Research On Japan’s Old-age Service Supply System And Its Enlightenment

The problem of global population aging is intensifying,and all countries in the world are actively seeking solutions.In the 1990s,Japan began to try to establish an elderly care service supply system integrating the needs of medical treatment,health care and daily life,and introduced the "Care Insurance Law" in 2000.The implementation of this legislation is not only the beginning of the legal construction of the elderly service supply system in Japan,but also promotes the transformation of the government monopoly supply pattern to socialization.After more than 20 years of development and reform,Japan has accumulated rich practical experience in the construction of elderly care service supply system.Aging population is a basic condition of our country.As the pension situation is becoming more and more grim,the pension service related content has become a hot issue in the academic circles.More and more experts and scholars are devoted to the exploration and research of the supply of new pension services.Based on the analysis and comparison of Japanese endowment service supply system,this paper summarizes the experience and inspiration of endowment service supply system construction in our country.Based on the theory of welfare pluralism,quasi-market theory,integrated care theory and other relevant theories,this paper utilizes the four-dimensional analysis framework of"distribution basis,distribution content,provision strategy and funding source" of Gilbert social welfare policy,and adopts several research methods such as historical research method,empirical research method and case study method.A systematic study is made on the supply system of the elderly service in Japan.First of all,in the process of development,Japan’s supply system of elderly care services has continuously enriched the supply of elderly care services through legal construction,community preventive service supply reform and sustainable development reform,showing the basic characteristics of constantly expanding service scope,gradually refined service standards and steadily improving service objectives.The selection of social insurance model makes the distribution basis of Japan’s endowment service supply system cover not only disabled and semi-disabled elderly people,but also independent and elderly groups suffering from specific diseases.By promoting the "community comprehensive care system" construction policy and the service concept of "self-reliance support" to the whole country,the Ministry of Health,Labor and Welfare has mobilized multiple subjects to participate in the elderly care service,promoted the development of various elderly care services within the community,and realized the home-based elderly care life in the familiar place.In order to ensure the effective coordination of multiple subjects,the Japanese government realizes the connection of multiple subjects and services by setting up comprehensive support centers,setting up posts of care management specialists and other measures.At the same time,through the release of discharge support,collaboration surcharge and other incentive policies,to promote medical care and other professional cooperation,and achieved some results;Japan’s care insurance adopts the financing mode shared by the state,local government and individuals and the compulsory transfer payment mode,which achieves a certain fairness,but also produces the problem of long-term income and expenditure imbalance.Secondly,through the practical case analysis and effect empirical analysis of Japan’s elderly care service supply system,this paper clarifies the practice path of multi-subject collaboration and the linkage mechanism of multi-occupation association in Japan,clarifies the research conclusion that decentralization can improve the supply efficiency of elderly care service,and draws the development experience and lessons of Japan.First,the case analysis method is used to verify the linkage mechanism of multi-subject coordination and multi-occupation joint in the elderly service supply system,and the study concludes that service upgrading,mutual assistance linkage and technical support are the efficiency mechanism of multi-occupation coordination,and clear goals,joint construction and sharing are the important basis of multi-subject collaborative development.The second is to select the data of the nursing insurance industry in Japan from 2006 to 2020,and verify the effect of the institutional reform on the service supply practice by constructing the DEA model.The results show that the reform of the community support industry effectively improves the supply efficiency of the elderly care service.Thirdly,based on the above research,it summarizes the experience and lessons of Japan’s elderly care service supply system.By integrating the theory of welfare pluralism,Gilbert’s analysis framework and the current situation of Japan’s pension service supply system,a framework model of Japan’s pension service supply system with Japanese characteristics is constructed.Japan’s endowment service supply system brings us two experiences:first,quasi-market mode is conducive to promoting the coordinated development of multiple subjects in endowment service supply;Secondly,through the construction of regional and integrated service supply system,the elderly can be helped to realize their old-age life in the familiar place.In addition,this paper also summarizes two lessons from Japan:first,due to the defects of the model itself,low reform efficiency,political stance and historical problems caused by the insurance "high open",resulting in huge financial pressure lessons;Secondly,it reveals the dilemma that Japan lacks a strong talent guarantee mechanism,which leads to a serious shortage of old-age service personnel.Thirdly,the article proves which lessons Japanese experience and lessons can provide for our country.This paper selects Shanghai,a city with serious aging and typical system development,as the comparison object,discusses the possibility of Japan’s endowment service supply system for reference,and then makes a comprehensive comparative analysis of the two through four dimensions of the social welfare policy analysis framework.The conclusions are as follows:first,the allocation basis of our long-term care insurance can adopt conditional and selective way to achieve fairness and efficiency of the system;Second,the purpose of realizing the old people’s old-age life as the goal was to carry out the construction of the community-based old-age service supply system,which not only coincides with the traditional concept of Chinese old-age,but also coincides with the goal of the construction of the old-age service in our country,and can better meet the realistic needs of the current elderly groups.Third,the service supply with high professional level,strong connection and interaction can not only guarantee the quality of elderly care service,but also integrate resources well and improve service efficiency.Fourthly,the introduction of the intermediary insurance system has promoted the development of the service supply system to a certain extent,but the insurance payment category,the payment demarcation of different insurance and the cooperative supply between systems are important factors to determine whether it can develop sustainably.Finally,through the study of enlightenment,thinking suggestions and countermeasures.Based on the scholars’ advance research and the current supply situation of Chinese elderly care service as the basis,this paper analyzes the existing practical problems in the supply system of Chinese elderly care service,such as policy fragmentation,supply structural imbalance,low degree of cooperation between service subjects and obvious passivity of service.According to the reason of the phenomenon,it can be found that the systematization system is not perfect,the misunderstanding of the supply side,the power and responsibility is unclear,the lack of synergy mechanism,the lack of fund investment mechanism and other factors are the crux of hindering the development of the pension service supply system.To sum up,this paper finally puts forward four parts of countermeasures and suggestions,including actively implementing the conditional long care system,establishing and perfecting the community home care system of familiar residence,forming a coordinated supply mechanism,and establishing a sustainable fund operation mechanism.The main innovations are:First,this paper constructs the supply framework of Japan’s elderly care service with multi-subject cooperation and multi-occupation union.This paper tries to combine the theory with the Japanese pension service model to construct the analysis framework of the Japanese pension service supply system model.Based on the four elements of Gilbert social welfare policy analysis framework,namely distribution basis(W1),distribution content(W2),provision strategy(D)and fund source(F),and the theory of multiple welfarism,combined with the basic concept and construction of the Japanese community comprehensive care system,this paper constructs the supply system framework of elderly care service with Japanese characteristics.Second,this paper found one of the experience to our country:decentralization can effectively improve the pension service supply efficiency.On the basis of the experience and lessons summing up and comparative analysis thinking,the development experience is found to be valuable to our country.In the process of Japan’s nursing insurance reform,it is found that the introduction and development of community support undertakings for the purpose of decentralization to local governments can not only effectively control the expenditure of nursing insurance costs,but also stimulate the development vitality and internal driving force of multi-subject co-construction and sharing in the community.It provides feasible practical experience for the reform and development of Chinese pension service supply system,and also provides new ideas for the strategic reform of population aging.Third,this paper found two experiences that can be used for reference in our country:promoting synergies in the fields of medical care,care,rehabilitation,life support and housing.Based on the practical experience of institutional synergy and multi-synergy in Japan,this paper constructs a new multi-synergy framework for elderly care service supply.The elderly care service is a process of joint action by multiple subjects.The central government of Japan has reached the consensus of the whole people by promoting the comprehensive community care system to the whole country,and promoted the synergy in multiple fields.Based on the study of system structure and typical cases,this paper concludes that service upgrading,mutual assistance linkage and technical support are the efficiency mechanisms of multi-occupational collaboration,and that clear objectives,joint construction and sharing are the guarantee mechanisms of multi-subject collaborative development,which provides a reference for the action path of multi-collaborative service supply for the elderly.To sum up,the supply system of Japanese pension service has accumulated rich practical experience on the road of development and reform,which can provide some thinking and enlightenment for the construction of our system.At the same time,we should learn from Japan’s mistakes and lessons in the process of development,avoid risks,identify and solve problems as soon as possible.In the face of the rapid development of population aging,we must actively explore the development path of elderly care service in line with China’s basic national conditions,and realize the construction of "Chinese-style elderly care service supply system".