“依托医保”长期护理保险模式可持续性研究——基于城乡居民与城镇职工的比较

通过测算城乡居民长期护理需求以及构建医疗保险精算模型,发现：依托城乡居民医疗保险的长期护理保险制度的建立会增加城乡居民医疗保险基金的赤字,因而医保基金支出占长期护理保险筹资额的比例不应超过20%,但是可以通过财政补贴的方式来维持制度的运行,在该模式下最大财政负担比不超过4.67%;依托城镇职工医疗保险的长期护理保险制度的建立会威胁职工医保统筹基金的安全,在当前医疗保险制度下应该谨慎采用。

Research on Sustainability of Long-term Nursing Insurance Model of “Relying on Medical Insurance”-Based on the comparison between urban and rural residents and urban workers

By calculating the long-term care needs of urban and rural residents and constructing an actuarial model of medical insurance, it is found that the establishment of long-term care insurance system relying on urban and rural residents' medical insurance will increase the deficit of medical insurance funds for urban and rural residents, so the proportion of medical insurance fund expenditure in the financing of long-term care insurance should not exceed 20%, but the operation of the system can be maintained by means of financial subsidies. In this mode, the maximum financial burden ratio does not exceed 4.67%. The establishment of long-term care insurance system based on urban employees' medical insurance will threaten the safety of the staff's medical insurance pooling fund, which should be carefully adopted under the current medical insurance system.