延迟退休年龄对城镇职工医保基金平衡的影响——基于政策模拟的研究

Postponing Retirement Age and Financial Sustainability of Basic Medical Insurance in China: A Policy Simulation

我国城镇职工医疗保险缴费与退休年龄相关的政策加剧了人口老龄化对基金平衡的影响。本文利用微观大样本数据估计生命周期医疗费用,再结合宏观汇总的医疗费用和人口数据,测算人口年龄结构对城镇职工医疗保险收入和支出的影响,并进一步模拟了延迟退休政策对城职保基金平衡的影响。结论表明,平均来看,我国城职保参保人在50-54岁之前,医保缴费大于支出,是医疗保险的净贡献者,超过这一年龄之后的参保人每年使用的医保基金大于其缴费。加入人口老龄化动态演变的研究发现,延迟退休方案在一定程度上可以缓解医保基金运行压力,使得2025年预计的基金赤字降低1/3左右。基于本文发现,我们指出探索退休后继续缴费方案具有必要性。

The design of Basic Medical Insurance(BMI)intensifies the impact of population aging onfinancial sustainability,since retirees do not contribute to the system.We use survey data to estimate life cycle health care expenditure,based on which we employ aggregate data of health care expenditure and population information to calculate the impact of demographic structure on the income and expenditure of BMI.The main findings are that averagely,before age 50-54,the participant’s contribution exceeds his or her fund expenditure,which makes he or she a net contributor.Once reaching age 55,the participant’fund expenditure on average exceeds his or her contribution.Based on demographic dynamics,we simulate the outcome of postponing retirement age.The result shows that postponing the retirement age will potentially reduce the fund deficit by one-third in 2025.Requiring the retirees to continue to contribute to BMI is a good policy stance.