Study On The Efficiency Of Long-term Care Insurance Operating Mode

Since the publication of the 2016 Guidance on Piloting the Long-Term Care Insurance System,various pilot areas and non-pilot areas that have introduced long-term care insurance have explored the establishment of a long-term care insurance system on a realistic basis.Judging from the contents of the policy documents issued by various places,there are many differences in the long-term care insurance schemes in the pilot areas in terms of coverage,objects of protection,funding standards,handling procedures,payment of benefits,and forms of services.Analysis of the characteristics of the development background,system design,financing situation,and service provision forms of typical countries such as Japan and the United States in the long-term care insurance system also summarizes the main characteristics and evolution laws of each country’s system,and how to design long-term care that meets Chinese characteristics.The issue of the model of the nursing insurance system also provides a good reference.There are two main models of the long-term care insurance system currently being implemented in China,the government-oriented social insurance model and the market-oriented commercial insurance model.In the three-year pilot period,the development of the long-term care insurance model in each pilot area has both advantages and exposed some problems.From the analysis of different policies,we can see that different The operating efficiency in the pilot areas is quite different.Based on the condensed previous policies and models,the main research goals of the article are: first,whether the long-term care insurance operation model in each pilot area is effective;second,which pilot areas have long-term care insurance performance is better,and which pilot areas have long-term care insurance operation The effect is poor,what are the main problems and how to improve them;Third,the problems exposed in the pilot areas have any significance for other regions to develop long-term care insurance.This article selects data from 15 pilot regions in 2018 as a sample and uses the DEA model to conduct an empirical test: 2 output variables(benefit number,fund expenditure)and 4 input variables(fund input,number of medical institutions,number of beds,health Number of staff),using DEA method to measure the efficiency of long-term care insurance operation mode,mainly measuring and analyzing technical efficiency(TE),pure technical efficiency(PTE),scale efficiency(SE),scale returns,input redundancy and insufficient output,etc.problem.After theoretical analysis and empirical test,relevant conclusions and suggestions are given.Through refining the characteristics of long-term care insurance operation mode,DEA empirical research,and market supply and demand analysis,it is found that:(1)Compared with commercial long-term care insurance mode,social long-term care insurance mode operates more efficiently.Whether in terms of coverage,fund raising,post-service,public trust,etc.,the social insurance model has gradually become the main model for the development of current long-term care insurance.(2)The long-term care insurance policies in different regions are different,and the system is “fragmented”.Under the guidance of the “Guidelines on Piloting the Pilot Program of Long-term Care Insurance System”,the development of long-term care insurance in various regions has certain differences and has local characteristics.(3)The efficiency of the long-term care insurance operation mode varies widely,and most of the total technical efficiency is less than 1.The input-output efficiency of the medium-and long-term care insurance in the 15 pilot areas is generally low,and the differences in the different pilot areas are more obvious: only Shanghai and Jingmen The long-term insurance operation mode in the pilot areas is relatively effective,with constant returns to scale,accounting for 13.33%;the 13 pilot areas are invalid for DEA,accounting for 86.67%,and all are in increasing returns to scale.(4)The funding standards and channels for long-term care insurance are fixed,and the budget gap is uncertain.Most of the funding standards and channels in the long-term care insurance implementation rules implemented by the government are linked to basic medical insurance,so their funding standards and fund sources are fixed in the short term,and it is difficult to follow the number of beneficiaries or the amount of funds paid.Such as dynamic adjustment,that is,there is a hidden gap in long-term care insurance budget,and potential financial unsustainable risks exist.Based on the analysis,the article gives suggestions based on the conclusions.First,increase the role of long-term commercial insurance in the market and improve the initiative of long-term commercial insurance.At the government level,it is necessary to provide reasonable policy support to increase the position of long-term insurance in the market;give insurance companies some tax benefits and encourage them to actively participate in the development of long-term insurance.At the level of insurance companies,they should be more proactive in exploring the market,improving the long-term care insurance product system,and designing products with reasonable rates,claims rates,and nursing services.Consumers have increased their risk awareness and increased their trust in long-term commercial insurance.Second,reduce the "fragmentation" of the system and avoid path dependence during the nationwide implementation.Links should be reserved between the long-term care insurance systems to map local seniority,disability,dementia,and care services,including nursing needs,funding channels,fund income,nursing cost calculations,nursing service grading,fund payments,To ensure accessibility of policy making.Third,improve the efficiency of the long-term insurance operation mode and reduce the ratio of input redundancy and output deficiency.Fourth,establish a dynamic monitoring mechanism for funds to avoid financial risks.As the operator,the insurance company uses its big data technology and database support to establish a dynamic monitoring model for the needs of disabled and demented elderly people and a dynamic monitoring model of funds to timely adjust the long-term care insurance budget to avoid financial gaps.