人口老龄化背景下中国基本医疗保险基金可持续性评估研究——来自上海的证据。

OBJECTIVE: As China's population aging process accelerates, the expenditure of China's basic medical insurance fund for employees may increase significantly, which may threaten the sustainability of China's basic medical insurance fund for employees. This paper aims to forecast the future development of China's basic medical insurance fund for employees in the context of the increasingly severe aging of the population. METHODS: This paper taking an empirical study from Shanghai as an example, constructs an actuarial model to analyze the impact of changes in the growth rate of medical expenses due to non-demographic factors and in the population structure on the sustainability of the basic medical insurance fund for employees. RESULTS: Shanghai basic medical insurance fund for employees can achieve the goal of sustainable operation in 2021-2035, with a cumulative balance of 402.150-817.751 billion yuan in 2035. The lower the growth rate of medical expenses brought about by non-demographic factors, the better the sustainable operation of the fund. CONCLUSION: Shanghai basic medical insurance fund for employees can operate sustainably in the next 15 years, which can further reduce the contribution burden of enterprises, which lays the foundation for improving the basic medical insurance treatment for employees.

目的：随着中国人口老龄化进程的加速，中国职工基本医疗保险基金的支出可能会大幅增加，这可能会威胁到中国职工基本医疗保险基金的可持续性。本文旨在预测在人口老龄化日益加剧的背景下，中国职工基本医疗保险基金的未来发展。

方法：本文以上海市为例进行实证研究，构建精算模型，分析由于非人口因素引起的医疗费用增长率和人口结构变化对职工基本医疗保险基金可持续性的影响。

结果：上海职工基本医疗保险基金可在 2021-2035 年实现可持续运行，2035 年累计结余 4021.500-8177.510 亿元。非人口因素引起的医疗费用增长率越低，基金的可持续运行状况越好。

结论：上海市职工基本医疗保险基金在未来 15 年内可以实现可持续运行，可以进一步减轻企业的缴费负担，为提高职工基本医疗保险待遇奠定基础。