Research On Vertical Balanced Rate Of The Basic Medical Insurance System For Urban Employee

Population aging of the Basic Medical Insurance for Urban Employee means structure aging of the participants, which has increased pressure on consolidated fund. The policy which regulated retirees and their former employees do not pay any premium, affects sustainable development of the Basic Medical Insurance System. This forces us to re-think the equity concept of financing, the mode of "pay-as-you-go" and the short-term actuarial balance principle of social medical insurance on the basis of structure aging. This dissertation, with the objective to balance the Basic Medical Insurance Fund for a long-term, changes traditional technique and learns from life insurance actuarial principles. It puts forward the concept of "Vertical Balanced Rate of the Basic Medical Insurance System for Urban Employees", in order to seek a new financing model, more scientific and reasonable. The vertical balanced rate is based on the principle of vertical balance of the Medical Insurance Fund, which is equal to participants' benefits in the actuarial sense.Beginning with the view of participants' age structure of the Basic Medical Insurance for Employees, the thesis establishes theoretical foundation and methodological innovation of minimum payment years. I set up an actuarial model after analysis on influencing factors of vertical balanced rate, and calculate the vertical balanced rate by empirical analysis in City Z to find a scientific method of setting minimum payment years, which is a universal approach of calculating minimum payment years with the use of vertical balanced rate. If changing parameters and variables of the model, we can get different minimum payment years for different regions. The study shows that, social risk pooling fund is not sufficient to support the vertical balance under the background of "pay-as-you-go" model, and the vertical balanced rates are significant differences for different initial enrollment age and different sex.The vertical balanced rate can be used to set up minimum payment years, which is important on the reform of the Basic Medical Insurance for employees. At present, the minimum payment years are not uniform nationwide, as our central government has not carried out any guidance for them. The vertical balanced rate can also be applied to the retirement health policy reform related to minimum payment years. This dissertation suggests that we should improve the policy of minimum payment years of medical insurance benefits for retirees; raise the statutory retirement age at an appropriate time, and set up financing mechanisms for retirees to participate health insurance system. As a result, the Basic Medical Insurance System can develop sustainably to protect medical needs of employees.