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目的:分析我国社会医疗保险基金收支平衡变化情况,评估基金超支风险发生的时点和程度。方法:根据社会医疗保险基金自1995年到2015年21年间收入、支出和年度结余情况,利用时间序列模型预测到2030年的收支、结余情况。结果:社会医疗保险基金收入与支出呈逐年递增趋势。基金支出与基金收入比值从1995年的75.35%上升到1998年的87.96%,随后逐渐下降到2001年的63.63%。其后又逐渐上升,2015年到达83.19%。预测到2021年基金收入总额为20 075.10亿元,支出为20 256.40亿元,年度基金支出大于年度基金收入。结论:在我国老龄化趋势不断加剧的背景下,医疗费用快速上涨,社会医疗保险基金的收支平衡压力越来越大,预测到2021年基金将出现收不抵支的超支风险。
OBJECTIVE: To analyze the changes in the balance of payments of social medical insurance funds in our country, and to assess the timing and extent of the risks of fund overruns. Methods: Based on the income, expenditure and annual balance of social medical insurance fund from 1995 to 2015 in 21 years, the time series model is used to predict the income and expenditure and balance in 2030. Results: The income and expenditure of social medical insurance fund are increasing year by year. The ratio of fund expenditure to fund income increased from 75.35% in 1995 to 87.96% in 1998, and then gradually dropped to 63.63% in 2001. Then it gradually increased, reaching 83.19% in 2015. It is estimated that the total fund income in 2021 will be 2.07511 trillion yuan, with an expenditure of 2.025640 trillion yuan. The annual fund spending will be larger than the annual fund income. Conclusion: Under the background of the aging trend in our country, the medical expense rapidly rises and the medical and health insurance fund has more and more pressure on the balance of payments. It is predicted that the fund will face the overrun risk of non-payment in 2021.