中国长期照护保险制度的地区比较与思考

本文通过对青岛等13个国家级试点城市和北京市海淀区已出台的长期照护保险相关政策进行梳理,总结各地长期照护保险面临的问题与挑战,并提出对长期照护保险制度建设过程中的福利化与市场化、长期照护保险与医疗保险的关系、具体实施方案等问题的初步思考。根据各试点地区和海淀区已出台文件中有关长期照护保险的基本内容,发现它们在保障对象、筹资来源、评定和保障方式、保障金额、保障内容等方面既有共性,也存在差异。本文认为,虽然各试点地区的长期照护保险制度已初步建立,但在监督管理、护理服务提供等方面的具体实施方案还有待论证;此外,各地还需要不断扩大长期照护保险的受益范围,做好长期照护保险与养老保险、医疗保险的协调与衔接,合理配置医疗、养老和照护资源。

Regional comparison and implications of China's long-term care insurance system

This paper attempts to review the long-term care insurance policies which have been issued in 13 national pilot cities such as Qingdao and Haidian district, Beijing. The paper investigates the problems and challenges China''s long-term care insurance system faces with, and put forward the construction of long-term care insurance system. The preliminary thinking on some issues, such as the relationship between welfare and marketization when the long-term care insurance has been put into practice on a trial basis, the relationship between long-term care insurance and medical insurance, and the specific implementation plan of the long-term insurance. According to the issued documents issued by pilot regions, it was found that there are not only differences but also similarities among the pilot cities in who are insured, who pays the insurance fee, what might be covered, what the levels of insurance are, and what kind of service will be provided. Although the long term care insurance system has been initially established in these cities, the specific implementation remains to be demonstrated, e.g. supervision and management, nursing service provision. In addition, local governments need to continuously expand the benefit range of long-term care insurance to ensure long-term success, do good coordination and connection of long-term care insurance and pension insurance, and reasonably allocate the medical insurance, pension, and health care resources.