经济困难人群长期护理保险可及性提升路径研究——基于跨部门协同机制

Study on enhancing accessibility to long-term care insurance for peaple experiencing financial hardship:Based on inter-agency collaboration mechanisms

目的:对部分试点城市长期护理保险制度针对经济困难人群的救助机制进行梳理和比较,基于跨部门协同机制提出优化建议,以期提升制度可及性。方法:搜集自2016年以来试点城市的长期护理保险制度政策文件中有关救助经济困难人群的规定,并进行归纳和分析。结果:有8个试点城市的长期护理保险制度建立了针对经济困难人群的救助机制,救助方法主要为资助缴费参保、补贴自负费用和提供就业培训三类。目前的实践存在着信息互通有待加强、不同政策交叠冲突、保费资助和个人自负费用补贴异质化等问题。结论和建议:从结构性协同和程序性协同两方面考虑优化路径,如数据平台互联互通、整合护理补贴制度、基层实现一窗受理、上级开展专项任务等结构性协同机制,以及明确救助边界、资助缴费参保、补贴自负费用、提供就业培训等程序性协同机制。

Objective:This paper aims to review and compare the assistance mechanisms for peaple experiencing financial hardship within the long-term care insurance systems of selected pilot cities.It proposes optimization suggestions based on inter-agency collaboration mechanisms to improve accessibility for peaple experiencing financial hardship.Methods:This paper collected and analyzed regulations related to assistance for peaple experiencing financial hardship from policy documents of long-term care insurance systems in pilot cities since 2016.Results:Eight pilot cities have established assistance mechanisms for peaple experiencing financial hardship within their long-term care insurance systems.The main forms of assistance are subsidized premium payments for insurance enrollment,subsidies for out-of-pocket expenses,and provision of employment training.Current practices face issues such as obstacles to platform interoperability,policy overlap conflicts,and heterogeneity in premium subsidies and out-of-pocket expense subsidies.Conclusion and Suggestions:It is recommended to consider optimization paths from structural and procedural collaboration aspects.Structural collaboration mechanisms may include platform interoperability,integration of care subsidy systems,single-window service at the grassroots level,and special tasks carried out by higher authorities.Procedural collaboration mechanisms may involve clarifying assistance boundaries,subsidizing premium payments for insurance enrollment,subsidizing out-of-pocket expenses,and providing employment training.