健康老龄化视域下人口老化的社会经济困境与优化策略

Socio-Economic Dilemma and Optimization Strategies of Population Aging from the Perspective of Healthy Aging

摘要: 本文采用规范研究法 + 宏观统计量化辅助分析 + 国际制度比较法，立足健康老龄化理论内涵，嵌入国家统计局、医保局、发改委最新人口、基金、经济测算数据，从宏观经济运行、社会保障体系、城乡社会结构、健康服务供给四大维度系统拆解人口老化衍生的多重社会经济困境：劳动适龄人口持续收缩将拉低中长期潜在GDP增速至4.3%以下；职工医保在职退休抚养比跌至2.6:1，退休群体仅占参保18.6%却消耗超55%统筹基金；农村老龄化率高出城镇7.2个百分点，城乡老年收入、健康差距持续分层；医养资源供需错配、护理人才流失率超30%等结构性矛盾叠加。研究整合世代交叠、福利多元主义、全生命周期健康、银发经济四大理论，借鉴德国长期护理保险分级筹资、家庭照护津贴成熟经验，从银发经济全产业链培育、多层次社保制度改革、一体化医养康养县域网络、城乡均衡老龄治理、全生命周期前置健康干预五大维度，配套分阶段落地工具、跨部门协同机制、财政配套方案构建系统性化解路径。本文区别于现有单一文献梳理类研究，创新打通“人口结构量化压力–社会经济传导逻辑–健康老龄化纾解工具”闭环分析链条，为推进中国式现代化进程中健康老龄社会建设提供量化依据与可操作政策参考。

Abstract: Based on the theoretical connotation of healthy aging, this paper adopts normative research method + macro-statistical quantitative auxiliary analysis + international institutional comparison method, embeds the latest population, fund and economic calculation data of the National Bureau of Statistics, the Medical Insurance Bureau and the National Development and Reform Commission, and systematically dismantles the multiple socio-economic dilemmas derived from population aging from the four dimensions of macroeconomic operation, social security system, urban and rural social structure and health service supply: the continuous contraction of working-age population will lower the medium-and long-term potential GDP growth rate to below 4.3%; The on-the-job retirement dependency ratio of employees’ medical insurance fell to 2.6:1, and the retired group only accounted for 18.6% of the insured but consumed more than 55% of the overall fund; The aging rate in rural areas is 7.2 percentage points higher than that in urban areas, and the income and health gap between urban and rural elderly people continues to be stratified; structural contradictions such as the mismatch between supply and demand of medical resources and the loss rate of nursing talents exceeding 30% are superimposed. The research integrates four theories: generation overlapping, welfare pluralism, life-cycle health and silver-haired economy, and draws lessons from the mature experience of Germany’s long-term care insurance grading financing and family care allowance, and constructs a systematic solution path from five dimensions: the cultivation of the whole industrial chain of silver-haired economy, the reform of multi-level social security system, the integrated network of medical care and health care in counties, the balanced aging governance between urban and rural areas, and the pre-health intervention in the whole life cycle, supporting phased landing tools, cross-departmental coordination mechanism and financial supporting programs. This paper is different from the existing single literature research, and innovatively opens up the closed-loop analysis chain of “quantitative pressure of population structure - socio-economic transmission logic - relief tools for healthy aging” to provide quantitative basis and operational policy reference for promoting the construction of a healthy aging society in the process of Chinese modernization.