我国长期护理保险试点运行的实践、问题及建议——以德国长期护理保险法改革为镜鉴

Practices,Problems and Countermeasures of the Pilot Operation of Long-Term Care Insurance in China--Taking German's Reform on the Long-term Care Insurance Act as a Reference

长期护理保险制度的构建是顺应老龄化社会发展、积极应对人口老龄化带来的社会问题的重要举措。我国长期护理保险试点运行中虽取得了一定成效,但在基金筹措、评估认定等方面存在问题,实质性地影响着长期护理保险的健康稳定运行。德国作为最早推行《长期护理保险法》的国家,该法的推行在德国社会老龄化压力的降低、老龄人权益的保障等方面有着突出的贡献,但在实施过程中也出现了与我国现阶段相似的问题。为回应与修正实践中的问题,德国对长期护理保险法中长期护理需求的法律定义、认定标准等进行了渐进式的法律改革,以保证其制度的可持续运行。本文立足于我国当前长期护理保险的实践现状及问题,结合德国法的改革经验,建议我国未来在国家层面构建长期护理保险制度的过程中,可以通过适当扩大其适用范围,建立动态多元的筹资机制,构建科学统一的认定体系,推行灵活多样的给付模式以及重视落实配套的服务体系,以保证长期护理保险制度的科学性和可持续性。

The establishment of the long-term care insurance system is an important measure to adapt to the development of the aging society and actively respond to the social problems caused by the aging population.Although certain achievements have been made in the pilot operation of long-term care insurance in China,problems have arisen in fund financing,assessment and determination,etc.,which substantially affect the healthy and stable operation of long-term care insurance.As the earliest country to implement the Long-Term Care Insurance Act,German's implementation of the Act has made outstanding contributions to the reduction of the aging pressure of the German society and the protection of the rights and interests of the elderly,but it has also encountered problems similar to those of China at this stage.In order to respond to and amend the problems in practice,German has carried out progressive legal reforms on the legal definition of long-term care needs,assessment standards and etc.in the Long-term Care Insurance Act,so as to ensure the sustainable operation of the long-term care insurance system.Based on the current status of practice and problems of long-term care insurance in China,and combined with the legal reform experience of German,this paper suggests that in the process of establishing a long-term care insurance system at the national level in the future,China should expand the scope of long-term care insurance appropriately,establish a dynamic and diversified long-term care insurance financing mechanism,build a scientific and unified long-term care insurance assessment system,implement flexible and diverse long-term care insurance payment models,and attach importance to the supporting long-term care insurance service system,so as to ensure the scientific nature and sustainability of the long-term care insurance system.