长期护理保险未建制地区借鉴试点城市政策可行性探讨

Exploring the Feasibility of Using Pilot City Policies for Reference in Areas Where Long-term Care Insurance is not Yet Established

目的:从政策扩散理论视角出发,探讨尚未建立长期护理保险制度地区学习借鉴试点城市筹资政策的可行性。方法:参考成都市筹资政策,基于ILO模型得出三套M市长期护理保险筹资标准测算方案,即利用调查已知成本数据测算筹资额、通过成都市待遇标准匡算M市待遇进而测算筹资额、平移成都市筹资比例测算筹资额。结果:测算得到方案一、二、三的筹资总额分别为3976万元、5239万元、6647万元,人均筹资额分别为93元、129元、163元,筹资率分别为0.19%、0.27%、0.34%。结论:三套方案测算所得筹资额,M市医保基金及个人可负担,且符合试点城市现行标准,说明未建制地区学习借鉴试点城市政策具有可行性。但政策扩散面临地区之间经济发展水平、人口结构、政策发展速度、养老服务市场供给不均衡等制约因素。为此,建议完善顶层设计,推进区域统筹,引导服务市场发展,加强区域协同。

This study aims to assess the feasibility of regions without a long-term care insurance system learning from pilot cities and adopting their funding policy,based on the theory of policy diffusion.Study methods are referring to the financing policy of Chengdu City,the financing standard of long-term care insurance in M City and based on the ILO model,three scenarios are obtained as follows,measuring the financing amount by using the known cost data from the survey,measuring the financing amount by converting the treatment standard of Chengdu City to the treatment of M City which followed by measuring the financing amount,and measuring the financing amount by leveling off the financing ratio of Chengdu City.The results are as follows,the total funding amounts for the three scenarios respectively are 39.76 million yuan,52.39 million yuan,and 66.47 million yuan.The per capita funding amounts respectively are 93 yuan,129 yuan,and 163 yuan.The funding rates are 0.19%,0.27%,and 0.34%,respectively.Conclusions are the calculated funding rates from the three scenarios are manageable for the M City's medical insurance fund and workers,and they align with the current standards in pilot cities.This indicates the feasibility of regions without a long-term care insurance system learning from and adopting the policies of pilot cities.However,Policy diffusion faces constraints such as disparities in economic development,population structure,policy development speed,and imbalances in the supply of elderly care services need to be addressed.To promote policy diffusion,it is recommended to enhance top-level design,advance regional coordination,guide the development of service markets,and strengthen urban collaboration.