Research On The Sustainable Operation Of Urban Employee Medical Insurance Fund

With the acceleration of aging process in China,the sustainable operation of urban employee medical insurance fund pooling account is full of challenges under the realistic background of "Aging but not affluent society,.On the one hand,the deepening aging degree has led to an increase in the expenditure end of the urban employee medical insurance fund;on the other hand,the decline in the proportion of the youth population in the overall insured employee has further reduced the income end of the urban employee medical insurance fund.Under the influence of two factors,it is difficult for the urban employee medical insurance fund pooling account to operate sustainably in a longer period,and it is also hard to ensure the basic medical security that urban employee should have.The report of the 19th National Congress pointed out that it is necessary to "Completely build a multi-level social security system,that is,to adhere to full coverage,basic protection,muiltiple levels,and sustainability." As an important part of China's social security system,it is particularly important to ensure the sustainable operation of urban employee medical insurance for a longer period.In this context,this paper takes the sustainable operation of the urban employee medical insurance ftund pooling account as the research subject,and explores the overall operation status and operational efficiency of the fund under different parameters.This research first expounds the research background,research significance as well as research methods of the selected topics,reviews the related literatures on the sustainable operation of basic medical insurance at home and abroad,and introduces the life cycle theory,insurance actuarial theory and population transformation theory applied in this paper.Moreover,the core concepts involved in the article are defined.Secondly,the article sorts out the development process of urban employee medical insurance,explains the current situation of urban employee medical insurance and the operation status of their funds,and conducts an in-depth analysis of the factors affecting the sustainable development of urban employee medical insurance funds.Thirdly,based on the internal logic of urban employee medical insurance system,this paper estimates the operation status of urban employee medical insurance funds under different policy backgrounds by constructing an actuarial model.In the field of basic medical insurance research,existing research usually only focuses on the role of a certain important factor,and rarely combines different factors.The specific calculation of this paper is based on the operation status of the fund under the current policy background.It not only focuses on the operation of the fund under different delayed retirement schemes and different individual account adjustment schemes,but also the operation status of the funds under different combinations between the two.The most innovative point focused in this paper is that we will determine a more suitable feasible scheme.Finally,based on the results of empirical calculations,the corresponding policy recommendations are proposed.The research in this paper finds that under the current medical insurance system,there is a payment risk in the urban employee medical insurance pooling funds.Delayed retirement can relieve the payment pressure of urban employee medical insurance funds in a short period of time,and the effect of retirement for men and women at the same age is better than that for different ages.Second,it is difficult to relieve the payment pressure of medical insurance fund for urban employee in the long term by only implementing delayed retirement.The mode of "Delayed retirement+Adjustment of individual account" is adopted,that is,adjust the individual account on the basis of delayed retirement,which is more conducive to the long-term stable operation of the fund.Third,the optimal solution measured in this paper is to cancel the personal account on the basis of the retirement of men and women at the same age,and reduce the contribution rate of urban employee medical insurance by 2%,which will not only help the sustainable operation of the urban workers' medical insurance fund,but also ensure effective operation of the funds and strengthen the mutual aid and mutual assistance of the urban employee medical insurance system.In order to ensure the sustainable development of urban employee medical insurance funds and ensure that the medical needs of urban employee are basically guaranteed,this paper suggests that countermeasures should be taken as soon as possible:Firstly,appropriate personal account adjustments should be launched on the basis of progressive delayed retirement as soon as possible to improve the operation mode of urban employee medical insurance funds.From the average life expectancy of men and women,the average life expectancy of women is longer than that of men,so it is more reasonable for men and women to retire at the same age.From the perspective of the sustainable operation of the urban employee medical insurance fund pooling account,the retirement mechanism of men and women retiring at the same age is more conducive to the long-term stable development of the fund.Secondly,further improve and reform personal accounts.At the current stage,the cancellation of individual accounts is of great benefit to the long-term sustainable operation of the fund,and on the basis of the corresponding delayed retirement scheme,the level of medical insurance contributions can be further reduced.Secondly,the specific policy design is to cancel the personal account on the basis of retirement for men and women at the same age,and to reduce the contribution rate of urban employee medical insurance enterprises by 2%,that is,"Delayed Retirement Plan+Personal Account Adjustment Plan",This will not only help the sustainable operation of the fund,but also ensure the effective operation of the funds,and strengthen the mutual aid and mutual assistance of the urban employee medical insurance system.Besides the cancellation of personal accounts,it is still necessary to establish an outpatient consultation system in time to realize the outpatient treatment guarantee for urban workers.Thirdly,accelerate the pace of comprehensive reform of urban employee medical insurance funds.At first,in order to further ensure the sustainable operation of urban employee medical insuranee funds,we should continue to strengthen the adjustment of birth policies,increase the willingness of residents to increase their fertility,and increase the number of incumbents in the future in order to cope with the payment pressure of the aging population structure.Secondly,at the expenditure level,the medical insurance payment method should be further optimized to reasonably control the unreasonable growth of medical expenses.Thirdly,at the management level,the medical insurance fund should be standardized and professionally managed to ensure the fund's investment income and investment efficiency.