南通市基本照护保险:制度设计、运行效果及前瞻
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摘要
南通市将长期照护保险作为独立的社会保险制度,在我国尚属首家。本文从保障政策、筹资机制、照护评估、成本管理四个维度对南通市基本照护保险制度进行分析,发现通过实施该制度,南通市实现了长期照护社会保障的"制度化",促进了长期照护服务的"社会化",形成了长期照护评估的"标准化",实现了照护保险城乡一体化。但是该项制度还存在专业照护服务不完善、基本照护资金过于依赖政府投入和医疗保险基金、保障范围小等难题。基于南通市的实践,我国应尽快建立全国性长期照护保险制度,厘清该制度的定位,建立可持续的保险筹资机制,破解老龄化严重态势下失能老人的长期照护难题。
Nantong has taken the long-term care insurance as one of the social security system,the first anywhere in China. This paper analyzed the policy design of the long-term care insurance system in Nantong based on four dimensions of security policy,financing mechanism,long-term care assessment and cost control. Four achievements has been found. Firstly,the long-term care insurance has become institutionalized. Secondly,the longterm care service has become socialized. Thirdly,the assessment of long-term care has become standardized. Finally,the long-term care insurance has coordinated development between urban and rural regions. However,there are still some problems in this system,such as imperfect professional care services,excessive reliance on government investment and medical insurance funds and small scope of insurance coverage. Based on the experience of Nantong,China should establish a national long-term care insurance system as soon as possible,clarify the positioning of the system and establish a sustainable insurance fund-raising mechanism. In this way,we can solve the problem of long-term care for the disabled elderly under the severe situation of aging.
Nantong has taken the long-term care insurance as one of the social security system,the first anywhere in China. This paper analyzed the policy design of the long-term care insurance system in Nantong based on four dimensions of security policy,financing mechanism,long-term care assessment and cost control. Four achievements has been found. Firstly,the long-term care insurance has become institutionalized. Secondly,the longterm care service has become socialized. Thirdly,the assessment of long-term care has become standardized. Finally,the long-term care insurance has coordinated development between urban and rural regions. However,there are still some problems in this system,such as imperfect professional care services,excessive reliance on government investment and medical insurance funds and small scope of insurance coverage. Based on the experience of Nantong,China should establish a national long-term care insurance system as soon as possible,clarify the positioning of the system and establish a sustainable insurance fund-raising mechanism. In this way,we can solve the problem of long-term care for the disabled elderly under the severe situation of aging.
引文
[1]刘同庆:《缓解失能人员家庭“不能承受之重”》,载《人民政协报》,2015-11-13。
[2]杨来胜、王美春、李锦诚:《人口老龄化与目标人群社会保障研究——以南通市为例》,载《人口学刊》,2004(6)。
[3]何乐、孙秋香:《破解养老照护难的“南通药方”》,载《群众(上半月版)》,2017(11)。
[4]杨扬、杨根来:《南通市:关于基本照护保险制度名称和内容的思考》,载《中国民政》,2016(17)。
[5]南方:《运用社会保险机制应对老龄化挑战》,载《中国劳动保障报》,2016-06-28。
[6]耿晨:《南通市基本照护保险制度试点探索路径》,载《中国医疗保险》,2016(9)。
[7]孙华、耿晨:《南通基本照护保险制度建设及其启示》,载《中国医疗保险》,2017(10)。
(1)数据来自南通市卫生和计划生育委员会2017年发布的数据及《中国统计年鉴2017》。
(2)数据来自《南通市“十三五”人口发展规划》报告。
(3)数据来自南通市政府2015年11月2日召开的“南通市建立基本照护保险制度”新闻发布会信息。
(1)《南通基本照护保险实施近两年4669名失能人员获保障》,http://js.people.com.cn/n2/2017/1212/c360302-31024866.html,2017-12-12。
(1)资料来源:《南通市基本照护保险实施细则(试行)》(通人社规[2016]28号)。
(2)资料来源:《关于建立基本照护保险制度的意见(试行)》(通政发[2015]73号)。
(1)数据来源:《江苏南通覆盖全社会基本照护保险制度效应显著》,http://news.xinhuanet.com/2017-07/19/c_1121347122.htm,2017-07-19。
(1)世界卫生组织:《关于老龄化与健康的全球报告》,121页,世卫组织网站,2016。
[2]杨来胜、王美春、李锦诚:《人口老龄化与目标人群社会保障研究——以南通市为例》,载《人口学刊》,2004(6)。
[3]何乐、孙秋香:《破解养老照护难的“南通药方”》,载《群众(上半月版)》,2017(11)。
[4]杨扬、杨根来:《南通市:关于基本照护保险制度名称和内容的思考》,载《中国民政》,2016(17)。
[5]南方:《运用社会保险机制应对老龄化挑战》,载《中国劳动保障报》,2016-06-28。
[6]耿晨:《南通市基本照护保险制度试点探索路径》,载《中国医疗保险》,2016(9)。
[7]孙华、耿晨:《南通基本照护保险制度建设及其启示》,载《中国医疗保险》,2017(10)。
(1)数据来自南通市卫生和计划生育委员会2017年发布的数据及《中国统计年鉴2017》。
(2)数据来自《南通市“十三五”人口发展规划》报告。
(3)数据来自南通市政府2015年11月2日召开的“南通市建立基本照护保险制度”新闻发布会信息。
(1)《南通基本照护保险实施近两年4669名失能人员获保障》,http://js.people.com.cn/n2/2017/1212/c360302-31024866.html,2017-12-12。
(1)资料来源:《南通市基本照护保险实施细则(试行)》(通人社规[2016]28号)。
(2)资料来源:《关于建立基本照护保险制度的意见(试行)》(通政发[2015]73号)。
(1)数据来源:《江苏南通覆盖全社会基本照护保险制度效应显著》,http://news.xinhuanet.com/2017-07/19/c_1121347122.htm,2017-07-19。
(1)世界卫生组织:《关于老龄化与健康的全球报告》,121页,世卫组织网站,2016。