| Summary: | 碩士 === 國立陽明大學 === 衛生福利研究所 === 87 === The NHI financing system is based on the different occupation categories to determine NHI computable salary and premium sharing rate of the insured in Taiwan.
Job-mobility includes three situations in the previous studies in Taiwan: a real change in job of the insured, choice of one identity made from the insured''s multi-identities, and the false identities of the insured. Therefore, these previous studies actually over-estimated the population with job-mobility. The real job change of the insured causes the efficiency problem. The insured with multi-identities is a normal situation. It is unreasonable to predicate this situation under the NHI law. In addition, it is difficult to identify those insured using false identities. Ignoring the problems of the insured with multi-identities and false identities may cause an equity problem.
Under the current financing system, this research find out the ineqity caused by the insurance category selection. This study uses the Survey of Family Income and Expenditure in Taiwan area (1996) to observe the relationship between the household current income and the expenditure of the NHI premium. Furthermore, this study uses the category for the district population as an example to distinguish 2 groups of the insured: (1) the insured population who really should be insured under other categories, but choose to be insured under this category, (2) the insured population who really should be insured under the sixth category, but choose to be insured under the other ones. The above two behavioral reaction should not be defined as job-mobility. In our economy, it is difficult to identify the real occupation type because it exists lots of small and family owned vendors, and the underground economy. The implementation cost is relatively high for those who can be reasonably identify the occupation. Therefore it is difficult for the Bureau of the NHI to enforce the category selecting principles and the other relevant rules written under NHI law. The gray area caused by this enforcement problem fosters the possibility of self-selection and increases people''s burden. It also induces a serious equity problem. The distribution function of the NHI insurance premium policy fails to achieve the goal of equity.
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