의료기관의 공공성이 고유목적사업준비금 설정과 사용에 미치는 영향 = Effect of the Public Nature of Hospitals on the Transfer and Use of Proper Purpose Business Reserve

다국어 초록 (Multilingual Abstract)

This study investigates the difference between the transfer and use of proper purpose business reserves between public and private hospitals. Proper purpose business reserve is a tax deferred item under the Corporate Tax Act. If a non-profit domestic corporation accumulates proper purpose business reserves to spend on its own business or designated donation, the amount transferred to the reserve can be recognized as tax deductible expenses within a certain limit. Tax reserves do not meet the definition of a liability under accounting principles. However, hospital accounting standards allow exceptions for tax reserves. When a hospital transfers part or all of its profits to the proper purpose business reserve, the reserve is recognized as a liability on the financial statements. Also, the transfer and reversal of the reserve are recognized as revenue and expense in the income statements, respectively. This is a kind of industry-specific special case. Previous studies point out that this proper purpose business reserve accounting treatment causes misrepresentation in the profits and debt ratio of hospitals, and as a result, impairs the comparability of accounting information among hospitals and makes it difficult to grasp accurate business performance. In addition, some point out that hospitals are abusing the proper purpose business reserve as a means of tax avoidance due to the lack of proper follow-up management of the use of the reserve. However, there are few studies that have attempted to empirically examine these controversies. To fill this gap, I used hospital financial data to examine the effect of publicity of medical institutions on decision-making related to transfer and use of proper purpose business reserves. Medical law obliges general hospitals with more than 100 beds to disclose financial statements on the Hospital Accounting System Public Announcement(HASPA). I conduct empirical analyses using these hospital financial statements disclosed on the HASPA from 2017 to 2019. Main findings are as follows. First, compared to private hospitals, public hospitals less transfer their proper purpose business reserves than the tax limit. Setting a reserve close to the tax limit can reduce tax-related cash outflows. Since public hospitals receive subsidies for operating expenses from the government, incentives to attempt excessive tax avoidance to reduce tax-related cash outflows. But, private hospitals have a strong incentive to minimize cash outflows using tax avoidance because their funding sources are limited. Second, public hospitals reinvest their proper purpose business reserves in hospitals rather than transferring the reserves to other non-profit organizations. The tax law restricts the use of proper purpose business reserves to the acquisition of fixed assets for medical purposes, donations to the public interest, or expenditures for proper purpose business. The former is to reinvest the profits generated by the hospital into the hospital. But the latter is to transfer the profits generated by the hospital to other non-profit organizations or hospital establishment institutions (for example, hospital establishment school or hospital establishment social welfare foundation). In the former, the effect of the use of reserves is presented in the hospital financial statements, whereas in the latter, the effect of the use of reserves is not presented in the hospital financial statements. As a result, the latter is more difficult to monitor externally than the former. The empirical result that private hospitals less reinvest their proper purpose business reserves in hospitals than public hospitals implies that external monitoring of reserve use of private hospitals is more difficult than public hospital. As a result, private hospitals are more likely to use their reserves as a means of tax avoidance taking advantage of loose monitoring. Third, hospitals that have transferred their proper purpose business reserve to ...

국문 초록 (Abstract)

본 연구는 공공의료기관과 민영의료기관의 고유목적사업준비금 전입과 사용 행태의 차이를 분석한다. 의료기관이 고유목적사업준 비금의 재량적 설정과 임의적 사용을 통해 병원의 경영성과와 재무건전성 표시에 왜곡을 초래하고, 조세회피를 하고 있다는 논란이 지속적으로 제기되었으나 이를 실증적으로 살펴본 연구는 드물다. 본 연구는 2017년부터 2019년까지 한국보건산업진흥원 의료기관 회계정보 공시시스템에 재무제표를 공시한 100병상 이상 법인종합병원 중 법인세차감전순이익이 0보다 큰 566개의 병원-연도 자료를 이용하여 의료기관의 고유목적사업준비금 전입 및 사용행태를 실증적으로 분석하였다. 본 연구의 주요 분석 결과는 다음과 같다. 첫째, 세무상 한도보다 고유목적사업준비금을 적게 설정하는 경향이 민영의료기관보다 공공의료기관에서 더 높게 나타났다. 둘째, 공공의료 기관은 민영의료기관에 비하여 고유목적사업준비금을 병원에 재투자하는 비중이 더 높고, 병원설립기관의 고유목적사업을 위하여 전출하는 비중이 더 낮은 것으로 나타났다. 셋째, 고유목적사업준비금을 세무상 한도보다 적게 전입하는 의료기관이 고유목적사업준비 금을 병원에 재투자하는 비중이 상대적으로 더 높은 것으로 나타났다. 이러한 실증결과는 공공의료기관에 비하여 민영의료기관에서 고유목적사업준비금을 활용한 조세회피가 나타날 가능성이 높고, 고유목적사업준비금의 사용처 역시 병원 시설 재투자보다 법인회계 전출금 등에 집중됐을 가능성이 높음을 시사한다.

참고문헌 (Reference)

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2 김기호 ; 김현동, "의료기관 회계제도의 문제점과 개선방안에 관한 연구 －주요 국립대학교병원의 회계처리 실태분석을 중심으로－" 한국세무학회 12 (12): 9-51, 2011

3 이천화 ; 이준규, "비영리의료법인의 채무불이행 위험에 따른 이익조정－고유목적사업준비금 전입액을 중심으로－" 한국세무학회 37 (37): 159-194, 2020