人口老龄化背景下日本医疗保险制度经验镜鉴  

Lessons from Japan s Medical Insurance System under the Background of Population Aging

作　　者：覃诚 王雪薏 QIN Cheng;WANG Xueyi(School of Economics,Guangxi University,Nanning,Guangxi 530004;China Frontier Economic Research Institute,Guangxi University,Nanning,Guangxi 530004,China)

机构地区：[1]广西大学经济学院,广西南宁530004 [2]广西大学中国边疆经济研究院,广西南宁530004

出　　处：《日本问题研究》2025年第2期67-80,共14页Japanese Research

基　　金：广西青苗人才资助科研项目“广西人口少子化发展趋势与政策优化研究”(202402051);广西高校中青年教师科研基础能力提升项目“广西人口少子化发展趋势与生育支持政策优化研究”(2025KY0005)。

摘　　要：中国人口老龄化程度加速发展,迫切需要加快完善适应人口老龄化新形势的医疗保险制度,强化老年人医疗保障。比较国际社会人口老龄化和医疗支出现状,发现日本医保制度具有较为先进的做法和较好的实践效果,以并不突出的人均医疗支出保持了最高的人均预期寿命。因此,系统总结人口老龄化下日本医疗保险改革主要经验,包括建立高龄老年人医保制度和长期护理保险制度,以及分年龄段设立差异化的医保结构与照护体系,对中国医保制度改革具有借鉴意义。借鉴日本医疗保险制度经验,结合中国现行医保制度与人口老龄化的矛盾,提出针对中国医保制度“适老化”改革的建议。With the rapid progression of population aging in China,there is an urgent need to improve the medical insurance system to adapt to demographic changes and strengthen healthcare protection for the elderly.Based on a comparative analysis of international trends in population aging and medical expenditure,this study finds that Japan s medical insurance system demonstrates advanced practices and effective outcomes,achieving the highest life expectancy with relatively moderate per capita medical expenditure.The study systematically summarizes Japan s key reforms in response to aging,particularly the establishment of the medical insurance system for the elderly and the long-term care insurance system,as well as the construction of age-differentiated insurance structures and care frameworks,which has reference significance for China s medical insurance system reform.Drawing on the experience of Japan s medical insurance system and combining it with the contradiction between China s current medical insurance system and aging population,this paper proposes suggestions for the“aging-friendly”reform of China s medical insurance system.

关 键 词：老龄化 日本 医疗保险 长期护理保险 适老化 改革 

分 类 号：C913[经济管理] F840[社会学]