For my long-term care insurance system design thinking

Paper Keywords: long-term care insurance, medical insurance, aging of the population of social care insurance care insurance business

Abstract: Although China's commercial insurance companies launched a long-term care insurance, but it is still in the initial stage. According to the article that China should learn from the advanced experience of foreign countries as soon as possible to establish long-term care insurance system, to enhance welfare of the elderly and to promote the harmonious development of economic and social goals.

Europe and the United States and other developed countries in order to meet their own aging population trends, taking into account the "silver market" potentially enormous purchasing power, timely introduction of a "long-term care insurance", in order to solve the "aged care crisis," provided the basic institutional guarantee. China should learn from the advanced experience of foreign countries as soon as possible to establish long-term care insurance system, to enhance welfare of the elderly and to promote the harmonious development of economic social objectives.

Foreign long-term care insurance Overview

World Health Organization (WHO) to Long Term Care (Long Term Care,

LTC) is defined as "by informal caregivers (family, friends or neighbors) and professionals (health and social services) for activities in system of care to ensure that those who do not have the ability to fully self-care can continue to be his personal favorite, as well as a higher quality of life, access to the greatest possible degree of independence, autonomy, participation, and personal satisfaction and dignity. " Therefore, the long-term care, including non-formal and informal types of support systems. The formal support system may include a wide range of community services (ie public health, primary health care, home health care, rehabilitation services and hospice care), private nursing home and hospice care homes, and those to suspend or reverse the disease and disability treatment.

Long Term Care Insurance (Long Term Care Insurance), also known as the long-term care insurance, is defined as those due to old age, illness or disability leading to loss of activities of daily living and need to be long-term care costs or to provide nursing care insurance. The elderly are the main users of long-term care services. The 20th century, 70's, long-term care insurance, commercial insurance in the United States appearing on the market. By 1986, the Israeli government first introduced the statutory nursing insurance system. Subsequently, Austria, Germany, Japan and other countries also have established a long-term care insurance system.

In the long-term care insurance, funding accountability exists for a different view. To sum up, there are two distinct views: one is individual and family should take a long-term care insurance, major financing responsibility, the Government only when the individual can not afford the funding responsibility, can be responsible as a last resort, thereby forming a business care insurance . Commercial care insurance offered by commercial insurance companies voluntarily to the United States as a typical representative; the other is the Government to ensure that the elderly enjoy a more comprehensive care services, the Government should be dominant, regardless of whether the elderly economic capacity, The resulting social care insurance. Social care insurance imposed by the government to Germany and Japan are typical examples.

The implementation of long-term care insurance need to consider the factors that

The need to develop long-term care insurance is that increased demand for aged care insurance, and the demand of the main individuals mainly

from elderly people (and their families) and the Government.

From the perspective of individuals and their families, individuals and their families, care for the elderly increased demand, mainly due to changes in population trends and socio-economic development trends in both effects. Mainly refers to changes in population trends of declining fertility, rising divorce rates and the distribution of factors such as age, the role of mortality decline; socio-economic development mainly refers to the population trends of higher levels of education, female labor force participation rate, wage income and retirement income (including social security payments , pensions, assets, etc.) also increases and other changes.

The average life expectancy of older persons, the elderly population aging trend becomes increasingly obvious, people with chronic non-communicable diseases, increased number of older persons, such as heart, brain and vascular diseases, gastrointestinal diseases, such as a significant increase in lumbar disc herniation, which led to the elderly disability and disability status of outstanding, to enable the elderly for long-term medical care or daily care needs of a sharp increase in the family and society a heavy burden. Weakening of the family care function. Family structures tend to miniaturization, the core technology, the

elderly living alone or with a spouse increased the number of people

living together; even the elderly living together with their children, most of them also work for children unable to receive timely and effective care. Many of them turned to hospital care, or admission into the professional nursing bodies, and huge medical expenses and cost of professional care to the elderly has brought a huge financial burden. China's aging population is based on the "421" based on family structure, namely a pair of one-child couples want to raise a child and support four elderly, the role of the family care protection is clearly insufficient.

Health insurance spending from the government point of view, in the long-term care insurance issued prior to China's current medical insurance system for the elderly can not solve the long-term care issue, and explicitly excluded the long-term care costs, which resulted in health insurance insuring the elderly hospital as care facilities, the elderly long-term hospitalization costs led to sharp rise in medical insurance expenses.

Long-term care insurance is to adapt to population aging trends in insurance products. China's current low level of economic development and large urban and rural, regional differences in the establishment of a unified social care insurance system, the feasibility is not yet available. However, aged care and commercial insurance policies have a huge market space. On the one hand, aging rapidly, health care needs of the larger areas, is generally higher level of economic development, the public insurance awareness is also strong, and some families already have the ability to purchase insurance, old age care; the other hand, the

complexity of elderly care needs, determines the content of health care insurance policy should have a diversity of commercial insurance, and flexible policy designed to better meet this requirement. Reposted elsewhere in the paper for free download http://

Improvement of long-term care insurance policy recommendations

(A) the phased long-term care insurance system to promote coordinated measures

Germany and Japan long-term care insurance system enforced by the government, under the social insurance system. In Germany, the social care insurance system is basically solved the elderly care needs and financial implications. Care insurance system of its home care and hospital care is divided into two levels. In recent years, projects have been from the everyday life of its nursing care, expanded health care and mental care, but also increased the content of psychological counseling and treatment to meet the psychological needs of older persons.

Japanese care insurance generally adopt the "care" means payment based, "insurance" payment method, supplemented by practice. Insured people who need care services, we must first submit an application through the specialized agencies of the review found, the care insurance

regulatory body will be based on the actual physical condition of the patient provide the appropriate content, the corresponding level of care services. Japan's nursing care insurance system covers a broad range of services, including doctors, caregivers come to visit care; pick for the elderly to day care facilities, or rehabilitation of health facilities; and loan wheelchairs, special beds and other benefits the majority of appliances 3 .

In China, the existing long-term care insurance business is still in its infancy, but also limited to the cost of care and compensation for a loss of activities of daily living is established, the elderly have received the amount of insurance is relatively fixed. In the future,

China's long-term care insurance system should not only be given to the elderly "insurance premiums" compensation, but should provide a "care services" and "Care Information", including full-scope safeguards. And the "insurance" payment as compared to "care" payment method can adapt to the diverse needs of the insured person, and can better prevent the occurrence of moral hazard, saving care expenses. In the "care" payment methods, should be properly classified care level, to set different levels for

different payment amount and services. Furthermore, it should actively encourage "home care" approach, both to meet the wishes of the elderly at home, but also save and hospital care costs high.

(B) to develop suitable to China's real "long-term Care Insurance Law"

China should the survey, based on projections of demand for good

long-term care to study the long-term care insurance premium starting age, payment standards, divided into long-term care level, the development suited to China's real "long-term care insurance law."

Germany, in 1992, adopted the "Care Insurance Act," which started in 1993. The scope of its health care insurance policy, criteria, method of payment and so explicitly. Since 1995, all persons to participate in the statutory health insurance have an obligation to participate in the social care insurance, that is, practicing care insurance is to follow the principles of medical insurance, care insurance for nursing services for the insured to provide home care, the purpose is to those who have lost self capacity and needs regular help pay cost of care, the main regulatory bodies are attached to the statutory health insurance companies care insurance.

Japan in 1997 adopted the "long-term care insurance law," since 2000. Its payment of premiums, nursing program options, the patient should receive care services, and insurance compensation for validation and approval procedures were strict rules and so on. Japan's elderly care insurance system consists of municipalities of specific operations, the insured person, whether good or bad physical condition are to attend. To demonstrate their diversity of funding sources, half from the insured to pay the premium, and the other half from the state, prefectures, municipalities three levels of government, according to the ratio of 2:1:1 to provide subsidies.

Our government should actively encourage the development of long-term care insurance, life insurance companies, and the development of long-term care insurance, the creation of an enabling policy environment should be introduced as early as possible "long-term Care Insurance Law," the scope of nursing insurance, standards, audit procedures such as method of payment do clear provisions to regulate the long-term care insurance market in the development of the legal system. As our country is "not rich first, the old" situation into an aging society, urban and rural dual economic structure and the size of a huge elderly population in China is still unable to establish a unified social long-term care insurance system, therefore, the Government should In the legal framework, for example, through tax incentives and other policy measures to encourage commercial life insurance companies to actively explore ways to implement long-term care insurance. Only in this way can be achieved not only

protect the elderly receive more comprehensive care to meet the demand, but also protect the health of life insurance companies to provide services for the elderly in order to achieve a win-win goal of profit maximization. Reposted elsewhere in the paper for free download http://