Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Department of Health Management and Economics, School of Public Health, Health Information Management Research Center, Tehran University of Medical Sciences, Tehran, Iran.
BMC Health Serv Res. 2022 Sep 30;22(1):1220. doi: 10.1186/s12913-022-08556-4.
Being the major source of revenue and essential economic tool for policymakers to improve public health, taxes contribute to government spending on the development of health care facilities and services. Given the financial challenges facing the health sector together with the public health issues that affect each society, placing specific taxes on some goods, services, and activities can be effective in this regard. The study aims to explain the various dimensions of specific taxes in the health sector and management of these resources in order to achieve the health system goals.
This study with a qualitative research design was conducted using semi-structured interviews with open-ended questions in 2020-2021. In total, 38 managers, policymakers, economists, key experts, and other individuals, as informants, were interviewed. Purposive and snowball with maximum variation was also employed. As well, content analysis was utilized to shed light on the data. The transcribed interviews were further imported into MAXQDA for extracting and classifying the relevant codes.
In this study, 5 main themes and 23 subthemes were labeled. The main themes accordingly included "Objectives and Conditions of Specific Health Taxes", "Earmarked Taxes", "Taxes on Goods and Measures of Harmful to Health", "Value-Added Taxes", and "Green Taxes".
Considering the specific taxes in the health sector, i.e., taxes on goods and measures of harmful to health, value-added taxes, and green taxes, all taxation and pricing policies need to take account of the effects as well as the advantages and disadvantages of types of taxes, a country's economic structure, the conditions of industries and manufacturing enterprises, cultural aspects in society, and peoples' socioeconomic status.
税收是政府为发展医疗设施和服务而投入的主要资金来源,也是政策制定者改善公共卫生的重要经济工具。考虑到卫生部门面临的财政挑战以及影响每个社会的公共卫生问题,对某些商品、服务和活动征收特定税在这方面可能是有效的。本研究旨在解释卫生部门的特定税收的各个方面,并管理这些资源,以实现卫生系统的目标。
本研究采用定性研究设计,于 2020-2021 年采用开放式半结构式访谈对 38 名经理、政策制定者、经济学家、主要专家和其他作为信息提供者的个人进行了访谈。还采用了目的抽样和滚雪球抽样以及最大变异法。此外,还利用内容分析法阐明数据。将转录的访谈进一步输入 MAXQDA 以提取和分类相关代码。
本研究共标记了 5 个主要主题和 23 个子主题。相应的主要主题包括“特定卫生税的目标和条件”、“专款专用税”、“对商品和有害健康措施的税”、“增值税”和“绿色税”。
考虑到卫生部门的特定税收,即对商品和有害健康措施、增值税和绿色税的税收,所有税收和定价政策都需要考虑到税收类型的影响以及优缺点、一个国家的经济结构、行业和制造企业的条件、社会的文化方面以及人们的社会经济地位。