城镇职工医保基金收支预测及其比较分析——基于不同政策组合视角并以湖北省为例

Prediction and comparative analysis of income and expenditure of medical insurance fund for urban workers:Based on policies portfolio and a case study of Hubei province

基于湖北省数据和精算模型分析延迟退休、“全面二孩”、缴费率调整三种政策不同组合下城镇职工基本医保基金收支差异,结果表明:既有政策下城镇职工基本医保基金在2024年开始出现当期赤字,2034年开始出现累计赤字并持续上涨;引入“全面二孩”政策后,出现赤字时点不变,当二孩生育意愿20.5%时,2090年基金累计赤字额度下降2.79%,二孩生育意愿的上升不会改变基金当期赤字野战和累计赤字,但累计赤字额逐渐减少;同时引入“全面二孩”与延迟退休政策后,在二孩生育意愿20.5%时,累计赤字时点推迟至2036年,2090年累计赤字额度下降34.4%;若缴费率同时提高2%~3%,可以保证基金在2090年及以前不出现累计赤字。

Based on the data and Actuarial Model of Hubei Province, the article analyses the revenue and expenditure differences of the basic medical insurance fund for urban employees with three different policies portfolio: delayed retirement, universal two-child policy and adjustment of contribution rate. The results show that with the existing policies, current deficit will be found in the basic medical insurance fund for urban employees in 2024, accumulated deficit in 2034 and the deficit will continue to rise. The deficit point remains unchanged despite the introduction of the "universal two-child" policy. The cumulative deficit of the fund will decrease by 2.79% in 2090 when the fertility willingness is 20.5%. The increase of the fertility willingness of the two child will not change the field deficit and the cumulative deficit of the fund, but the cumulative deficit will gradually decrease. After the introduction of "universal two child" policy and delayed retirement, the cumulative deficit will be postponed to occur in 2036 when the fertility willingness is 20.5%, and 34.4% decline in the cumulative deficit in 2090;a 2%~3% increase in the contribution rate will guarantee that the fund will not have a cumulative deficit in or before 2090.