Establishment And Empirical Study Of Fund-raising Pattern Of Long-term Care Integrating With Health Care In China

With the rapidity of population aging process and increasing burden oftraditional family cares, on the one hand, the phenomenon of care absence for theelders needing care are widespread, on the other hand, the structural imbalancesproblem of long term care provision is becoming more and more serious. Therefore,it’s urgent to guarantee citizen’s right of health by optimizing the long term caresystem and establishing a scientific fund-raising pattern that will strengthen thecitizen’s purchasing power.The main contributions of the paper are as follows:Firstly, the paper proposed the way of long term care services integrating withhealth care. According to the original classified way, the paper reclassified the way oflong term care services by three dimensions: the ability of daily activities andinstrumental activities, the availability of care resources from family members and theprevalence of chronic disease. Then four ways of long term care services areformulated: home/community care, home/community care combined withhome sickbed, institution and institution integrating with health care.Secondly, establishing the forecasting model of long term care and thenforecasting the number of people needing long term care based on the number ofpopulation predicted by the PADIS and micro survey data from CHARLS, et al..Results shows that, the number of population needing home/community carecombined with home sickbed is largest, the number of population needing careinstitutions integrating with health care ranks second. Therefore, the establishing oflong term care integrating with health care is a necessary requirement for the ageingsituation.Thirdly, grounded firmly on the realistic urgency to establish a scientificfund-raising pattern, the paper proposed to establish a scientific fund-raising patternthat is composed of pooling funds transferring from urban basic medical insurancecombined with individual contribution by studying from Qingdao’s long term medicalcare insurance system systematically, considering the current situation of social medical system and lessoning from the international experience.Fourthly, lessoning from the ILO model, the paper established the fund-raisingpattern model which is composed of demographic and economic module, incomemodule, expenditure module and result module. Then the relevant parameters, itseffective and its sensitivity to each other are calculated based on the macro socialeconomic and demographic data and micro survey data.Results show that:(1) The total amount of long term care cost will increase year by year and theaverage growth rate is6.61%; its proportion to the national tax revenues shows anincreasing trend and the average change rate is0.14percentage points. The total costis438.961billion in2014and will increase to8166.738billion by2060while itsproportion to the national tax revenues is3.45%in2014and will increase to9.97%by2060.(2) In the fund-raising pattern of long term care integrating with health care, thetotal amount of pooling fund transferring from Urban Worker Medical Insurance,pooling fund transferring from Urban Resident Medical Insurance and individualcontribution fees will increase year by year and the average growth rate is7.59%,5.87%and6.19%respectively; the proportion of the total amount of pooling fundtransferring from Urban Worker Medical Insurance to the total raising fund shows aincreasing trend while both the proportion of the total amount of pooling fundtransferring from Urban Resident Medical Insurance and individual contribution feesto the total raising fund show a decreasing trend and the average change rate is0.32,-0.17and-0.15percentage points.The total compensation amount of pooling fund transferring from Urban WorkerMedical Insurance, pooling fund transferring from Urban Resident Medical Insuranceand individual contribution fees is115.258billion,115.353billion and164.453billion in2014and it will increase to3230.222billion,1577.372billion and2542.470billion respectively. Their proportion to the the total raising fund is29.17%,29.20%and41.63%in2014and will increase to43.95%,21.46%and34.59%.(3) In the fund-raising pattern of long term care integrating with health care, the per capital compensation amount of pooling fund transferring from Urban WorkerMedical Insurance and pooling fund transferring from Urban Resident MedicalInsurance will increase year by year, the average growth rate is both5.24%. Thecompensation contribution rate will both increase year by year and the average changerate is0.04and0.08percentage points.The per capital compensation amount of pooling fund transferring from UrbanWorker Medical Insurance and pooling fund transferring from Urban ResidentMedical Insurance is both￥937.85yen/year in2014and it will increase to￥9732.23yen/year by2060. The compensation contribution rate is1.59%and3.14%respectively and will increase to3.49%and7.02%by2060.(4) In the fund-raising pattern of long term care integrating with health care, theper capital individual contribution fee for people aged45-49in the Urban WorkerMedical Insurance, people aged45-49in the Urban Resident Medical Insurance, andpeople aged60and above will increase year by year and the average growth rate is4.32%,4.29%and4.59%. The per capital individual contribution rate also willincrease year by year and the average change rate is0.02,0.02and0.03percentagepoints.The per capital individual contribution fee is￥888,￥450and￥669yen/year in2014and it will increase to￥6157,￥3078and￥5146yen/year in2060. The percapital individual contribution rate is1.51%,1.51%and2.24%in2014and it willincrease to2.21%,2.21%and3.69%in2060.(5) The compensation amount and rate of pooling fund transferring from theUrban Basic Medical Insurance will greatly cut down, compared to that of originalpolicy’, ant it’s also effective for the individual aged45-59and individual aged60and above both contribute to the fund-raising pattern of long term care withintegrating with health care. The establishment of the fund-raising pattern of longterm care integrating with health care in China is an effective policy to satisfy therapidly growing elders’ medical needs and long term care needs in advance. Based on the results above, the paper putted forward some advices on promotingthe construction of long term care system integrating with health care and the pioltwork of establishing the fund-raising pattern.