“依托医保”长期护理保险模式可持续性研究——基于城乡居民与城镇职工的比较

›› 2019 ›› Issue (02): 91-101.

“依托医保”长期护理保险模式可持续性研究——基于城乡居民与城镇职工的比较

田勇, 殷俊

武汉大学社会保障研究中心, 湖北武汉 430072

收稿日期:2018-08-21 出版日期:2019-03-15 发布日期:2019-03-25
作者简介:田勇(1990-),男,湖北襄阳人,武汉大学社会保障研究中心博士研究生,研究方向为医疗保险;殷俊(1962-),男,湖北武汉人,武汉大学社会保障研究中心教授,博士生导师,研究方向为社会保障基金管理。
基金资助:
教育部人文社会科学重点研究基地重大项目"社会保障精算研究"（11JJD840017）；教育部人文社会科学重点研究基地重大项目"人口老龄化与养老服务体系建设研究"（16JJD840009）；中央高校基本科研业务费专项资金资助项目"生育、退休和费率政策调整背景下城镇职工基本养老保险财务可持续性研究"（2017QN069）。

Research on Sustainability of Long-term Nursing Insurance Model of “Relying on Medical Insurance”-Based on the comparison between urban and rural residents and urban workers

TIAN Yong, YIN Jun

Social Security Research Center, Wuhan University, Wuhan 430072, China

Received:2018-08-21 Online:2019-03-15 Published:2019-03-25

摘要/Abstract

摘要： 通过测算城乡居民长期护理需求以及构建医疗保险精算模型，发现：依托城乡居民医疗保险的长期护理保险制度的建立会增加城乡居民医疗保险基金的赤字，因而医保基金支出占长期护理保险筹资额的比例不应超过20%，但是可以通过财政补贴的方式来维持制度的运行，在该模式下最大财政负担比不超过4.67%；依托城镇职工医疗保险的长期护理保险制度的建立会威胁职工医保统筹基金的安全，在当前医疗保险制度下应该谨慎采用。

关键词: 依托医保, 长期护理保险, 医保基金, 精算平衡

Abstract: By calculating the long-term care needs of urban and rural residents and constructing an actuarial model of medical insurance, it is found that the establishment of long-term care insurance system relying on urban and rural residents' medical insurance will increase the deficit of medical insurance funds for urban and rural residents, so the proportion of medical insurance fund expenditure in the financing of long-term care insurance should not exceed 20%, but the operation of the system can be maintained by means of financial subsidies. In this mode, the maximum financial burden ratio does not exceed 4.67%. The establishment of long-term care insurance system based on urban employees' medical insurance will threaten the safety of the staff's medical insurance pooling fund, which should be carefully adopted under the current medical insurance system.

Key words: relying on medical insurance, long-term care insurance, medical insurance fund, actuarial balance

中图分类号:

F840.612

田勇, 殷俊. “依托医保”长期护理保险模式可持续性研究——基于城乡居民与城镇职工的比较[J]. , 2019(02): 91-101.

TIAN Yong, YIN Jun. Research on Sustainability of Long-term Nursing Insurance Model of “Relying on Medical Insurance”-Based on the comparison between urban and rural residents and urban workers[J]. , 2019(02): 91-101.