You may know that an old man has cancer and died of more than 5 million smallpox in the hospital intensive care unit for 68 days. In fact, this typical example is not enough to show that our medical system is very corrupt. More than 5 million is very normal for a critically ill patient who has taken care of him for 68 days. The hospital only charged him more than 6.5438 million yuan. Various experts came to consult him, and his family demanded that at all costs. In fact, more than 654.38+0 million is not much, because more than 4 million of them are all kinds of expensive drugs he bought abroad. This is really a piece of cake in America. Pension is a difficult problem for every country. The United States has established a social security system from 1935, that is to say, the pension is paid to 1965, and the old-age medical insurance is established. Now the government has a very, very heavy burden. The number of people covered by old-age medical insurance is small, but it accounts for a very high proportion of government expenditure. As soon as the elderly patients arrive, the hospital has a special incentive to treat them hard, and then the government pays the bill, so this problem is a headache for the US government. How to reform is mentioned every year, but it is difficult to change because it involves the interests of too many people. Therefore, the medical expenditure of the elderly is a great challenge to the elderly in terms of medical expenses. In this article, I want to discuss the influence of aging on medical expenses in China. Here we have made a simple calculation, that is to say, how much the aging process will affect our medical expenses.
First, let's see what others have done. The United States uses medicine.
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PanelSurveysdata data for research. Research shows that although the per capita medical expenses of the elderly population are 3-5 times that of young people, and the expenses of the elderly are very high, the impact of population aging on the overall medical expenses is not so serious. According to the forecast of OECD, aging will lead to the increase of social expenditure related to the elderly population from 19% in 2000 to 26% in 2050, of which pension expenditure and medical and health expenditure of the elderly population will account for half. In addition, South Korea uses three methods to estimate the impact of aging on medical costs. It is found that although it is predicted that the per capita actual health expenditure will increase by more than 30% by 2030, age itself is not a crucial factor, but medical expenses and insurance coverage will be very important to the growth of medical expenses. China has also done some research in this regard. According to the actual medical expenditure 1998, by 2025, the burden of medical demand brought by the aging population will increase by 47%. It is a conservative estimate to consider the year-on-year increase of medical expenses of all ages according to the annual growth rate of GDP. By 2025, China's medical demand will reach more than 6 trillion yuan, accounting for about 12% of GDP in that year. As we all know, we only account for 5.7% at present, which is the data before the economic census. According to the economic census, GDP has increased by 16.8%, so it is only about 5% now, and it will be 12% in 2025. In addition, the annual per capita medical expenses of the elderly are 2.56 times of the total population, and the medical expenses of the elderly population, which accounts for 10% of the total population, account for 30% of the total per capita medical expenses. To sum up, the aging population will lead to a sharp increase in the medical expenses of the elderly population. On the one hand, it is due to the increase in the number of elderly people, on the other hand, it is due to the changes in the health status of the elderly population, because people will get various diseases when they get old. There are two different views on the influence of population aging on the total medical and health expenditure. One view holds that the aging of population is the main driving force for the increase of medical and health expenditure, while the other view holds that the aging has little effect on the increase of medical and health expenditure, one of which is the increase of medical and health expenditure.
Our research wants to look at the impact of aging on the overall medical expenses in China. We must take into account the total population of China. The total population will peak around 2040, but the increase of the total population, including the increase of aging, is very uneven among regions. Just now, Professor Du also talked about the imbalance between rural areas and cities. We have done some surveys, that is, the aging in rural areas of China is more serious than that in cities, which was also confirmed by Professor Du's article just now. Rural people say in simpler language that there are three kinds of "ghosts" in our countryside, which are called "old ghosts, imps and sick ghosts". As you can see, the old man stayed, the children stayed, and those who were in poor health stayed in the countryside. Therefore, the change of the whole medical scale and structure actually poses a great challenge to our medical system. Some medical and health needs are rising with the increase of the total population. In many areas, the demand for medical services has actually declined due to population migration. For example, those left behind in rural areas are old, weak, sick and disabled, and their needs are different from those in densely populated urban areas. We use the charts predicted by the World Health Organization, the World Bank and the United Nations to predict the population size. Changes in population will change medical needs.
Another is that the change of age structure will also have a great impact on the structure of medical services. Nowadays, the causes of death of urban residents have changed greatly. Our disease spectrum is now at the level of developed countries, and the incidence of chronic diseases, especially those caused by aging, has increased. Because many people died at the age of 60 before they got sick. Now they all live a long life. We now have a life expectancy of 72, so the proportion of chronic diseases among the elderly is very high. Besides, it is an emotional disease, such as Alzheimer's disease. I haven't heard much about it before. Now, how can an old man be stupid when he is old? It is because he didn't live that long in the past that he died before he waited for stupidity. After the age of 80, the proportion of Alzheimer's Harmo's disease is very high. In fact, there is no cure for Alzheimer's disease in the world, and the life span of the elderly will not be affected after they become stupid. In fact, they can live a long time after they are stupid. The most typical example is former US President Ronald Reagan who suffered from Alzheimer's disease. After suffering from Alzheimer's Harmo's disease, he wrote an open letter to improve Americans' understanding of Alzheimer's Harmo's disease, saying that he had already suffered from Alzheimer's Harmo's disease. I hope everyone can contribute to it and work hard to overcome this stubborn disease. At that time, his daughter set up a foundation for Alzheimer's Harmo's disease, and her daughter went around the world to raise funds to contribute to the fight against Alzheimer's Harmo's disease. Reagan lived 10 years after he got that disease, and his daughter was much younger than him. She was probably too busy. Before Reagan died, Reagan died five years after her death. Therefore, this disease will not affect his life span. As long as he is properly cared for, he will live a long life. This cost is very high.
As we all know, our future population structure will be inverted pyramid. In addition, there is the distribution of people over 80 years old in various countries. China is the largest country because we have a large population base. Previous professors also said that it is costly and burdensome to take care of the elderly over 80 years old. The other is the proportion of medical expenses of different age groups to the total medical expenses. We listed four countries, namely Finland, Germany, Portugal and the United States. As you can see, the two are basically similar, that is to say, the medical expenses of the elderly, especially those over 65, are three to five times that of the young. The situation of the elderly population in our country, chronic diseases and tumors, cardiovascular and cerebrovascular diseases, which cost more. The data surveyed by the Ministry of Health are two-week prevalence data of residents by age, one is 1998 and the other is in 2003, both of which are increasing. You can see that it is increasing, especially over 65 years old, and the incidence rate is also increasing. The other is the proportion and growth rate of China's total health expenditure to GDP. You can see that the growth rate of total health expenditure exceeds GDP most of the time.
Let me quickly say a simple estimate of the medical expenses of the elderly population. After simplification, the change of the condition is not considered, because there are too many uncertainties in the condition, which is very troublesome. Therefore, we assume that the per capita medical expenses of the elderly population is equal to three times the per capita medical expenses of other age groups, so the total medical expenses of the elderly population in our country have already occurred, and the per capita medical expenses of the elderly population multiplied by the number of the elderly population is the total medical expenses of the elderly population. We know that there is a very special situation in our country, and many of us look down on illness. According to the data of the health survey in 2003, nearly 50% people in China did not go to the clinic because of illness, because of economic reasons, and nearly 30% people were not hospitalized because of illness. At this time, the actual needs of the elderly population should be considered, but their needs have not been met. At this time, a conversion is made, except for one factor (1- the proportion of elderly people who should have seen a doctor but didn't) and /( 1- the proportion of elderly people who should have been hospitalized but didn't). In this way, the increase in the total medical expenses of the elderly population is equal to the increase in the per capita medical expenses of the elderly population multiplied by the increase in the number of the elderly population. I can show you the results of the calculation. In 2000, we used actual data, and later we estimated the data according to the previous formula. As you can see, the growth rate is very fast. In fact, we are still low. Assuming that many diseases remain unchanged, the per capita medical expenses used to increase linearly. As we all know, these are actually conservative estimates. Because today's science is changing with each passing day, you can change your heart, lungs and liver, and you can change your head in the future. This cost is actually extremely high. As you can see, the medical expenses of the elderly in China will be huge in the future, and the proportion of the medical expenses of the elderly population in GDP will be extremely high in the future. Nearly 9% in 2030 is still a conservative estimate. This is a relatively simple estimate, but from this relatively simple estimate, we can also see that the challenge of providing for the aged in the future is enormous.
This is an estimate of the number of patients in two weeks and the number of patients with chronic diseases calculated according to what happened before. As you can see, this situation is increasing. The number of patients and hospitalization also changed.
To sum up, through our simple estimation, we can see that the aging in China is rapidly increasing the demand for medical care, which will cause great pressure on society and families. Therefore, we should establish a corresponding medical security mechanism to meet the challenge of providing for the aged in the future. In addition, an important factor for the increase in medical and health expenses is the increase in medical prices. Therefore, in order to cope with the rising medical expenses caused by aging, controlling medical prices is an important means. How to provide efficient medical services at low prices means that we must establish a medical service system that can cope with future challenges and have corresponding policies. For the elderly over 65 in Britain, the state will not allow them to replace their hearts, livers and lungs. If you want to pay for it yourself, you must establish corresponding systems and systems. In addition, the change of population aging needs to adjust the medical service structure. I especially agree with the previous two professors that health education is the most important thing. How to make him the healthiest from birth and healthy all his life, and then his health expenses must be low. Therefore, the real problem to be solved is actually universal health education, but also to provide medical services in line with new diseases. In addition, there is community medical care for senile diseases. Another point is the characteristics of China, so we must promote Chinese medicine. Traditional Chinese medicine massage and acupuncture have relatively low costs and good effects. There is great uncertainty in the future population health and scientific and technological development. Our research is very preliminary, and you are welcome to do further research in this field. Thank you!