Study On The Urban Employees’ Basic Medical Insurance Fund Balance And Its Influencing Factors

Urban employees’ basic medical insurance is an important part of medical security system. As a compulsory social insurance, urban employees’ basic medical insurance has been playing a great role in protecting the health of the people, improving the quality of the population and maintaining social stability. The balance of urban employees’ basic medical insurance fund is a precondition for the sustainable development of the insurance system.This paper aims to study the equilibrium problem of urban employees’basic medical insurance fund and its influnces. At the beginning of this paper, the existing urban employees’ basic medical insurance condition is analyzed and the development of the insurance is reviewed at first in this paper. And then analyses the factors affecting the balance of urban employees’ basic medical insurance fund through the aspects of raising and expenditure. Finally puts forward suggestions of fund balance respectively from three aspects of fund raising, expenditure and management. In the analysis method, using a combination of theoretical and empirical way, using health policy analysis, focus group interview method, literature method, principal component analysis and log linear regression models.Firstly the paper introduces the concept of fund balance from the actuarial balance equation, analysis of the reform of the foreign experience to maintain actuarial balance, current situation of domestic medical insurance fund balance. Secondly, taking city T as a sample, the problems exist in the balance of urban employees’basic medical insurance at municipal overall level is analyzed and the conclusion is that the fund is hard to maintain its balance at municipal overall level. Thirdly, with the example of city T, analyses are undertaken in two aspects, namely income and expenditure, to study the influencing factors in urban employees’ basic medical insurance fund balance and the potential problems are discussed as well, In the respect of fund raising, studies are carried out under health policy analysis and principal component analysis and conclusion is that the ranges of participator amount, contribution bases, contribution proportion, situations of population structure, investment and yield as well as governmental health payments all have an impact on the medical insurance fund raising, among which the situations of population structure influences the most. The study also comes to a conclusion that under the present pay-as-you-go operation, the recessive debt gap in urban employees’ basic medical insurance fund in city T will gradually go expanse. In the respect of fund expenditure, methods of literature survey, focus group interview and log linear regression model are adopted to analyze the influencing factors in urban employees’basic medical insurance fund expenditure in city T from2003to2012. The result shows that the fund expenditure is not obviously related with the retired while it is relevant with the total participator amount, average salary level of the employed, medical technology and involvement of new equipments, number of health institutions and governmental health payments. Among those factors, the most influential are the total participator amount, medical technology and involvement of new equipents and governmental health payments. They are all in positive correlation with the fund expenditure. And the conclusion is that the reasons of urban employees’basic medical insurance fund rise, on the one hand, are the logical factors such as the rise of participator amount and investment of new technology and equipments. While on the other hand, some unreasonable factors contribute to the fund rise. These unreasonable factors include the increase of health facilities as discussed above and the possibility of over treatment. Last but not the least, based on the conclusions drawn above and in reference of overseas experiences, proposals are presented respectively on aspects of finance increase, expenditure control and strengthening the management.