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南京医科大学学报（社会科学版）京医科大学学报（社会科学版）
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Journal of Nanjing Medical University（Social Sciences）of Nanjing Medical University（Social Sciences） 2025年4月
Journal

The prediction of the development scale of China’s medical insurance

fund from the perspective of sustainability

DING Haifeng，CHEN Xi’an
School of Public Administration and Law，Hunan Agricultural University，Changsha 410128，China
Abstract：Based on the perspective of sustainability， this paper analyzes the current revenue and
expenditure of China’s basic medical insurance and its constituent insurance types. Using the revenue and
expenditure data of China’s basic medical insurance fund from 2009 to 2022 as the prediction indicator，this
study constructs a grey GM（1，1）prediction model to predict the scale and balance of China’s basic medical
insurance fund revenue and expenditure. From 2023 to 2030，the scale of China’s basic medical insurance
fund will continue to expand，but the growth rate of the fund’s current balance will decline. During the“15th
Five⁃Year Plan”period，the expansion of the medical insurance fund will decelerate，with potential structural
risks. Specifically，there is a risk of age structure imbalance in urban employee medical insurance，while urban
and rural resident medical insurance encounters government fiscal pressure risks caused by disproportionate
welfare tendency and medical service optimization ⁃ seeking behavior. Moving forward，we should uphold the
safety ⁃ net function of the medical insurance system in protecting people’s livelihood，further optimize the
operation mechanism of the medical insurance fund，and enhance service quality to ensure the sustainable
development of the system.
Key words：basic medical insurance；medical insurance fund；sustainable perspective；GM（1，1）