CAJ | 학술논문

基于计量学和精算学建立了我国城镇职工医疗保险基金的收支平衡精算模型,结合我国未来人口结构,特别是我国人口老龄化的数据以及未来我国参保人员的平均工资水平,预测了我国医疗保险基金统筹账户在未来近30年的收支平衡状况。结果表明：在当前的基本医疗保险政策下,统筹账户基金的收入和支出在长期不具有可持续性,医保基金收支缺口巨大。如果从缴费费率进行调整,为了保持统筹基金账户收支平衡,个人和单位所需缴纳的费率将不断提高,个人和用人单位需要缴纳的费率将分别从2012年的2.09%和6.28%提高到2040年的8.93%和26.8%。我国人口老龄化的控制以及在老龄化情形下医保基金的改革与运作对我国经济的可持续发展具有重要意义。
기우계량학화정산학건립료아국성진직공의료보험기금적수지평형정산모형,결합아국미래인구결구,특별시아국인구노령화적수거이급미래아국삼보인원적평균공자수평,예측료아국의료보험기금통주장호재미래근30년적수지평형상황。결과표명：재당전적기본의료보험정책하,통주장호기금적수입화지출재장기불구유가지속성,의보기금수지결구거대。여과종격비비솔진행조정,위료보지통주기금장호수지평형,개인화단위소수격납적비솔장불단제고,개인화용인단위수요격납적비솔장분별종2012년적2.09%화6.28%제고도2040년적8.93%화26.8%。아국인구노령화적공제이급재노령화정형하의보기금적개혁여운작대아국경제적가지속발전구유중요의의。
A health insurance actuarial model is built to analyze the urban basic medical insurance fund in China.Based on Chinese population structure data,especially Chinese population aging data,this paper forecasts the balance situation of Chinese urban basic medical insurance fund in the next 3 decades.It can be clearly seen that,under the current policies,our urban basic medical insurance pooling account would not make both ends meet in the long run.From an analysis of current contribution rate,in order to make ends meet,both individual and enterprise contribution rates should increase to a relative high level,8.93%and 26.8%in 2040 respectively.The conclusions indicate that it is high time that a more efficient strategy be proposed to improve the fund＇s balance under the problem of population aging.