我国长期护理保险可行性研究

I提要自上世纪末，人口老龄化所引发的社会问题开始在各国逐渐显现，尤其是老年人的长期护理问题开始受到各国政府的关注。一方面，现代社会的发展使得家庭的养老功能逐渐弱化，家庭护理已经无法满足日益增长的老年护理需求；另一方面，医疗水平的进步使得医疗费用迅速攀升，尤其是老年护理需求牵涉的治疗周期长、专业护理费用高，这不仅给老年人带来了巨大的经济负担，也使得政府的医疗保险支出急剧增加。为了应对日益增长的老年护理需求问题，美国在上世纪七十年代率先推出了商业性的长期护理保险，以此来缓解政府的财政压力以及老年人的经济负担。之后，德国、法国等也陆续推出了适合本国国情的长期护理保险制度。我们的邻国日本和韩国也于本世纪相继推出了社会性的长期护理保险制度。目前，长期护理保险制度已经成为各国应对人口老龄化问题的主要手段之一。我国自本世纪初进入人口老龄化社会以来发展迅速，且具有“未富先老”、绝对数大，区域发展不平衡等特点。而且，由于计划生育政策的施行，使得我国家庭结构日益小型化，近年来，“空巢家庭”更是大量涌现，传统的家庭养老功能已经逐渐弱化。加上我国现行的医疗保险制度尚不健全，长期护理的相关费用将会给老年人带来巨大的经济负担。在未来的几十年，我国老龄化加速发展的情况下，如果这些问题处理不当，不仅会给家庭造成经济负担，还有可能给全社会带来负面影响。因此，现阶段研究建立我国长期护理保险制度的可行性具有极为重要的现实意义。本文首先从长期护理保险的概念界定入手。通过对美国、日本长期护理保险制度的详细阐述，得出了可以供我国借鉴的宝贵经验。之后，结合我国的现实国情对我国构建长期护理保险制度的必要性和可行性进行了深度分析，并最终提出了构建我国长期护理保险制度的对策和建议。关键词：长期护理保险人口老龄化可行性IIAbstractSincetheendoflastcentury,thesocialproblemscausedbytheagingofthepopulationhavegraduallyemergedinmanycountries;especiallytheproblemofelderlylongtermcarehasarousedconcernamongthegovernments.Ontheonehand,withthedevelopmentofmodernsociety,thefunctionofelderlysupportinfamilyhasgraduallyweakened.Homecarehadnolongermetedtherequestofelderlylongtermcare.Ontheotherhand,withtheprogressofmedicaltechnology,medicalexpenditurehasbeenrisingfast.Especially,elderlylongtermcaremeanslongertreatmentandhighercosts.Thisnotonlyhasbroughtenormouseconomicburdentotheelderly,butalsohasraisedmedicalinsuranceexpensesofgovernments.Inordertocopewiththeproblemofthegrowingdemandforelderlylongtermcare,theAmericanpioneeredthelong-termcareinsurancebusinessinthe1970stoalleviatetheeconomicburdenoftheelderlyandthegovernment.Afterthat,Germany,Franceandothercountriesrolledoutlongtermcareinsurancesystem.Bythebeginningofthiscentury,JapanandKoreaalsolaunchedsociallongtermcareinsurancesystem.Thelongtermcareinsurancesystemhasbecomeoneofmajormeasurestodealwiththeagingproblem.Bythebeginningofthiscentury,Chinasteppedintoagingsocietyandhasbeendevelopingrapidly.Theagingofourcountryhavethefeatureofgetoldbeforeitgetsrich,absolutelarge,andtheparticularityoftheregionalimbalance.Becauseoftheone-childpolicy,thesizesoffamilyarebecomingincreasinglysmaller.Inrecentyears,emptynestfamilyappearedinabundance.Inadditionto,ourcountrypresentmedicalinsurancesystemisnotyetperfect,thecostsoflongtermcarewillbringenormouseconomicburdentotheelderly.Therefore,throughanalyzingthedevelopmentoflongtermcareinsurancesysteminothercountryandcombiningwithournationalconditions,researchingtheestablishmentoflongtermcareinsurancesysteminChinawillhasgreatpracticalsignificance.Forthispaper,thefirstpartdefinestheconceptoflongtermcareinsurance.Afterthat,thepaperintroducesthebackground,contentanddevelopmentofthelongtermcareinsuranceinAmerican,JapanandKorea.Throughanalysisofthesecountries,itcouldbethevaluableexperienceforourcountry.Again,thepaperanalysisthenecessityandfeasibilityoflongtermcareinsurancesystemcombinedwiththesituationofourcountry.Finally,somemeasuresandproposalswereproposedontheimplementationoflongtermcareinsurancesysteminChina.KeyWords：long-termcareinsurance,Theagingofpopulation,FeasibilityIII目录1．引言..............................................................11.1研究意义........................................................11.2文献综述........................................................21.2.1国外关于长期护理保险的研究..................................21.2.2国内关于长期护理保险的研究..................................41.3研究内容和思路..................................................51.4研究方法........................................................52．长期护理保险概述...................................................72.1长期护理保险的概念界定..........................................72.1.1长期护理的概念..............................................72.1.2长期护理保险的概念..........................................72.1.3长期护理保险与传统人身保险的区别............................82.2长期护理保险的主要内容..........................................92.2.1长期护理保险的保险责任......................................92.2.2长期护理保险的保险金给付....................................92.2.3长期护理保险的给付限制.....................................103．国外长期护理保险的实践............................................113.1美国的长期护理保险.............................................113.1.1美国长期护理保险产生的社会背景分析.........................113.1.2美国商业性长期护理保险的产品设计...........................123.1.3美国长期护理保险的实施情况.................................143.2日本的长期护理保险.............................................143.2.1日本长期护理保险产生的社会背景分析.........................143.2.2日本社会性长期护理保险的具体内容...........................153.2.3日本长期护理保险的实施情况.................................173.3国外长期护理保险的经验给我国带来的启示.........................174．我国建立长期护理保险制度的必要性分析...............................194.1我国人口老龄化问题的特殊性.....................................194.2家庭结构的变化带动长期护理保险的需求...........................204.2.1家庭结构日益小型化.........................................214.2.2“空巢家庭”大量涌现.......................................214.3医疗费用的上涨进一步刺激长期护理保险需求.......................224.3.1不断上涨的医疗费用给老年人带来沉重负担.....................224.3.2现行医疗保险制度不完善引致对长期护理保险的需求.............23IV5.我国建立长期护理保险的可行性分析...................................265.1商业性长期护理保险在我国的作用有限.............................265.2建立社会性长