我国长期照护服务供给:市场化政策、实践与反思

The Supply of Long-term Care Services in China:The Policies,Practices and Reflections of Marketization

全球视野下,为老年人提供充分和高质量的长期照护服务成为老龄化国家面临的重大挑战。面对政府直接参与照护服务供给机制出现的诸多问题,许多国家普遍将市场化作为一种解决方案,将市场机制嵌入长期照护服务的改革。就我国的长期照护服务市场化政策发展历程与试点实践来看,尽管在长期照护服务供给中形成了以民营照护机构为主、政府协议管理等市场化供给机制,但仍存在市场整体供给能力低、市场竞争不充分、市场与政府的职能边界模糊、监督管理机制不健全以及消费者选择权利难以实现等问题。推进我国长期照护服务改革,需要充分发挥市场在资源配置中的决定性作用,政府应承担起市场培育者和规制者角色,同时重视家庭照护传统,将市场化改革内嵌于本土情境。

From a global perspective,providing adequate and high-quality long-term care services for the elderly has become a major challenge for aging countries.Faced with the problems of the government′s direct participation in the supply mechanism of care services,many governments generally regard marketization as a solution and embed the market mechanism into the reform of long-term care services.According to the market-oriented policy and practice of long-term care service in China,the market-oriented supply mechanism with private care institutions as the main organ and government agreement management has been formed in the supply of long-term care service.However,there are still some problems,such as the low supply capacity of the market as a whole,the insufficient market competition,the fuzzy functional boundary between the market and the government,the imperfect supervision and management mechanism,and the difficult realization of consumers′right to choose.To promote the reform of long-term care services in China,we need to give full play to the decisive role of the market in resource allocation,and the government should assume the role of market cultivator and regulator.At the same time,the government should attach importance to the tradition of family care and embed the market-oriented reform in the local context.