Analysis on the current status and equity of Beijing's urban and rural residents'basic medical insurance funding
10.3969/j.issn.1674-2982.2025.11.005
- VernacularTitle:北京市城乡居民基本医保筹资现状及公平性分析
- Author:
Jin-tao SONG
1
;
Ruo-bin XING
;
Jin-xuan ZHENG
;
Yan-tao MA
;
Wan-yu YANG
;
Yan-bing ZENG
Author Information
1. 首都医科大学公共卫生学院 北京 100069
- Publication Type:Journal Article
- Keywords:
Urban and Rural Residents'Basic Medical Insurance;
Funding status;
Equity;
Policy optimization
- From:
Chinese Journal of Health Policy
2025;18(11):31-38
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To systematically evaluate the current financing status of Beijing's urban and rural residents'basic medical insurance,analyze equity disparities among different groups under the existing flat-rate financing policy.By simulating the equity changes of various financing schemes with different contribution rates,this study aims to provide foundations for advancing medical insurance financing system reform.Methods:Based on the per capita disposable income and number of insured residents in Beijing's 16 districts from 2018 to 2023,we separately calculated the Gini coefficient,concentration index,and Kakwani index,along with their changes before and after financing adjustments,to assess the funding burden among different insured groups.Using the geometric mean method,we projected per capita disposable income and insured populations for each district in Beijing from 2024 to 2035,simulating various financing schemes under different premium rate systems.Results:From 2018 to 2023,the Gini coefficient of net income after financing consistently exceeded that of original income before financing.The concentration index remained positive and showed an upward trend,while the Kakwani index was negative for all periods.The Gini coefficient after financing slightly decreased for the elderly and working populations with fiscal subsidy support,whereas it remained higher than that for students and children.Under the simulated differentiated rate system,the post-funding Gini coefficient for 2024-2035 was lower than the original value,and the Kakwani index was positive.Conclusions:The current fixed-amount financing mechanism for urban and rural residents'basic medical insurance exhibits regressive characteristics and insufficient fairness,with disparities in equity among different insured groups.It is necessary to establish differentiated financing standards based on differential rates,particularly implementing a financing mechanism with dynamic adjustments according to regional and group income levels,to enhance the fairness of financing for urban and rural residents'basic medical insurance.
