Background: With the rapidity of population aging process and increasing burden of traditional family cares, on the one hand, the phenomenon of care absence for the elders needing care are widespread, on the other hand, the structural imbalances problem of long term care provision is becoming more and more serious. Therefore, it’s urgent to optimize the long term care system and establish a scientific fund-raising pattern.
Objective: Guided by the notion of integrated care, the paper proposed to establish a scientific fund-raising pattern with the opportunity of long term care integrating with health care by learning from the international experience and some areas of China and considering the current situation of Chinese long term care system and social medical care. The fund-raising pattern is pooling funds transferring from urban basic medical insurance combined with individual contribution. In this way, the long term care system will be optimized, the purchasing power will be strengthened and the individual’s social right of health will be guaranteed.
Data and methods: Lessoning from the ILO model, the paper established the fund-raising pattern model which is composed of demographic and economic model, fund-raising estimation model, expenditure estimation model and the results model. Then the relevant parameters are calculated based on the macro social economic and demographic data from the sixth population census, China Statistical Yearbook et al. and micro survey data from CHARLS et al.
Results: (1) The amount and rate of pooling fund transferring from Urban Basic Medical Insurance will increase year by year. By 2060, the amount of pooling fund transferring from Urban Worker Basic Medical Insurance and Urban Resident Basic Medical Insurance is 3245.306 billion and 1577.372 billion respectively, and the ratio is 3.49% and 7.02% respectively. (2) The compensation amount and rate of pooling fund transferring from the Urban Basic Medical Insurance will greatly cut down, compared to that of original policy. By 2060, the compensation amount transferring from Urban Worker Basic Medical Insurance and Urban Resident Basic Medical Insurance will cut down 94.64% and 94.48% respectively. The ratio will cut down 61.70 percentage points and 119.47 percentage points respectively. (3) The per capita contribution fee and rate for 45+ will increase year by year. By 2060, the per capita contribution fee for people between 45–49 insured by Urban Worker Basic Medical Insurance and Urban Resident Basic Medical Insurance will increase to 6157 and 3078 yuan per year respectively, the rate is both 2.21%. The per capita contribution fee for people over 60 will grow to 5146 yuan per year and the ratio to 3.69%.
Conclusions: The building of the fund-raising pattern of long term care integrating with health care is not only feasible economically, but also the systematic optimization of urban basic medical insurance and the opportunity of facilitating innovation of long term care service policies. Finally, the paper putted forward some advices on promoting the construction of long term care system integrating with health care and the pilot work of establishing the fund-raising pattern.