Construction Of Government Responsibility In Long-Term Care Insurance

The seventh national census shows that 18.7%of population is 60 years old and over,of which 13.5%is over 65 years old,a significant increase compared to the sixth national census.Population aging is often accompanied by the trend of old age and disability.In order to alleviate the pressure of balanced population,the Fifth Plenary Session of the 19th Central Committee of the Communist Party put forward the "implementation of the national strategy to actively respond to population aging".Prior to this,government launched the pilot of long-term care insurance system.At the same time,local governments are encouraged to explore innovative social models.Overall,the outline of long-term care insurance system is preliminarily depicted in terms of breadth and depth.Local governments cooperate with qualified commercial insurance institutions through entrustment,purchase,etc.,to improve the handling capacity.However,at present,the academic has neglected the service supply model of "social-business cooperation" in pilot areas to some extent.In the selection of contractors and subsequent management,public sector has problems such as unclear positioning,conflicts between efficiency and fair value,etc.,which seriously weakens people’s sense of service acquisition.Clarifying government’s responsibilities is the first step to make the long-term care insurance system move towards the sustainable prospect.Based on this,this thesis takes public service outsourcing as perspective,responsible government as core theory,and constructs the government responsibility system according to the logic of "proposing question-analyzing connotation-empirical research-path suggestion".Specifically,the main contents are as follows:First,the necessity of government responsibility is clarified,and the content of "San Ze Yi Bao" applicable to long-term care insurance is summarized from the connotation of responsible government theory.(1)Organizational responsibility is the foundation.It mainly includes determining the scope of outsourced public services,selecting qualified contractors,and cultivating the market of aged care.(2)Contractual responsibility is the core.It refers to equal consultation in public service outsourcing,and jointly undertake supply tasks.Specifically,it includes legal bidding procedures and ensuring that government has strong contractual management capabilities.(3)Regulatory responsibility is the key.Divided by procedure,there is mainly contract content and result supervision;divided by content,there are mainly supervisions of service quality,price and agency withdrawal.(4)Government guarantees are support.Based on the human rights principles in the constitution,the long-term care insurance should protect citizens from possible violations caused by outsourcing of public services.Secondly,focusing on the current pilot,the two main models of insurance service outsourcing are sorted out.Then it starts from a case to analyze the general status of local government,the existing problems,and the internal and external incentives.(1)There are problems such as difficulties in the construction of outsourcing operation mechanisms,lack of government supervision and poor accountability,and ineffective guarantees of citizens’ rights and interests.First,service outsourcing does not meet the procedural requirements of openness,transparency and competitiveness,and lacks a scientific pricing and evaluation system.Second,both the subject and object of supervision are insufficient,the methods are backward,and there is no effective outsourcing accountability mechanism.Third,the protection of citizens’ right to know and to participate is insufficient,the effect of co-working is not significant,and there is a lack of risk awareness and bottom-line measures.(2)The reason is objectively derived from the expedient institutional settings.Subjectivity stems from the deviation of insurance service’s goals and values,and the government’s weak awareness of decentralization in outsourcing management.Finally,combined with the dynamic environments,the realization path of "concept reshaping-capacity enhancement-normative accountability-law guarantee" of responsibility guarantee mechanism is proposed.(1)Reshape "responsibility-based" concept,strengthen government’s "society-business cooperation" awareness of "spending money to buy services",and speed up the process of building a service-oriented government;(2)Strengthen contractual management and multi-resource collaborative management.Promote positive interactions between the multiple participants in elderly care services;(3)Improve social identity through normative accountability.Establish a monitoring and evaluation system with the participation of multiple subjects,and make public power shine under the sun;(4)The legitimacy of a modern country is endowed by the rule of law,and the rule of law is based on the system,establishing the independent status of the "sixth insurance" from the national legal level,and improving the operational guidance related to public service outsourcing.On the whole,this thesis expounds the guarantee mechanism of government responsibility,and tries to construct an overall framework for long-term care insurance consisting of responsibility subjects,responsibility objects,responsibility content and guarantee mechanism.