城乡人口迁移对基本医疗保险统筹基金长期精算平衡的影响分析——基于分区域人口发展模型的研究

Analysis of the Impact of Urban and Rural Population Migration on the Long-term Actuarial Balance of Urban Employees’ Basic Medical Insurance Co-ordination Fund——A Research Based on Sub-Regional Population Development Model

本文运用分区域人口发展模型和社会医疗保险精算模型,测算了2016—2060年城乡人口迁移对基本医疗保险统筹基金的收入、支出、当期结余和累计结余的影响。研究结果表明:城乡人口迁移对统筹基金当期结余呈现出先积极后消极的影响效应;从短期来看,大规模年轻化迁移人口可以减缓城镇人口老龄化,将当期结余转负的时间节点从2036年推迟至2041年,从长期来看,城乡人口迁移反而加剧了当期收支失衡的风险;城乡人口迁移对累计结余的影响方式与当期结余类似,但时间节点略有滞后;鼓励生育、推迟退休年龄和提高缴费比例对统筹基金累计结余的影响程度和作用时间不同。建议科学评估城乡人口迁移对基本医疗保险的影响效应,设计劳动力迁入迁出地的利益平衡机制,合理调整生育政策、退休政策和医保政策,探索人口新常态下基本医疗保险制度的可持续发展长效机制。

This paper uses the sub-regional population development model and the social medical insurance actuarial model to calculate the impact of the urban-rural migration in 2016-2060 on the revenue,expenditure,current balance and accumulated balance of the urban employees' basic medical insurance co-ordination fund.The results of the study show as follow:the urban-rural migration has a positive and then negative effect on the current balance of the co-ordination fund;in the short term,large-scale younger migrants can slow down the aging of urban population,and postpone the current imbalance time nodes from 2036 to 2041 while in the long run,the migration of urban and rural populations has intensified the risk of current imbalance;the impact of urban and rural population migration on accumulated balances is similar to the current balance,but the time nodes are slightly lagging;encouraging fertility,postponing retirement age,and increasing contribution ratio have different effects on the cumulative balance of the pooling fund.Assessing the impact of urban and rural population migration on basic medical insurance scientifically,designing a mechanism for balancing the interests between labor force's immigration areas and emigration areas,adjusting fertility policy,retirement policy and medical insurance policy rationally,and exploring a long-term mechanism for sustainable development of basic medical insurance system under the new normal population are suggested.