中国长期护理保险基金需求规模预测

Forecast of China’s Long-term Care Insurance Fund Demand

文章使用2015和2018年中国健康与养老追踪调查数据,采用Markov模型测算健康状态转移概率,以17个长期护理保险试点地区现行政策为基础,预测2021~2030年中国长期护理保险基金需求规模及变化趋势。研究发现:(1)队列效应显著影响老年人健康状态转移概率,较晚出生的人口队列具有明显的健康优势和生存优势。(2)2030年中国60岁及以上失能人数将是2021年的1.60倍,其中轻度失能的老年人规模最大,重度失能的老年人增长速度最快,年均增长6.50%。65岁及以上人口中,失能人数增幅最大的为75~79岁组,年均增长6.93%。2030年失能人群中女性将达到4 098.90万人,是男性的1.21倍。(3)按照低方案,2030年中国长期护理保险基金需求规模为1 891.90亿元,约为2021年的2.14倍。高方案下的基金需求规模为低方案的5.66倍。2021~2030年3种方案下的基金需求规模年均增长率为8.68%。测算结果表明,中国长期护理保险基金负担将日益加重。因此文章建议,试点政策的逐步推进要与筹资渠道、筹资水平及整体经济发展状况相适应;将护理服务端口前移,从被动护理转向主动预防,在实现节约基金支出的同时提高老年人生活质量。

Under the current policies in 17 long-term care insurance pilot areas, using CHARLS data in 2015 and 2018, this paper predicts the scale and trend of changes in China’s long-term care insurance funds from 2021 to 2030 with the Markov model. The study finds firstly the cohort effect significantly affects the transition probability of the older adults’ health status. Compared with earlier-born cohorts, the later-born cohort has noticeable health advantages and survival advantages. Second, the number of the disabled aged 60 and above in China will be 1.60 times larger in 2030 than in2021, among which mildly-disabled elderly people will be the largest proportion and the number of severely-disabled elderly people will increase most rapidly with a growth rate of 6.50% per year. Among the aged 65 and above, the ratio of the age group between 75-79 has the largest annual growth rate, 6.93%. It is expected that till 2030, disabled females will be 1.21 times more than disabled males, reaching 40 989 900. Finally, according to the Low Plan, the demand for long-term care insurance funds in China will be 189.11 billion yuan by 2030, approximately 2.14 times of that in 2021.The scale of fund demand under the High Plan will be 5.75 times higher than that of the Low Plan. The average growth rate of the fund scale calculated by the three plans is 8.68% from 2021 to 2030. The calculation results show that the burden of China’s long-term care insurance funds will become increasingly heavier. The paper suggests that the gradual advancement of the pilot policy should be adapted to the financing channels, financing level and overall economic development. Besides, policymakers should seek to construct a disability prevention system to transfer from passive caring cost compensation to active disability prevention so as to save long-term care insurance funds and improve the quality of life.