| 老龄化时代如何厘定职工医保长期精算平衡费率？——基于筹资与偿付联动改革的研究 |
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| 引用本文：孙翎1，刘润迪2.老龄化时代如何厘定职工医保长期精算平衡费率？——基于筹资与偿付联动改革的研究[J].财经理论与实践,2025,(3):41-48 |
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| 中文摘要:选择2020—2050年作为测算区间，运用寿险与非寿险精算方法，构建职工医保长期精算平衡费率厘定模型，分析筹资与偿付联动改革对职工医保长期精算平衡费率的影响。结果发现：与维持传统筹资、偿付和退休政策的基准情形相比，同步推进筹资和偿付改革，辅以渐进式延迟退休政策的实施，可以显著降低职工医保长期精算平衡费率。这种降费效果在不同的筹资机制改革方案下存在明显差异，相对于其他影响因素，提高个人缴费率的降费效果最为明显。鉴于此,应当综合运用取消个人账户、引入终生缴费制、落实门诊共济以及实施渐进式延迟退休等多种措施，形成强大的政策合力，实现老龄化时代职工医保制度的可持续发展。 |
| 中文关键词:职工医保 长期精算平衡 筹资机制 门诊共济 渐进式延迟退休 |
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| How to Determine the Long-Term Actuarial Balance Rate of Employee Medical Insurance in the Aging Era?—Research on the Linkage Reform between Financing and Repayment |
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| Abstract:Selecting the period of 2020—2050 as the calculation interval, using actuarial methods of life insurance and non-life insurance, a long-term actuarial balance rate determination model for employee medical insurance is constructed, and the impact of the financing and repayment linkage reform plan on the long-term actuarial balance rate of employee medical insurance is analyzed. The results showed that compared with the benchmark situation of maintaining traditional fundraising, repayment, and retirement policies, synchronously promoting fundraising and repayment reforms, supplemented by the implementation of gradual delayed retirement policies, can significantly reduce the long-term actuarial balance rate of employee medical insurance. The cost reduction effect varies significantly under different financing reform plans, and compared to other influencing factors, the cost reduction effect of increasing individual contribution rates is the most obvious. In view of this, various measures such as canceling personal accounts, introducing a lifetime payment system, implementing outpatient mutual assistance, and implementing gradual delayed retirement should be comprehensively utilized to form a strong policy synergy and achieve the sustainable development of the employee medical insurance system in the aging era. |
| keywords:employee medical insurance long-term actuarial balance funding mechanism outpatient mutual assistance gradual delayed retirement |
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