| Since the 21 st century,China's aging population situation is grim.With the decline of the physical function of the elderly,the problem of disability of the elderly is also emerging,and the demand for pension services is growing rapidly.However,the traditional pension model is gradually declining,so it is necessary to establish a long-term care insurance system.In 2016,the Ministry of human resources and social security issued the implementation opinions on the establishment of long-term care insurance system,and stipulated 15 pilot areas.In the report of the 19 th National Congress of the Communist Party of China,the concept of "providing for the aged" was put forward,and the importance of the pension service system was reiterated.Since then,civil affairs and medical departments have made frequent voices to accelerate the construction of long-term care insurance.Based on the framework of social welfare policy analysis of Neil Gilbert,a famous American social policy scholar,this paper compares the policies of five pilot areas of long-term nursing insurance in Jiashan County,Tonglu County,Jiaxing City,Ningbo City and Yiwu City in Zhejiang Province from four dimensions of security object,service content,service delivery and financial model,and combines the actual pilot situation to carry out the pilot policies Evaluation and summary.Based on the experience of 15 national pilot cities in China and some OECD countries in foreign countries,this paper puts forward suggestions for different dimensions of the policy.The development trend of long-term care insurance in Zhejiang Province is obtained by comprehensively considering the pilot situation in Zhejiang Province and the experience of advanced regions at home and abroad.From the above four dimensions,we found the problems of the current pilot policy of long-term care insurance in Zhejiang Province.In terms of security objects,the coverage of the system itself is not uniform,the scope of benefits is narrow,and there is a lack of understanding channels.In terms of service content,the uncertainty of nursing level leads to the inconsistency of service supply standards,the lack of service care for the mentally retarded,and the dislocation and absence of nursing services.In terms of service delivery,there are problems such as poor stickiness of the nursing industry itself,lack of a reasonable training system for nursing staff,and poor progress of "medical and nursing integration".In terms of financial model,there are defects in the financing mechanism,and the imperfect main body leads to weak risk resistance and unbalanced pressure sharing.Finally,the short-term and middle-term suggestions are put forward to expand long-term care insurance in Zhejiang Province.First,broaden the publicity channels,adjust the access criteria,form the publicity channels exclusive to social security,and strive to include all the people who are at risk of disability into the scope of security;second,establish a screening system for service supply,improve the standards and contents of disability level and nursing level,so that the service supply content can be followed;third,in view of the difficulty in speeding up service delivery,It is necessary to establish a reasonable training and promotion mechanism from the two aspects of nursing staff and nursing institutions,and correct the social cognition of nursing industry;fourthly,adjust the proportion of pressure burden reasonably,improve the financing system,explore a sustainable multi financing model,increase financial support and establish a special adjustment fund;fifthly,through the investigation of the aging loss of all prefecture level cities in Zhejiang Province The ability,pension service foundation and financial situation form a step-by-step comprehensive strategy.Based on the above suggestions and the summary of advanced experience at home and abroad,this paper explores a model for Zhejiang Province and even the whole country to expand long-term care insurance. |
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