고유목적사업준비금을 통한 비영리법인 조세부담 변화의 추정：의료기관을 중심으로

In this study, we review the hypothetical additional tax burden to be borne by medical institutions when the current medical institution’s essential business reserve setting rate is lowered or the reserve system is abolished. We use data from the medical institution accounting information disclosure system of the Korea Health Industry Development Institute. From the perspective of the estimated average effective tax rate, when analyzed by type of medical institution, it was found that tertiary hospitals receive more tax benefits from the reserve system than secondary hospitals. The estimated average tax rates were found to increase by 17.02%p (setting rate：100%) and 14.78%p (setting rate：50%) respectively in the absence of the reserve system. In terms of establishment type, in the case of institutions with a 100% setting rate of reserves, medical institutions established by education entities were found to receive higher tax benefits from the reserve system. In the absence of the reserve system, the estimated average effective tax rate was found to increase by 21.58%p. In the case of medical institutions with a 50% setting rate, it was found that medical institutions established by foundations receive higher tax benefits from the reserve system. In the absence of the reserve system, it was found to increase by 17.94%p. Estimated average tax payable per medical institution was also found to be higher in those types of medical institutions. Despite the potential tax revenue increased above from a government perspective, the following needs to be considered. First, given the Medical Service Act which disallows for－profit corporations to establish medical institutions, caution needs to be taken for taxation of non－profit medical institutions like for－profit corporations. Second, there should be consideration of the characteristics of the medical industry, such as the public interest and public welfare provided by he medical industry. If the current reserve setting rate is lowered or eliminated which leads to taxation of medical institutions like for－profit corporations, the medical institution can pass on the increased cost to the medical service consumer, which in turn increases the economic burden on the medical service consumer or the national health insurance finances. Third, if the current medical institutions’ reserve system is required to be changed, tax benefits for medical institutions can be collectively controlled through the alternative minimum tax system. Unlike the prior studies which focused on medical institutions’ profit reporting behavior through a reserve fund, this study is different in that it analyzes medical institutions’ tax burden change and how their tax burden would increase if the reserve setting rate was gradually lowered.