老龄化视角下，商业健康险与城职保的共同发展路径探讨——基于跨期消费决策模型

The Co-Development of Private Insurance and Medical Insurance for Urban Workers in China with Aging Population—Based on the Intertemporal Consumption Model

摘要: 随着人口老龄化程度的加剧，我国即将步入“人人带病，长期生存”的长寿时代，老年人在基本医疗保险中的获益份额也会逐渐增加，在现收现付制下，基本医疗保险基金很可能会捉襟见肘，进而带来严重的代际矛盾和财政压力。基于跨期消费决策模型，本文将商业健康险、城镇职工基本医疗保险以及老龄化同时纳入理论模型，发现商业健康险和职工医保的关系并非简单的线性关系，而是取决于老龄化水平和年轻人医保受益比率的异质性关系。本文以30个省的省级面板数据为样本，通过实证验证了以上假说，同时发现随着老龄化程度的提升，年轻人受益比率对商业健康险保费收入及其与职工医疗保险保费收入比值的负效用越发明显。

Abstract: As the aging of the population, China is about to enter the longevity era of “everyone is sick but has longevity”. The benefit ratio of the elderly in the basic medical insurance will gradually increase. Under the pay-as-you-go system, the basic medical insurance fund is likely to be stretched, which will cause serious intergenerational conflicts and financial pressure. Based on the intertemporal consumption model, we incorporate private insurance, medical insurance of urban workers and aging into the theoretical model, and find that the heterogeneous relationship between commercial health insurance and medical insurance of urban workers depends on the level of aging and young workers’ benefit ratio of the national insurance. We use panel data from 30 provinces to verify the above hypothesis and find that with the increase of aging, the more the young workers benefit from the national insurance, the more resource will turn to the national insurance from private insurance.