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河北省建立社会长期护理保险的可行性研究报告DOC

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当前,随着医疗水平提高,国内外人口老龄化现象日益严重,各种慢性疾病频发, 家庭结构越来越小,失能老人的护理问题成为国内外共同关心的话题。以色列、德国、 日本、韩国等国家建立了社会长期护理保险,有效提高了失能老人的生活质量,使福 利性支出利用更有效率,减轻了医疗保险的压力。我国青岛、上海等地也开展了社会 长期护理保险试点,取得了良好效果。 截至 2014 年 6 月,河北省 60 岁及以上老人占河北省总人口的 14.7%,高于全国 老龄化平均水平。同时,随着城镇化的发展,空巢老人越来越多,已超过 120 万,这 些老年人的长期护理成为亟待解决的问题。因此,研究社会性长期护理保险在河北省 的可行性便成为重要课题。 国内外成功的社会长期护理保险模式,都建立在一定的社会、政策、经济等条件 之上,因此本文也从社会条件、政策条件与经济条件三个方面介绍河北省建立社会长 期护理保险的可行性。 在社会条件方面,河北省老龄化现象严重,具有旺盛的护理需求。在护理服务供 给上,河北省的医疗卫生资源与以色列的水平相当,机构护理和居家护理服务逐渐充 足,河北省拥有建立社会长期护理保险的配套设施,将逐步满足河北省的护理需求。 另外居民传统养老观念弱化,社会参保意识不断加强,都是建立社会长期护理保险的 利好方面。因此河北省具备建立社会长期护理保险的社会可行性。 在政策条件方面,国家修订的新《老年人权益保护法》为发展长期护理保险提供 依据,河北省也明确提出尽快出台长期护理保险制度。在发展老龄事业上,河北省出 台了一系列支持政策,支持养老设施的建设,使养老院与床位等逐渐充足,吸引学生 学习护理专业,培养专业护理人员。另外,我国对高龄老人制定的津贴政策,在一定 程度上提高了投保人的付费能力,这些都支持了长期护理保险的发展。因此,河北省 具备建立社会长期护理保险的政策可行性。 在经济条件方面,从经济总量上来讲,河北省的经济水平与以色列建立时相当, 但因各地区经济水平发展不同,所以应分步骤的建立,先在经济水平较高的地区进行 试点;在居民缴费能力上,未来工资水平不断增长,居民能承受社会保险费的上涨, 因此居民能够缴得起社会保险费;财政补贴能力方面仍具有较大潜力,通过优化财政 支出结构,可大大提高补贴能力与福利支出的利用效率。从而,河北省已具备建立社IV 会长期护理保险的经济可行性。 最后,本文参考代表地区的经验,结合河北省实际情况从管理体系、资金筹集、 覆盖范围与服务对象及服务供给几个方面设计了河北省社会长期护理保险,同时为河 北省建立社会长期护理保险提出建议。 关键词,河北省 社会长期护理保险 社会可行性 政策可行性 经济可行性V Abstract At present, with the improvement of medical standard, phenomenon of aging population is growing at home and abroad. Frequent various chronic diseases, smaller family structure make disability and half disability elderly nursing problems become a topic of common concern at home and abroad. Israel,Germany,Japan,South Korea and other countries set up social long-term care insurance, effectively improve the quality of the disabile old man's life, make use of welfare spending more efficiently. Our Qingdao, Nanjing and other places also conducted a pilot social long-term care insurance, and achieved good results. As of June 2014, the population aged 60 or older, in Hebei Province, accounting for 14.7% of the total population, aging is higher than the national average. With the development of urbanization, more and more empty nesters has appeared, more than 1.2 million. the nursing problems become a problem to be solved.Therefore, the study of social feasibility of long-term care insurance in Hebei Province, has become an important issue. Success long-term care insurance model, at home and abroad, are built on certain social, policy, economic and other conditions, so the research on the feasibility to establish social long-term care insurance in hebei province is mainly on the question of feasibility from social, policy three aspects . In terms of social conditions:In Hebei province, the aging phenomenon is serious and has strong demand. On the supply of nursing services, compared with the established areas, medical and health resources in hebei province is same to the level of Israel. Institutional care and home care service are graduatly accepted by people. The potential nursing staff are gradually enough. Hebei’s basically hardware conditions have been established for long-term care insurance. Other residents of the traditional endowment weakening concept, ginseng protect social consciousness constantly strengthen, this is to establish positive aspects of social long-term care insurance. According to the specific situation in hebei province, should walk route is given priority to with family endowment. Another, traditional concept of resident pension is weakening ,insured continuouslyVI strengthen social consciousness, which are built on the positive aspects of social long-term care insurance. Depending on the circumstances of Hebei Province, home care should go to the main route. In terms of policy conditions: Hebei has realized the importance of long-term care for the elderly, cooperate with national policy, has develop policies to support the development of elderly care service. In the aspect of long-term care insurance, the state's newly revised elderly Protection Act to provide the basis for the development of long-term care insurance, Hebei Province also clear that the introduction of long-term care insurance system as soon as possible. In hebei province, for development of aging, a series of support policy of supporting endowment facilities, nursing homes and the beds and other ramp were draw up, attracting student to study the nursing profession, cultivate professional nursing staff. In addition, the subsidy policy of elderly in our country, to a certain extent , to improve the ability to pay policyholders' , which support the development of long-term care insurance. Therefore, our province has established social long-term care insurance policy feasibility. In terms of the economy: For hebei province's economy, the economic level in hebei province was created with Israel, but because of the regional economic development level is different, so the establishment of the duty to step,we can first tested at higher levels. On the residents' payment ability, with the rising future wages, people can withstand the rising social insurance premium, so people can afford pay society insurance premium. In addition, by optimizing the structure of fiscal expenditure, the subsidies ability can improve the utilization efficiency of welfare spending. Thus, the establishment of a social long-term care insurance in our province has the economic feasibility. Finally, on the basis of experience reference on the important regional, this article combined with the actual situation of hebei province from the management system, fund-raising, coverage and design the service object and service supply several aspects of social long-term care insurance in hebei province, at the same time , put forward suggestions for the establishment of the social long-term care insurance in hebei province. Keywords: Hebei province, social long-term care insurance, Social feasibility, policy feasibility, economic feasibilityVII 目 录 摘要III ABSTRACT V 目 录VII 1 引 言1 1.1 研究背景与研究意义...................................................................................................1 1.1.1 研究背景..............................................................................................................1 1.1.2 研究意义..............................................................................................................2 1.2 文献综述.......................................................................................................................2 1.2.1 国外相关研究......................................................................................................2 1.2.2 国内相关研究......................................................................................................3 1.3 研究思路与方法...........................................................................................................5 1.3.1 研究思路..............................................................................................................5 1.3.2 研究方法..............................................................................................................6 1.4 创新与不足...................................................................................................................6 1.4.1 主要创新..............................................................................................................6 1.4.2 存在的不足..........................................................................................................6 2 社会长期护理保险的概念界定及其建立条件7 2.1 社会长期护理保险的概念界定...................................................................................7 2.1.1 长期护理保险......................................................................................................7 2.1.2 社会保险..............................................................................................................7 2.1.3 社会长期护理保险..............................................................................................8 2.2 社会长期护理保险代表国家和地区建立时的条件...................................................9 2.2.1 社会条件..............................................................................................................9 2.2.2 政策法律条件....................................................................................................12 2.2.3 经济条件..............................................................................................................13 2.3 小结.............................................................................................................................14 3 河北省建立社会长期护理保险的社会可行性15 3.1 长期护理需求旺盛.....................................................................................................15VIII 3.1.1 人口老龄化........................................................................................................15 3.1.2 家庭结构小型化................................................................................................16 3.2 护理服务供给增多.....................................................................................................17 3.2.1 医疗卫生资源日益丰富....................................................................................17 3.2.2 机构护理资源日益增多....................................................................................18 3.2.3 居家护理日益普遍化........................................................................................19 3.2.4 潜在护理队伍壮大............................................................................................19 3.3 居民观念变化利好.....................................................................................................20 3.3.1 传统“养儿防老”观念弱化............................................................................20 3.3.2 居民社会保险参保意识增强............................................................................20 3.4 小结.............................................................................................................................21 4 河北省建立社会长期护理保险的政策可行性 22 4.1 政府对长期护理保险的鼓励政策.............................................................................22 4.2 政府对老龄事业的推动政策.....................................................................................23 4.2.1 政府对建设养老设施的鼓励政策....................................................................23 4.2.2 政府对护理人员的培养政策............................................................................24 4.2.3 政府对高龄老人的津贴政策............................................................................25 4.3 小结.............................................................................................................................26 5 河北省建立社会长期护理保险的经济可行性27 5.1 河北省总体经济能力分析.........................................................................................28 5.1.1 河北省的经济总量位居前列............................................................................28 5.1.2 河北省人均 GDP 达到代表国家和地区建立时的水平....................................29 5.2 河北省居民缴费能力分析.........................................................................................31 5.2.1 河北省工资逐年上升........................................................................................31 5.2.2 河北省居民的社会保险费用最大承受能力提高............................................34 5.3 河北省财政补助能力分析.........................................................................................36 5.3.1 河北省一般性财政收入与社会保障支出增长速度快....................................36 5.3.2 河北省社会保障支出上涨空间大....................................................................37 5.4 小结.............................................................................................................................37 6 河北省社会长期护理保险的框架设计及发展建议39IX 6.1 河北省社会长期护理保险的框架设计.....................................................................39 6.1.1 管理体系............................................................................................................39 6.1.2 资金筹集............................................................................................................40 6.1.3 覆盖范围与服务对象........................................................................................40 6.1.4 服务供给............................................................................................................41 6.2 河北省社会长期护理保险的发展建议.....................................................................42 6.2.1 政府起主导作用................................................................................................42 6.2.2 尽快完善相关的法律法规................................................................................42 6.2.3 提高河北省财政支出利用效率........................................................................43 6.2.4 试点先行,后期经验推广................................................................................43 6.2.5 加大社会长期护理保险的宣传力度................................................................43 结 论44

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