SummaryThis study aims to examine the impact of China's population policy changes on social insurance. Nearly 4 decades ago, China ushered in the 1‐child policy as a family planning policy to control the adverse effect of high population growth. The current maternity insurance system in China is designed to fit the operations of the 1‐child policy. However, the implementation of the comprehensive 2‐child policy can pose a challenge to the sustainability of the current maternity insurance scheme hence the call for reform.The study empanels a novel and comprehensive system dynamic model that incorporates all the related factors that influence the income and expenditure of maternity insurance in the Jiangsu Province. Data are mainly derived from the historical data of the Statistical Yearbook of Jiangsu Province and the National Bureau of Statistics of China. These are used to construct and simulate a system dynamic model to determine a sustainable contribution rate for maternity insurance.In conclusion, if the rate of contribution of the current maternity insurance policy is not increased, the burden of implementing the comprehensive 2‐child policy will exacerbate the current deficit balance of the maternity insurance fund. The existing maternity insurance benefits thus cannot be maintained, and women's health will be threatened. In the short term, the study proposes an increase in the rate of premium payment to prolong the life of the maternity insurance. In the long term, there is a need to improve the level of coordination and expand the coverage of maternity insurance.
Background: Declining birth rates have become a challenge for many countries around the world. This study aimed to analyze the influencing factors of the sustainable development of the maternity insurance system and find ways to promote higher birth rates. Methods: We used four multi-stakeholder workshops and in-depth interviews to bring together three groups of people: maternity insurance system developers, implementers, and researchers. Then, we analyzed the factors influencing the sustainability of the maternity insurance system using grounded theory. Results: In this study, the most powerful and effective intervention measures for China in the short term include the policy of merging national health insurance with maternity insurance and a dynamic payment rate policy. In the long term, expanding the coverage of the maternity insurance system and improving the management level of the maternity insurance fund are effective intervention measures. Conclusion: This study subdivides the factors influencing the sustainable development of the maternity insurance system, which has certain theoretical significance and can be used as the theoretical basis for quantitative and empirical research model construction in the future.
Background This paper seeks to assess the sustainability of the reformed maternity insurance system and the extent to which China’s current maternity insurance system can support different levels of fertility incentives in the future. Our findings will serve as a reference for countries in a similar demographic predicament and those about to face it. Methods This study used a combination of qualitative and quantitative methods. In the qualitative assessment, we used a grounded theory model to generalize the factors influencing the sustainability of maternity insurance funds. For the quantitative analysis, we used a novel and comprehensive system dynamics model to visualize the status of the combined operation of maternity and health insurance. Data are mainly derived from the historical data of the Statistical Yearbook of Jiangsu Province and the National Bureau of Statistics of China. Results In the short term, fertility incentive payments can be set to motivate people to have children. It is therefore recommended that when the scope of the fertility incentive policy is limited to two children, and an average amount above RMB 10 000 could be set, it would be prudent to set the amount at a level not exceeding RMB 10 000 when the scope of the fertility incentive policy is for all newborns. In the long term, a system of incentives for childbirth should be built from education policy, house price regulation, tax relief and childcare services. Conclusion Our research not only highlights the significance of improving the resilience of maternity insurance by combining maternity insurance and health insurance funds, but also suggests a way to economically incentivize beneficiaries to have children so as to mitigate the decline in China’s birth rate and cope with the crisis of an ageing population.
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