需求實屬不足，因此台灣應儘速建立一完整長期照護體系。 近年世界各國經歷2008年金融危機之後，都面臨經濟成長的趨緩甚至衰退，以社會福利堪稱的歐洲各國，面臨歐債的壓力，社會福利及長照支出變得更加吃重，台灣也面臨經濟遲緩出口衰退的困境，因此在政府實施長照制度之際，若可參考已實行逆向抵押貸款國家的制度，包含英國、美國、加拿大、澳洲、紐西蘭等等，把房屋淨值轉變成有流動性的現金，對於年長者來說，便成了另一項資金來源，亦可解決政府社會福利支出的壓力。 由於逆向抵押貸款還未為國人所知，未來可能以逆向抵押貸款的市場供給面研究出發，以貸款者角度做相關的損益分析。同時國外情況似乎是以國家單位推動的成果較私人金融機構佳，可研究台灣的情形是以公部門或私部門來提供較好。如果私部門欲提供此項商品，則是否由專職金融機構較合適承作逆向抵押貸款？因為提供此商品的風險大，再加上需要有長期且穩定的資金來源，才能提供給借款人，或由保險公司從長期照護保險的資金來承作更優於一般商業銀行去承作。 建議可對此類商品的各類風險研究，如道德風險、長壽風險、房價風險等等，以及對應的保險費制度與訂價之研究。此外，如果以固定年金方式給付貸款金額，則給付期間愈長，愈可能面臨通膨風險及房價折損風險。故未來在考慮逆向抵押貸款的年金給付時，也可考慮到與物價連動的給付方式。未來的房市行情、利率水準，必定影響此商品相當大的程度，故可做更多關於房價的研究，例如房價與物價、利率的關聯性研究。

Ageing is a problem every person faces in the long run, and long-term care system has become increasingly important with the advance of living quality, sanitation and biotechnology. Many developed countries, under the influence of declining marital rate and birth rate as well as elevation in medical resources and technology, are faced with an ageing population structure, and Taiwan is no exception. With the percentage of senior citizens getting higher every year, long-term care problems have grown increasingly important in Taiwan. For now the price of commercial long-term care insurance sold on the market remains too high to afford for average people. Besides, in Taiwan only a small portion of long-term care is supported by social welfare and national health insurance with the rest untended. Thus, it is urgent that a complete long-term care system be built in Taiwan. Recently, nations all over the world have gone through the financial crisis in 2008 and are faced with economic decline or even depression. Many European countries, which have been known for their social welfare system, suffer from Euro debt. Taiwan also faces economic decline and difficulty in exports. Therefore, our government can learn from countries such as Britain, America, Canada, Australia and New Zealand, who have practiced reverse mortgage loans, to turn the mortgage net value into liquid cash. This will be good news both for the government and for senior citizens. Because reverse mortgage loan is still unknown to the general public, we will target at the demand of reverse mortgage loan and do cost-benefit analyses. Meanwhile, based on foreign examples, public sectors run better at providing reverse mortgage loans than private sectors. Besides, since offering reverse mortgage loans is risky and demands long-term stable source of funds, insurance companies will be better at handling this job than general commercial banks. It is advised to do risk investigation on this type of product, such as moral risk, longevity risk, house value risks…etc. and how it affects insurance money. Besides, if the loans are yearly paid, the longer the duration is, the more likely it is to be affected by inflation and house value depreciation. Therefore, it is highly suggested that reverse mortgage loans go closely with prices fluctuation. The future house value and interest rate will greatly influence this product, so related studies can be done such as house prices, prices of commodities and interest rate.