The Study On Medical Insurance Fund Balances Paying Elderly Long-term Care Costs

Elderly long-term care is a risk that every elderly facing after they lose ability of daily living and economic capacity. With the intensification of aging population, the ratio of elderly people suffering from chronic disease and disability is improving, the elderly faced with the risk of long-term care in the whole society are increasing, at the same time, along with the changes in family structure, the economic burden of the elderly long-term care is becoming heavy. However, due to the absence of long-term care protection system, the contents of pension and medical insurance are limited. When the elderly is long sick in bed,the long-term care risk compensation has been excluded from the existing social insurance.In the case of the income is limited, The heavy burden of care costs affect the health,rehabilitation of the elderly and their family ultimately, and thus not conducive to social harmony and progress, stability and tranquility. In the case of there are a lot of difficulties to establish Long-term care insurance system, how to ease the elderly’s burden of long-term care costs is an issue urgently to delve.Under the background of "medical support integration", combined with the pilot lessons of Qingdao and Shanghai that long-term care and health insurance combination,due to urban basic medical insurance fund balance continued,medicare and the elderly long-term care has a close relationship.For long-term care costs of the retired elderly participated in the basic urban medical insurance, this paper proposes a bold vision that use the urban basic medical insurance fund balance transfers to pay, and analyzes the feasibility of a nationwide promotion.On the basis of theoretical analysis and empirical analysis of urban basic medical insurance balance fund paying long-term care costs,using system dynamics in this paper,the author simulate the reality of urban basic medical insurance fund system and the system of retired elderly long-term care needs, constructing the elderly long-term care costs of supply and demand simulation model, forecasting and analysising the ratio of thefund balance supply of urban basic medical insurance and the long-term care costs demand of insured disability retired elderly from 2014 to 2050.Through the system dynamics model simulation, under the current policy regime, the ratio trend of Chinese basic urban medical insurance fund balance supply and retired elderly long-term care costs demand in the future: reduced after the first increase, reaching a maximum value 1.337934 in 2016; At the same time, due to the aging population and other factors affecting, the fund balance of basic urban medical insurance is facing a deficit in 2040, unabling to pay the elderly long-term care costs. On the basis of the above,through further adjust the collection rate, corporate and individual contribution rate,long-term care needs of the elderly and other simulation parameters to change the supply and demand ratio in the future. Finally, on the basis of the paying mechanisms that the basic medical insurance fund balances and individual participated in retired disability elderly’s long-term care costs, according to the simulation results, in this paper, concepting the simple payment schemes under different parameter settings, from the paying mechanism, pay objects, pay levels in three dimensions, and proposing relevant safeguards measures that program implementation required.