我國長期護理保險立法初探
發(fā)布時間：2018-11-13 20:49
【摘要】：經(jīng)濟的發(fā)展使得科學技術、醫(yī)療衛(wèi)生水平不斷進步,進而使得人均壽命逐漸延長,加之生育率持續(xù)降低,造成越來越多的國家老齡化日趨嚴重。自19世紀末發(fā)達國家首先進入老齡化社會以來,世界上眾多發(fā)達國家已陸續(xù)進入老齡化社會。而進入21世紀以后,發(fā)展中國家也開始陸續(xù)進入老齡化社會。目前怎樣提高老年人的生活品質(zhì),減輕家庭對失能老人長期護理的負擔,是世界各國正在面臨或即將面臨的重要課題。建立長期護理保險制度,發(fā)展與完善第三方護理的模式是各國應對老齡化問題,解決失能老人長期護理需求的不二選擇。按照國際老齡化的標準,再根據(jù)我國人口普查數(shù)據(jù),我國已經(jīng)是老齡化社會中的一員。同時伴隨著經(jīng)濟的增長、家庭養(yǎng)老功能的弱化、人們對生活質(zhì)量的要求提高等多種因素,長期護理保險制度的建立已經(jīng)有了一定的基礎。但經(jīng)濟發(fā)展不均衡,保險意識薄弱以及"養(yǎng)兒防老"的陳舊觀念等因素成了我國建立并發(fā)展長期護理保險制度的攔路虎。作為世界人口第一大國,龐大的人口基數(shù)使得老齡人口規(guī)模巨大,空巢老人、失能半失能老人也逐漸增多。然而,老年人的護理早已超出了衣食住行的范圍,其精神上更加需要得到關心和慰藉,而這些在生活節(jié)奏日益加快的今天,單靠家庭成員已經(jīng)難以滿足老年人的需求。從而使得我國急需建立分散家庭護理負擔的長期護理保險制度。美國、德國、日本等少數(shù)發(fā)達國家已經(jīng)根據(jù)自已的國情建立起長期護理保險制度并實施了幾十年不等,取得了良好的效果。不同的模式各有所長,但毫無疑問必須要符合本國的國情,無論哪種模式在實施過程中都遇到了不同的問題,為我們提供了寶貴的經(jīng)驗和教訓。怎樣取其精華,避免其實施過程中已經(jīng)出現(xiàn)過的問題,建立起與我國現(xiàn)階段國情相適應的長期護理保險制度是我們亟待探討的問題。本文的大致結構如下:首先介紹長期護理保險制度產(chǎn)生的背景及意義、與護理保險相關的概念、以及國內(nèi)的文獻綜述;然后大致介紹日本和德國的社會性長期護理保險模式與美國的商業(yè)性長期護理保險模式的制度設計,再分析兩種模式的利弊,從而得出我國有哪些可以借鑒,哪些必須注意避免的地方;其次從我國老齡化的現(xiàn)狀、家庭結構的變化、不斷增長的醫(yī)療費用及有限的醫(yī)療資源之間的矛盾等幾個角度分析我國建立長期護理保險制度的必要性及面臨的問題;最后對我國應當選擇的模式、選擇該模式的原因提出建議,并從立法層面對長期護理保險制度涉及的主體、保障的對象、費率的設計和保險待遇等幾個方面提出具體的立法建議。
[Abstract]:With the development of economy, the level of science and technology, medical and health have been improved, and the average life expectancy has been lengthened gradually, and the fertility rate has been decreasing, which has caused the aging of more and more countries to become more and more serious. Since the developed countries first entered the aging society in the late 19th century, many developed countries in the world have entered the aging society one after another. And after entering 21 st century, developing country also begins to enter ageing society one after another. At present, how to improve the quality of life of the elderly and reduce the burden of long-term care for the disabled is an important issue facing or about to face in the world. Establishing long-term care insurance system and developing and perfecting the mode of third party nursing are the best choice for countries to deal with the aging problem and solve the long-term nursing needs of the disabled elderly. According to the international standard of aging and according to the census data of our country, our country is already a member of the aging society. At the same time, with the economic growth, the weakening of the family pension function, the improvement of people's quality of life and other factors, the establishment of long-term care insurance system has a certain basis. However, such factors as unbalanced economic development, weak insurance consciousness and the old idea of "raising children and preventing old age" are the obstacles to the establishment and development of long-term nursing insurance system in China. As the largest population in the world, the large population base makes the aging population large, empty nest elderly, disabled semi-disabled elderly also gradually increase. However, the care of the elderly has long gone beyond the scope of food, clothing, housing and transportation, and its spiritual need to be cared for and comforted, and these in the accelerating pace of life today, the family members alone has been unable to meet the needs of the elderly. Therefore, our country urgently needs to establish the long-term care insurance system which distributes the family nursing burden. The United States, Germany, Japan and a few developed countries have established long-term care insurance system according to their own national conditions and implemented it for several decades, and achieved good results. Different models have their own strengths, but there is no doubt that they must be in line with their national conditions. No matter which model has encountered different problems in the process of implementation, it provides us with valuable experience and lessons. How to take its essence to avoid the problems that have already appeared in the course of its implementation and to establish a long-term nursing insurance system suitable to the current situation of our country is an urgent problem that we need to discuss. The general structure of this paper is as follows: firstly, it introduces the background and significance of the long-term care insurance system, the concepts related to nursing insurance, and the domestic literature review; Then it introduces the system design of social long-term care insurance model in Japan and Germany and the commercial long-term care insurance model in the United States, and then analyzes the advantages and disadvantages of the two models. What needs to be avoided; Secondly, from the current situation of aging in China, the change of family structure, the contradiction between increasing medical expenses and limited medical resources, the necessity and problems of establishing long-term nursing insurance system in China are analyzed. Finally, it puts forward some suggestions on the mode that our country should choose, the reasons for choosing the model, and the main body involved in the long-term care insurance system and the object of protection from the legislative level. The design of the rate and insurance treatment and other aspects of specific legislative proposals.
【學位授予單位】：深圳大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：F842.6
[Abstract]:With the development of economy, the level of science and technology, medical and health have been improved, and the average life expectancy has been lengthened gradually, and the fertility rate has been decreasing, which has caused the aging of more and more countries to become more and more serious. Since the developed countries first entered the aging society in the late 19th century, many developed countries in the world have entered the aging society one after another. And after entering 21 st century, developing country also begins to enter ageing society one after another. At present, how to improve the quality of life of the elderly and reduce the burden of long-term care for the disabled is an important issue facing or about to face in the world. Establishing long-term care insurance system and developing and perfecting the mode of third party nursing are the best choice for countries to deal with the aging problem and solve the long-term nursing needs of the disabled elderly. According to the international standard of aging and according to the census data of our country, our country is already a member of the aging society. At the same time, with the economic growth, the weakening of the family pension function, the improvement of people's quality of life and other factors, the establishment of long-term care insurance system has a certain basis. However, such factors as unbalanced economic development, weak insurance consciousness and the old idea of "raising children and preventing old age" are the obstacles to the establishment and development of long-term nursing insurance system in China. As the largest population in the world, the large population base makes the aging population large, empty nest elderly, disabled semi-disabled elderly also gradually increase. However, the care of the elderly has long gone beyond the scope of food, clothing, housing and transportation, and its spiritual need to be cared for and comforted, and these in the accelerating pace of life today, the family members alone has been unable to meet the needs of the elderly. Therefore, our country urgently needs to establish the long-term care insurance system which distributes the family nursing burden. The United States, Germany, Japan and a few developed countries have established long-term care insurance system according to their own national conditions and implemented it for several decades, and achieved good results. Different models have their own strengths, but there is no doubt that they must be in line with their national conditions. No matter which model has encountered different problems in the process of implementation, it provides us with valuable experience and lessons. How to take its essence to avoid the problems that have already appeared in the course of its implementation and to establish a long-term nursing insurance system suitable to the current situation of our country is an urgent problem that we need to discuss. The general structure of this paper is as follows: firstly, it introduces the background and significance of the long-term care insurance system, the concepts related to nursing insurance, and the domestic literature review; Then it introduces the system design of social long-term care insurance model in Japan and Germany and the commercial long-term care insurance model in the United States, and then analyzes the advantages and disadvantages of the two models. What needs to be avoided; Secondly, from the current situation of aging in China, the change of family structure, the contradiction between increasing medical expenses and limited medical resources, the necessity and problems of establishing long-term nursing insurance system in China are analyzed. Finally, it puts forward some suggestions on the mode that our country should choose, the reasons for choosing the model, and the main body involved in the long-term care insurance system and the object of protection from the legislative level. The design of the rate and insurance treatment and other aspects of specific legislative proposals.
【學位授予單位】：深圳大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：F842.6
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