我国长期护理保险立法初探
发布时间：2018-11-13 20:49
【摘要】：经济的发展使得科学技术、医疗卫生水平不断进步,进而使得人均寿命逐渐延长,加之生育率持续降低,造成越来越多的国家老龄化日趋严重。自19世纪末发达国家首先进入老龄化社会以来,世界上众多发达国家已陆续进入老龄化社会。而进入21世纪以后,发展中国家也开始陆续进入老龄化社会。目前怎样提高老年人的生活品质,减轻家庭对失能老人长期护理的负担,是世界各国正在面临或即将面临的重要课题。建立长期护理保险制度,发展与完善第三方护理的模式是各国应对老龄化问题,解决失能老人长期护理需求的不二选择。按照国际老龄化的标准,再根据我国人口普查数据,我国已经是老龄化社会中的一员。同时伴随着经济的增长、家庭养老功能的弱化、人们对生活质量的要求提高等多种因素,长期护理保险制度的建立已经有了一定的基础。但经济发展不均衡,保险意识薄弱以及"养儿防老"的陈旧观念等因素成了我国建立并发展长期护理保险制度的拦路虎。作为世界人口第一大国,庞大的人口基数使得老龄人口规模巨大,空巢老人、失能半失能老人也逐渐增多。然而,老年人的护理早已超出了衣食住行的范围,其精神上更加需要得到关心和慰藉,而这些在生活节奏日益加快的今天,单靠家庭成员已经难以满足老年人的需求。从而使得我国急需建立分散家庭护理负担的长期护理保险制度。美国、德国、日本等少数发达国家已经根据自已的国情建立起长期护理保险制度并实施了几十年不等,取得了良好的效果。不同的模式各有所长,但毫无疑问必须要符合本国的国情,无论哪种模式在实施过程中都遇到了不同的问题,为我们提供了宝贵的经验和教训。怎样取其精华,避免其实施过程中已经出现过的问题,建立起与我国现阶段国情相适应的长期护理保险制度是我们亟待探讨的问题。本文的大致结构如下:首先介绍长期护理保险制度产生的背景及意义、与护理保险相关的概念、以及国内的文献综述;然后大致介绍日本和德国的社会性长期护理保险模式与美国的商业性长期护理保险模式的制度设计,再分析两种模式的利弊,从而得出我国有哪些可以借鉴,哪些必须注意避免的地方;其次从我国老龄化的现状、家庭结构的变化、不断增长的医疗费用及有限的医疗资源之间的矛盾等几个角度分析我国建立长期护理保险制度的必要性及面临的问题;最后对我国应当选择的模式、选择该模式的原因提出建议,并从立法层面对长期护理保险制度涉及的主体、保障的对象、费率的设计和保险待遇等几个方面提出具体的立法建议。
[Abstract]:With the development of economy, the level of science and technology, medical and health have been improved, and the average life expectancy has been lengthened gradually, and the fertility rate has been decreasing, which has caused the aging of more and more countries to become more and more serious. Since the developed countries first entered the aging society in the late 19th century, many developed countries in the world have entered the aging society one after another. And after entering 21 st century, developing country also begins to enter ageing society one after another. At present, how to improve the quality of life of the elderly and reduce the burden of long-term care for the disabled is an important issue facing or about to face in the world. Establishing long-term care insurance system and developing and perfecting the mode of third party nursing are the best choice for countries to deal with the aging problem and solve the long-term nursing needs of the disabled elderly. According to the international standard of aging and according to the census data of our country, our country is already a member of the aging society. At the same time, with the economic growth, the weakening of the family pension function, the improvement of people's quality of life and other factors, the establishment of long-term care insurance system has a certain basis. However, such factors as unbalanced economic development, weak insurance consciousness and the old idea of "raising children and preventing old age" are the obstacles to the establishment and development of long-term nursing insurance system in China. As the largest population in the world, the large population base makes the aging population large, empty nest elderly, disabled semi-disabled elderly also gradually increase. However, the care of the elderly has long gone beyond the scope of food, clothing, housing and transportation, and its spiritual need to be cared for and comforted, and these in the accelerating pace of life today, the family members alone has been unable to meet the needs of the elderly. Therefore, our country urgently needs to establish the long-term care insurance system which distributes the family nursing burden. The United States, Germany, Japan and a few developed countries have established long-term care insurance system according to their own national conditions and implemented it for several decades, and achieved good results. Different models have their own strengths, but there is no doubt that they must be in line with their national conditions. No matter which model has encountered different problems in the process of implementation, it provides us with valuable experience and lessons. How to take its essence to avoid the problems that have already appeared in the course of its implementation and to establish a long-term nursing insurance system suitable to the current situation of our country is an urgent problem that we need to discuss. The general structure of this paper is as follows: firstly, it introduces the background and significance of the long-term care insurance system, the concepts related to nursing insurance, and the domestic literature review; Then it introduces the system design of social long-term care insurance model in Japan and Germany and the commercial long-term care insurance model in the United States, and then analyzes the advantages and disadvantages of the two models. What needs to be avoided; Secondly, from the current situation of aging in China, the change of family structure, the contradiction between increasing medical expenses and limited medical resources, the necessity and problems of establishing long-term nursing insurance system in China are analyzed. Finally, it puts forward some suggestions on the mode that our country should choose, the reasons for choosing the model, and the main body involved in the long-term care insurance system and the object of protection from the legislative level. The design of the rate and insurance treatment and other aspects of specific legislative proposals.
【学位授予单位】：深圳大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：F842.6
[Abstract]:With the development of economy, the level of science and technology, medical and health have been improved, and the average life expectancy has been lengthened gradually, and the fertility rate has been decreasing, which has caused the aging of more and more countries to become more and more serious. Since the developed countries first entered the aging society in the late 19th century, many developed countries in the world have entered the aging society one after another. And after entering 21 st century, developing country also begins to enter ageing society one after another. At present, how to improve the quality of life of the elderly and reduce the burden of long-term care for the disabled is an important issue facing or about to face in the world. Establishing long-term care insurance system and developing and perfecting the mode of third party nursing are the best choice for countries to deal with the aging problem and solve the long-term nursing needs of the disabled elderly. According to the international standard of aging and according to the census data of our country, our country is already a member of the aging society. At the same time, with the economic growth, the weakening of the family pension function, the improvement of people's quality of life and other factors, the establishment of long-term care insurance system has a certain basis. However, such factors as unbalanced economic development, weak insurance consciousness and the old idea of "raising children and preventing old age" are the obstacles to the establishment and development of long-term nursing insurance system in China. As the largest population in the world, the large population base makes the aging population large, empty nest elderly, disabled semi-disabled elderly also gradually increase. However, the care of the elderly has long gone beyond the scope of food, clothing, housing and transportation, and its spiritual need to be cared for and comforted, and these in the accelerating pace of life today, the family members alone has been unable to meet the needs of the elderly. Therefore, our country urgently needs to establish the long-term care insurance system which distributes the family nursing burden. The United States, Germany, Japan and a few developed countries have established long-term care insurance system according to their own national conditions and implemented it for several decades, and achieved good results. Different models have their own strengths, but there is no doubt that they must be in line with their national conditions. No matter which model has encountered different problems in the process of implementation, it provides us with valuable experience and lessons. How to take its essence to avoid the problems that have already appeared in the course of its implementation and to establish a long-term nursing insurance system suitable to the current situation of our country is an urgent problem that we need to discuss. The general structure of this paper is as follows: firstly, it introduces the background and significance of the long-term care insurance system, the concepts related to nursing insurance, and the domestic literature review; Then it introduces the system design of social long-term care insurance model in Japan and Germany and the commercial long-term care insurance model in the United States, and then analyzes the advantages and disadvantages of the two models. What needs to be avoided; Secondly, from the current situation of aging in China, the change of family structure, the contradiction between increasing medical expenses and limited medical resources, the necessity and problems of establishing long-term nursing insurance system in China are analyzed. Finally, it puts forward some suggestions on the mode that our country should choose, the reasons for choosing the model, and the main body involved in the long-term care insurance system and the object of protection from the legislative level. The design of the rate and insurance treatment and other aspects of specific legislative proposals.
【学位授予单位】：深圳大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：F842.6
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