| 關 鍵 詞： |
長期照護；所得稅法；扣除額；健康權；量能課稅原則 |
| 中文摘要： |
身心失能無力自理生活須長期照護者之醫藥費，限以付與所得稅法所定醫療院所始得列舉扣除，是否違憲？司法院釋字第 701 號認為，中華民國 94 年 12 月 28 日修正公布之所得稅法第 17 條第 1 項第 2 款第 2 目之 3 前段規定：「…（二）列舉扣除額：…3. 醫藥…費：納稅義務人及其配偶或受扶養親屬之醫藥費…，以付與公立醫院、公務人員保險特約醫院、勞工保險特約醫療院、所，或經財政部認定其會計紀錄完備正確之醫院者為限」（上開規定之「公務人員保險特約醫院、勞工保險特約醫療院、所」，於民國 97 年 12 月 26 日經修正公布為「全民健康保險特約醫療院、所」，規定意旨相同），就身心失能無力自理生活而須長期照護者（如失智症、植物人、極重度慢性精神病、因中風或其他重症長期臥病在床等）之醫藥費，亦以付與上開規定之醫療院所為限始得列舉扣除，而對於付與其他合法醫療院所之醫藥費不得列舉扣除，與憲法第 7 條平等原則之意旨不符，在此範圍內，系爭規定應不予適用。
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| 英文關鍵詞： |
long term care；Income Tax Act；deduction；right to health；ability-to-pay principle |
| 英文摘要： |
Is the requirement limiting the itemized deductions of medical expenses for long term care of disabled persons to expenses paid to health care providers prescribed in the Income Tax Act unconstitutional? The first part of Article 17, Paragraph 1, Subparagraph 2, Item 2, Division 3 of the Income Tax Act revised and publicized on December 28, 2005 provides: “…. (2) Itemized Deductions: …. 3. Medical Expenses: The medical expenses deductible by a taxpayer, spouse, and supported family members are limited to public hospitals, contract hospitals of the Civil Servants Insurance Plan, contract hospitals of the Labor Insurance Plan, and hospitals with sound accounting records certified by the Ministry of Finance (The name of the said “contract hospitals of the Civil Servants Insurance Plan, and contract hospitals of the Labor Insurance Plan” has been revised and publicized on December 26, 2008, as “contract hospitals of the Public Health Insurance Plan,” with the same legislative intent.). For the medical expenses of disabled persons in need of long-term care (e.g. persons with mental disability, persons in a vegetative state, persons with severe chronic psychosis, persons bedridden as the result of a stroke or other severe disease) to be eligible for itemized deductions, they must have been paid to health care providers prescribed in the abovementioned provision, thus disallowing deduction for medical expenses paid to other lawful health care providers. The said provision is inconsistent with the principle of equality in Article 7 of the Constitution, and to the extent that such inconsistency exists, the said provision shall not be applicable.
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| 目 次： |
壹、前言
貳、司法院釋字第 701 號解釋
一、本案事實與經過
二、當事人釋憲聲請書之主張
三、司法院釋字第 701 號解釋
四、本號解釋之憲法意義
參、長期照護與國民健康權、生存權
一、長期照護之國家責任
二、「醫療」與「長期照護」的異同
三、國民健康權、生存權之人權譜系
肆、所得稅法與「醫藥及生育費」扣除額
一、所得稅法第 17 條關於「醫藥及生育費」立法沿革考察
二、財政部相關解釋函令
三、主觀淨所得原則的實踐
四、租稅減免與立法裁量、租稅優惠概念之釐清
伍、結語
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