The Evolution Of Welfare Mix In Long-Term Care Provision In China

The 21st century is a century in which the global population is aging.A series of social problems caused by population aging has become a huge challenge for social policymakers.The construction of long-term care insurance system targeted for the elderly has become an necessary measure to deal with the problem of population aging in worldwide.Since the United States took the lead in establishing a commercial long-term care insurance system in the 1970s,Israel,Germany,Japan and other countries have been started developing a long-term care insurance system suitable for their national conditions,well-known as socialization long-term care insurance system.In 2016,the Ministry of Human Resources and Social Security of China promulgated a policy document named "Guidelines on Piloting the Long-Term Care Insurance System",proposing to explore the establishment of a social long-term care insurance system in 15 cities.Qingdao,as on of the 15 pilot cities,has a representative characteristics of large ageing population and early start-up.It took the lead in exploring social policy practices related to long-term care for the elderly as early as 10 years ago.As the first Chinese city to explore the establishment of long-term care social insurance system,the construction and development of Qingdao's long-term care service system has its distinctive features and has achieved quite remarkable policy results.Based on the welfare mix theory of welfare pluralism and the system-behavior theory,thesis analyzed a case history of Qingdao's long-term care social service system construction-Horizontally,from three aspects of service delivery,financing and regulation,and vertically,analyzing the construction and development process of long-term care insurance system in Qingdao from 2000 to 2018,which takes medical insurance reform as the opportunity.Then thesis have summarized the change logic of welfare supply mode in the field of long-term care social service in China represented by Qingdao.That is to say,from the one-way state-dominated mode changed to the contemporary mixed mode influenced by multi-subjects,including state,market,society and family,in which the role of the government has changed from the omnipotent "paddler" to the authorized "steering man",but still playing the role of the main fundraiser,regulator and regulator.The role of the market has changed from the marginalized service supplier to the main service supplier and service supervisor.The society is in the process of changing its role to personalized and characteristic service delivery.And family role in long-term care service field has gone through the second revival process of functional remodeling.Under the East Asia culture,the development of long-term care social services for the elderly has increasingly emphasized the return to family.However,it has shown an increased burden of the family as well as the effect of family long-term care service model is still not satisfactory.Under the premise of lack of a good service market and supervision system,the idea of relying solely on the community and the family to directly undertake social welfare services is tantamount to paper discussion.Therefore,when building a long-term care service system with the long-term care insurance system as the main body,we should balance social equity and financial burden comprehensively,and promote the construction of multi-content of long-term care social welfare system step by step.Qingdao's policy practice showed that the success of home-based long-term care service system is based on a sound long-term care service market.At the same time,we need social medical insurance and social endowment insurance to temporarily assume part of the social responsibility of long-term care insurance in the period of imperfect long-term care insurance system construction,in order to meet the expanding care needs of the aging society.This is the exploratory value of Qingdao's long-term care social welfare system construction.