四川省长期护理保险制度研究

Study on Long-term Care Insurance System in Sichuan Province

围绕长期护理保险制度构成的政策体系、基金体系和服务体系,以四川省长期护理保险唯一试点城市——成都市为例,在总结其有益经验的基础上,从筹资、偿付、服务、管理等运行角度,就如何建立公平、持续、有效的长期护理保险制度进行研究。结果显示:长期护理保险应以"制度覆盖广起步,保障覆盖窄起步"为原则确定覆盖范围;独立筹资,由政府、企业和个人共同分担;与医疗保险、工伤保险划清支付范围界限;支付方式应逐渐向服务为主转变;评估方式应兼顾规则判定和专家判定;经办管理密切与商业保险机构合作。

Around the policy system,fund system and service system composed of long-term care insurance system,and take Chengdu as the only pilot city for long-term care insurance in Sichuan Province.Based on summarizing its useful experience,this paper makes an in-depth study on how to establish a fair,sustained and effective long-term care insurance system in Sichuan Province from the perspective of financing,repayment,service and management.The scope of coverage should be determined by the principle of"system widely covered and guarantee narrowly covered";the way of raising funds should be raised independently and shared by the government,enterprises and individuals;the scope of payment should be separated from medical insurance and industrial injury insurance;the mode of payment should be gradually changed to service-oriented;evaluation should take into account both rule judgment and expert judgment;management should cooperate closely with commercial insurance institutions.