Study On The Construction Of Long-Term Care Insurance In China

Aging problem has become increasingly serious in our country in recent years,and the aging population in China is expected to rise from existing 241 million to 487 million around the year of 2050,when it will reach 34.9% of our country's population.The consequent increase in the number of disabled elderly in China leads to a sharp rise in demand for long-term care.Our country is located in Asia where the filial piety culture is very popular,and it usually shall be taken the responsibility to take care of the disabled elderly people by the family in the traditional sense.As the change of family structure,informal care services for older people gradually reduce,and informal care has been unable to meet the growing demand,which makes some disabled elderly people accept long-term care services in nursing institution.However,nursing cost is very high in professional institutions and many elderly people can't afford it in the long term.Under this background,it is very necessary to introduce long-term care insurance.Compared with the western developed countries,China has introduced long-term care insurance for a relatively short period of time.The development of long-term care insurance in our country is relatively slow and lacks top-level design,so it is urgent to construct long-term care insurance system in China.Based on the above background,this dissertation studies the construction of long-term care insurance system in China,which is expected to provide theoretical basis for the construction of China's long-term care insurance system.This dissertation mainly adopts literature research method,comparative research method,empirical research method,and mathematical model derivation method.The main research contents include the following five aspects: the practice and implications of long-term care insurance in developed countries,factors affecting the intention of purchasing long-term care insurance,long-term care insurance pricing,social long-term care insurance contribution rate mechanism,construction of long-term care insurance system in China.This dissertation analyzes the long-term care insurance system in America and Japan.The United States is the representative country of commercial long-term care insurance system and Japan is the representative country of social long-term care insurance system.From the practical experience of the United States and Japan,China should build long-term care insurance system combining social long-term care insurance and commercial long-term care insurance.It is necessary for the government and the market to play a role at the same time when building long-term care insurance in China.China should build a long-term care insurance system which social long-term care insurance is the mainstay and commercial long-term care insurance is the supplement.Social long-term care insurance must achieve wide coverage and basic guarantees.The empirical part of this dissertation uses survey data to analyze the factors affecting the willingness to purchase long-term care insurance,focusing on the influence of children's situation,cognition of long-term care and long-term care insurance on the willingness to buy long-term care insurance.The empirical results show that the lower the number of children,the higher the education level of thechildren,the better the economic situation of the children,the worse the relationship between the parents and their children,the farther the parents and their children live,and the more economic independence between parents and children,the stronger the willingness of parents to purchase long-term care insurance;the individuals whose family has received long-term care in the past decade,thinking long-term care cost are high,worrying nobody to take care of them when in need,knowing more about long-term care insurance and thinking long-term care insurance will play a big role,will have more demand for long-term care insurance.In terms of long-term care insurance pricing,the dissertation classifies disability status into mild disability and severe disability,and the first time attempts is made to pricing long-term care insurance using multistate Markov model on the basis of four types of health status(health,mild disability,severe disability,death).Most of the previous studies are based on three classes of health status(health,disability,death)and there is no subdivision of disabled status.The subdivision of disabled status in this dissertation is more consistent with the actual situation.When calculating the contribution rate of social long-term care insurance,this dissertation calculates it by province(city).This dissertation mainly considers the government's financial transfer and individual contributions as the source of funds for long-term care insurance and calculates the contribution rates of governments and individuals in various provinces(cities)in China.The dissertation also calculates the proportion of the provincial(municipal)government's fiscal transfer of social long-term care insurance to the GDP of local government.Finally,the dissertation proposes a development strategy for the social long-term care insurance system and the commercial long-term care insurance system.In the construction of social long-term care insurance system,the scope of social long-term care insurance should be expanded step by step.Social long-term care insurance should provide a variety of nursing services,such as institutional nursing,home care,community nursing and set unified standards for disability determination,nursing grade and payment,which can reduce uncertainty in pricing and cost control.It is necessary to adopt multi-channel financing methods and establish special accounts for long-term care insurance funds.When constructing commercial long-term care insurance system,different development strategies should be formulated for low,middle,and high-income groups.The middle-income group should be the main target group for commercial long-term care insurance.The middle-income people have higher income and savings and they value quality of life.At the same time,they have a strong sense of prevention of future nursing risks in the elderly.These groups have both long-term care needs and payment ability which can form effective demand for long-term care insurance.In order to draw the attention of the middle-income groups to long-term care insurance,insurance companies need to design different long-term care insurance products to meet the diverse needs of this group.For the high-income groups,they have enough money to deal with the risk of long-term care and they are more willing to use the premiums used to purchase long-term care insurance to invest instead of buying long-term care insurance.Therefore,when long-term care services are needed,high-income groups often choose to pay for themselves.For low-incomegroups,they are often unable to pay long-term care insurance premiums,but this group is the one that really needs to be protected and the government should do more to help.However,social long-term care insurance has not been officially carried out in China.In order to meet the long-term care needs of low-income groups,insurance companies are required to design low-cost and low-security long-term care insurance products.