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解决医疗保险基金的可持续性风险:代际精算平衡和代际股权观点
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
概括
中国的基本医疗保险面临着可持续性风险. 协调政策改革,特别是涉及退休人员缴费和退休年龄调整,对于长期的财务可行性至关重要.
科学领域:
- 公共卫生
- 健康经济学
- 社会政策
背景情况:
- 全球公共医疗保险系统面临着人口老龄化和医疗保健支出上升带来的可持续性挑战.
- 中国的雇员基本医疗保险 (CEBHI) 系统特别容易受到几代人的精算不平衡和几代人的不平等影响,从而危及其长期可行性.
研究的目的:
- 为CEBHI系统构建一个代际会计框架.
- 分析CEBHI系统在几代人之间的精算平衡和几代人之间的公平性方面的可持续性.
- 评估潜在政策调整对CEBHI系统可持续性的影响.
主要方法:
- 为CEBHI系统量身定制的一种代际会计框架的开发.
- 通过几代人的精算平衡和几代人的公平性来分析可持续性.
- 模拟政策影响,包括延迟退休,退休人员缴费,保险费率调整和退款率调整.
主要成果:
- CEBHI系统表现出严重的几代人之间的精算不平衡和几代人之间的不平等.
- 个人政策干预措施 (如延迟退休,退休人员缴费,保费增加,退款减少) 提供部分缓解,但不能独立地实现精算学平衡和代际公平.
- 退休人员的缴费被认为是有效政策组合的关键组成部分,而延迟退休却具有有限的影响.
结论:
- 为了确保中国医疗保险基金的长期可持续性,协同政策组合至关重要.
- 优先考虑退休年龄和退休人员缴费政策的改革至关重要.
- 需要整合策略来应对系统性风险,因为单独的调整是不够的.
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