| Aging has become a typical feature of China’s population age structure.In the process of aging,reducing the poverty of the aging population and realizing active aging is the goal of achieving common prosperity.According to the data released by the National Bureau of statistics,China’s population aged 60 and over was about 267 million by the end of 2021,accounting for 18.9% of the total population,significantly exceeding the aging standard line defined by the United Nations by 10%.This huge elderly population base makes the sustainability of China’s social security system face severe challenges.Endowment insurance and medical insurance are important components of China’s social security system.Although China has basically achieved full coverage of endowment insurance and medical insurance,which has laid a solid foundation for the realization of active aging,how to achieve the sustainability of the social security system is a problem worthy of in-depth study.On the other hand,although China has achieved the goal of fully escaping from absolute poverty by 2021,relative poverty still cannot be ignored.Due to age,health and other factors,the opportunities of labor participation of the elderly population are reduced,resulting in material poverty in terms of income,assets,consumption and so on;In terms of nonmaterial poverty,with the development of digitalization,the popularization of network and the wide application of intelligent electronic terminals,how to bridge the "digital divide" is also a difficult problem for the elderly population;Empty nests,living alone and other life patterns are common among the elderly population.The psychological status,life satisfaction and confidence in the future of the elderly population are also issues that need attention in the real economy and society.This phenomenon is reflected in the Multidimensional Poverty characteristics of the elderly population.Therefore,it is necessary and urgent to objectively and accurately measure the multidimensional poverty degree of the elderly population in China,deeply study the poverty reduction effect of social security systems such as old-age insurance and medical insurance on multidimensional poverty of the elderly,and then pay attention to the poverty reduction effect of different levels and types of old-age insurance and medical insurance.This paper studies along the logic line of "the impact of aging on fiscal sustainability → the impact of aging on the sustainability of the pension and medical security system → the definition and measurement of Multidimensional Poverty of the elderly population → the empirical analysis of the poverty reduction effect of the social security system → the overall research conclusion".On the basis of combing and commenting on the relevant literature,this paper reviews the relevant theories of aging,social security system,poverty and poverty reduction process,and makes a detailed study on the relevant issues by comprehensively using mathematical model deduction,econometric model and other analysis methods and means in combination with the macro provincial panel data and micro survey data.The main research contents,analysis methods and research conclusions of this paper are as follows:First,the financial burden is a concrete manifestation of financial sustainability,which is related to the stable and sustainable operation of the social security system.Based on the two period overlapping generation model,this paper studies the impact of the elderly dependency ratio on the local financial burden.Using China’s inter provincial panel data from 2012 to 2019(excluding Hong Kong,Macao and Taiwan),taking the indirect tax burden as the threshold variable,and on the basis of constructing a panel smoothing threshold regression model,this paper empirically studies the nonlinear characteristics of the impact of population aging on local fiscal burden.The results show that with the increase of indirect tax burden,the impact of population aging on local fiscal burden turns from positive to negative.Further research shows that the level of indirect tax burden and population aging affect the level of local financial burden by adjusting the level of household consumption and the allocation of household resources.Therefore,in the context of the increasing elderly population,local governments should adjust their fiscal policies for the elderly and adjust the level of indirect tax reasonably,which is the financial basis to ensure the sustainable operation of the social security system.Second,under the background of aging,the improvement of the level of old-age security will not be conducive to the sustainable development of the old-age security system;Population aging has direct and indirect effects on the sustainability of medical insurance funds,but it is not the decisive factor for the sustainable development of medical insurance funds.Based on the panel data of 31 provinces,cities and regions(excluding Hong Kong,Macao and Taiwan)in China from 2002 to2018,this paper constructs a PSTR model,taking the average replacement rate representing the level of pension security as the core explanatory variable,and analyzes the nonlinear characteristics,time trend and regional differences of the changes in the accumulated balance rate of urban employees’ pension insurance fund under the background of aging.The empirical results show that the average substitution rate has a negative nonlinear effect on the cumulative balance rate.When the population aging level exceeds the threshold value(10.63%),increasing the average substitution rate will accelerate the consumption of the accumulated balance of the pension insurance fund.The population aging has a negative direct effect on the sustainability of medical insurance for urban employees,and a positive direct effect on the sustainability of medical insurance fund for urban residents.The population aging has a positive indirect effect on the accumulated balance of the medical insurance fund for urban employees through the number of hospital admissions;The population aging has a positive indirect effect on the sustainability of the medical insurance fund for urban residents through the per capita income level and the number of hospital admissions,and a negative indirect effect through the utilization rate of hospital beds.In order to ensure the stable and sustainable development of China’s pension insurance funds,the current average replacement rate should be maintained in the short term.In the long term,it is necessary to gradually reduce the regional differences in the changes in the income and expenditure of the pension insurance funds,further reduce the system maintenance rate,and timely adjust the impact of price changes on the income and expenditure of the pension insurance funds.We will implement more proactive fiscal and employment policies,improve the payment ability of units and individuals in a balanced manner,further improve the insurance payment policy,focus on flexible employees and individual employees,improve the expansion space of medical insurance and endowment insurance for insured employees,and optimize the participation structure.Third,in the process of population aging,multi-dimensional poverty of the elderly tends to occur,and the contribution rate of information,income,assets,health,consumption and psychology to multi-dimensional poverty of the elderly decreases in turn.Based on the personal and family data in CHFS database in 2017,this paper constructs a multi-dimensional poverty measurement system for the elderly including information dimensions,and uses A-F method to measure the multi-dimensional poverty degree of the elderly in China.Empirical research shows that with the deepening of information means,information poverty presents more significant characteristics.In the information society,the impact of information dimension on the multi-dimensional poverty of the elderly exceeds the income,assets,health,consumption and psychological dimensions in the traditional multi-dimensional poverty.There are differences in multidimensional poverty levels among the elderly in different provinces,regions and cities.The multidimensional poverty level of the elderly in rural areas is higher than that in urban areas;The multi-dimensional poverty faced by elderly women and single elderly people is more serious than that faced by men and non-single people;The multi-dimensional poverty degree of the elderly groups with different types of endowment insurance and medical insurance is different.Fourth,the higher the level of old-age insurance and medical insurance,the better effect of the poverty reduction,and the larger dimension range of the poverty reduction.In the aspect of poverty reduction effect,the propensity score matching method is used to test the poverty reduction effect of different types of old-age insurance and medical insurance on the multidimensional poverty of the elderly aged60 and above based on the measurement results of multidimensional poverty;Comparing the poverty reduction effects of different types of old-age insurance,it is found that the urban workers’ pension has the best poverty reduction effect and the largest poverty reduction effect range,followed by the government and public institutions’ pension,and the poverty reduction effects of urban and rural residents’ pension and other public welfare security funds are relatively weak and close.Comparing the poverty reduction effects of different medical security policies on the multidimensional poverty of the elderly,the medical insurance for urban employees has the best poverty reduction effect,and the dimension range of effective effect is the largest,followed by the public medical insurance,and the medical insurance for urban and rural residents has the weakest poverty reduction effect,and the dimension range of effect is the smallest.Fifth,the regional distribution of the elderly population,the number of family population,gender,the level of old-age insurance and medical insurance have an impact on the multidimensional poverty of the elderly.Logit regression and Poisson regression models were used to analyze the impact of micro individual characteristics on multidimensional poverty in the elderly.The results show that the multidimensional poverty degree and the ratio of multidimensional poverty in rural areas are higher than those in urban areas;The multidimensional poverty degree and the multidimensional poverty rate of the elderly population in the eastern,central and western regions increased in turn;The larger the number of families where the elderly live,the more conducive it is to alleviate the multidimensional poverty problems faced by the elderly;The degree of multidimensional poverty and the rate of multidimensional poverty will increase with age;among the elderly population,women are more likely to fall into multidimensional poverty than men,and the degree of multidimensional poverty is more serious;the higher the level of old-age insurance and medical insurance for the elderly,the more conducive it is to curb multidimensional poverty.In the information society,the information elements of multidimensional poverty have an increasingly obvious impact on the multidimensional poverty of the elderly.Targeted social security policies should be implemented for urban and rural residents and workers.Sixthly,medical insurance is an effective measure to improve the health status of the elderly population.The individual characteristics of the elderly population,such as the number of family population,gender,age and education level,will affect the health poverty level of the elderly population.Based on the data of four times China Household follow-up surveys(CFPS)from 2012 to 2018,this paper uses A-F method to measure the degree of health poverty among the elderly aged 60 and over,and analyzes the impact of different types of medical insurance on health poverty among the elderly.The research shows that the contribution rate of disease status,self-rated health level and mental health to the health poverty of the elderly is high.Further,using logit regression and poisson regression models,we analyzed the impact of different types of medical insurance and micro individual factors on health poverty.The empirical results show that the influence of employee medical insurance,public medical insurance,medical insurance for urban and rural residents and supplementary medical insurance on the health poverty of the elderly is weakened in turn,and the elderly groups such as large families,rural areas,older people,women,illiterate and single are more likely to fall into health poverty.To ensure the continuous operation of China’s social security systems such as endowment insurance and medical insurance,and to achieve the social development goals of active aging and healthy aging,on this basis,the fundamental goal of China’s inclusive development can be achieved only by reducing the multidimensional poverty of the elderly.This paper makes an empirical study on the sustainability and poverty reduction effect of the social security system related to medical insurance and endowment insurance,and the conclusions provide a new research idea for coping with the aging of the population. |
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