Expenditure Forecast And Policy Simulation Of Long-Term Care Insurance In China

China is in a severe situation of population aging,and the need for care for the aged disabled population is increasing.In order to cope with the financial risks brought about by the steadily increasing care expenditures for the elderly disabled,China should gradually build a social long-term care insurance system to protect the long-term care needs of the Chinese elderly disabled.The Chinese government clearly stated in the outline of the 14th Five-Year Plan for National Economic and Social Development:"Improve a multi-level social security system and steadily establish a long-term care insurance system.”In the first year of the“14th Five-Year Plan”,there is an urgent need to carry out a comprehensive analysis of the influence mechanism of long-term care and informal care,so as to carry out systematic and theoretical policy design for the long-term care insurance system,and predict the future China's aged disabled population and the scale of long-term care insurance expenditure based on the disability transfer model,construct a life cycle model to simulate and analyze the effects of long-term care insurance policies,attempt to build a long-term care insurance system which is suitable for China's national conditions.As population aging has become the norm in China's social development,under the current social background of the new era,the Chinese government has the ability and necessity to establish a social long-term care insurance system.This dissertation discusses the level of demand for long-term care insurance and the scale of expenditures.The prediction research results provide a certain theoretical basis for exploring the long-term care needs and nursing decision-making of disabled groups,and can provide effective policy recommendations and data references for the development and improvement of China's long-term care insurance system.Meanwhile,this dissertation constructs the theoretical model of long-term care insurance and specific policy simulation analysis results can provide a practical and effective theoretical framework and policy-oriented support for the policy formulation of the long-term care insurance system.The dissertation first explains the research background and research significance,focusing on the main research content of the dissertation,various research methods and research frameworks,and puts forward the main innovations and deficiencies of the dissertation.Secondly,through a comprehensive description of the relevant literature in the research field of the long-term care insurance system,the relevant literature is divided into foreign literature and domestic literature to carry out research,and various types of literature are classified according to the research,so as to discuss the current research status of the field of long-term care insurance.Thirdly,the main concepts involved in the paper are defined in detail,including defining the concepts of health and disability at the micro level,elaborating the contents of social security system and population aging at the macro level,and explaining the theoretical framework of long-term care including informal care and long-term care security system.This paper attempts to build a micro consumption life cycle model with long-term care insurance as the core mechanism,and deeply analyze the long-term care insurance mechanism from the perspective of insurance products and social system,so as to provide theoretical basis for the related research of long-term care expenditure prediction and policy simulation.By referring to the operation of the long-term care insurance system in some countries and pilot cities in China,and combining with the characteristics of China's social security system,this paper systematically analyzes the main problems to be solved in the development of China's long-term care insurance system,and expounds the relationship between the long-term care insurance system and China's multi-level social security system.Taking the long-term care insurance practice experience of representative developed countries and the first batch of pilot cities in China as an example,this paper compares different long-term care insurance system options,designs and conceives specific long-term care insurance development and implementation plans,and explores the financing mode and insurance mechanism of social long-term care insurance in line with China's national conditions,In order to maximize the utilization of social security resources,expand policy design ideas.In terms of empirical research,since long-term care insurance is still in the pilot stage,the dissertation conducts empirical research based on panel data from the survey of factors affecting the health and longevity of the elderly in China,and uses appropriate measurement models to analyze the degree of influence of core factors on informal care choices of the elderly,make use of the multiple mediation effect model to deeply explore the influence mechanism and channels of related factors on informal care choice.Therefore,based on empirical data,it explores the main influencing factors that affect the long-term care needs of the elderly in China,analyzes the purchase decision of the elderly in the long-term care insurance,and tries to explore the influence mechanism of the informal care service model on the long-term care insurance system.The research found that disease shock and intergenerational support are the core influencing factors of informal care choice.Disease shock affects the elderly to make informal care decisions through the degree of intergenerational support of family members,Intergenerational support can significantly change the informal care choice of the elderly by improving their disability;Age,type of urban and rural areas,number of children,number of chronic diseases,smoking status can significantly affect the degree of individual disability,thus changing the needs of aged disabled groups for long-term care insurance.Informal care and social care can be an important part of the future long-term care insurance system.In order to effectively investigate the demand level and expenditure scale of China's long-term care insurance,the dissertation established a disability transfer model for the elderly population,and creatively designed a merged averaging algorithm,combined with population forecast data to estimate the scale of the aged disabled population in China,using long-term The relevant data of the nursing insurance pilot cities construct the contribution rate hypothesis,so as to predict and analyze the related costs and expenditure scale of the long-term care insurance fund.It is estimated that China's aged disabled population and long-term care insurance expenditures will reach 51.84 million and 502.5 billion yuan respectively in 2050.The results of the study reflect that China's future aged disabled population will have a large scale and rapid growth rate,and there is an urgent need for social long-term care.The insurance system guarantees the care needs of the elderly with disabilities,but the development of the long-term care insurance system will also bring severe policy challenges to China's fiscal expenditures.The country needs to adopt effective measures to improve the planning and design of the long-term care insurance system,and related research results can provide effective data support for the orderly development of China's long-term care insurance system.Furthermore,based on the life cycle theory model with long-term care insurance as the core mechanism,this dissertation uses the simulation moment method to estimate the key parameters,uses the theoretical model combined with the tracking survey data to match and simulate the long-term care insurance data,and analyzes the long-term care insurance mechanism and system design suitable for China's national conditions by means of parameter estimation and policy simulation.The results show that the current nursing risks faced by the middle-aged and aged groups in China can not be underestimated,and the demand for long-term care insurance is relatively strong.The long-term care insurance with service subsidy and Urban-Rural Coordination mechanism is more suitable for the characteristics of the elderly disabled in China.In the future,we can adopt the long-term care insurance system based on urban-rural long-term subsidy and multiple insurance mechanisms,so as to effectively deal with the disability risk of the elderly and fully protect their long-term care needs.Finally,the dissertation elaborates the main research conclusions obtained through theoretical and empirical research.Based on the full analysis and research on the related issues of long-term care insurance,the comprehensive research results provide science for responding to the challenges of China's aging and improving the health and welfare of the elderly.Effective policy recommendations include building a long-term care insurance system centered on social urban-rural coordination,scientifically planning the financing system and payment methods of the long-term care insurance system,actively introducing support policies to encourage family members to provide informal care services,nursing institutions cooperate with commercial insurance companies to build a high-quality nursing service system and continue to reform China's social insurance system and improve China's multi-level social security system.In order to achieve the continuous improvement and sustainable development of the long-term care insurance system,the research results can provide feasible policy-oriented support of development of China's multi-level social security system.The research results and innovations of this dissertation are mainly reflected in the following aspects:This dissertation combines the characteristics of China's aging disabled population and social development,and studies the long-term care insurance system from the theoretical and empirical levels,in order to obtain research conclusions that meet the characteristics of China's social security system;It is difficult to obtain high-quality long-term care insurance direct enrollment data at this stage,so we focus on the core influencing factors of informal care choices and long-term care needs,using the Chinese Longitudinal Healthy Longevity Survey(CLHLS)four-phase panel tracking data from 2008 to 2018,based on a large sample of panel fixed effect models and mediation effect models,carry out empirical research on the impact mechanism of informal care and long-term care.The overall analysis process is more in-depth,The research results have important reference and guiding significance for the practice process of long-term care related services.This dissertation build a disability transfer model based on the discrete Markov chain,combine population forecast data to calculate a disability transfer matrix that meets the characteristics of the Chinese elderly,and creatively design the merging average algorithm to calculate the aged disabled population and long-term care insurance expenditure,which have effectively improved the accuracy of long-term predictions.The micro consumption life cycle model with long-term care insurance as the core mechanism is constructed,and the design ideas of long-term care insurance policies in line with China's national conditions are explored from the perspective of theoretical research,Using parameter estimation and policy simulation methods to study the specific insurance mechanism and system design of long-term care insurance,and use the simulation moment method to measure the key parameters of the model,which can avoid the inability to use generalized moment conditions for direct estimation and make up for the gap of domestic long-term care insurance in related theoretical research,resolved to a certain extent the current insufficiency of long-term care related indicators.The results of policy simulations have a certain degree of robustness,which can be used to build and improve China's long-term care insurance system and improve China's multi-level society guarantee system,contributes to theory and academic value.