Study On The System Pattern Of Long-Term Care Insurance In China

Since the Guiding Opinions has been released,all pilot regions have explored long-term care insurance according to realistic conditions.At present,there are two patterns of long-term care insurance system in China,namely,social insurance mode and commercial insurance mode.After studying relevant politic documents from all pilot regions,this paper finds that there are many differences between different pilot regions in some respects of long-term care insurance system,such as coverage,security objects,disability assessment,fund-raising,payment of benefits and administrative services.What's more,in the pilot phase,the social insurance mode has exposed some problems as follows: Firstly,most urban and rural residents haven't been covered by long-term care insurance.Secondly,the standard of disability assessment is incomprehensive and non-uniform.Thirdly,fund-raising is overly dependent on medical insurance fund.Fourthly,the safeguard scope and the level of benefits are still limited.Fifthly,the supply of professional nursing services is out of line with actual demand.In Haidian District,the disability care mutual insurance has some distinct characteristics in the aspects of coverage,security objects,fund-raising,payment of benefits and administrative services.However,the positivity of purchasing insurance,disability assessment and service standards are also confronted with some challenges.In addition,the welfare pluralism theory and path dependence theory are applied into the analysis of long-term care insurance system in America,Germany and Japan.The dimensions of analysis include establishment background,framework,development dilemmas and reform measures.Through comparing different patterns of long-term care insurance,this paper summarizes the intrinsic characteristics and developmental laws of long-term care insurance in three countries.Accroding to experience or lessons of reform and development of foreign long-term care insurance system,some enlightenments can be obtained as follows: Firstly,the institutional design and mode selection of long-term care insurance should respect the background and traits of the development of social welfare.Secondly,the level of fund-raising and the standard of benefits should insist on the actuarial balance principle.Thirdly,the major providers and forms of nursing services should reflect diversification.Last but not the least,in view of China's current economic,social and cultural background,the paper puts forward some opinions and suggestions to the institutional design and mode selection of China's long-term care insurance.For example,the basic long-term care insurance should adopt social insurance mode,and the supplementary long-term care insurance can develop commercial insurance mode.Urban and rural residents should be covered by long-term care insurance.The standard of disability assessment should become comprehensive,scientific and uniform.People who have dementia or moderate disability should be incorporated into security objects.Fund-raising should adopt multiple financing pattern.The scope and methods of payment should be further standardized.Administrative services should be more entrusted.In addition,improving the coordination mechanism and information communication mechanism between different departments and promoting the construction and development of long-term care service system are equally necessary.In these ways,the top-level design of China's longterm care insurance system can be speeded up,and problems or challenges in the pilot phase can be solved.