居家照护的多元社会保障:国际经验与启示

Diversified Social Security for Home-based Care:International Experience and Enlightenment

为疏通我国老年人居家照护与医疗保险、长期护理保险资金之间存在的“梗阻”,从德国、日本、美国和新加坡居家照护社会保障体系中总结得出完善社会保险和商业保险并行发展的多元社会保障体系;健全预防保健为主、全方位保障的老年人医疗保险制度;构建以居家护理优先为原则的长期护理保险制度;引导管理商业健康保险和长期商业护理保险发展并给予政策优惠等经验。建议我国推进以“健康保险”为理念的医保改革,拓宽保障覆盖面;建立以居家护理优先、覆盖广且给付方式多元的长期护理保险制度;发展衔接居家医疗的商业健康保险和长期商业护理保险。

In order to unblock the"obstruction"between home-based care and medical insurance and long-term care insurance funds for the elderly in China,a diversified social security system that improves the parallel development of social insurance and commercial insurance is summarized from the social security systems for home-based care in Germany,Japan,the United States and Singapore.We will improve the medical insurance system for the elderly,which focuses on preventive health care and provides all-round protection;establish a home-care-prioritized long-term care insurance system;guide the development and offer preferential policy for commercial health insurance and long-term commercial nursing insurance.It is suggested that China should promote the reform of medical insurance with the concept of"health insurance"and expand the coverage of insurance;establish a long-term care insurance system that gives priority to home care,covers a wide range of areas and provides multiple payment methods.It is also advocated to develop commercial health insurance and long-term commercial nursing insurance connecting home-based care.