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我国医保体系债务风险规模评估与政策启示 被引量:2

Scale Assessment for Debt Risk of Medical Insurance System in China
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摘要 随着人口快速老化、医疗费用不断膨胀,医保基金债务风险加剧,迫切需要客观评估、预测医保债务规模,为医保政策创新奠定基础。利用人口统计、保险精算等方法,基于六普等宏微观数据,对中国医保系统的隐性负债、基金债务及可能的财政压力进行评估和预测。结果显示,在代表性方案预测结果中,医保基金隐性负债规模约为85.52万亿,基金债务规模约为184.15万亿;潜在财政压力高达228.99万亿,财政负担占GDP和财政支出比例先降后升,总体呈上升趋势,在2110年将分别达到约1.40%、4.66%;我国医保体系改革的最佳时间窗口是2015-2025年。我国医保体系债务规模巨大,潜在财政风险严峻,迫切需要推进医保制度及相关制度变革,尽早应对医保体系债务风险、提升基金可持续性。 With the rapid aging of the population and the continuous expansion of medical expenses,the debt risk of social medical insurance increases,and it's critical to assess the debt scale of social medical insurance in China to initiate the reform of medical insurance system. With demographics and actuarial sciences,the paper is to assess and predict the scale of medical implicit debts,explicit debts and burden on public finance with macro and micro data such as China's sixth census data. The research result shows that,in the prediction of medium term plan,the implicit debt and explicit debt of China's medical insurance system is about 85,52 trillion Yuan and 184.15 trillion Yuan respectively,and the contribution ratio of Medical Insurance of Urban Employee,Urban Resident Basic Medical Insurance,and New Type of Rural Cooperative Medical Insurance in the total medical insurance explicit debts are 81.22%,13.64% and 5.14%,respectively. The best time window for reform is 2015-2025. The potential financial burden of medical insurance explicit debt is about 228.99 trillion Yuan,and the ratio of potential financial burden to GDP and financial expenditure will be increased up to 1.40% and 4.66% in 2110,respectively. Based on the research finding,it's urgent to launch and accelerate the institutional reform to handle the debt risk and to enhance the security of medical insurance system in China.
出处 《中国行政管理》 CSSCI 北大核心 2017年第3期113-118,共6页 Chinese Public Administration
基金 国家社会科学基金项目“医疗保险体系隐性负债、基金负债与财政压力评估”(编号:11CGL072) 北京市社科基金项目“老年人长期护理服务需求评估与护理保险设计”(编号:13SHB009) 中央高校基本科研业务费专项资金资助重点项目“老年护理保险成本动态测算与财政压力评估”(编号:2014ZD47)
关键词 医保体系 隐性负债 基金债务 评估 medical insurance system implicit debts explicit debts assessment
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