中国长期护理保险制度的目标定位与实现路径

Targeting Social Benefits and Realization Path of Long-term Care Insurance System in China

2016年6月中国开始在全国部分地区试点长期护理保险制度,但在制度试点过程中存在着地区间目标定位差异大,参保对象、补偿对象、补偿标准和补偿范围等不明确,导致制度公信力缺失。认为长期护理保险制度应该覆盖全体城镇职工医疗保险和城乡居民医疗保险制度的参保者。补偿对象为经过失能等级评估的且符合法定失能等级的被保险人。补偿范围遵循"因果原则",即因为失能而产生的额外护理服务损失。补偿标准应适度,以体现政府、雇主、个人的责任。长期护理保险制度的目标定位可以采取分步推进战略,以实现制度可持续发展。

Long-term care insurance system has been carried out as a pilot project in parts of our country since June 2016, but some problem occurred such as huge differences in targeting between districts, ambiguity in insured target, compensation target, compensation standard and compensation range, thereby leading to an absence of public trust of the system. All participants of medical insurance for urban workers system and medical insurance for urban and rural residents system should be covered by long-term care insurance system. Compensation target are the insured who have gone through disability level evaluation and meet statutory disability conditions. Compensation range follows the principle of ＂cause and effect＂ , that is, extra loss in nursing service due to disability. Compensation standard should be moderate to embody responsibility of government, employers and individuals. Targeting in long-term care insurance system can take step-by-step strategy to achieve sustainable development of the system.