Research On The Sustainability Of Funds After The Combined Implementation Of Maternity Insurance And Employee Basic Medical Insurance

In recent years,my country’s social and economic development has entered a new normal stage of slowing growth due to factors such as the international situation and the COVID-19 epidemic,In order to cope with the impact of the declining birth rate and the aging of the population structure,our country has successively implemented policies to encourage population birth,such as the comprehensive two-child policy and the three-child birth policy.In January 2017,in order to meet the needs of changes in the population fertility policy in the new normal stage,better guarantee the maternity benefits of the insured employees and enhance the mutual aid ability of the fund.The state has decided to carry out a one-year pilot program for the implementation of the two-insurance merger in 12 cities across the country.On the basis of the successful pilot,in March 2019,the General Office of the State Council issued the "Opinions on Comprehensively Promoting the Combined Implementation of Maternity Insurance and Employee Basic Medical Insurance",it is required to comprehensively promote the implementation of the merger of the two insurances across the country by the end of 2019,it is proposed to implement the "four unifications and two guarantees" on the basis of retaining the types of maternity insurance,one of which is to ensure the sustainability of the system.After the combination of the two insurances is implemented,the core and premise of the sustainability of the system is the sustainability of the fund.Based on this,this paper takes the fund sustainability after the implementation of the two insurance mergers as the topic,Taking sustainable development theory,risk management theory and social insurance actuarial theory as the theoretical basis,Comprehensive analysis of the current situation of the fund operation after the implementation of the two insurance mergers and the main factors affecting the sustainability of the fund,On this basis,an actuarial model of fund sustainability is constructed.Then,the model was used to empirically evaluate the fund sustainability after the implementation of the two insurance mergers in the sample area of Wuxi City.It is mainly to forecast the income,expenditure and balance of the basic medical insurance pooling fund for employees inWuxi City in the next ten years,And discuss the sustainability of the fund under different scenarios.The study found that after the implementation of the merger of the two insurance companies,the fund will continue to be affected by many factors.It includes the influence of medical insurance policy factors such as medical insurance payment base,payment rate,reimbursement ratio of disease medical expenses,reimbursement policy for maternity medical expenses,and maternity allowance payment standards.It also includes the impact of socio-economic factors such as the level of regional economic development,fertility policy,socio-demographic structure,and the COVID-19 epidemic.The empirical evaluation results show that the fund can maintain a good sustainability in the next ten years under the condition that the current social and economic development status,medical insurance policy and medical consumption of Wuxi City remain relatively stable.However,when the growth rate of wages declines or the medical expenses increase too fast,the co-ordinating foundation has a financial deficit that cannot be covered by the current period,The consumption of the accumulated balance will also increase,which will be detrimental to the sustainability of the fund in the long run.When the birth rate increases appropriately,it will bring certain payment pressure to the medical insurance pooling fund in the short term.But in the long run,the sustainable impact on the medical insurance fund is small.The adjustment of the proportion of funds allocated to individual accounts has resulted in a substantial increase in both the income and expenditure of the employee medical insurance pooling fund,which has a certain role in promoting the sustainability of the fund.Based on the above analysis,suggestions for promoting the sustainability of the fund are put forward:First,take various measures to ensure the steady growth of fund income;Second,strengthen the control of medical expenses;The third is to increase the willingness of the population to have children;Fourth,do a good job in the prevention and control of the new crown pneumonia epidemic;Fifth,adjust the allocation ratio of funds in individual accounts.