城镇职工基本医疗保险制度抚养比研究

Study on Institution Dependency Ratio of Urban Basic Medical Insurance for Workers

城镇职工基本医疗保险的"制度抚养比"比"系统老龄化"更能反映缴费人口的真实负担。文章借鉴"人口抚养比"概念分析了城镇职工基本医疗保险的"制度抚养比",发现,当前我国中部地区职工医疗保险缴费人口真实负担最重,西部地区居中,东部地区负担最轻。未来,我国医疗保险改革方向是提高医疗保障的范围和水平,同时将覆盖面扩展至农民工的难度不断加大,通过降低职工医疗保险系统老龄化和老年人人均医疗消费支出来降低制度抚养比的效果不明显。为降低制度抚养比,应抓住当前职工医疗保障的范围和水平正在不断提高这一历史时机,对退休老人实行分类终生缴费:养老金低于政府规定的最低缴费养老金的退休老人,由政府按照最低缴费养老金的2%进行代缴;养老金水平高于最低缴费养老金的退休老人,由个人缴费。

Institution Dependency Ratio （IDR） is better than systematic aging to reflect the real population burden of urban basic medical insurance for workers. This article analyses institution dependency ratio of urban basic medical insurance, which comes from the concept of Population Dependency Ratio （ PDR）, and finds that the real population burden of urban basic medical insurance is the heaviest in the central region and lightest in the eastern region. The direction of China~ medical insurance reform is to improve the coverage and level of medical care, and difficulties of extending coverage to migrant workers is increasing. Therefore, it is not effective to reduce IDR by reducing systematic aging of medical insurance and per capita health expenditure of elderly. We should seize the historic opportunity of improving coverage and level of medical care in our country, and implement lifetime contribution of retirees by pension level. The government contributes 2% for the retirees whose pensions are less than the minimum standard of contribution level and the retirees whose pensions are higher than it should contribute for themselves.