Opinions on promoting the construction of a basic elderly care service system

Q: Please brief us on the background and significance of the Opinions on Promoting the Construction of the Basic Elderly Care Service System issued by the General Offices of the CPC Central Committee and The State Council.

A: The Party Central Committee and The State Council attach great importance to basic elderly care services.  Premier Li Qiang pointed out that it is necessary to implement the national strategy to actively cope with the aging population and strengthen the security of elderly care services. It is necessary to establish a positive outlook on aging, do a good job in hierarchical and classified elderly care services, so that the elderly and disabled elderly have some support, and the young and healthy elderly have something to do. The Fifth Plenary Session of the 19th CPC Central Committee made major decisions and deployments on improving the basic elderly care service system. The 20th National Congress of the CPC proposed to promote the realization of basic old-age care services for all elderly people. The "Opinions on Strengthening the Work of Aging in the New Era" issued by the Central Committee of the Communist Party of China and The State Council proposed to "establish a basic elderly care service list system." In accordance with the decision-making and deployment of the Party Central Committee and The State Council, the Ministry of Civil Affairs, together with relevant departments, studied and drafted and submitted to the Central Office and the State Office for issuance of the Opinions on Promoting the Construction of the Basic Elderly Care Service System.

Basic elderly care services refer to the basic, inclusive and backstop services provided directly by the state or guided by certain means by relevant subjects to provide the elderly with basic, inclusive and backstop services necessary to realize the elderly have their own care and support. Promoting the construction of the basic old-age service system is an institutional measure to promote the high-quality development of old-age service. It is the key link to construct the supply pattern of government, society, market and family to fulfill their responsibilities in an orderly and coordinated manner. It is a basic institutional arrangement for ensuring basic people's livelihood, promoting social equity and maintaining social stability, and embodies the fundamental purpose of our Party to serve the people wholeheartedly. By the end of 2022, there will be more than 280 million elderly people aged 60 or above, accounting for 19.8 percent of the total population, of which 210 million elderly people aged 65 or above, accounting for 14.9 percent of the total population. Since the 18th National Congress of the Communist Party of China, the improvement of the system of elderly care services has been accelerated, and the fairness and accessibility of basic elderly care services have been continuously improved. By the end of 2022, the Old age allowance, old-age service subsidy, nursing subsidy and comprehensive subsidy for the elderly benefited 33.302 million, 5.461 million, 971,000 and 672,000 elderly people respectively. A total of 13.95 million elderly people across the country are covered by minimum living allowances, and 3.68 million elderly people in extreme poverty are covered by assistance and support, so that they should be fully supported. There are 381,000 institutions and facilities for the elderly, including 40,000 institutions for the elderly, 341,000 community institutions and facilities for the elderly, and 8,223,000 beds. All these laid a solid foundation for the construction of a basic elderly care service system. At the same time, basic elderly care services are still the shortcomings of the new era of elderly care services, the problem of unbalanced and inadequate development is still prominent, and there is still a certain gap with the deployment requirements of the Party Central Committee and The State Council and the expectations of the people, its basic concept and service objects, content, standards need to be further clarified, and the responsibilities and tasks of various departments need to be further refined. In the central document, the "Opinions" for the first time determined the connotation and main tasks of promoting the basic elderly care service system, clarified the responsibilities and positioning of the government, society, market and family in the basic elderly care service, clarified the main contents of basic elderly care service including material help, care service and care service, and highlighted the security of life and long-term care service for the elderly. The key questions of "whom to serve", "what to serve" and "how to serve" are answered.

The "Opinions" make important basic institutional arrangements for promoting the construction of the basic pension service system, realizing the elderly have access to support and support, reflecting the great importance attached by the Party Central Committee and The State Council to the work of pension services, and is an important milestone in the history of the development of pension services in China. It is to promote the solution of the elderly's problems in pension services, including the bottom, the bottom, the bottom, and the bottom. Continuously enhance the sense of gain, happiness and security of the elderly, and realize the important system design of elderly care.

Q: What are the basic principles for building a basic elderly care service system?

A: The construction of a basic elderly care service system should adhere to the basic, inclusive, shared and systematic principles. These four principles are a unified whole and run through the whole process of the construction of the basic elderly care service system.

The basic principle is to base on China's basic national conditions, take into account the necessity and possibility, focus on ensuring basic, wide coverage and sustainability, and do what we can to ensure the basic life and care needs of the elderly.

The principle of inclusiveness means that in the process of improving the level of equality of basic public services, the object and content of basic elderly care services should be gradually expanded, so that all eligible elderly people can easily access basic elderly care services and obtain them roughly equally.

The principle of shared responsibility is to help needy families share the burden of support and care by providing basic elderly care services, giving play to the role of the market, and guiding social mutual assistance on the basis of effectively fulfilling their obligations to support and support their dependents.

The systematic principle is to promote the optimization and integration of institutional resources such as social insurance, social assistance, social welfare, charity, and preferential treatment for the elderly, strengthen the coordination of institutional reforms in relevant fields, and support the development of the basic old-age service system.

Q: What are the goals and tasks of building a basic elderly care service system?

A: The Opinions have specified specific targets by 2025. The "14th Five-Year Plan" period focuses on the basic needs of elderly care services when the elderly face difficulties such as disability, disability, and no one to take care of them that are difficult for families and individuals to cope with. By 2025, the basic elderly care service system will be basically complete, the list of basic elderly care services will be continuously improved, the service object, service content and service standards will be clear, the service supply, service guarantee and service supervision mechanisms will be continuously improved, and the basic elderly care service system will cover all elderly people.

The Opinions put forward five key tasks. The first is to formulate and implement the list of basic elderly care services, requiring all relevant departments to strictly implement the "National List of basic elderly care Services", and the provincial government to formulate and publish the specific implementation plan and list of basic elderly care services in the region. The second is to establish a precise service active response mechanism, carry out a comprehensive assessment of the ability of the elderly, and gradually realize the transition from "people looking for services" to "services looking for people". We will strengthen support for elderly people with disabilities. For the elderly living alone, empty nest, left-behind, disabled, severely disabled, family planning and other special families to provide visiting care services, relying on the grass-roots management service platform to provide elderly care service policy consultation, information inquiry, business management and other convenient services. The third is to improve the basic old-age service security mechanism, promote the establishment of relevant insurance and welfare and assistance of the long-term care security system, reasonably determine the scope of financial difficulties disabled elderly care subsidies and subsidy standards, establish a basic old-age service funding security mechanism, implement the development of preferential support policies for old-age services, encourage social forces to participate in the provision of basic old-age services. The fourth is to improve the supply capacity of basic elderly care services, formulate an overall plan to promote the development of elderly care service facilities at different levels, and construct elderly care service facilities in accordance with standards and requirements. Elderly care service facilities invested by the government or funded by the government are given priority to basic elderly care services, and ensure the effective operation of service institutions supporting the extremely poor. Fifth, improve the facilitation and accessibility of basic elderly care services, develop street (township) regional elderly care service centers or service complexes for the elderly, give priority to the transformation of public service facilities closely related to the daily life of the elderly, implement home aging transformation for disabled, elderly and disabled elderly families who are included in the decentralized special poverty support, and strengthen the construction of barrier-free information.

Q: What are the contents of the national basic elderly care service list system? What is the significance of formulating the National Basic Elderly Care Service List?

A: The Opinions on Strengthening Aging Work in the New Era issued by the CPC Central Committee and The State Council clearly require the establishment of a basic elderly care service list system. The system contains three aspects, one is the system structure. That is, there is a national List of basic pension services at the national level, and the Opinions require that the list formulated and issued by provincial governments should contain the service items in the National List of basic pension Services, and the coverage and realization degree should not be lower than the requirements of the National List of basic pension Services. The second is the content of the list. The list should clarify the service object, service content, service standards, etc. Third, dynamic adjustment. The clear objects, projects, contents, etc. of the National Basic Elderly Care Service List shall be dynamically adjusted according to factors such as the level of economic and social development and financial status, and the Ministry of Civil Affairs shall put forward revised opinions jointly with relevant departments in a timely manner, and be issued and implemented in the name of the department after approval according to procedures. According to the country's economic and social development, the country's financial security capacity, and the people's living needs and other factors, the adjustment includes both new projects and changes in the coverage and realization of existing projects.

The National List of Basic elderly Care Services includes 16 service items in three categories, including material help, care service and care service, and defines the service object and content of each project. In combination with the implementation of the requirements of the National Basic Public Service Standards (2021 edition), the List of National Basic Elderly Care Services focuses on ensuring the basic life security of the elderly, and summarizes the basic service items that have been clearly related to the elderly in the current effective laws, regulations and policy documents, and integrates them into the institutional framework of basic elderly care services. At present, among the 16 services listed in the National List of Basic Elderly Care Services, 13 are clearly stipulated in the National Basic Public Service Standards (2021 edition), and the remaining three are clearly stipulated in laws, regulations and policies. The elderly care service is divided into basic elderly care service and non-basic elderly care service, and basic elderly care service is provided to all elderly people as a public product in a inventorized and standardized way, which is an innovative policy measure made according to China's national conditions, and its significance is mainly reflected in the following three aspects:

First, it is conducive to ensuring and improving the basic people's livelihood. The "National List of Basic elderly Care Services" clarifies the scope and bottom line standards of basic elderly care services that governments at all levels must guarantee at this stage, allowing local governments to have a clear idea of the "key to guarantee" and "to what extent" of old-age care services at this stage, which is helpful to guide local governments to check the central requirements, make up for deficiencies, and optimize resource allocation. The limited financial resources will be used in the areas that the elderly are most concerned about and the key links that the elderly need most in their lives. At the same time, it is also conducive to the majority of elderly people for what kind of service security they can get from the state and society, so that they can better arrange their later life.

Second, the fruits of development will be shared by all. The National List of Basic Elderly Care Services is the basis for improving the basic elderly care service system, providing an important basis for all localities to determine their regional implementation standards and for elderly care service institutions to implement standardized service process management, and is conducive to promoting the standardization and equal supply of basic elderly care services nationwide. We will gradually realize that all elderly people have fair and accessible access to roughly equal basic elderly care services, and jointly share the fruits of reform and development.

Third, it is conducive to the modernization of the national governance system and governance capacity. The formulation and promulgation of the "National List of Basic Elderly Care Services" to clarify the bottom line standards of basic elderly care services is a solemn commitment made by the state to the people, and the basic work of improving the national basic public service system, which is conducive to promoting the livelihood security system of urban and rural areas to be more mature and finalized, and is conducive to promoting the modernization of the national governance system and governance capacity.

Q: At present, the development of different regions in China is still uneven, and the gap between the aging degree is obvious. In this context, how should we realize the fair protection of basic elderly care services?

A: There are great differences in the level of economic and social development in different parts of China, and the development of population aging has obvious regional gradient characteristics from east to west, and the population aging in the economically developed eastern coastal areas is significantly faster than that in the economically underdeveloped central and western areas. To advance the development of a basic old-age service system, we must not only meet the bottom line of ensuring people's livelihood and providing basic old-age services, but also properly handle the issue of sustainable financial affordability and balanced regional development. The core of this is to adhere to the basic principles, that is, to base on China's basic national conditions, take into account the necessity and possibility, focus on ensuring basic, wide coverage and sustainability, and do what we can to ensure the basic life and care needs of the elderly. There are four main considerations:

One is "everything". Specifically speaking, all laws and regulations have clear provisions, the Party Central Committee and The State Council have clarified that the basic elderly care services that China's elderly should enjoy should be incorporated into the full, in principle to achieve full coverage, no leakage, and further refine service standards. The second is "promises must be kept". The National List of Basic elderly Care Services is a hard commitment made by the state to every citizen, and the listed service items must be basically implemented at this stage. Third, "adapt to local conditions". Governments at the provincial level and below can, according to the actual development of the local economy and the needs of the elderly, study and propose specific local implementation projects and standards, and on the basis of ensuring the implementation of the national basic elderly care service list project, the most suitable services are sent to the side of the elderly. Fourth, "dynamic sustainability". In accordance with the general requirements of meeting the bottom line of people's livelihood and ensuring basic people's livelihood, we will continue to do our best and do what we can, focusing on the most direct and realistic interests of the people. It is necessary to find the best balance between meeting the needs of the people's basic elderly care services and the national financial security capacity, so as to make the fiscal sustainable and dynamically adjust in accordance with the procedure.

Q: How to give play to the role of the market and promote the diversification of the providers and ways of providing basic elderly care services?

A: The elderly care service is divided into two parts, one is basic elderly care service and the other is non-basic elderly care service. Non-basic elderly care services are mainly provided by the market. The "Opinions" require that basic elderly care services are mainly provided directly by the state or through certain ways to support the relevant subjects to provide, which includes the requirement to give full play to the role of the market, and promote the diversification of the providers and the diversification of the ways of providing them.

First, we should give full play to the role of effective markets and competent governments and encourage diversified supply. We will implement preferential support policies for the development of elderly care services, encourage social forces to participate in the provision of basic elderly care services, combine government purchase of services with direct provision of services, and give priority to ensuring the service needs of disabled, elderly, unattended and other elderly people with financial difficulties. Localities where conditions permit will optimize policies such as bed construction subsidies and operation subsidies for elderly care service institutions, and support elderly care service institutions in providing basic elderly care services. Second, give full play to the power of charity and voluntary service. Encourage and guide enterprises, social organizations, individuals and other social forces to provide support and assistance for basic elderly care services through donations, the establishment of charitable funds, voluntary services and other means in accordance with the law. Third, actively support the development of inclusive elderly care services, and realize that inclusive elderly care services can be enjoyed by payment, affordable prices, guaranteed quality, and safe supervision. Fourth, actively guide the development of high-quality and diversified non-basic elderly care services, make them a useful supplement to the basic elderly care service system, and jointly build a multi-level sustainable elderly care service system with Chinese characteristics.