Research On The Optimization Of Financing Mechanism Of Basic Medical Insurance For Erban And Rural Residents In Jiangxi

The State Council’s "Opinions on Deepening the Reform of the Medical Security System" clearly point out that the payment of basic medical insurance for urban and rural residents should be linked to the level of economic and social development and per capita disposable income of residents,establish a basic medical insurance benchmark rate system,and reasonably determine and dynamically adjust the rate.At present,the fixed financing mechanism of basic medical insurance for urban and rural residents in Jiangxi Province has gradually widened the gap between the financing level and the two systems of employee medical insurance,and the financing of residents’ serious illness insurance relying on residents’ basic medical insurance will also aggravate its insufficient problem.At the same time,the burden of payment for low-and middle-income groups is heavier,which is contrary to the policy goal of building fair medical insurance.In the long run,the basic medical insurance for urban and rural residents will be difficult to adapt to the increase in medical expenses and economic development,and it cannot meet the growing medical insurance needs of residents.This thesis conducts a special study on the financing mechanism of basic medical insurance for urban and rural residents in Jiangxi Province from the perspective of fairness and affordability,in an attempt to provide reference for optimizing the financing mechanism of residents’ medical insurance ratio.This thesis summarizes the operation status of the fixed amount financing mechanism for basic medical insurance for urban and rural residents in Jiangxi Province from four aspects:financing standard,financing structure,financing level and financing adjustment method,and reveals that this financing method has problems such as unfair financing burden,unbalanced financing structure,insufficient financing level,and lack of automatic adjustment of financing.Therefore,based on the relevant data of medical expenses and disposable income in Jiangxi Province from 2017 to 2020,assuming that 2021 is the first year of reform,according to the principle of fixed income by expenditure,the financing standard of basic medical insurance for urban and rural residents in Jiangxi Province in 2021—2030 is 1280 ～ 2406 yuan by using the ILO model,and the rate is between 3.71% ～ 4.18%.This standard is within the affordability of residents and the government.Based on the results of the above calculations,three government-individual sharing options were designed,considering the difficulty of the initial implementation of the policy in Jiangxi Province and the original intention of increasing the responsibility of residents,this thesis believes that the optimal sharing ratio between the government and individuals is 3:2,and the ratio will gradually transition to 1:1after the awareness of personal responsibility is continuously enhanced and the policy is continuously improved and matured.Further,according to the income levels of different income groups to divide their contributions,in accordance with the 1:1 sharing ratio of Option I,the contributions of each income group from low to high will be 228 yuan,399yuan,529 yuan,733yuan and 1312 yuan in 2021.In 2025,it will be 305 yuan,552yuan,658 yuan,985yuan and 1735 yuan.In 2030,it will be 440 yuan,829yuan,863 yuan,1424yuan and 2459 yuan.The burden on low-income groups is reduced by 0.58% to 0.84%,and the burden of contributions on high-income groups is increased by 1.06% to 1.08%.According to the 3:2 sharing ratio of Option II,the contributions for each income group will be 182 yuan,319yuan,423 yuan,586yuan and1,049 yuan in 2021.In 2025,it will be 244 yuan,442yuan,526 yuan,788yuan and 1,389 yuan.In 2030,it will be 352 yuan,663yuan,690 yuan,1,139 yuan and 1,967 yuan.The burden on low-income groups will be reduced by 0.86%～1.13%,and the burden of contribution for high-income groups increases by 0.77%～0.80%.A comparative analysis using the kakwani index and redistributive effects then verifies that the division of contribution responsibilities by earning capacity and proportional funding can,to a certain extent,reduce the contribution burden of the lower income groups and increase the contribution responsibilities of the middle and upper income groups,thus enhancing the vertical equity of funding.In summary,fixed ratio financing can meet the medical needs of residents with built-in dynamic adjustment mechanism for financing to improve fairness and affordability.Based on the above conclusions,this thesis puts forward policy suggestions such as improving the income verification system,reasonably determining the financial contribution responsibilities of governments at all levels,constructing a dynamic financing adjustment mechanism,exploring and broadening financing channels,and establishing medical insurance risk reserves.