应对老龄化的养老服务政策需要理性思考

Rational Thinking on Eldercare Policy to Cope with Aging

基本养老服务有广义与狭义之分,从狭义的基本养老服务考察,"确保人人享有基本养老服务"主要是指当老年人失能、失智,生活自理有困难时均能获得亲属和社会提供的基本照护服务。我国应力争在"十四五"期间实现"长期护理保险"制度全覆盖和参保人员全覆盖,从而"确保人人享有基本养老服务"。在我国养老服务体系中,"机构为补充"和"机构为支撑"是从数量和功能上对养老机构的不同定位;这两种表述在不同时期强调的重点可以有所不同,但不存在互相排斥关系。完善我国的养老服务补贴制度,主要应确保一个"底线"、实施三个"梯度"、制定全国统一的失能状况评估标准,同时中央应给予专项"均衡性"财力支持。从长远看,应将养老服务补贴制度纳入长期护理保险制度的顶层设计框架中。

In this thesis basic eldercare services are distinguished between broad sense and narrow one. In the narrow sense,'basic eldercare services for nearly all residents'refer to basic care services that relatives and the society provide to old people when they are disabled,with dementia and lose self-care ability in daily life. Long-term care insurance should be implemented in the 14thFive-year Plan and the insured people should be covered in it to ensure basic eldercare services for all. In our eldercare service system,'institutions as supplementation ' and 'institutions as support ' are differently positioned in terms of quantity and function of institutions. Although they may be paid different attention to,these two expressions are not mutually exclusive. To improve our subsidy system on eldercare services,we should ensure one bottom line,implement three gradients,develop national evaluation standards on disability and establish the balanced financial support that the central government specially funds. Moreover,it is necessary to include the subsidy system on eldercare services in the top design of long-term care insurance from a long-term perspective.