上海市老年长期护理保险发展中的政府责任研究

发布时间：2018-04-20 08:10

本文选题：长期护理保险 + 供给　；参考：《上海师范大学》2014年硕士论文

【摘要】：全国老龄委发布的数据显示，目前我国失能老年人已经达到3300万，到本世纪中叶将达到一亿人左右，这些老年群体最需要就是长期护理的服务。但在未富先老的现实国情下，我国面临与发达国家诸多的差异：社会医疗保障制度尚未健全、公共部门财政负担较重、社区医疗体系薄弱等，失能老人长期护理基本上由家庭承担。一方面是失能老人越来越多，另一方面是失能老人家庭越来越难以承受这方面的压力。多年的计划生育政策使得我国家庭模式日趋集中，4-2-1的典型家庭结构使得中年夫妇在沉重的工作压力面前，难以应对四个老人和一个孩子的照顾责任，更别说还有一个是失能老人。这些现实困难的存在，使得大力发展长期护理保险变得非常必要。发展长期护理保险不但可以满足失能老年人的护理需求，而且可以使得医疗保障模式多元化，使社会保障的内涵更为丰富。而作为我国金融中心的上海，拥有发达的金融市场和监管体系以及雄厚的财政能力支持，完全可以成为率先推动长期护理保险的阵地，探寻一条合适长期护理保险发展的道路。但是相较发达国家而言，长期护理保险对于上海市仍然属于一个新兴险种，如果像美国那样以商业保险的形式实施，，以上海市目前的保险市场成熟度以及配套政策的完善度，是不合理的；或者像德日荷兰那样将长期护理保险作为社会保险的一个新型分支强制实施，由于上海市目前人口众多，所需资金过于庞大，不利于城市经济的发展。所以对于上海市而言，这一护理体系不应像美国那样是单一的商业保险，也不应像德国日本荷兰那样是专门的强制性的社会保险，而应该是一种多层次的保险模式。故本文从上海市老年长期护理保险的需求和供给两个方面展开分析，并借鉴德国、日本和荷兰三个发达国家长期护理保险制度的经验，从上海市长期护理保险的供求均衡入手，探寻在长期护理保险中，政府应承担的责任。
[Abstract]:According to the data released by the National Committee for the elderly, the number of disabled elderly in China has reached 33 million and will reach about 100 million by the middle of this century. These elderly people most need long-term care services. However, in the reality of being old before becoming rich, our country is facing many differences with developed countries: the social medical security system is not yet sound, the public sector has a heavy financial burden, the community medical system is weak, and so on. Long-term care for the disabled elderly is basically undertaken by the family. On the one hand, there are more and more disabled old people, and on the other hand, families of disabled people are becoming more and more difficult to bear the pressure. The family planning policy of many years has made the family pattern in our country increasingly concentrated on the typical family structure of 4-2-1, making middle-aged couples unable to cope with the care responsibilities of four old people and one child in the face of heavy work pressure. Not to mention a disabled old man. These practical difficulties make it necessary to develop long-term care insurance. The development of long-term nursing insurance can not only meet the nursing needs of the disabled elderly, but also make the medical security mode diversified and enrich the connotation of social security. As the financial center of our country, Shanghai, with developed financial market, supervision system and abundant financial support, can be the first to promote long-term care insurance and explore a suitable way to develop long-term care insurance. However, compared with developed countries, long-term care insurance is still a new type of insurance in Shanghai. If it is implemented in the form of commercial insurance as in the United States, the maturity of Shanghai's current insurance market and the degree of perfection of its supporting policies will be taken into account. It is unreasonable; or, like Germany, Japan and the Netherlands, long-term care insurance is compulsory as a new branch of social insurance. Because of the large population in Shanghai, the capital needed is too large, which is not conducive to the development of the urban economy. So for Shanghai, the care system should not be a single commercial insurance, like Germany, Japan and the Netherlands, but a multi-level insurance model. Therefore, this paper analyzes the demand and supply of long-term nursing insurance for the elderly in Shanghai, and draws lessons from the experiences of Germany, Japan and the Netherlands in three developed countries, starting with the balance of supply and demand of long-term care insurance in Shanghai. Explore the responsibility of the government in long-term care insurance.
【学位授予单位】：上海师范大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：D669.6;F842.6

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