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健康保険基金における持続可能性リスクへの対処:世代間精算学的なバランスと世代間エクイティの視点
Yi Qin1, Wenfang Ji1
1School of Insurance and China Institute for Actuarial Science, Central University of Finance and Economics, Beijing, China.
Frontiers in public health
|August 27, 2025
まとめ
中国の従業員の基本的健康保険は 持続可能性のリスクに直面しています 調整された政策改革,特に退職者手数料と退職年齢の調整は,長期的な財政的生存に不可欠です.
科学分野:
- 公衆衛生
- 健康 経済
- 社会政策
背景:
- 世界的な公衆衛生保険制度は 人口の高齢化と医療費の上昇によって 持続可能性の課題に直面しています
- 中国の従業員基本健康保険 (CEBHI) システムは,特に世代間の精算的不均衡と世代間の不平等に敏感であり,長期的な生存可能性を危うくしています.
研究 の 目的:
- CEBHIシステムの世代間会計の枠組みを構築する.
- 世代間の精算学的なバランスと世代間の公平性に関するCEBHIシステムの持続可能性を分析する.
- CEBHIシステムの持続可能性に対する潜在的な政策調整の影響を評価する.
主な方法:
- CEBHIシステムに合わせた世代間会計の枠組みの開発
- 世代間の精算学的なバランスと世代間の公平性のレンズを通して持続可能性の分析
- 政策の影響のシミュレーション,退職遅延,退職者手数料,保険料率の調整,払い戻し率の変更など
主要な成果:
- CEBHIシステムは,世代間の不均衡と世代間の不平等を顕著に表しています.
- 個々の政策介入 (例えば,退職延期,退職者手数料,保険料の増額,払い戻しの減額など) は部分的な緩和をもたらすが,独立して精算学的なバランスと世代間公平性を達成することはできない.
- 有効な政策の組み合わせにおいて,退職者の貢献は重要な要素として認識されており,遅延した退職は限られた影響を及ぼしている.
結論:
- 中国の医療保険の長期的持続性を確保するには,政策の連携が不可欠です.
- 退職年齢と退職者手数料政策の改革を優先させることが不可欠です.
- システム上のリスクに対処する統合された戦略は必要であり,孤立した調整は不十分である.
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