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    Title: 非營利組織稅式支出之估算－以醫療財團法人為例
    Authors: 蔡琇文
    Tsai, Hsiu Wen
    Contributors: 何怡澄
    蔡琇文
    Tsai, Hsiu Wen
    Keywords: 非營利組織
    醫療財團法人
    稅式支出
    社區公益活動
    Date: 2008
    Issue Date: 2009-09-19 13:46:41 (UTC+8)
    Abstract: 　　非營利組織具有提供公共服務，補充政府職能之不足的功能，隨著經濟社會發展多元化，人民生活素質大幅提升，非營利組織也日益蓬勃發展，以各式各樣的型態，普遍存在於社會的各個層面。非營利醫院，同時兼具非營利組織角色及醫療產業兩方面的特質，任由市場價格機能運作，會造成醫療服務在供給及需求兩方面均有不足的情形，故非營利醫院的存在有其必要性，而政府為鼓勵私人興辦非營利醫院，多採取租稅減免的優惠。

    　　本研究以我國醫療財團法人作為研究對象，使用94至96年度的會計師查核簽證財務報告，並依現行稅法的租稅優惠規定，估算營利事業所得稅及營業稅的稅式支出金額。主要目的係為了解目前對醫療財團法人所實施的租稅優惠，其稅收影響數為何，同時分析稅式支出金額，占全國營利事業所得稅及營業稅之稅收比重，並比較醫療財團法人之免稅利益及其對整體社會貢獻程度。

    　　估算結果發現， 54家醫療財團法人94、95、96年度之營利事業所得稅稅式支出占全國營利事業所得稅稅收比例為0.64%、0.72%、0.45%；至於營業稅稅式支出之金額，則分別占各年度全國營業稅稅收比例的0.55%、0.59%、0.56%。若以醫療財團法人之社區公益活動支出，占社會福利總支出金額之比例，作為醫療財團法人對社會的貢獻程度，則95及96年度醫療財團法人對社會之貢獻程度，分別大於其享有之免稅利益，代表就整體醫療市場而言，醫療財團法人可基於其對政府在社會福利支出項目之輔助功能，而合理享有免稅的資格；然而就個體的醫療財團法人而言，則必須考慮其個別所享有的租稅利益及社區公益基金之實際支用情況。

    　　社區公益活動是醫療財團法人享有免稅地位主要原因之一，故在政策上，似宜仿效美國，建立社區公益活動與免稅利益之間的關聯性，其作用不僅可合理化醫療財團法人免稅地位的取得，促使醫療財團法人實際支用社區公益活動之公益金，亦可作為政府評估及測度對醫療財團法人免稅政策的實施成效。
    Reference: 一、中文部分:
    王建煊（2000），《租稅法》，台北：文笙書局。
    朱澤民、陳津美與歐俊男（2004），「所得稅稅式支出報告理論架構暨編算模式之研究」，《財政部委託計畫》。
    李應芳（2001），「醫療機構租稅問題與其管理之研究」，《中正大學企業管理研究所碩士論文》。
    林惠玲、陳正倉與鄭秀玲（2007），「我國現行稅式支出報告增列加值型及非加值型營業稅可行性之研究」，《財政部委託計畫》。
    許崇源、吳國明(2000)，「我國非營利組織租稅問題之研究」，《財稅研究》，第三十二卷第五期，頁107-120。
    陳志愷（2007），《稅務法規》，台北：智勝文化。
    黃世鑫、宋秀玲（1989），「我國非營利組織功能之界定與課稅問題之研究」，《財政部賦稅改革委員會專題報告14》。
    謝幸兒（1996），「財團法人醫院課稅及對及財務管理影響之研究」，《陽明大學醫務管理研究所碩士論文》。
    盧瑞芬，謝啟瑞（2003），「臺灣醫院產業的市場結構與發展趨勢分析」，《經濟論文叢刊》，第三十一卷第一期，頁107-153。
    二、英文部分
    Arrow, K. J. (1963),“Uncertainty and the welfare economics of medical care,” American Economic Review, 53(5), pp. 941-973.
    Bittker B. I. and George K. R. (1976), “The exemption of nonprofit organizations from federal income taxation,” Yale Law Journal, 85(3), pp. 299-358.
    Clement, J. P., Smith D. G., and Wheeler J. R. (1994), “What do we want and what do we get from not-for-profit hospitals?” Hospital and Health Services Administration, 39, pp. 159-178.
    Folland, S., Goodman, A. C. and Stano M. (1993), in “The ecomomics of health and health care,” NJ: Prindce-Hall Inc.
    Gentry, W. N. and Penrod, J. R. (1998), “The tax benefits of not-for-profit hospitals,” NBER Working Paper No. W6435.
    Goodspeed, T. J. and Daphne A. K. (1993), “The nonprofit sector’s capital constraint: does it provide a rationale for the tax exemption granted to nonprofit firms?” Public Finance Quarterly, 21(4), pp. 415-433.
    Hansmann, H. (1981), “The rationale for exempting nonprofit organizations from corporate income taxation,” Yale Law Journal, 91(1), pp. 54-100.
    Hansmann, H. (1980), “The role of nonprofit enterprise,” Yale Law Journal, 89(5), pp. 835-898.
    Hsiao, W. (1995), “Abnormal economics in the health sector,” Health Policy ,32(1-3), pp. 125-139.
    Morrisey, M. A., Wedig G. J., and Hassan M. (1996), “Do nonprofit hospitals pay their way?” Health Affairs, 15(4) , pp. 132-143.
    Needleman, J. (2001), “The role of nonprofits in health care,” Journal of Health Politics, Policy and Law, 26(5), pp. 1113-30.
    Norton, Edward C., and Douglas O. Staiger.（1994）, “How hospital ownership affects access to care for the uninsured.” RAND Journal of Economics, 25(1), pp. 171-185.
    Omer, T. C. and Yetman, R. J. (2001), “Taxable income management by nonprofit organizations,” Available at SSRN: http://ssrn.com/abstract=294748.
    Rose-Ackerman, S. (1996), “Altruism, nonprofits, and economic theory,” Journal of Economic Literature, pp. 701-728.
    Sanders, S. M. (1995), “The ‘Common Sense’ of the nonprofit hospital tax exemption: a policy analysis,” Journal of Policy Analysis and Management, 14(3), pp. 446-466.
    Sloan, F. A. (1998), “Commercialism in nonprofit hospitals,” Journal of Policy Analysis and Management, 17(2), pp. 234-252.
    Sloan, F. A., Valvona, J., Mullner, R. (1986), “Identifying the issues: A statistical profile,” In F.A.Sloan, J. F. Blumstein, & J. M. Perrin (Eds.), Uncompensated hosptial care: Rights and responsibilities, Baltimore,Md.: Johns Hopkins University Press.
    Surrey, S. S. and McDaniel P. R. (1985), “International Aspects of Tax Expenditures: A Comparative Study,” Kluwer Law and Taxation.
    Thorpe, K. E. (1991), “The social role of not-for-profit organizations: hospital provision of charity care,” Economic inquiry, 29(3), pp. 472-484.
    Weisbrod, B. A. (1975), “Toward a theory of the voluntary nonprofit sector in a three-sector economy,” in: The Economics of Nonprofit Institutions, ed. By Rose-Ackerman Susan, New York: Oxford University Press, pp. 21-44.
    Young, G. J., Desai, K. R., and Lukas C. V. (1997), “Does the Sale of Nonprofit HospitalsThreaten Health Care for the Poor?” Health Affairs, 16(1), pp. 137-141.
    三、網路資源
    U.S Government Accountablity Office (2005), “Nonprofit, for-profit, and government hospitals uncompensated care and other commuity benefits,” http://www.gao.gov/, report number: GAO-05-743T.
    U.S Government Accountablity Office (2008), “Nonprofit hospitals variation in standards and guidance limits comparison of how hospitals meet community benefit requirements,” http://www.gao.gov/, report number: GAO-08-880.
    Description: 碩士
    國立政治大學
    財政研究所
    94255009
    97
    Source URI: http://thesis.lib.nccu.edu.tw/record/#G0094255009
    Data Type: thesis
    Appears in Collections:[Department of Public Finance] Theses

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