Study On The Financing Mechanism Of Long-term Care Insurance Based On Financial Sustainability

The population base of our country is large and with the policy of family planning in the early years,the population distribution of each age stage is uneven.At present,the age structure of our country presents olive type.Although the two-child policy is now liberalized,due to the increasing cost of living and the influence of the concept of eugenics and eugenics,the fertility rate of women has not been greatly improved,and this expectation is continuous,so the possibility of a significant increase in the future fertility rate is not high.This also indicates that when our country enters the old age society,the social population structure will appear the situation that the old age population base is large,and the labor force population supply is insufficient;on the other hand,with the continuous progress of medical technology,the life expectancy will continue to increase,but with the increase of age,the degradation of physical function and cognitive function,some old age diseases can not be well treated Cure.Disability and dementia caused by diseases or normal functional decline are becoming more and more common in the elderly,and the demand for care is expanding.How to make the disabled and mentally retarded elderly live a dignified and high-quality life is a major problem that must be faced and solved in the next social development,and also an important part of the 13 th five year plan.Nowadays,the family structure has changed a lot.The family structure is becoming more and more simple.It is not common for people to live together for several generations,and the labor participation rate of women is increasing,which makes the lack of nursing staff even more scarce.Under the condition that the demand for care is increasing,but the supply of care is decreasing instead of increasing,it is imperative for the government to establish a reasonable care system.However,no matter what kind of care insurance system is adopted,the government must estimate the cost of long-term care for the disabled and the income that may be obtained in the future through reasonable calculation,and separate the government’s burden from it PartAt present,China has set up 15 pilot projects to carry out the trial of long-term care insurance in the whole country,but the economic situation,population structure and other conditions of each pilot project are different,the payment rate,guarantee scope and treatment conditions are different,and there is no specific system design in the whole country.The funds of the 15 pilot long-term care insurance mainly come from government subsidies and medical fund allocation,and the individual contribution only accounts for a small part.Some pilot individuals even do not pay,and the long-term care fund cannot continue to develop under the condition of excessive dependence on government and medical fund subsidies;the treatment level should be adjusted according to different price levels,and in the water of economic development It is unreasonable to implement the same treatment level in cities and rural areas with different level of development;at present,the guarantee population of 15 pilot areas is only limited to the severely disabled population,and there are no corresponding welfare measures for other disabled people and people with dementia.Therefore,it is necessary to establish a national unified basic system of long-term care insurance,which can be adjusted according to the actual situation.In this paper,we use the Chinese Longitudinal Health Longevity Survey(clhls)and China Health and retirement longitudinal Study(hereinafter referred to as Charles)and other data,based on the indicators of disability and dementia in MMSE scale and ADL scale,divide the people with disability and dementia into six groups: severe disability,severe dementia,moderate disability,moderate dementia,mild disability and mild dementia,and predict the population rate of disability and dementia in the future by using the random Logistic model and GEE model,combined with the world people 2019 released Population age structure of China’s population in the future 2020-2070 calculates the number of disabled people in urban and rural areas in 2020-2070.Based on the care prices of different levels and different care locations in Beijing in 2009,and considering the factors of different levels of care service prices and wage growth rate in urban and rural areas of China,the annual treatment levels of urban and rural areas in 2020-2070 are estimated.Finally,according to the above calculation results,taking inflation into account,the annual long-term care cost of 2020-2070 is calculated.Combined with the income calculation of Changhu fund,the fund income in 2020-2070 is calculated.Finally,the sensitivity tests of the population growth rate,payment rate and the benefit group included in the treatment stage were carried out to further verify the effectiveness of the long-term care system design.This paper intends to solve the following problems: 1.With the aggravation of aging and the progress of medical technology,the number of the disabled elderly is also increasing.How to ensure that the disabled elderly have dignity and high quality of life in their later years.2.With the rising price level,how to reduce the impact of family economy on the elderly care,and how to ensure the reasonable and sustainable development of the government’s long-term care subsidies.The solution of these problems depends on the calculation of long-term care insurance fund.This paper mainly uses two methods,the first is the literature research method.First,through reading foreign literature,we can understand the development process and current situation of foreign long-term care and the future direction of reform;at the same time,we can also read the policy documents of 15 domestic pilot sites to understand some basic information of the long-term care policy implemented in the current pilot and summarize it.The second is the empirical research method,which uses clhls and Charls,the national large-scale data survey database,MMSE scale,the data of the sixth national census,etc.to calculate the fund revenue and expenditure in 2020-2070,and then calculate the funds that the government needs to bear in terms of Finance and compare with foreign countries.The innovation of this paper: the first innovation is to bring dementia into the long-term care system.At present,only disability is included in the long-term care system in the literature,as is the case in the domestic pilot,and dementia is also included in the long-term care system as the direction of future reform in the international community.The second innovation is that according to the clhls database,Charles data and MMSE scale,the random Logistic model and GEE model can be used in the national cities The rate of disability in towns and villages is predicted,and the rate of disability is no longer set as a fixed value in a certain year.