A Research on the Different Financing Models of Long-term Care Insurance in China

IF 2.3 Q2 ECONOMICS
T. Wei, Su Fang
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引用次数: 0

Abstract

Establishing a long-term care insurance (LTCI) system covering the whole people and balancing urban and rural areas is an important strategic plan for China to deal with the aging and disability of the population. Since the establishment of the LTCI system at the national level in 2016, China has 49 pilot areas for LTCI by 2020. Each pilot area is seriously fragmented, and the financing model of LTCI has not yet been finalized. So what is the financing model of LTCI that suits China’s national conditions? In addition, different financing models have their own advantages and disadvantages. The optimal financing model may depend on economic, social and demographic factors. Since the fund funded system does not have the function of mutual assistance in social insurance, this paper limits the financing model of LTCI between the pay-as-you-go system and the mixed system. Which one is optimal for the long-term sustainable development of China’s LTCI? Starting from the evolutionary law of the health status of elderly individuals, this paper explores the operation of China’s LTCI system under different financing models.This paper uses multi-period micro-tracking survey data, through the continuous time homogeneous Markov process and the generalized linear model, to describe the movement law of the health status transition of the elderly in China, and combines the seven census data and the age shift algorithm to calculate the size and structure of the disabled elderly population from 2020 to 2040. Further, based on the social insurance actuarial balance theory, a dynamic actuarial model under the pay-as-you-go system and three mixed systems is constructed to simulate the equilibrium premium rate and payment amount of LTCI for urban employees and urban and rural residents in the next 20 years. The study finds that, in terms of the size of disabled population, the female elderly are the main body of disabled population; the scale of disabled population in urban areas is significantly higher than that in rural areas. The main reason is that rural-urban migration has made urban elderly population larger, and the urban disability rate is higher than that in rural areas. In addition, in terms of funding pressure, the study shows that at any time and under any financing model, the relative payment pressure of LTCI for urban employees is significantly lower than that of urban and rural residents, but the absolute payment pressure is slightly higher than that of urban and rural residents. Finally, in terms of the selection of financing models, this paper believes that LTCI for urban employees should adopt a mixed system, and LTCI for urban and rural residents should adopt a pay-as-you-go system.The contribution of this paper is mainly reflected in two aspects: First, at the level of empirical research, it combines macro and micro data to describe the evolution of the health status of the elderly from the micro level, predicts the size of disabled population in China from the macro level, and finally establishes a LTCI system that covers the entire population. This not only deepens the research on individual health, but also enriches the research results in the social insurance actuarial field. Second, at the policy level, based on the results of the research, it provides an optimal financing model for LTCI for urban employees and LTCI for urban and rural residents. This optimal model can alleviate the payment burden of financing entities and enhance the stability of the LTCI system. It has important practical significance for the work focus and further promotion of China’s LTCI system.
中国长期护理保险不同融资模式研究
建立覆盖全民、城乡均衡的长期护理保险制度,是中国应对人口老龄化和残疾问题的重要战略部署。自2016年在国家层面建立长期信托基金制度以来,到2020年,中国将有49个长期信托基金试点地区。各试点地区碎片化严重,LTCI融资模式尚未最终确定。那么,适合中国国情的LTCI融资模式是什么呢?此外,不同的融资模式各有利弊。最优融资模式可能取决于经济、社会和人口因素。由于基金资助制度在社会保险中不具备互助功能,本文将LTCI的融资模式限定在现收现付制和混合制之间。哪一种才是中国LTCI长期可持续发展的最佳选择?本文从老年人健康状况的演化规律出发,探讨了不同融资模式下中国LTCI体系的运行。本文利用多周期微跟踪调查数据,通过连续时间齐次马尔可夫过程和广义线性模型,描述了中国老年人健康状态转变的运动规律,并结合七次人口普查数据和年龄转移算法,计算了2020 - 2040年中国残疾老年人口的规模和结构。进一步,基于社会保险精算平衡理论,构建现收现付制度和三种混合制度下的动态精算模型,模拟未来20年城镇职工和城乡居民LTCI的均衡费率和缴费金额。研究发现,从残疾人口规模来看,女性老年人是残疾人口的主体;城镇残疾人口规模明显高于农村。主要原因是城乡人口迁移导致城市老年人口增多,城市残疾率高于农村。此外,在资金压力方面,研究表明,在任何时间、任何融资模式下,城镇职工LTCI的相对支付压力明显低于城乡居民,但绝对支付压力略高于城乡居民。最后,在融资模式的选择上,本文认为针对城镇职工的LTCI应采取混合制,针对城乡居民的LTCI应采取现收现付制。本文的贡献主要体现在两个方面:一是在实证研究层面,结合宏观和微观数据,从微观层面描述了老年人健康状况的演变,从宏观层面预测了中国残疾人口的规模,最终建立了覆盖全人口的LTCI体系。这不仅深化了对个体健康的研究,也丰富了社会保险精算领域的研究成果。其次,在政策层面,根据研究结果,提出了针对城镇职工和城乡居民LTCI的最优融资模式。该最优模型可以减轻融资主体的支付负担,增强LTCI系统的稳定性。这对中国LTCI体系的工作重点和进一步推广具有重要的现实意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Economics, Finance and Administrative Science
Journal of Economics, Finance and Administrative Science Economics, Econometrics and Finance-Economics, Econometrics and Finance (all)
CiteScore
5.10
自引率
20.80%
发文量
23
审稿时长
12 weeks
期刊介绍: The Universidad ESAN, with more than 50 years of experience in the higher education field and post graduate studies, desires to contribute to the academic community with the most outstanding pieces of research. We gratefully welcome suggestions and contributions from business areas such as operations, supply chain, economics, finance and administration. We publish twice a year, six articles for each issue.
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