中国基本医疗保险基金存在当期收不抵支风险!

2017-06-12 徐金波 中国新闻网

按《中国医疗卫生事业发展报告2016》的推算,2029年城镇职工基本医疗保险基金将出现当期收不抵支的现象,到2034年将出现基金累计结余为负的情况。

6月10日,《中国医疗卫生事业发展报告2016》(卫生改革与发展绿皮书)发行。报告指出,中国城镇职工基本医疗保险基金存在出现当期收不抵支和累计结余为负的风险。

10日出版的《中国医疗卫生事业发展报告2016——中国医疗保险制度改革与发展专题》,由华中科技大学、武汉大学、安徽医科大学、中山大学等诸多高校教授参与编写。报告在广泛的文献研究和大量数据收集的基础上,全面分析了中国医疗保险体系发展的历史沿革、规模结构、筹资与支付、医保运行的质量与效果,体系整合、风险防范等。力图通过对整个体系的系统阐述,发现现阶段最为关键的问题,并提出对未来体系构建的设想。

该报告主编、华中科技大学同济医学院教授方鹏骞指出,整体说来,中国通过城镇职工基本医疗保险、新型农村合作医疗、城镇居民医疗保险,建立了一张覆盖全国96.5%人口的医疗保障网。在此基础上,还通过大病保险、商业保险、慈善救助等逐步健全了医疗保障体系。

截至2015年底,上述三项基本医疗保险参保人数超过13亿人,基本医疗保险覆盖范围不断扩大,基本实现人员全覆盖,从“极少数人享有”到“人人享有”;保障范围和补偿比例不断提高,补偿比例从最初的20%左右增加至现在的50%左右;居民就医经济负担逐步减轻,2015年个人卫生支出占卫生总费用比重较2014年下降1.43个百分点,比2001年的59.97%下降了30%。

同时,也存在中国基本医疗保障制度呈现出城乡制度分设、管理分割、资源分散的“三分”格局和“碎片化”现象,有损公平和效率,并不能适应中国快速工业化和城镇化带来的人口大规模转移的形势;城镇居民医保过度依赖财政投入,运行风险加剧;基金收不抵支与利用水平较低的现象并存,城乡居民大病保险利用不均影响保险效果发挥等诸多问题。

特别是在中国经济进入新常态发展阶段后,一方面国民经济增长速度放缓,职工工资增长也将减速,按工资比例收取的基金收入的增幅也将下降。另一方面中国已进入全民医保时代,医保的扩面已无空间,由扩面牵动的基金收入的增长效应也将微乎其微。结合以上因素,预测未来的基金收入增幅将进入10%左右的中速增长时代。而基金支出由于受到医疗费用、进一步释放的医疗服务需求、人口老龄化加速等因素的影响,预计短时期内其增幅将不低于以往。

按2000-2015年医保基金收入年均增幅19.75%、支出年平均增幅21.43%的增长率推算,2029年城镇职工基本医疗保险基金将出现当期收不抵支的现象,到2034年将出现基金累计结余为负的情况。

“以上预测结果是基于当前发展态势对未来趋势的初步预判,显示中国基本医疗保险的基金在运行上仍然存在一定压力。随着国家对国民健康问题在重视程度越来越高,以及医疗卫生体制改革的深入,医保支付方式也在不断地改革与完善中,当国家经济、财政投入、政策制度发生变化时,尤其是逐步建立三医联动机制,加强了对医疗行为的监管后,预警时间可能推迟,甚至不发生。”方鹏骞最后强调。

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    2017-06-14 xuyu
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    2017-06-14 feifers
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    2017-06-13 惠映实验室

    学习了,确实要重视。

    0

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    2017-06-13 189****7206

    学习了谢谢分享。

    0

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    2017-06-12 1e13566dm72(暂无匿称)

    国家本来就义务为医保基金补缺口,要不然,优越性?

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    2017-06-12 有备才能无患

    以上预测结果是基于当前发展态势对未来趋势的初步预判,显示中国基本医疗保险的基金在运行上仍然存在一定压力

    0

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