醫療財團法人的租稅優惠與社區公益服務

The Relationship between “Tax-Exemption” and “Community Benefit Service” of Not-for-Profit Hospitals

目標：政府常透過租稅優惠的方式間接補助非營利組織，鼓勵其從事社區公益服務。本文探討我國的醫療財團法人從事社區公益服務的支出，與其所享有的免稅利益間關聯性。方法：本文採用我國2006-2010 年43 家醫療財團法人資料，估計追蹤資料的固定效果模型與工具變數法，分別估計醫療財團享有之免稅利益與其從事之醫療社會服務活動、教育研究活動及社區公益服務等支出的關聯性。結果：迴歸結果顯示免稅利益與醫療社會服務支出呈現反向關係，但與教育研究發展支出呈正向關係，且與社區公益服務支出沒有顯著的關係。結論：社會大眾與主管機關普遍認為給予醫療財團法人租稅優惠，是為了鼓勵其提供醫療資源貧乏者免費醫療等醫療社會活動，而非與社區民眾公益較為間接的教育研究活動。實證結果顯示醫療財團法人取得之免稅利益對其從事教育研究活動有正面的助益，卻對醫療社會服務活動呈現反向關係。至於免稅利益與社區公益服務總支出無顯著關聯，可能是醫療財團法人提供社區公益服務受其他因素影響，或其取得免稅地位與提供社區公益服務無關所致。 The government often subsidizes nonprofit organizations with tax benefits to encourage theirengagement in community benefit services. This paper discusses the connection betweencommunity benefit service expenditure and the tax-exempt interest of not-for-profit hospitals inTaiwan. Method: We used the panel data from 43 not-for-profit hospitals in Taiwan from 2006 to2011 and analyzed the data with fixed effects model and instrumental variables models. The abovementioned method is utilized for the examination of the relationship between the tax-exemptinterest and the expenditure of medical juridical persons (not-for-profit hospitals) inuncompensated care services, educational research activities, and community benefit services.Results: Regression results show that tax-exempt interest has a negative relationship withuncompensated care services spending, a positive relationship with educational research anddevelopment expenses, and no significant relationship with community benefit serviceexpenditure. Conclusion: The public and the authority generally consider that the main purpose ofgranting not-for-profit hospitals tax benefits is to encourage more medical social activities, such asproviding free medical care and healthcare, rather than to improve research momentum oreducational quality, although educational research activities are indirectly related to communitybenefits. However, empirical results show that gaining tax-exempt interest can make a positivecontribution to not-for-profit hospitals in engaging in educational research activities, while has areverse relationship with uncompensated care services. Tax-exempt interest and total expenditureof community benefit services are not significantly related, possibly because not-for-profithospitals provide community benefit services which are mainly affected by other factors, or maybebecause the tax-free status has no connection with the supply of community benefit services.

The government often subsidizes nonprofit organizations with tax benefits to encourage theirengagement in community benefit services. This paper discusses the connection betweencommunity benefit service expenditure and the tax-exempt interest of not-for-profit hospitals inTaiwan. Method: We used the panel data from 43 not-for-profit hospitals in Taiwan from 2006 to2011 and analyzed the data with fixed effects model and instrumental variables models. The abovementioned method is utilized for the examination of the relationship between the tax-exemptinterest and the expenditure of medical juridical persons (not-for-profit hospitals) inuncompensated care services, educational research activities, and community benefit services.Results: Regression results show that tax-exempt interest has a negative relationship withuncompensated care services spending, a positive relationship with educational research anddevelopment expenses, and no significant relationship with community benefit serviceexpenditure. Conclusion: The public and the authority generally consider that the main purpose ofgranting not-for-profit hospitals tax benefits is to encourage more medical social activities, such asproviding free medical care and healthcare, rather than to improve research momentum oreducational quality, although educational research activities are indirectly related to communitybenefits. However, empirical results show that gaining tax-exempt interest can make a positivecontribution to not-for-profit hospitals in engaging in educational research activities, while has areverse relationship with uncompensated care services. Tax-exempt interest and total expenditureof community benefit services are not significantly related, possibly because not-for-profithospitals provide community benefit services which are mainly affected by other factors, or maybebecause the tax-free status has no connection with the supply of community benefit services.