Study On The Comparison And Optimization Strategy Of Long-term Care Insurance Policies In The First Batch Of Pilot Areas

In the global context,most developed countries are experiencing the transition from traditional family endowment to social endowment insurance,and our country is in the initial stage of the transformation.In the past decade,the number of elderly population proportion and rapid growth,suggests that China has entered the aging population base,growing faster ageing of high speed development,in the elderly population growing today,disability,the total number of the old man more and more,the growing need for long-term care,long-term care problems become a prominent contradiction.Due to the long-term effect of the family planning policy,the old pension mode relying on family care has been difficult to cope with the current severe situation.Therefore,it is very urgent to establish the system arrangement which is adapted to it.In order to reduce the social burden,improve the quality of life of the elderly,in June 2016,the General Office of the Ministry of Human Resources and Social Security issued the Guiding Opinions on the Pilot of Long term Care Insurance System,marking the beginning of the practical exploration of long-term care insurance in China.In 2020,the Guiding Opinions of the National Medical Security Bureau and the Ministry of Finance on Expanding the Pilot of Long term Care Insurance System was issued.Because the implementation of long-term care insurance requires huge financial support from the government,and also involves issues such as coordination of interests of all social parties,China has not yet fully implemented the long-term care insurance system.However,from the practical experience of various places,it is of great significance and imperative.Therefore,it is necessary to timely analyze the trial policies of pilot cities,analyze the advantages and disadvantages of each pilot policy,find out the problems,and earnestly summarize the experience and lessons learned in practice in recent years,in order to benefit the formulation of new policies in the future,and also provide valuable practical experience for the in-depth exploration of long-term care insurance system in China.Based on this,on the basis of referring to the existing research results,this paper firstly sorts out and clarifies the related concepts of long-term care insurance and disabled elderly,as well as the related theories of welfare pluralism.Second,the mature regional,economy,culture and time,on the basis of the pilot chose the first pilot city 15 long-term care insurance policy as the research target,15 cities on the relevant policies of collecting,sorting,and using policy text analysis to understand the usage and characteristics of the different types of policy tools,and then by comparing several key dimensions of policy,The long-term care insurance policy of these cities in which to cover the population,which to protect the object,how to raise funds,what tools to use for disability assessment,pay and management of the differences and the advantages and disadvantages of the policy,summed up the long-term care insurance policy suitable for our country.Finally,through the analysis of the problems existing in each pilot policy and the causes of these problems to provide countermeasures and suggestions for policy optimization reform.The main findings are:(1)Since the issuance of the Guiding Opinions and the Expansion Opinions,the first batch of 15 pilot cities have formulated,modified and improved the pilot policies of long-term care insurance based on the econmic,cultural and demographic factors of the city,and achieved certain results.Whether the coverage of different policies covers urban and rural residents with basic medical insurance is a major difference,and the development trend is to continue to expand the coverage.The difference in the protection objects is whether the moderately disabled and the mentally disabled are included in the protection scope after the implementation of unified protection for the severely disabled.In terms of financing channels,most of the 15 cities adopt the way of individual payment and employer payment,but there are large differences in financing standards,including proportional financing,quota financing and mixed financing.The development trend is to adopt better proportional financing.In the selection and application of disability assessment tools in the first batch of pilot cities,there are two models:the use of the Activities of Daily Living Assessment Scale and the self-development of assessment tools in combination with the actual situation of the city.In the formulation of pilot policies,the cities with more developed economy and later introduction of new policies perform better and more comprehensive policies.(2)The long-term care insurance policies in the first batch of pilot cities are limited in coverage scope and level,and rely too much on medical insurance funds for financing.Meanwhile,a scientific and unified disability assessment standard system has not been established for each policy.The existing nursing resources and supporting facilities also hinder the design and development of the policy.Finally,the participants have low awareness of long-term care insurance and insufficient understanding of the policy.