金融学院知识库

2022年我国出现近几十年来首次人口负增长的情况，伴随于此的是育龄夫妇人口的持续减少、新生儿数量的不断下降、老年人所占比例不断增加。这势必会引发生育、老龄化和人口减少这三者之间的恶性循环，人口负增长下“少子老龄化”正成为常态，传统的家庭照护模式已经不能适应这样的人口状况。长期护理保险正是我国应对人口老龄化政策探索的重要一环。

长期护理保险的实施一方面会减轻孕龄夫妻的对父辈的赡养压力同时提高人们对未来社会保障的的照护预期，从而将原本用于应对年老时发生失能情况的资金，更多的用于抚养新生儿或者提前生育时间，而另一方面，长期护理保险试点也会使得人们愿意将更多的老年照护需求交予长期护理保险或者其他社会保障政策或保险，进一步淡化人们“养儿防老”的心理。综合上述背景，实证探究了长期护理保险试点对人口出生率的影响作用。

因此，本文基于2010-2019年共287个地级市的面板数据，在相关理论基础上利用双重差分法来构建模型，评估长期护理保险试点对人口出生率的影响方向、大小和机制。实证结果发现：（1）总体上，长期护理保险试点提高了人口出生率，相较于未实施试点提高了2.7‰，并且通过了平行趋势检验、滞后一期自变量、PSM-DID、排除其他政策效应、改变政策试点时间、随机分配试点地区一系列稳健性检验，使得结果具有一定的可靠性。（2）研究发现保险兜底机制在发挥长期护理保险提高人口出生率的过程中起到了一定的中介效应，随着保险业保费收入增长和城镇基本医保参保人数的不断增多，保险兜底机制的完善减轻了孕龄夫妻的赡养压力，从而促进生育率的增加。（3）进一步进行异质性分析发现，对于中西部和非富裕地区长期护理保险试点政策对人口出生率的提高具有显著的正向影响，而在东部和富裕地区则表现为不显著。根据以上结论，本文提出相应的对策建议：首先，应利用财政拨款支持传统的家庭照护模式；其次，大力支持养老护理产业的发展，明确建设多元养老护理的服务体系，同时通过推动商业长期护理保险发展使保障范围更加全面；最后，逐步扩大农村长期护理保险的试点范围，加快建立覆盖全民的社会养老护理保障体系。

In 2022, for the first time in recent decades, we experienced negative population growth, accompanied by a continued decline in the number of couples of childbearing age, a declining number of newborns, and an increasing proportion of the elderly. This will inevitably lead to a vicious circle between fertility, aging and population reduction. Under the negative population growth, "aging of young children" is becoming the normal state, and the traditional family care model can no longer adapt to such a population situation. Long-term care insurance is an important part of our country to deal with the aging population policy.

On the one hand, the implementation of long-term care insurance will reduce the pressure of pregnant couples on their parents' support and increase people's expectation of future social security care, so that the funds originally used to deal with disability in old age will be more used to raise newborns or advance the time of childbirth. On the other hand, The long-term care insurance pilot will also make people willing to pay more of their elderly care needs to the long-term care insurance or other social security policies or insurance, further diluting people's psychology of "raising children for old age". Based on the above background, this paper empirically explores the effect of long-term care insurance pilot on birth rate.

Therefore, based on the panel data of 287 prefecture-level cities from 2010 to 2019, this paper uses the difference-difference method to build a model on the basis of relevant theories to evaluate the direction, size and mechanism of the impact of the long care insurance pilot on the birth rate. The empirical results show that: (1) In general, the long-term care insurance pilot increased the birth rate by 2.7‰ compared with the pilot without implementation, and passed a series of robustness tests including parallel trend test, independent variable with a lag of one period, PSM-DID, exclusion of other policy effects, change of policy pilot time, and random allocation of pilot areas, making the results have certain reliability. (2) The study found that the insurance cover mechanism played a certain intermediary effect in the process of improving the birth rate of the long-term care insurance. With the growth of insurance premium income and the continuous increase of the number of urban basic medical insurance participants, the improvement of the insurance cover mechanism alleviated the support pressure of the pregnant couples, thus promoting the increase of the fertility rate. (3) Further heterogeneity analysis shows that the pilot policy of long-term care insurance has a significant positive impact on the increase of birth rate in the central and western regions and non-rich regions, while it is not significant in the eastern and rich regions. According to the above conclusions, this paper puts forward corresponding countermeasures and suggestions: First, we should use financial allocation to support the traditional family care model; Secondly, vigorously support the development of the elderly care industry, clearly build a diversified elderly care service system, and promote the development of commercial long-term care insurance to make the coverage more comprehensive; Finally, we will gradually expand the pilot scope of rural long-term care insurance and speed up the establishment of a social old-age care security system covering the entire population.