中国基本医疗保险制度财务运行状况的精算评估

Actuarial Evaluation of the Financial Operation Situation of China's Basic Medical Insurance System

人口老龄化的加剧可能会恶化我国城镇职工医疗保险制度的财务状况。文章在相关参数假设的基础上通过精算模型评估发现,虽然城镇职工医疗保险个人账户累计余额逐年增加,但是在2025年统筹基金将会收不抵支,收支差为-102.11亿元,这一差值还会逐年扩大,至2033年累计结余会使用完毕。针对以上状况,文章在评估了几种改善统筹基金财务状况的政策方案后发现,个人账户与统筹基金合并能将收不抵支和出现赤字的年份推迟到2034年和2046年,这一方案优于其他方案。

The increasing population aging may worsen the financial sit uation of China＇s urban resident basic medical insurance system. Based on the hypothesis of related parameters and the actuarial evaluation models, this paper finds that the accumulated amount of the urban resident medical sav ings accounts increases year by year, but the income of the pooling fund will not balance the expense in 2025; the gap between income and expenditure is -10. 211 billion yuan and as the gap will gradually widen, the accumulated amount of the pooling fund will be used up in 2033. After evaluating some policy options of improving the financial status of the pooling fund, this pa per shows that the integration of individual medical savings accounts and pooling fund can postpone the time of income over expenditure until 2034 and the time of deficit until 2046, so it is better than other policy options.