人口老化與健康保險: 以泰國為例

Abstract

此篇研究為探討泰國人口老化，對其健康保險(Universal Health Insurance, UHI)的影響。本文主要使用動態一般均衡模型(Dynamic General Equilibrium)，並加入了勞動生產力衝擊以及醫療支出衝擊，來探討泰國人口老化對健保制度的影響。研究結果發現，在2025年以及2050年的人口老化下，定額稅以及定額稅佔薪資的比例會增加，並導致社會福利減少。若在人口老化的情況下，政府實施擴大正式部門(formal sector)勞動力的政策，民眾租稅負擔會下降，社會福利因此獲得改善。除此之外，在人口老化的情況下，若政府調整以人計酬的醫療支出，並固定醫院費用，以人計酬的醫療支出可以調降，定額稅以及定額稅佔薪資的比例會減少，社會福利獲得改善。

This paper studies the impact of population aging on the Universal Health Insurance (UHI), which is capitation payment, in Thailand. A dynamic general equilibrium model with the labor productivity shock and medical expenditure shock is employed to estimate the impacts of population aging on UHI in Thailand. The result suggests that the lump-sum tax (ζ) and the lump-sum tax to wage ratio (ζ/w) increase in Aging 2025 and Aging 2050. Besides, the welfare decreases in Aging 2025 and in Aging 2050. In the scenarios with larger formal sector, tax burden is lower and welfare is improved. Also, we explore the policy of fixing the level of the total hospital expenditure (H) and changing the lump-sum medical subsidy from the government. We find that the lump-sum medical subsidy for young and old agents can be lower in scenarios of population aging. Additionally, the lump-sum tax (ζ) and the lump-sum tax to wage ratio (ζ/w) decrease in the Aging 2025 and Aging 2050, and the policy improves the welfare of workers.