【摘要】：當(dāng)前,公共財(cái)政不僅要補(bǔ)助城鄉(xiāng)居民醫(yī)保基金籌集,還要承擔(dān)其可能存在的赤字風(fēng)險。隨著人口老齡化程度加深和財(cái)政收入增速放緩,城鄉(xiāng)居民醫(yī)保財(cái)政負(fù)擔(dān)日益加重。為解決人口老齡化及其引發(fā)的系列問題,國家接連調(diào)整生育政策,那么,調(diào)整生育政策能減輕城鄉(xiāng)居民醫(yī)保的財(cái)政負(fù)擔(dān)嗎?研究以江蘇省為例,通過構(gòu)建精算模型對生育政策調(diào)整前后城鄉(xiāng)居民醫(yī)保財(cái)政負(fù)擔(dān)的變化情況進(jìn)行仿真分析,并得到以下結(jié)論:第一,如果不調(diào)整生育政策,2090年時城鄉(xiāng)居民醫(yī)保財(cái)政負(fù)擔(dān)是當(dāng)年公共財(cái)政支出預(yù)測值的119.78倍;第二,如果按照"單獨(dú)二孩"政策的實(shí)際生育意愿計(jì)算,預(yù)測期內(nèi)累計(jì)財(cái)政負(fù)擔(dān)相比原政策將下降3.35個百分點(diǎn);第三,"全面二孩"政策下,生育意愿越高,累計(jì)財(cái)政負(fù)擔(dān)下降越快。當(dāng)生育意愿達(dá)到100%時,累計(jì)財(cái)政負(fù)擔(dān)相較原政策將下降62.27個百分點(diǎn)。
[Abstract]:At present, public finance not only subsidizes the raising of health insurance fund for urban and rural residents, but also bears the risk of deficit. With the deepening of population aging and the slow growth of fiscal revenue, the financial burden of medical insurance for urban and rural residents is increasing day by day. In order to solve the aging of the population and its series of problems, the country has adjusted its fertility policy. Can the adjustment of birth policy reduce the financial burden of medical insurance for urban and rural residents? Taking Jiangsu Province as an example, the change of health insurance financial burden of urban and rural residents before and after the adjustment of fertility policy is simulated and analyzed by establishing an actuarial model, and the following conclusions are obtained: first, If the fertility policy is not adjusted, the financial burden of health insurance for urban and rural residents in 2090 will be 119.78 times the projected value of public expenditure in that year; second, if calculated according to the actual fertility intentions of the "single two-child" policy, In the forecast period, the accumulated financial burden will be reduced by 3.35 percentage points compared with the original policy. Thirdly, under the policy of "all-around two-child", the higher the fertility will be, the faster the cumulative financial burden will decrease. When the fertility intention reaches 100 percent, the accumulated financial burden will be 62.27 percentage points lower than the original policy.
【作者單位】： 江蘇大學(xué)管理學(xué)院;中南財(cái)經(jīng)政法大學(xué)公共管理學(xué)院;
【基金】：國家社會科學(xué)基金項(xiàng)目“生育政策調(diào)整對中國社會保險基金可持續(xù)性的影響評估及相關(guān)對策研究”(批準(zhǔn)號15XRK005)
【分類號】：F842.684;R197.1

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