Zheng Meng, Zhu Junli
School of Public Health, Capital Medical University, Beijing, People's Republic of China.
Research Center for Capital Health Management and Policy, Beijing, People's Republic of China.
Risk Manag Healthc Policy. 2021 May 24;14:2133-2144. doi: 10.2147/RMHP.S298145. eCollection 2021.
During the transformation of economy to a high-quality level in China, industrial restructuring and upgrading have played an important role. The upgrading of the industrial structure has affected not only the development in society and economy but also other fields, thereby having great impact on social security. In recent years, with the aging of the population and economic development, the social medical insurance fund is undertaking more payment pressure. However, the existing research rarely focuses on the impact of industrial structure upgrading on medical insurance.
The main aim of this study was to analyze the impact of the upgrading of industrial structure on the income and expenditure of the urban employee basic medical insurance fund.
China's provincial panel data from 2007 to 2018, collected by the National Bureau of Statistics of China, were used to establish a panel regression model in order to investigate the impact of the upgrading of the industrial structure on the income and expenditure of the urban employee basic medical insurance fund.
The research showed that the upgrading of the industrial structure, in combination with the internal upgrading in the tertiary industry, had a positive impact on the income and expenditure of the urban employee basic medical insurance fund and that there were regional differences. The simple upgrading of the three major industries had no effect on the income or expenditure of the urban employee basic medical insurance fund. In addition to the upgrading of industrial structure, other factors such as the average salary of employed persons in urban units, the proportion of retirees among all insured persons in urban employee basic medical insurance and the expenditure of urban employee basic medical insurance were also found to have impact on the income of urban employee basic medical insurance. Moreover, the expenditure of urban employee basic medical insurance was associated with the proportion of retirees among all insured persons in urban employee basic medical insurance, GDP and an aging population.
In the context of the upgrading of the industrial structure, measures such as strengthening employment and income security, delaying retirement, adjusting birth policy, strengthening the scientific management of personal accounts and accurately positioning the regional industrial structure were suggested to be adopted in order to minimize the payment pressures on the urban employee basic medical insurance fund.
在中国经济向高质量水平转型过程中，产业结构调整与升级发挥了重要作用。产业结构升级不仅影响社会经济发展，还波及其他领域，进而对社会保障产生重大影响。近年来，随着人口老龄化和经济发展，社会医疗保险基金承受着越来越大的支付压力。然而，现有研究很少关注产业结构升级对医疗保险的影响。
本研究的主要目的是分析产业结构升级对城镇职工基本医疗保险基金收支的影响。
利用中国国家统计局收集的2007年至2018年中国省级面板数据，建立面板回归模型，以研究产业结构升级对城镇职工基本医疗保险基金收支的影响。
研究表明，产业结构升级，结合第三产业内部升级，对城镇职工基本医疗保险基金收支有积极影响，且存在区域差异。三大产业的单纯升级对城镇职工基本医疗保险基金的收入或支出没有影响。除产业结构升级外，还发现城镇单位就业人员平均工资、城镇职工基本医疗保险参保人员中退休人员的比例以及城镇职工基本医疗保险支出等其他因素也对城镇职工基本医疗保险收入有影响。此外，城镇职工基本医疗保险支出与城镇职工基本医疗保险参保人员中退休人员的比例、国内生产总值和人口老龄化有关。
在产业结构升级背景下，建议采取加强就业和收入保障、延迟退休、调整生育政策、加强个人账户科学管理以及精准定位区域产业结构等措施，以减轻城镇职工基本医疗保险基金的支付压力。
