Measurement Research On The Balance Of Income And Expenditure Of Urban Workers' Basic Medical Insurance Fund In Sichuan Province

Although the basic medical insurance system for urban workers has a long history and a sound system,it still faces many problems under the current circumstances.Statistical data show that the majority of the provinces in the country have experienced excessive precipitation of funds in the personal account of staff and workers medical insurance,and excessive expenditure of funds in the overall account.In addition,considering the aging population,the decline in wage growth of workers,the high incidence of chronic diseases,the rapid growth of medical expenses and other factors,the pressure of urban workers' medical insurance co-ordinate fund payment is increasing day by day,some provinces have appeared the phenomenon of staff and workers' medical insurance fund income decreased,expenditure increased,and so on.Coming,we should take precautions against the unsustainability of the medical insurance fund for urban workers.Sichuan Province is located in the southwest of China,with a large population,the rising new front-line city of Chengdu has obvious location advantages.Its industrial structure is upgraded,its attraction for talents is increasing,and its economic development is leading the western region.However,the degree of population aging in Sichuan Province is slightly more serious than the national average,which poses a challenge to the sustainability of the current medical insurance system for urban workers.Taking Sichuan Province as an example,this paper calculates the income and expenditure of the staff and workers' medical insurance co-ordinated fund from 2018 to 2050,explores the operational risk of the basic medical insurance fund for urban staff and workers in Sichuan Province under the triple background of accelerating population aging,rising medical expenses and slowing down economic growth,and rationally estimates the gap and adjusts the existing financing mechanism.In order to maintain the balance of payments of the fund,we can ensure the sustainability of the medical insurance system for urban workers in Sichuan.The author establishes an actuarial income and expenditure model,reasonably sets up the relevant assumptions affecting income and expenditure,and forecasts the income and expenditure in the coming years.The author attempts to explore the following questions: First,under the current medical insurance system for urban workers,what impact will the aging population and the decline in economic growth rate have on the sustainability of the medical insurance fund? Two,how much payment pressure will the current urban employee medical insurance system face in the future? 3.Is the design of individual account and overall account reasonable? How to solve the problem of individual account balance and insufficient overall account? Four,the existing payment age,payment ratio and reimbursement ratio of medical expenses for employees will be revised in the future.Five,is the financing mode of the current urban employee health insurance sustainable and how to improve the financing mechanism?The results of 33 years' calculation in 2018-2050 show that the overall fund for medical insurance for urban workers in Sichuan Province first appeared incomes and expenditures in 2032,and the gap reached 2.62 billion yuan.At the end of the calculation period,the gap reached 183.232 billion yuan.At the end of 2035,the accumulated balance of the overall fund reached the maximum,about 423.336 billion yuan.The gap decreases year by year,and decreases to a negative value of 93.922 billion yuan in 2046.At the end of 2050,the final gap of the overall fund for staff and workers medical insurance reached 780.328 billion yuan.Thus it can be seen that the staff and workers medical insurance fund in Sichuan Province will face greater pressure to pay in the future.In order to maintain the balance of income and expenditure during the calculation period of the medical insurance fund,and taking into account the investment rate of the fund,the author estimates the required adjustment rate: the current payment rate will be increased by 8.6%,that is,the unit payment rate will be increased to 7.61%,and the individual payment rate.If the management efficiency of the medical insurance fund is on the low side,the adjustment coefficient will be greatly increased,and the pressure on the payment of the unit and individual staff will be greater.In order to further ensure the accuracy of the results of calculation and analysis,and put forward effective solutions,the author based on the income and expenditure factors for sensitivity analysis.The effects of wage growth rate of on-the-job workers,extension of retirement age,change of reimbursement ratio of hospitalization expenses,growth rate of per capita hospitalization expenses and payment of retirees on the future revenue and expenditure of the urban workers' medical insurance pooling fund in Sichuan Province were discussed.Finally,according to the sensitivity analysis of the factors affecting income and expenditure,the paper puts forward practical suggestions to the government to cope with the coming pressure of medical insurance fund payment,and promotes the development of medical insurance for urban workers in Sichuan Province.The author used literature analysis,current situation analysis,actuarial model method,sensitivity analysis method to study the income and expenditure of medical insurance fund for urban workers in Sichuan Province.This paper takes Sichuan Province as an example,based on the study of the sustainability of the medical insurance fund for urban workers in the region,which can not only provide an analysis and calculation method for the operation of the medical insurance fund for urban workers in each province,but also provide data support for the overall planning of the medical insurance system for workers in the whole country.Based on provincial data and provincial medical policy,the author fully embodies the particularity of Sichuan Province.This article can be divided into the following six chapters.The first chapter is the introduction,including the background and significance of the research on the sustainability of the medical insurance fund for urban workers in Sichuan Province,and the related discussions on the medical insurance fund and policy in domestic and foreign literature.Finally,the author briefly describes the research ideas and methods,innovation and shortcomings in the research process.The second chapter is the overview of the basic medical insurance system for urban employees in Sichuan province and the analysis of the current development situation.Firstly,this paper introduces the financing policy and medical expense reimbursement policy of representative prefecture-level cities in Sichuan Province,analyzes and summarizes the characteristics of the medical insurance policy for employees in Sichuan Province,and then introduces the past situation of fund income and expenditure,the per capita hospitalization rate and the per capita hospitalization expense growth in Sichuan Province.Chapter 3 introduces the population prediction model of cohort elements.Firstly,it estimates the relevant parameters needed by Lee-Carter model to predict the mortality rate,and predicts the total population of Sichuan province by sex and age according to the fertility rate and population migration rate of women of the right age.Finally,it estimates the urbanization rate of household registration population and the population migration rate.Age labor participation rate and employment rate predict future payment population and insured population.Chapter 4 analyzes the factors influencing the balance of income and expenditure of staff and workers' medical insurance funds,establishes the actuarial model of income and expenditure of staff and workers' medical insurance funds and the actuarial model of sustainability analysis,and sets the assumptions of payment rate,the growth rate of staff and workers' wages,the proportion of overall fund allocation,the growth rate of medical expenses and other relevant parameters,and finally calculates the future 2018-2050 years.The results of the medical insurance fund.The fifth chapter analyzes sensitivity of the actuarial model.Sensitivity analysis was carried out on the factors such as wage change rate,prolonged retirement age,change rate of average hospitalization expenses,reimbursement ratio of medical expenses,and payment of retired workers.The results of influence of one factor change were explored,and the actual changes of each factor in the coming years were analyzed.Chapter 6,based on the results of the empirical analysis,puts forward some suggestions,such as extending the retirement age,increasing the payment of retired workers,increasing the investment rate of urban workers' medical insurance fund,controlling medical expenses,promoting the graded medical treatment system,realizing the overall planning at the provincial level,promoting the adjustment of the whole country,reforming the individual account system and improving the individual account.Based on the perspective of population aging in Sichuan Province,the author explores the future operation of basic medical insurance for urban workers in Sichuan Province under the three major risks.The results of sensitivity analysis and calculation are of great significance for guiding the sustainable development of the medical insurance fund for urban workers in Sichuan Province.The conclusion of this paper is of great significance to the national medical insurance system for urban workers.The reform is also of reference significance.In addition,the population forecast model and the income and expenditure model of the staff and workers' medical insurance co-ordinated fund established by the author can also be applied to other provinces,which has a certain significance.The possible innovations of this paper are as follows: firstly,the author abandons the static mortality rate and adopts the dynamic Lee-Carter model to predict the mortality rate according to sex,fully considering the dramatic improvement of the mortality rate in the next 30 years;secondly,the estimation of the fertility rate of women of all ages.The author did not use the national fertility rate,but combined with the results of the sixth population census in Sichuan Province and the set target total fertility rate,using the revised fertility rate method proposed by Li Yongsheng to calculate;third,the urban population forecast,the author found that the urbanization rate of the permanent population used by predecessors is not applicable to the history of Sichuan Province.Fourth,the author abandoned the customary method of estimating the medical expenses per capita,and gave different weights to the medical expenses of different age groups(that is,the ratio of hospitalization expenses in different age groups to the average hospitalization expenses).The cost of medical care is estimated in more detail.The author's analysis methods and calculation methods in the writing process have some shortcomings: First,because the employee medical insurance overall level stays at the prefecture-level level,this paper estimates the income and expenditure of the province's employee medical insurance fund,artificially assumes the provincial level.Coordinating and adopting a unified unit and individual contribution rate,measuring the future income and expenditure gap based on the population of the province,and not calculating the contributor and the retired population by the city;secondly,the future medical treatment is not considered in the process of predicting the per capita hospitalization expenses.The impact of changes in uncontrollable factors such as policies.