The impact of China's latest population policy changes on maternity insurance-a case study in Jiangsu Province

Effects of incentive-based population policies on sustainability of China's recent maternity insurance system reform: a system dynamics simulation

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.

Research on Supply and Demand of Aged Services Resource Allocation in China: A System Dynamics Model

With the rapid growth of the elderly population of China in recent years, the service demands of older Chinese people continue to increase. The increasingly severe situation with respect to the elderly population is an important social problem that China will face for a long time into the future. It is urgent to solve the problem of how to scientifically carry out allocation planning of service resources for the aged and guide the effective supply of service resources. This paper analyzes the factors affecting service resources for the aged, divides China’s service resource supply and demand system into a supply subsystem, a demand subsystem, and a population and economy subsystem. Using system dynamics methods to analyze the causal relationship between variables and the state space method to build a mathematical model and perform simulation analysis, we research the the current situation of China’s service resources supply and demand balance for the aged. In addition, we put forward resource configuration optimization measures for the future allocation of service resources for the aged, providing a practical basis for future decision-making.

Sustainable Development of China’s Maternity Insurance System in the Context of Population Policy Changes: Using a Grounded Theory Approach

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.

Environment, Business, and Health Care Prevail: A Comprehensive, Systematic Review of System Dynamics Application Domains

System dynamics, as a methodology for analyzing and understanding various types of systems, has been applied in research for several decades. We undertook a review to identify the latest application domains and map the realm of system dynamics. The systematic review was conducted according to the PRISMA methodology. We analyzed and categorized 212 articles and found that the vast majority of studies belong to the fields of business administration, health, and environmental research. Altogether, 20 groups of modeling and simulation topics can be recognized. System dynamics is occasionally supported by other modeling methodologies such as the agent-based modeling approach. There are issues related to published studies mostly associated with testing of validity and reasonability of models, leading to the development of predictions that are not grounded in verified models. This study contributes to the development of system dynamics as a methodology that can offer new ideas, highlight limitations, or provide analogies for further research in various research disciplines.

A Comparative Analysis of Impact of Universal Two-Child Policy on Maternity Insurance Fund in Jiangsu Province and Guangxi Zhuang AR

The maternity insurance fund in some provinces in China has accumulated unprecedented deficit levels. This imminent depletion can cause a catastrophic health crisis for maternal health. This study analyzed the post-policy impact of key factors on maternity insurance income inflow and outflow in Jiangsu Province and Guangxi Zhuang Autonomous Region (AR). We applied Pasera’s ARLD model and VECM Granger Causality Test to establish long- and short-term impact of selected factors that determines the income and expenditure of the maternity insurance fund in the two regions based on data from 2011 to 2019. Our results show that the addition of new births due to the universal two-child policy has increased the per capita utilization of the maternity insurance fund in both areas. We further observed that the impact of the maternity insurance contribution rate to the maternity insurance fund decays with time giving a long-run limited impact in both provinces. Thus the positive impact is stronger in the short term, but in the long term, its influence or contribution to stability of the funds reduces. The positive impact of interest from investment in the maternity insurance fund is however insignificant in both provinces, giving a major cause for concern on its role in maternity insurance fund income generation. In the short term, the contribution rate of the maternity insurance fund must be adjusted upward or the payment base expanded to receive additional contribution from all employees to avoid complete depletion of the fund. In the long term, we recommend the need to replenish the maternity insurance funds through proper investment options for the funds. We further recommend the need to look for other sources of funding social interventions based on existing practices in other countries.