德国长期照护保险制度:缘起、规划、成效与反思

The long-term care insurance system in Germany: Origin,planning,effects and reflections

在人口老龄化加剧、长期照护需求增加、原有社会保障制度存在缺陷的背景下,德国在原有健康保险制度的基础上,于1994年推出了具有全民性与强制性、公私混合给付的长期照护保险运行模式。对长期照护保险关系、申请资格、给付条件、筹资机制等进行了详细规定。经过多年的运行和完善,长期照护保险在社会保险中的份额和贡献逐渐提升、投保人与受益群体不断扩大。但另一方面,在服务质量、申请条件和内容、筹资机制等方面仍面临许多争议。德国在完善社会保障体系、重视长期照护质量、完善筹资机制等方面积累的经验可以为我国长期照护保险制度的发展提供有益借鉴。

Confronted with many problems such as the aged population, increase in the demand for long-term care and financial pressure resulted from the previously defective social security system, after years of efforts, Germa- ny eventually succeeded in putting forward an effective national compulsory long-term care system in 1994. The sys- tem which is based on the original health insurance system and supports multiple payments involves both local govern- ments and private organizations. Specific rules are clarified in terms of the insurance relations, application qualifica- tions, payment conditions and financial mechanism. Shares and contributions of the long-term care have been in- creased after years of practice. Besides, the number of applicants and beneficiaries is rising. Yet on the other hand, problems and controversies still exist in service quality, qualifications and contents for application and financial mech- anism. Germany＇s experience in improving the social security system, the quality management of long-term care and effective control of financial balance serves as a significant reference for China in planning and implementing long- term care insurance system.