Study on Path to Alleviate Fiscal Pressure from Pension Insurance Fund:Background to the Implementation of the National Pooling System Based on Inter-Regional Fund Surplus and Deficit Adjustment

In January 2022,China introduced a national pooling system for pension insurance fund,With the objective of inter-regional fund surplus and deficit adjustment.With the ongoing trend of population aging,can the national pooling and adjustment system operate sustainably?What level of fiscal obligations does it entail?This is related to the long-term stability of pension insurance fund and the whole social security system.This paper employs econometric and actuarial models to assess the sustainability of the national pooling and adjustment system under five scenarios:(1)not introducing any policy interventions;(2)implementing parameter reforms such as expanding pension insurance coverage,progressively extending retirement age,and enhancing collection rates;(3)transferring state-owned capital from central state-owned enterprises to strengthen the social security fund;(4)transitioning the national pooling and adjustment system from turning over current surplus to accumulated surplus;and(5)implementing all parameter reforms,transferring state-owned capital,and turning over accumulated surpluses.The results suggest that a coordinated implementation of reform measures like pension insurance parameter adjustments,reallocation of state-owned capital to enhance social security funds,and leveraging the national pooling and adjustment system for turning over accumulated surplus can ensure the sustainability of the system and significantly alleviatefiscalpressures.

The effects of the National Drug Pooled Procurement(NDPP)pilot program in China

In 2018,the Chinese government identified four municipalities and seven sub-provincial cities for the implementation of the National Drug Pooled Procurement(NDPP)pilot program(the“4+7”policy).In the present study,we analyzed the effects of the“4+7”policy with data of 25 pilot drugs from the National Healthcare Security Administration(NHSA)from the aspects of drug price,volume,and expenditure.After the implementation of the policy,the average price of total and winning drugs was decreased by 54.47%and 73.82%,respectively,while the DDDc of non-winning drugs was decreased by only 1.54%,and the DDDc of uncertificated generic drugs was increased 83.18%.The DDDs indicating the volume of total and winning drugs was increased by 21.18%and 353.98%,respectively,and the DDDs of non-winning drugs was decreased by 61.35%.The costs of total and non-winning drugs were decreased by 44.83%and 61.94%,respectively,and the cost of winning drugs was increased by 18.87%.The“4+7”policy reduced the price and cost of pilot drugs and improved the affordability and accessibility of drugs.However,there were also problems with unexpected excessive price increases of uncertificated generic drugs and relatively high prices of non-winning products.Therefore,we highly suggested promoting the normalization and institutionalization of pooled drug procurement,enhancing the administrative capacity of local procurement platforms,and strengthening monitoring the price of non-winning,especially for the uncertificated generic drugs.