Abstract The Ministry of Human Resources and Social Security recently released the "China Social Insurance Development Annual Report 2015". Statistics show that the employee retirement ratio of urban workers' medical insurance has dropped to 2.84, the lowest level in seven years. This also means that from a national perspective, there are currently only less than three active employees...
The Ministry of Human Resources and Social Security recently released the "China Social Insurance Development Annual Report 2015". Statistics show that the employee retirement ratio of urban workers' medical insurance fell to 2.84, the lowest level in seven years. This also means that from the national point of view, there are currently less than three working employees who are “paying the bill†for the medical expenses of a retire. According to the report, as of the end of last year, the national basic medical insurance for 289.93 million workers increased by 5.97 million over the previous year, an increase of 2.1%, an increase of 51.58 million over 2010, and an average annual growth rate of 4%. Among them, the number of employees participating in employee medical insurance was 213.62 million, accounting for 73.9% of the total number of participants, while the total number of retirees was 75.31 million, accounting for 26.1%. Compared with the 2014 data, the proportion of active employees decreased by 0.5 percentage points, and the proportion of retirees increased by 0.5%.
It is worth noting that the ratio of employee retirement (the ratio of the number of employees to the number of retirees) in urban employee medical insurance in 2015 was 2.84, which was the fourth consecutive year of decline. From 2009 to 2014, this value was 2.97, 2.99, 3.02, 3, 2.95, and 2.9, respectively. Among them, the retirement ratio of employees in 24 provinces is lower than the national average.
According to the employee medical insurance policy, retirees do not pay, and the per capita medical expenditure of retirees is much higher than that of employees. The decline in the retirement rate of employees indicates that the income of medical insurance funds has decreased, and the expenditure of medical insurance funds has increased.
In fact, in the context of increased medical expenses and an accelerated pace of aging, health care funds are facing increasing payment pressure. The China Medical and Health Care Development Report 2014 predicted that in 2017, the urban workers' basic medical insurance fund will have a phenomenon of not receiving the current income. By 2024, there will be a serious deficit in the fund.
Some people believe that the current rapid growth of health care costs put pressure on the balance of medical insurance funds, and controlling the growth of medical expenses is the focus of solving the sustainability problem of medical insurance funds.
Experts interviewed by the Economic Information Daily said that the reform of payment methods should be placed in the prominent position of medical reform, and the positive role of payment methods in regulating medical service behavior and controlling the unreasonable growth of medical expenses should be exerted. Linked with public hospital reforms, price reforms, etc., and exert the incentive and restraint effect of medical insurance payments on medical institutions and medical personnel.
The next step will be to combine the budget management of medical insurance funds, comprehensively promote the control of total payment, accelerate the promotion of payment methods by disease type and per capita, explore the combination of total control and point method, and establish a composite payment method. At the same time, medical insurance should actively participate in the price reform of medicines and medical services, formulate medical insurance payment standards for medicines and medical services that are compatible with price reforms, explore the establishment of a mechanism to guide the rational formation of drug prices, and promote medical institutions to actively reduce procurement prices. (Finish)
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