日本长期照护保险制度实践及启示

发布时间：2018-03-05 19:59

本文选题：长期照护　切入点：长期照护保险　出处：《湖南师范大学》2016年硕士论文　论文类型：学位论文

【摘要】：日本长期照护保险制度是日本特定社会、制度、经济、政治等因素影响的产物。人口老龄化、长期照护需求攀升、家庭长期照护功能弱化、老人福利制度与老人保健制度问题凸显、社会保障财政窘迫与经济长期低迷、女权主义运动以及政党博弈共同影响了日本长期照护保险制度的建立。文章利用Gilbert社会福利政策分析架构对日本长期照护保险制度设计进行了分析,发现日本长期照护保险制度设计无论是分配基础、分配内容、服务输送还是财务模式都力求精良,并通过多次改革不断完善,其制度设计也显现出“在地老化”、“地区主义”、“福利多元主义”等理念在日本的发展和应用。制度实施十五年来,不仅在较大程度上解决了社会性长期照护难题、完善了老年社会保障制度、实现全社会共同支撑老龄社会,而且促进了长期照护产业的发展、创造了新的就业岗位。但是日本长期保险制度也面临着财政缺乏可持续性、统筹层次过低导致地区负担不公平、服务供给失衡、家庭成员照顾负担仍然沉重、照护人力不足等问题。中国人口老龄化进程加快,老年长期照护需求日渐攀升,发展长期照护保险制度是中国应对长期照护社会风险的重要选择。借鉴日本经验,我国长期照护保险制度设计要力求简洁、努力实现应保尽保,要明确保险给付内容与给付办法,同时服务输送要注重可及性,筹资机制要注重可持续性。同时需要完善相关政策法规体系、完善长期照护服务体系、建立健全需求评估机制、建构跨专业整合型人才队伍、并通过宣传教育增强民众的长期照护保险意识,保障长期照护保险制度的健康运行。
[Abstract]:Japan's long-term care insurance system is the product of specific social, institutional, economic, political and other factors in Japan. The problems of the welfare system for the elderly and the health care system for the elderly are highlighted, and the social security system is in financial straits and the economy is in a long downturn. The feminist movement and the political party game influence the establishment of the long-term care insurance system in Japan. This paper analyzes the design of the long-term care insurance system in Japan by using the Gilbert social welfare policy analysis framework. It is found that the design of Japan's long-term care insurance system, whether it is on the basis of distribution, the content of distribution, the delivery of services or the financial model, is striving to be excellent, and it has been continuously improved through many reforms. Its system design also shows the development and application of the concepts of "local aging", "regionalism" and "welfare pluralism" in Japan. In the past 15 years, the system has not only solved the social long-term care problem to a large extent. It has improved the social security system for the elderly, realized that the whole society supports the aging society, promoted the development of the long-term care industry, and created new jobs. However, Japan's long-term insurance system also faces a lack of financial sustainability. The low level of co-ordination leads to unfair regional burden, unbalanced service supply, heavy care burden for family members and insufficient care manpower. The aging process of China's population is accelerating, and the demand for long-term care for the elderly is rising day by day. The development of long-term care insurance system is an important choice for China to deal with the social risks of long-term care. It is necessary to clarify the contents and methods of insurance payment, at the same time, to pay attention to accessibility and financing mechanism for service delivery. At the same time, it is necessary to perfect the relevant policies and regulations, perfect the long-term care service system, and establish and improve the needs assessment mechanism. To build a cross-professional integrated talent team and strengthen the awareness of long-term care insurance through propaganda and education to ensure the healthy operation of long-term care insurance system.
【学位授予单位】：湖南师范大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：F843.13

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