Forecasting China's Medical Insurance Policy for Urban Employees Using a Microsimulation Model

This paper uses microsimulation techniques to model individual's medical behavior and forecast the effects of different settings of medical insurance policies. The aim of the simulation is to measure the possible change and difference in policies in the process of implementation of the medical insurance policy settings for government policy makers. Based on predicting the medical expenses for urban employees in Zhenjiang, Jiangsu Province of China, the medical insurance policy was simulated over the five-year forecast period 2002 - 2006. The results estimated that the medical expenses of medical insurance participants in Zhenjiang will increase over this period. Retirees were found to be the main group of participants receiving the highest share of medical resource expenditure, with their medical expenses accounting for more than 45% of total medical expenses of all age groups. The proportion of medical expenses paid by the social pool funds for all groups of participants will increase annually. In addition to the base case forecasting the current policy setting, this paper also modeled two other policy settings to investigate what happens to key output variables if the policy settings are changed.Medical Insurance, Policy Research, Microsimulation, Model

Constructing a Basefile for Simulating Kunming’s Medical Insurance Scheme of Urban Employees

Focusing on China’s medical insurance scheme which covers all employers and employees in urban areas, this research aims to assess the distributional impacts of medical insurance policies and to predict medical expenses by using microsimulation techniques. As an important part of the project, this article provides a brief overview of China’s medical insurance reform of urban employees and detail the techniques and processes to construct a basefile in 2005 for projecting the medical expenditures for urban employees over the period of 2006-2010. The main data used are administrative medical records of medical insurance participants provided by the Bureau of Labour and Social Security of Kunming, Yunnan Province. Along with the initial analysis for the raw datasets and age processing and adjustment for the individual records, monthly income information was imputed and personal savings accounts were established for each individual record. Important modelling parameters such as death rates and income adjustment factors were constructed. Furthermore, this article identifies medical insurance for government officials by using the combination of logarithm curve fitting and binary discriminant analysis. Based on this basefile, a static microsimulation model can be built to assess the implementation effects of the medical insurance policy and analyse the impact of the medical insurance scheme on urban employees.Urban medical insurance, China, microsimulation, basefile, Policy Research

Constructing an Urban Population Model for Medical Insurance Scheme Using Microsimulation Techniques

China launched a pilot project of medical insurance reform in 79 cities in 2007 to cover urban nonworking residents. An urban population model was created in this paper for China's medical insurance scheme using microsimulation model techniques. The model made it clear for the policy makers the population distributions of different groups of people, the potential urban residents entering the medical insurance scheme. The income trends of units of individuals and families were also obtained. These factors are essential in making the challenging policy decisions when considering to balance the long-term financial sustainability of the medical insurance scheme

SARS-CoV-2 bivalent mRNA vaccine with broad protection against variants of concern

IntroductionThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant has rapidly spread around the globe. With a substantial number of mutations in its Spike protein, the SARS-CoV-2 Omicron variant is prone to immune evasion and led to the reduced efficacy of approved vaccines. Thus, emerging variants have brought new challenges to the prevention of COVID-19 and updated vaccines are urgently needed to provide better protection against the Omicron variant or other highly mutated variants.Materials and methodsHere, we developed a novel bivalent mRNA vaccine, RBMRNA-405, comprising a 1:1 mix of mRNAs encoding both Delta-derived and Omicron-derived Spike proteins. We evaluated the immunogenicity of RBMRNA-405 in BALB/c mice and compared the antibody response and prophylactic efficacy induced by monovalent Delta or Omicron-specific vaccine with the bivalent RBMRNA-405 vaccine in the SARSCoV-2 variant challenge.ResultsResults showed that the RBMRNA-405 vaccine could generate broader neutralizing antibody responses against both Wuhan-Hu-1 and other SARS-CoV-2 variants, including Delta, Omicron, Alpha, Beta, and Gamma. RBMRNA-405 efficiently blocked infectious viral replication and lung injury in both Omicron- and Delta-challenged K18-ACE2 mice.ConclusionOur data suggest that RBMRNA-405 is a promising bivalent SARS-CoV-2 vaccine with broad-spectrum efficacy for further clinical development

Evaluating Sustainability of Medical Insurance Scheme for Urban Employed Individuals in China*

In the late 1990s, the Chinese government established the medical insurance scheme for urban employees and retirees. Given China's considerable size and diversity, the reform of the medical care system faces many challenges. It is important to analyse and evaluate the impact of the reform on individuals’ health care benefits and on their financial burden due to medical expenses. This research investigates the sustainability of the urban medical insurance system. With co-operation from the Bureau of Labour and Social Security of Kunming of China, this article creates a static micro-simulation model for predicting and evaluating the medical insurance policies. The model investigates the balances of the social pool fund and personal savings accounts. In the model, administrative data over 2001–2005 were used as the micro-simulation base data sets. With 2006 as the commencement year, the model forecasts medical service expenses and medical insurance policy settings for five years until 2010. This research aims to advance the understanding and impact of health insurance reform in China, and to assist in future policy formulation and implementation.

The integration of urban and rural medical insurance to reduce the rural medical burden in China: a case study of a county in Baoji City

Abstract Background In 2003, the Chinese government launched the New Rural Cooperative medical System(NRCMS) for its rural population. In 2007, the Urban Resident Basic Medical Insurance Scheme(URBMS) was inaugurated, which aimed to cover all urban residents who are out of the labor market. However, the accessibility and fairness of the healthcare service have hindered the progress of universal healthcare. At the beginning of 2010, the Integration of Urban and Rural Medical Insurance Scheme(IURMIS) was implemented to bridge the gap in medical care between urban and rural areas. The main objective of this study is to determine the extent to which the IURMIS has been successful. Methods The statistical software packages SPSS 19.0 and STATA 12.0 were used for all analyses, and P < 0.05 was set as the required level of significance. Data were collected from outpatients from 2009 (July to December, n = 20,459) through 2011 (n = 65,258 in 2010, n = 59,036 in 2011) and from inpatients in 2011 (n = 3662). Due to the enormous amount of data and the short time span, most of our analysis was descriptive. However, regression discontinuity (RD) and the chi-squared (χ2) test were used to compare the ratios of medical expenses before and after the IURMIS. Results In the RD analysis, there was a downward trend in the mean medical expense (Coef. = − 0.66, P < 0.001), and rural outpatients flowed to township hospitals and village clinics after the implementation of the IURMIS (Coef. = − 0.45, P < 0.001). However, compensation expenses showed an upward trend (Coef. = 11.59, P < 0.001). In the analysis of inpatient expenses, the average expenses (CNY 2067) and hospitalization days (10.0) for all the hospitals were less than those in the Chinese Fourth National Health Services Survey (CNY 3412 and 10.3, respectively). Conclusions Rural residents’ healthcare options and quality were improved and medical expenses were significantly reduced after implementation of the scheme. These results provide an evidence-based reference for improving the integration of the urban and rural medical security systems throughout China