The Empirical Research Of Dalian Urban Basic Medical Insurance Fund's Income And Expenditure Factors

Since "State Council on the Decision of Establishing the Basic Medical Insurance System for Urban Staff'came on in Dec.1998, Chinese government has been working on the sustainable development and approximate perfection of the basic medical insurance system for urban staff. A further expansion of health insurance coverage has grown since the experimental work of medical insurance for urban residents was carried out in a number of cities throughout the country in 2007. There exist many problems in the process of running the medical insurance system, including the problem of the balance between income and expenditure of Medical Insurance Fund, which has gradually been paid special attention to from all walks of life and also become a hot topic of running the medical insurance system.The paper chooses social pooling accounts of urban basic medical insurance fund in Dalian City as positive research object, makes actuarial models respectively based on fund income and expenditure, and estimates the available data in Dalian City according to the present value method of actuarial science, aiming to study the specific impact made by each factor on the fund balance, coming to find the way of relieving the balance pressure of urban basic medical insurance fund.The first thesis is the part of introduction, mainly introducing study background, theoretical basis, study situation at home and abroad, innovative ideas and flaws in this paper. The theoretical basis consists of welfare economics, law of large numbers, market failure theory, Health Management Theory and actuarial theory of medical insurance. Thesis two states the system changes and the financial balance of urban basic medical insurance fund in Dalian City, as well as the problems existing in the process of fund operation. Currently, the medical insurance system for urban employees in Dalian City has driven to maturity; however, the medical insurance system for urban residents is still in its infancy with abundant development space. With the continuous improvement of the medical insurance system, the total amount of fund balance also rise, along with the serious imbalance problem. Thesis three makes a qualitative analysis of the effect factors to urban basic medical insurance funds. Thesis four makes a qualitative analysis of the effect factors combining with the fund balance. The last thesis provides strategy and advice to achieve the aim of balance between financial revenue and expenditure with a small surplus.There are plenty of studies on the balance of medical insurance funds, and the calculation by use of an actuarial method has not developed mature enough. It takes practical significance for this paper to adopt the actuarial method and make an empirical research based on the fund balance in Dalian City. Besides, the innovation lies to add the factors never to be considered of chronic disease expenses and inflation rate. However, owing that the fund operation has a complicated process, the data is difficult to accumulate, this paper makes a study only based on current data, and the inevitable error becomes the flaw of this paper. The conclusion still provide advice of making fund standard for the relevant departments of medical insurance in Dalian City.