德国长期护理保险制度的风险定位、发展演变与政策启示

Risk positioning,development evolution and policy implications of the long-term care insurance system in Germany

在老龄、疾病、失业、工伤等风险之外,德国政府重新审视已有社会保险立法逻辑中的“广泛社会权利”理念,将长期护理保险制度所应对的风险独立化,并为此出台了一系列法案和政策。德国长期保险制度经历了初步建立、全面改革和局部调整三个发展阶段,主要发展经验包括持续优化长期护理等级评定流程、动态调整长期护理保险缴费率和为家庭护理者提供多元供给激励。德国的经验可为老龄社会背景下我国完善长期护理保险制度带来以下重要启示:精准定位长期护理风险,理清其与其他社会保障制度的关系;完善失能等级评估标准,重点关注特殊群体需求;合理划分长期护理保险筹资责任,动态调整缴费比例;重视发展非正式照护,完善家庭护理者支持政策。

The German government has re-examined the concept of"broad social rights"within the logic of existing social insurance legislation,beyond the risks of aging,sickness,unemployment,and occupational injuries.It has made the risk addressed by long-term care insurance system independent,for which a series of legislative acts have been introduced,and corresponding measures have been actively taken.The development of long-term care insurance system in Germany has gone through three stages:initial establishment stage,comprehensive reform stage and partial adjustments stage.Its main development experiences include continuously optimizing the assessment process of long-term care levels,dynamically adjusting the contribution rates of long-term care insurance,and providing diverse incentives for family caregivers.The Germany experience can provide the following important implications for the improvement of the long-term care insurance system in China under the background of aging society:accurately position long-term care risks and clarify their relationship with other social security systems;improve disability assessment standards with a focus on the needs of special groups;reasonably allocate the funding responsibility for long-term care insurance and dynamically adjust contribution rates;emphasize the development of informal care and improve support policies for family caregivers.