A Research On The Balance Of Income And Expenditure Of Critical Illness Insurance Fund Of Urban And Rural Residents In China

In recent years,the incidence of critical illness and medical expenses have increased year by year,urban and rural residents have become poorer and poorer due to critical illness.To solve this problem,the state established urban and rural residents critical illness insurance system in August 2012.Critical illness insurance system has reduced the personal medical burden of patients with critical illness effectively for more than four years.However,it is a matter of concern whether critical illness insurance could be sustainable,while the core of sustainability is the balance of income and expenditure of the critical illness insurance fund.This paper takes the income and expenditure of urban and rural residents’ critical illness insurance fund as the research object,and estimates whether the critical illness insurance system could be sustainable,and puts forward the corresponding policy recommendations.Firstly,the paper defines the basic concepts of critical illness insurance and introduces the relevant theory of critical illness insurance.Secondly,the paper analyzes the financing methods and compensation methods of the existing critical illness insurance at home and abroad respectively.Thirdly,based on the financing mode and compensation method of critical illness insurance in China,the financing model and cost compensation model of the critical illness insurance fund are constructed to calculate the balance of the income and expenditure of the critical illness insurance fund of 31 provinces,municipalities and districts in China.Finally,based on the model of fund-raising and cost compensation,the surplus process model of the critical illness insurance fund is established to calculate the income and expenditure of the critical illness insurance fund in each province,municipality and district in the next 25 years.Finally,the paper analyses the sustainability of the regional critical insurance fund and has a sensitivity analysis of indicators such as funding and compensation ratios.Through the calculation of the income and expenditure of the fund,this paper finds that the vast majority of provinces will face the problem of imbalance of critical illness insurance fund in the next 25 years,which may lead to unsustainable insurance system in most provinces.The results of sensitivity analysis shows that the proportion of financing,the proportion of compensation and the proportion of compliance hospital fees will affect the income and expenditure of critical illness insurance fund,so the paper puts forward some policy recommendations such as the establishment of long-term financing mechanism and reasonable compensation mechanism.