The Influence Of Long-term Care Insurance On The Sustainability Of The Basic Medical Insurance Fund For Urban Employees ——A Case Study Of Qingdao

As the crucial elements of the social security system,the basic medical for urban workers（rename as employee medical insurance）fund balance is a valuable assure for the sustainable development of the system.According to the seventh national census,there are264 million people over sixty in China,the scale of the national population is 18.7%,among which 191 million people over sixty five in proportion as 13.5% of the country’s total population.Contradistinguished to the sixth census data,the amount of people over sixty added up to 5.44 percentage points,and that of people over sixty five added up to4.63 percentage points.With the improving aging of the population,the spending of employee medical insurance fund in China enhances,and the revenue growth rate is gradually lower than the spending growth rate,and the payment pressure is increasing day by day.Due to the National Bureau of Statistics,in 2020,the annual revenue of the national employee medical insurance fund is 15731.6 billion yuan,and the spending is12867.0 billion yuan.Contradistinguished to 2019,the growth rate of revenue was-0.72%and that of spending was 1.61%,separately.In the same breath,as a result of the aging of the population,medical costs are rising and the scale of disability among the elderly continues to expand.To this end,the People club bureau realsed the Guiding Opinions on The Pilot of Long-term Care Insurance System in 2016,selecting some cities to implement long-term care insurance.At present,most of the financing origin of long-term care insurance in China’s pilot cities relies on the employee medical insurance fund.Changing the the aging of population and the continuous aggravation of disability,whether the employee medical insurance fund can make a break even and attain sustainable development in the future,deeply detection of the above problems will be conducive to the coordinated and orderly development of employee medical insurance and long-term care insurance in China.Then comparing and analyzing the even of employee medical insurance fund before and after the completion of long-term care insurance,and conducts policy simulation from two aspects of investment rate of return and delay of retirement age,in order to analyze the sustainable operation of employee medical insurance fund under different conditions after the completion of long-term care insurance.In this paper,the development of long-term care insurance system in Qingdao is more mature as an example,and on the elements of the theory of employee medical insurance fund related theories,first of all,the development status of employee medical insurance and long-term care insurance in Qingdao are analyzed.Secondly applying the principles of actuarial science,considering “outpatient service in all aid” policy on the basis of the construted respectively before and after the long-term care insurance of employee medical insurance as a whole of fund revenue and spending,the one-year and two-year balance actuarial model,and contrast analysis of the long-term care insurance in employee before and after medical insurance fund balance of payments situation,In order to analyze the sustainable operation of employee health insurance fund under different conditions after the implementation of long-term care insurance,the policy simulation is carried out from the two aspects of investment rate of return and delay of retirement age.The results show that without any policy intervention,the one-year and annual income and expenditure gap of Qingdao employees’ medical insurance pooling fund will appear in 2021 and 2023 respectively.If the "outpatient mutual aid" policy is implemented from 2021 and long-term care insurance is not implemented,the occurrence of one-year and annual income and expenditure gap of the employee medical insurance pooling fund will be delayed by two years and one year.Under the premise of the implementation of the "outpatient mutual aid" policy,when the pilot of long-term care insurance was carried out,the one-year income and expenditure gap of the employee medical insurance pooling fund appeared one year earlier,and the time of the annual income and expenditure gap of the employee medical insurance pooling fund as same.With the increase of investment yield,the annual income and expenditure gap of the employee medical insurance pooling fund gradually decreases,but the time of the gap still cannot be delayed.Appropriate delay of retirement age can effectively delay the occurrence of the gap between the income and expenditure of the pooling fund of medical insurance for employees.Finally,based on the above research,the paper puts forward countermeasures and suggestions to promote the sustainable operation of Qingdao employee medical insurance fund from the aspects of employee medical insurance and long-term care insurance.