社会长期护理保险筹资渠道：经验借鉴、面临困境及未来选择

发布时间：2018-05-21 12:44

  本文选题：社会长期护理保险 + 筹资渠道　； 参考：《西北大学》2017年硕士论文

【摘要】：目前,随着经济社会的发展,人口老龄化的程度在不断加深,未来将会加速发展。在老龄人口增加的同时,需要照顾的失能的老人也在逐渐增加。世界各国政府给予了高度的重视,并针对老龄化问题逐步建立和发展了长期护理保险制度并取得了良好成效。我国的老年人和失能老人的数量大,而且随着城镇化、工业化的不断发展,中国的家庭规模也呈现小型化和空巢化的趋势,在这样的情形下,老年人对于日常生活照料以及康复护理的需求也就愈加强烈。如何在这样严峻的老龄化形势下提高老年人的生活质量,促进老龄事业的健康发展,是我国社会发展中面临的具有重大意义的问题。本文就是在这样的背景下,提出了社会长期护理保险未来可选的筹资渠道。我国目前尚未创设长期护理保险,资金的缺乏是制约社会长期护理保险创设的最重要的因素,疏通筹资渠道,是解决这一问题的关键。本文借助马斯洛的需求层次理论、个人或家庭责任理论、税收制理论、公共护理保险责任理论以及社会福利政策理论,运用实证研究法、规范研究法和比较分析法,从社会长期护理保险资金筹集渠道的角度出发,首先界定了社会长期护理保险以及社会长期护理保险筹资渠道的概念。其次分析目前国外典型国家和国内试点地区的社会长期护理保险的筹资渠道,在此基础上提出了中央和地方财政补贴、医疗保险基金、企业缴费、个人缴费、住房公积金、反向按揭、社会支持七个方面的筹资渠道,接着从缺乏法律法规依据、现有政策理解与执行存在偏差、筹资比例和办法难以确定、试点地区的经验尚未形成体系、个人参保意识薄弱和老年人支付意愿偏低、观念落后六个方面分析了在资金筹集中面临的困境,最后提出了社会长期护理保险筹资渠道的未来选择和对策建议。第一,确定了社会长期护理保险的未来选择是以政府补贴、企业缴费以及个人缴费为主,医疗保险、反向按揭和住房公积金为辅,社会支持为补充的社会长期护理保险筹资渠道;第二,提出了建立健全法律法规、纠正现有政策理解与执行的偏差、确定具体的筹资比例和方法、总结试点地区的成熟经验并形成体系、加大宣传并鼓励积极参保和改变老年人支付意愿偏低的状态及落后的观念六方面的政策建议,其中由于确定缴费比例是关键,因此在政策建议中运用ILO模型以及相关的理论和实践估算出了主要筹资方即政府、企业和个人的缴费比例,分别是6.24%、2.25%和3.53%,并对各方的负担能力进行了分析;第三,估算出目前的缴费总额,并与目前总的护理费用进行对比,得出供缴费总额大于护理费用的结论,进一步证明筹资比例的合理性。
[Abstract]:At present, with the economic and social development, the degree of population aging is deepening, which will accelerate the development in the future. As the elderly population increases, so does the number of disabled people in need of care. Governments all over the world have attached great importance to it, and have gradually established and developed long-term care insurance system in view of the problem of aging and achieved good results. The number of the elderly and the disabled in China is large, and with the continuous development of urbanization and industrialization, the family size in China is also showing a trend of miniaturization and emptiness. Under such circumstances, The need for daily care and rehabilitation care for the elderly is growing. How to improve the quality of life of the elderly and promote the healthy development of the cause of aging under such a severe aging situation is a significant problem in the social development of our country. In this context, this paper puts forward the future funding channels of social long-term care insurance. At present, the long-term nursing insurance has not been established in our country. The lack of funds is the most important factor restricting the establishment of social long-term care insurance, and the key to solve this problem is to dredge the channels of raising funds. Based on Maslow's hierarchy of needs theory, personal or family responsibility theory, tax system theory, public care insurance liability theory and social welfare policy theory, this paper applies empirical research method, normative research method and comparative analysis method. From the point of view of raising funds of social long-term care insurance, this paper first defines the concept of social long-term care insurance and the financing channels of social long-term care insurance. Secondly, it analyzes the financing channels of social long-term care insurance in typical foreign countries and domestic pilot areas. On this basis, it puts forward the central and local financial subsidies, medical insurance funds, enterprise contributions, individual contributions, housing provident funds. Reverse mortgage, financing channels for seven aspects of social support, and then from the lack of legal and regulatory basis, the existing policy understanding and implementation of the deviation, financing ratio and methods are difficult to determine, the experience of the pilot area has not yet formed a system. This paper analyzes the difficulties in raising funds from six aspects of weak consciousness of individual insurance participation and low willingness to pay of the elderly, and puts forward the future choice and countermeasures of the financing channels of social long-term care insurance. First, it was determined that the future choice of social long-term care insurance would be government subsidies, enterprise contributions and individual contributions, supplemented by medical insurance, reverse mortgages and housing provident funds. Social support is a supplementary funding channel for long-term social care insurance. Secondly, it proposes to establish and improve laws and regulations, correct the deviation between the understanding and implementation of existing policies, and determine the specific proportion and methods of financing. Summing up the mature experience of the pilot areas and forming a system, increasing the promotion and encouraging active participation in the protection and changing the low willingness to pay and the backward concept of the elderly, six aspects of policy recommendations, among which the determination of the proportion of contributions is the key, Therefore, using the ILO model and related theory and practice in the policy recommendations, the paper estimates the contribution ratio of the main financing parties, that is, the government, enterprises and individuals, which are 6.2425% and 3.53%, respectively, and analyzes the affordability of each party. The total amount of current contribution is estimated and compared with the total nursing cost at present, and the conclusion that the total amount of contribution is greater than the cost of nursing is obtained, which further proves the rationality of the proportion of financing.
【学位授予单位】：西北大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：F842.6
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本文编号：1919252