Forecasting the Income and Expenditure of the Urban Employees'Basic Medical Insurance Co-ordination Fund——Multi-scenario Simulation Analysis Based on Evidence from City E
Basic medical insurance practitioners examine the implementation of welfare policies and ensure the stable and healthy development of the basic medical insurance fund,which is the guarantee for the sustainable operation of the system.This article takes E City,a fund pooling area with high surplus,as an example.Based on the current financing and treatment policies,a prediction model for the income and expenditure of the employee medical insurance pooling fund is constructed.Three simulation scenarios are set up,including no policy intervention,implementation of outpatient pooling security reform,and cancellation of individual accounts and improvement of treatment levels by 2035,to predict the income and expenditure of the pooling fund from 2022 to 2050.The results show that without policy intervention,the E city employee medical insurance pooling fund will experience current and cumulative surplus deficits in 2022 and 2034,respectively;After the implementation of the outpatient mutual assistance reform,the occurrence time of the current and cumulative surplus deficit was delayed by 20 and 8 years,respectively;If personal accounts are cancelled by 2035,there will be a fund gap in 2049.Simultaneously increas-ing the level of general outpatient,outpatient chronic diseases,and hospitalization protection will not result in the cumulative balance returning to zero before 2050.Based on this,it is necessary to gradually cancel personal accounts,achieve strategic pur-chases of medical insurance,strengthen multi-level security effectiveness,and enhance the sustainability of the medical insur-ance pooling fund.
employee medical insuranceintegrated fundrevenue and expenditure forecastreform of outpatient mutual aid guarantee