Building a long-term care system for the elderly: Family responsibility, government leading social participation

The "Notice" proposes to break the bottleneck of the development of the elderly care service industry as soon as possible, stimulate the market vitality and the potential of private capital, promote social forces to gradually become the main body of the development of the elderly care service industry, and cultivate and build a number of branded, chain and large-scale elderly care service enterprises and social organizations. The move is said to open a new window for social forces to participate in the elderly care service industry.

According to the relevant provisions of the Notice, the government will have "release" and "management" of elderly care service enterprises and social organizations in the future. "Release" is to simplify the procedures of administrative examination and approval, real estate registration and other matters; "Management" refers to the handling of administrative illegal cases of elderly care institutions in strict accordance with legal authority and procedures, the information on administrative penalties made by elderly care service enterprises shall be publicized according to law, and a social evaluation mechanism shall be established.

According to the requirements of The State Council's "on fully opening up the elderly care service market to improve the quality of elderly care services", in 2020, the proportion of long-term care beds should reach more than 30%, and encourage the development of community nursing homes to meet the nearby care needs of disabled and mentally disabled elderly people.

Behind the gap in service teams and facilities for the elderly is the lack of funds. At present, the average disposable pension for the elderly in our country is generally between 1800-2000 yuan, and the cost of care for the handicapped and dementia is about 3500 yuan, according to Tang Wenxiang, member of the national Expert Committee on pension service Industry of the Ministry of Civil Affairs and chairman of Hunan Puqin Aging Industry Development Co., LTD. There is a difference between 1500 and 1700 yuan.

A trial of a long-term care insurance system was carried out to break the bottleneck of pension funds

In order to explore the establishment of a social insurance system that can raise funds through social mutual assistance and provide funds or service guarantees for basic living care and medical care closely related to basic living for disabled and mentally disabled elderly people, the Ministry of Human Resources and Social Security issued the Guiding Opinions on carrying out the Pilot Long-term Care Insurance System last year, and 15 cities including Shanghai, Guangzhou and Qingdao were included in the first batch of pilot cities.

Pilot projects have been launched in many places. In July 2016, Beijing Haidian District introduced the local measures of "home care disability care mutual insurance", of which the disability service standards, around the "eating, dressing, sleeping, toilet" 4 content, by a professional third-party agency will be the elderly disability degree to do four levels of division, corresponding to enjoy 900 to 1900 yuan of services.

Shanghai announced that from January 2017 in Xuhui, Putuo, Jinshan three districts to carry out the pilot, 60 years old and above enjoy the employee pension insurance retirees or residents pension insurance personnel, can voluntarily apply for the elderly care needs assessment. After the assessment of nursing needs of grade 2 to 6, the designated nursing service agencies can provide corresponding nursing services and reimburse nursing expenses according to regulations. During the pilot period, individuals and units will not pay for the time being, and the required funds will be transferred from the balance funds of medical insurance; After the city's pilot, long-term care insurance will be funded in accordance with the basic principles of the social insurance system.

In both the Beijing and Shanghai pilot schemes, an assessment of the disability or care needs of the elderly is mentioned. "There are people who are able to get out of bed and move around on their own, and there are people who may have lost the ability to move around freely and need 24-hour care. Chu Fuling, director of the China Social Security Research Center, suggested that the national unification of disability rating and nursing service rating standards should be realized as soon as possible.

"Long-term care insurance is mainly for disabled and semi-disabled people, but these elderly people are diverse and need different levels of care." Du Peng, director of the Organization Department of Renmin University of China and director of the Institute of Gerontology, believes that in order to implement the insurance, it is also necessary to subdivide the insurance and carry out targeted services and support projects.

In addition, Tang Wenxiang pointed out that the current pilot is to consider taking money from the financial and medical insurance, and then pay part of the individual to form a new insurance, such a practice may lead to excessive medical care, aggravate the tension of medical resources, overdraft the possibility of medical insurance funds. It is suggested that the pilot direction should be further diversified from the perspective of assisting some necessary medical care on the basis of basic life care.