Study On The Impact Of Long-term Care Insurance On Medical Costs ——Concurrent Cost-benefit Analysis On The Balance Of Health Insurance Fund

The increase in the number of elderly people,the decline in their health,and the inflated price of medical services have led to high medical costs for the elderly,especially the disabled,and have increased the financial risk of the elderly.Further,the increase in the number of elderly households with disabilities has led to direct problems such as the inability of care supply to meet care needs and indirect problems such as intergenerational conflicts in care philosophy and family financial strife.China thus proposed to pilot and construct a long-term care insurance system,building on previous international experience and pilots,and exploring policies adapted to socialist conditions with Chinese characteristics.At the beginning of the pilot,the emergence of long-term care insurance has,to some extent,affected residents’ personal medical expenses and the basic medical insurance to which they are attached.In this regard,this paper will explore the impact of long-term care insurance on medical expenses,and the impact of long-term care insurance on the fund medical insurance fund.The significance of this paper is that,at the theoretical level,it provides a more comprehensive and innovative perspective on the reciprocal feedbacks between longterm care insurance and medical insurance;at the practical level,it can improve the government’s financial investment in the health care system and the budget growth of the medical insurance fund because of the cost-control effect of long-term care insurance,and it can contribute to the improvement of various indicators of the long-term care insurance system,especially the fund raising.This paper empirically investigates the effect of long-term care insurance on health care costs by using four years of data from the China Health and Retirement Tracking Survey database（CHARLS）in 2011,2013,2015,and 2018 through a counterfactual approach,i.e.,the asymptotic double difference method,and further robustness tests such as parallel trend test,placebo test,and Abadie SDID test are used to affirm The above-mentioned views are confirmed.Again,this paper conducts a mechanism analysis to empirically investigate the effect of long-term care insurance on the number of outpatient visits and hospitalizations.Finally,based on the results of the benchmark regression,this paper conducts a cost-benefit analysis of the basic medical insurance fund.Specifically,this paper measures the impact of long-term care insurance on the sustainability of the medical insurance fund,using the medium scenario population projection as the base data,the "90+10" scenario as the care model,and the 70% reimbursement model as the example.The impact of long-term care insurance on the sustainability of the health insurance fund is measured,and sensitivity analysis is conducted based on different population projections,different care models and different reimbursement rates.This paper finds that: first,long-term care insurance has a reducing effect on medical costs,and the results of specific tests can be concluded that long-term care insurance reduces individual medical costs by 50% per year on average;second,the implementation of longterm care insurance reduces the annual number of individual outpatient visits,which has a substitution effect and a health effect;third,long-term care insurance has a positive effect on the sustainability of health insurance funds.This study will provide theoretical basis and policy reference for the national and local governments to improve the long-term care insurance system and explore the mutual feedback mechanism between long-term care insurance and medical insurance: First,the design of long-term care insurance system should be further improved,including expanding the scope of long-term care insurance pilot cities,clarifying the coverage of long-term care insurance system,establishing independent longterm care insurance funding mechanism,and the treatment design should emphasize the principle of priority of home care.Second,promote the equal importance of disability compensation and disability prevention to enhance the happiness of the disabled elderly;third,develop commercial long-term care insurance and promote and encourage individuals to purchase it;fourth,link nursing and medical service institutions and integrate long-term care insurance throughout the industrial chain.