基于独立型和依附型模式差异的长期护理保险制度实践与完善对策

Practice and Improvement of Long-term Nursing Insurance System Based on the Difference Between Independent and Dependent Models

长期护理保险制度是为保障失能、半失能老人的基本生活需要而设计的,具有风险分散、资金互助的功能。目前国家层面的长期护理保险制度尚未建立,但已有试点和相关研究。通过文献分析和对比分析,我国试点城市的长期护理保险主要有两种模式选择,一种是以南通和上海为代表,将长期护理保险作为独立险种设计的独立型模式;另一种是以青岛为代表,将长期护理保险的制度设计、具体实施和操作都依附于医疗保险的依附型模式。基于独立型模式和依附型模式差异研究,对两种模式实施效果进行评价,分析两种模式的优劣势,总结实践中存在的问题,提出建立完善法律法规、整合资金筹集、完善评估体系、培育专业性护理团队、健全监督管理体制等完善对策。

The long-term nursing insurance system is designed to protect the basic needs of the disabled and semi-disabled elderly. It has the function of risk dispersion and mutual aid of funds. At present, the national long-term care insurance system has not been established, but pilot studies have been carried out in various regions. On the basis of literature analysis and comparative analysis, this paper concludes that there are two models of long-term nursing insurance in pilot cities in China. One is the“independent” model, represented by Nantong and Shanghai, which takes long-term nursing insurance as an independent insurance type;the other is represented by Qingdao, which designs, implements and operates the system of long-term nursing insurance on the“dependent” model of medical insurance. Based on the study of the difference between the “independent” and “dependent” models, this paper evaluates the implementation effect of the two models, analyzes the advantages and disadvantages of the two models, and summarizes the existing problems in practice. Finally, it puts forward some perfect countermeasures in establishing and perfecting laws and regulations, integrating fund raising, perfecting evaluation system, cultivating professional nursing team and perfecting supervision and management system.