互助保险机制在长期护理保障中的应用:典型案例的政策设计及绩效

自长期护理保险政策试点启动以来,部分地区以互助保险为基础架构的长期护理保险制度,在制度框架、筹资机制、支付范围、服务提供方式等方面均具有一定的创新性。基于北京市海淀区试点政策的评估表明,以自愿参保、同质群体风险分摊和收益分享为前提的互助保险机制不能兼顾保障公平性、可持续性和可负担性等多重目标。应坚持以社会保险为基础构建多层次长期护理保障体系,支持商业健康保险公司提供多层次、补充性的保险产品。同时,要做好医疗、养老服务体系的改革和衔接,充分发挥护理保险基金的保障功能和保障潜力。

The Application of Mutual Insurance Mechanism in Long-term Care Security:Design and Performance of Policy Based on Typical Cases

Since the pilot launch of long-term care insurance policy,the long-term care insurance organized by mode of mutual insurance has certain innovation in the system framework,financing mechanism,payment scope,service provision and other aspects in some regions.The evaluation of the pilot policy of Haidian district in Beijing shows that the mutual insurance mechanism based on voluntary participation,risk sharing and revenue sharing of homogeneous groups cannot take into account multiple objectives such as fairness,sustainability and affordability.China should build a multi-level long-term care security system based on social insurance,and support commercial health insurance companies to provide multi-level and complementary insurance products.At the same time,the reform and connection of medical and elderly service system should be done well,and the security function and potential of long-term care insurance fund should be brought into full play.