How to solve the risk of fiscal burden of the medical insurance fund? Simulation analysis under the universal three-child policy in China

Abstract

Abstract Background The aging population poses a huge challenge to the health care system and puts great burden on the financial operation, and has become a common problem faced by countries around the world. Will the implementation of the universal three-child policy enhance the sustainability of medical insurance funds? How to effectively relieve the financial burden? Method This study analyzes the sustainability of the medical insurance fund and the financial burden under different fertility levels of the universal three-child policy by constructing a dynamic population projection model and an actuarial model of medical insurance. Results Compared with the current fertility policy (fertility rate 1.3), under the adjusted fertility policy (fertility rate 1.4-3.0), the occurrence of the current deficit and accumulated deficit of the medical insurance fund will be gradually postponed, and the fiscal subsidies burden will be significantly alleviated. Conclusions The universal three-child policy is conducive to improving the sustainability of the medical insurance fund and reducing the financial pressure, and the effect is more obvious at higher fertility levels. Considering the time-lag of the fertility policy, medical cost control and outpatient co-payment policies should be promoted simultaneously to improve the efficiency of fund utilization and the modernization of medical insurance governance by adjusting the stock.