人口老龄化进程中的医疗卫生支出:WHO成员国的经验分析

Health care expenditure under population aging:an empirical analysis of the WHO members

基于世界卫生组织(WHO)成员国的经验,本文探讨了人口老龄化进程中医疗卫生支出的基本特征和一般规律。研究表明:世界各国医疗卫生水平存在极大的不平衡。随着人口老龄化的加深,医疗卫生支出中政府支出比例趋于上升,而私人卫生支出比例趋于下降。医疗卫生支出占GDP的比例逐步提高,而政府卫生支出占政府总支出比例也趋于提高,人口老龄化进程中政府在医疗卫生支出中将承担更重要的责任。而且,在政府卫生支出中,医疗保障支出比例趋于提高,并将成为政府卫生支出越来越重要的部分。当一国进入老龄化社会后,医疗卫生支出速度将会递增,经济发展和政府财政将承受越来越重的医疗支出负担。"未富先老"的中国面临着医疗卫生支出急剧增长的严峻挑战,这应该成为医疗卫生体制改革关注的议题。

Based on experiences of WHO members,this paper discusses basic features and general rules about total health care expenditure（THE）under the increasing population aging.Studies show that there exists an extreme inequality about THE among countries in the world.With the increasing of population aging,the ratio of government＇s health care expenditure to THE rises,whereas the ratio of private expenditure to THE declines.The proportion of government＇s health care expenditure to total government expenditure tend to increase,and the proportion of THE to GDP as well.It is obvious that government will take more responsibilities for THE under population aging.Furthermore,expenditure for medical security account for government＇s health care expenditure larger and larger,and will become one of most important part of that.After one country enters an aging society,its THE will tend to mushroom progressively and result its economic development and government finance suffering from a serious burden of health care expenditure.China in an ＂aging but not affluent society＂ will face large challenge on a sharp rise of THE,which should be taken account into the reform of medical care system.