Objective: The paper takes N City as an example to explore a stable, reasonable and sustainable financing mechanism of long-term care insurance, providing useful reference for exploring the "model of long-term care". Methods: Based on the data of China's Seventh National Population Census and the population cohort element model, the health status transition probability matrix results of people aged 60 and over were calculated to obtain the future disability population in N City. At the same time, the actuarial balance model of long-term care insurance was constructed to predict the future operation of the fund, and a variety of schemes were designed to calculate the sustainability and financial burden of the fund. Results: If the status quo is maintained, the cumulative fund balance in 2050 can reach 11.066 billion yuan. Moderately disabled individuals can be gradually included in the coverage, and a stable average level of guarantee in the initial stage is preferable. Under different schemes, the proportion of fiscal burden in general public budget expenditure is between 0.18% and 0.32%, and the burden is relatively reasonable and controllable. Suggestions: We should improve the design of benefit guarantee mechanism, improve the quality of long-term care services, and actively explore the connection between social security and commercial insurance in the field of long-term care.
Key words
long-term care insurance /
health state transition probability matrix /
sustainability /
government financial burden
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] 巴曙松,曾好,孙维嘉,等.长期护理保险筹资政策有效性研究——基于49个试点城市的实证分析[J].西北人口,2024,45(01):1-15.
[2] 薛惠元,张永高.共同富裕视域下我国长期护理保险政策评价与优化路径研究——基于PMC指数模型[J].中国卫生政策研究,2023,16(06):10-19.
[3] 刘方涛,费清.中国长期护理保险需求规模预测和保障路径研究——基于第七次人口普查数据的测算[J].保险研究,2023(03):59-69.
[4] 孙凌雪,冯广刚,米红.我国长期护理保险基金支出可持续性研究——以青岛市为例[J].东岳论丛,2020,41(05):52-62.
[5] 周贝浠. 不同筹资模式下长护险可持续性研究——以长三角地区为例[J].中国医疗保险,2024(01):66-74.
[6] 朱铭来,马智苏.长期护理保险“整体化”路径设计研究——基于29个试点城市基金可持续性测算[J].社会保障评论,2023,7(04):114-135.
[7] 汤薇,虞幸然,粟芳.中国长期护理保险的筹资调整机制及缴费负担[J].保险研究,2022(11):93-109.
[8] 钱丽,沈梦园.长期护理保险筹资水平与人口经济的耦合协调关系研究[J].西安建筑科技大学学报(社会科学版),2022,41(03):76-83.
[9] 朱旭豪,陈布彤,梁雨,等.南宁市长期护理保险筹资水平测算及分担机制研究[J].中国医疗保险,2023(04):81-86.
[10] 万谊娜. 长期护理保险独立筹资机制的构建逻辑与方案测算[J].江西社会科学,2023,43(06):170-179.
[11] 汤薇,虞幸然,粟芳.长期护理保险对城乡居民医疗保险财政负担的影响——基于地区视角和替代效应[J].江西财经大学学报,2023(06):40-55.
[12] 郭瑜,谢雨凝.精算平衡还是制度公平?长期护理保险试点推广的财政负担研究[J].保险研究,2024(03):87-99.
[13] 陈鹤,赵姗姗,崔斌.长期护理保险试点财务赤字风险的评估研究——基于第一批15个试点方案的分析[J].中国卫生政策研究,2021,14(12):42-50.
[14] 张良文,付思佳,方亚.基于SD模型的长期护理保险筹资可持续性研究——以厦门市为例[J].中国卫生统计,2023,40(01):62-67+73.
[15] BAHNSEN L, WIMMESBERGER F M.Curbing the demographic "drifting dune" in long‐term care insurance financing: the case of Germany[J]. International social security review, 2023, 76(1): 35-56.
[16] LEE S H, CHON Y, KIM Y Y.Comparative analysis of long-term care in OECD countries: focusing on long-term care financing type[C]//Healthcare. MDPI, 2023, 11(2): 206.
[17] 李伟群,马禄伟.日本介护保险财源建构模式的最新研究及启示[J].现代日本经济,2024,43(02):26-40.
[18] LEE S H, CHON Y, KIM Y Y, et al.Long-term care cost drivers and expenditure projection to 2036 in Hong Kong[J]. BMC health services research, 2009 (09): 1-14.
[19] MEIJER D C, KOOPMANSCHAP M, UVA D B T, et al. Determinants of long-term care spending: age, time to death or disability?[J].Journal of health economics,2010,30(2):425-438.
[20] KIM N.Long‐term care services expenditure projection in South Korea from 2015 to 2050[J]. The international journal of health planning and management, 2015, 30(1): 45-56.
[21] 崔晓东,陈友华,周海花.中国老年寿命与健康寿命变动趋势研究[J].人口与发展,2022,28(05):20-31.
[22] 李佳. 中国长期护理保险制度财政负担可持续性研究——基于17种试点方案测算[J].社会保障评论,2020,4(04):53-71.
[23] 曹信邦. 中国失能老人长期护理保险制度研究[M].北京:社会科学文献出版社,2016(08):279.
