美国长期护理保障制度改革及其对我国的启示

The U.S. Long-Term Care Security System Reform and It's Enlightenment

本文主要运用文献研究法,对美国长期护理保障制度的现状进行了分析。分析发现,当前美国长期护理保障制度存在两大问题,分别是政府财政转移支付缺乏可持续性、私人保单难以覆盖广大中低收入阶层。为解决上述问题,美国政府对长期护理保障制度采取了一系列改革措施,但改革始终没能达到预期效果。美国长期护理保障制度改革启示我们,长期护理保障制度的设计应当重视政府与市场关系的准确定位、建立有可持续性的筹资机制、严格审查控制资金给付条件以及注重社会保障体系的顶层设计。

This article mostly used the literature methodology to analyze the current situation of Medicare, Medicaid and private medical insurance,which are the constituent parts of the U. S. long-term care security system, and found two major problems in the U. S. system, namely, the transfer payment from the government exchequer lacking sustainability and private insurance policies unable to cover the extensive mid-low-income class. In order to resolve abovementioned problems,the U. S. government has taken a series of reform actions on the long-term care security system,such as tax subsidies,marketing initiatives,LTCPP, CLASS, Obama＇s Healthcare Act and so on. But the reform didnt achieve the desired effect. The U. S. experience and lessons enlighten us that we should value the accurate relationship positioning between government and market, establish sustainable financing mechanism, strictly examine and control fund payment prerequisites, and emphasize the top-level design of the long-term care security system.