Research On Long Term Care System Models And Choices

Low rate and prolonged expected age raise the possibilities of organ and mental disorders by aging and changing family structures, thus long term care becomes a social risk. The government subsidy dependent people through policies of health care and social care to live a decent live, establishing public long term care systems in OECD countries. In funding aspect, developed countries’long term care system exist four different models, namely residual model, welfare model, social insurance and commercial insurance with obvious characters. Most of countries are supported by mixed models, which dispute about funding system properly, the relationship between formal care and informal care, development of institutional and home based care, roles of government and market and benefits. Although path dependence of welfare system slow down the development of long term care system, developed countries reform long term care by cash for care and market competition among long term care providers, incentive private sector to provide home based care.China’s old dependent people present the characteristics of a large population base and fast growing, aging, men and women’s gender imbalance, the urban and rural differences. Relying on the family’s informal care will not be able to resist the potential risk of long-term care, so we had better to establish and improve the system of long-term care as soon as possible. At present, three long term care modes exist in China:cash for frail people’s care, commercial insurance funding by subsidy and individuals, social insurance for long-term care. Establishing actuarial funding model of long term care, from the aspects of sustainability and affordability, this paper forecasts the feasibility of the system models. The results show that under the burden of low security level, commercial insurance fund can fund the participants under 35. When expanding coverage, the government and individual can’t bear contribution burden. From the perspective of long-term care fund balance, the government subsidy system of commercial insurance pattern is not suitable for promotion in China in the short term. China’s long-term care system can choose the combination of social insurance and cash for care and also can choose three pillars model. On the whole, the three pillars model are more in line with the baseline fair concept, insurance the rights and interests of the weak in the priority at the same time, and emphasize responsibilities of the government, individuals, and families in the long term care, which reduce the risk of long-term care at large.In explorative stage of long term care, for the fact that level of differences between urban and rural areas, fragmented social security system, promoting the long-term care allowance, the development of the social insurance and commercial insurance at the same time may bring heavy burden to national finance and personal and conflicts among models, which fails the goal of long term care system. We should choose one model as a breakthrough in the development of long-term care system, and the make the appropriate adjustment and reform, and eventually establish three pillars.With the experience of western countries the development of long-term care system, based on the experiment of long-term care in our country, the government should give priority to the development of social insurance for long-term care or long-term care allowance, choose the cash benefit and market-oriented reform of the long-term care service providers, to incentive the development of long-term care services industry, finding a way out of long-term care dilemma.