Expand the coverage of inclusive elderly care services
2024-08-27
General Secretary emphasized the need to promote the coordinated development of the elderly care industry and the elderly care sector, and to develop inclusive elderly care services. The Third Plenary Session of the 20th Central Committee of the Communist Party of China made important arrangements around improving the system of safeguarding and improving people's livelihoods, proposing to "improve the basic public service system and strengthen the construction of inclusive, fundamental, and bottom-up people's livelihoods". The "14th Five Year Plan for the Development of National Aging Industry and Elderly Care Service System" proposes to expand the coverage of inclusive elderly care services. This issue invites experts to discuss relevant issues. What is inclusive elderly care service? Why emphasize expanding the coverage of inclusive elderly care services? Yang Xiaoqi, Deputy Director and Researcher of the Institute of Aging Economy and Industry at the China Aging Science Research Center, pointed out that since the 18th National Congress of the Communist Party of China, the system of elderly care services in China has accelerated its improvement, and the fairness and accessibility of basic elderly care services have continuously improved. The supply pattern of multi-level and diversified elderly care services has also accelerated its formation. The "14th Five Year Plan for the Development of National Aging Industry and Elderly Care Service System" proposes to expand the coverage of inclusive elderly care services. Universal elderly care services, as the name suggests, "universal" refers to the wide coverage of people and service projects; 'Hui' refers to affordability and accessibility of elderly care services. Developing inclusive elderly care services means mobilizing all sectors of society to provide convenient, affordable, and high-quality elderly care services for all elderly people. Inclusive elderly care services have characteristics such as fairness, accessibility, comprehensiveness, and reliability. Specifically, its service targets all elderly people, and the opportunities for each elderly person to receive services are equal and fair; The service price is affordable and accessible for the elderly, and the price level is linked to the disposable income and retirement benefits of local residents. Generally, it is significantly lower than the market-oriented elderly care service price of the same service level in the local area; Its service supply is convenient for the elderly to access and has accessibility, such as establishing a "15 minute" home-based elderly care service circle, where the elderly can obtain elderly care services in the community. In addition, inclusive elderly care services are comprehensive and of guaranteed quality, capable of meeting the multi-level and diversified needs of the elderly. Currently, China has entered a moderately aging society. As of the end of 2023, there will be 297 million elderly people aged 60 and above, accounting for 21.1%, and 217 million elderly people aged 65 and above, accounting for 15.4%. With the deepening of population aging and changes in family structure, the number of elderly people who are old, disabled, living alone, and left behind continues to increase, and the demand for elderly care services continues to rise. Vigorously developing inclusive elderly care services is of great significance for better meeting the health and elderly care needs of the elderly, achieving a sense of security, support, happiness, and safety in old age. At different periods and stages, China has developed different models of elderly care services. In the early days of the founding of the People's Republic of China, due to the low level of economic development, the main focus was on developing supplementary elderly care services. Families were the main providers of elderly care services, while the government and market were supplementary. Basic elderly care services were only provided to special disadvantaged groups such as "Five Guarantees" personnel and urban "Three Nos" personnel, with obvious selectivity and remedial measures. In 2007, the Ministry of Civil Affairs promoted the moderate and inclusive development of social welfare, including elderly care services, to provide more benefits to special groups. Compared with the filling type elderly care services, the moderate universal elderly care services pay more attention to the role of the government, the coordination of various social forces, and provide more accurate services for the elderly on a larger scale. In the new era, in order to actively respond to the aging population, the country vigorously develops inclusive elderly care services, constructs and improves a bottom-up, inclusive, and diversified elderly care service system, and continuously meets the growing multi-level, high-quality and healthy elderly care needs of the elderly. In recent years, China has focused on developing inclusive elderly care services. One is the continuous improvement of the community home-based elderly care service network. A group of community elderly care service institutions have been cultivated from districts and counties, streets to communities, with care as their main business, radiating to the surrounding areas of the community, and taking into account door-to-door services. The second is to promote standardization and branding operations to further reduce prices. Inclusive elderly care services are mainly operated with light assets, promoting standardized and branded development, realizing resource sharing, achieving economies of scale, continuously reducing service prices, and truly achieving both inclusive and sustainable development. The third is the diversification of participating entities and the continuous improvement of service quality. The inclusive elderly care service market is an open market where all types of business entities can participate. Under fair market competition rules, we continuously improve and enhance service quality, and promote the standardization of elderly care services. At present, the problem of unbalanced and insufficient elderly care services still exists in China, with rapid development of institutional services and insufficient supply of home-based services; Urban services are developing rapidly, while rural services are lagging behind; High end services are developing rapidly, while mid to low end services are developing slowly; Wealthy areas develop faster, while remote and impoverished areas develop slower. The Third Plenary Session of the 20th Central Committee of the Communist Party of China made important arrangements around improving the system of safeguarding and improving people's livelihoods, proposing to "improve the basic public service system and strengthen the construction of inclusive, fundamental, and bottom-up people's livelihoods". The 2024 National Civil Affairs Work Conference emphasized the vigorous development of inclusive elderly care services, accelerated the legislation of elderly care services, focused on the construction of demonstration community home-based elderly care service networks, actively developed elderly meal assistance services, improved rural elderly care service systems, strengthened the construction of elderly care nursing staff teams, launched and implemented a three-year action plan to tackle the root cause of safety production in elderly care institutions, and improved the quality of elderly care services. The elderly care industry is the foundation of the development of the elderly care industry, and the elderly care industry promotes the improvement and efficiency of the elderly care industry. Vigorously developing inclusive elderly care services is an important measure to implement the national strategy of actively responding to population aging and enabling the elderly to have a happy and fulfilling old age. What measures has China taken to develop inclusive elderly care services and how effective are they in continuously improving the fairness and accessibility of elderly care services? Fang Lianquan, a researcher of the Chinese path to modernization Research Institute of the Chinese Academy of Social Sciences and Secretary General of the World Social Security Research Center, said that the CPC Central Committee attaches great importance to improving the system of ensuring and improving people's livelihood, strengthening the construction of inclusive, basic and inclusive people's livelihood, and constantly expanding the coverage of inclusive elderly care services. In 2013, the State Council issued the "Several Opinions on Accelerating the Development of the Elderly Care Service Industry", which made "adhering to the guarantee of basic needs" the basic principle for developing the elderly care service industry and proposed "ensuring that everyone enjoys basic elderly care services". In 2019, the National Development and Reform Commission and other departments issued the "Implementation Plan for the Special Action of Urban Enterprise Joint Inclusive Elderly Care (Trial)", supporting the cooperation between urban governments and enterprises to carry out inclusive elderly care service projects for ordinary elderly people. Following the concept of "government support, social operation, and reasonable pricing", convenient and affordable elderly care services are provided. The "14th Five Year Plan for the Development of National Aging Industry and Elderly Care Service System" further deploys the expansion of the coverage of inclusive elderly care services. In 2023, the General Office of the Communist Party of China and the General Office of the State Council issued the "Opinions on Promoting the Construction of the Basic Elderly Care Service System", launched a national list of basic elderly care services, and provided them as public goods to all elderly people in a standardized and itemized manner, becoming an important lever for developing inclusive elderly care services. Under the promotion of a series of policy measures, China's multi-level elderly care service system has been continuously improved and perfected, and the fairness and accessibility of basic elderly care services have continued to improve. One is that the social security system covers all elderly people, and the level of bottom line protection continues to improve. The basic pension insurance system in China has covered 1.07 billion people, including 310 million beneficiaries, and the level of pension benefits is gradually increasing. In 2023, 13.95 million elderly people across the country will be included in the minimum living allowance, and 3.68 million elderly people in extreme poverty will be included in extreme poverty assistance and support. The coverage of projects such as elderly allowance, elderly care service subsidy, and nursing subsidy for the elderly is becoming increasingly wide. The pilot program of long-term care insurance system is steadily advancing, continuously providing care services for the disabled elderly population. The number of people participating in long-term care insurance in 49 pilot cities across the country has reached 180 million, with 1.343 million people receiving benefits. There are 8080 designated service institutions and 303000 nursing service personnel. Secondly, we will increase the supply of inclusive elderly care facilities and significantly improve the service capabilities of institutions. As of the end of 2023, there are 41000 registered elderly care institutions nationwide, with 8.201 million beds for elderly care services. Among them, public institutions account for 45%, providing guaranteed elderly care services to low-income and extremely poor groups. The proportion of nursing beds in elderly care institutions nationwide exceeds 60%, achieving the goal of the 14th Five Year Plan ahead of schedule. Organize and implement the action plan to improve basic elderly care services at home and in the community, promote the construction of community home-based elderly care service networks in various regions, and develop regional elderly care service centers at the county (city, district) and township (street) levels with comprehensive functions such as full-time care, day care, and home services. The compliance rate of supporting elderly care service facilities in newly built residential areas in cities is over 83%. At the same time, the network of rural elderly care service facilities continues to strengthen, with 16000 rural nursing homes, 1.681 million beds, and 145000 mutual aid elderly care service facilities nationwide. The third is to improve the quality and increase the quantity, and to implement and refine the basic elderly care service list system. All provinces in China have introduced implementation plans and lists of basic elderly care services, gradually forming a favorable situation of promoting the construction of basic elderly care services system according to local conditions. On the basis of the national list of 16 service items, some provinces have included family care services, elderly preferential treatment, accidental injury insurance and other contents in their local elderly care service list, refining and clarifying the specific standards for elderly subsidies, elderly care service facility planning, and financial subsidies at all levels. Various regions actively carry out centralized care services to support economically disadvantaged and disabled elderly people, implement elderly friendly transformation for families of special disadvantaged elderly people, promote elderly meal assistance services, and improve the pilot of a comprehensive platform for basic elderly care services. Orderly promote the grading of elderly care institutions and improve the national unified quality standards and evaluation system for elderly care services. The fourth is to leverage the role of the market and promote the diversification of the main providers and modes of providing basic elderly care services. Actively promoting the reform of various institutional mechanisms in the elderly care industry, comprehensively utilizing support policies such as planning, land, and housing, and guiding various entities to provide inclusive elderly care services, not only broadens investment and financing channels, but also brings a large number of employment and entrepreneurship opportunities. Promote the reform of public elderly care institutions, improve the entrusted operation mechanism, introduce operating institutions with strong professional capabilities in the field of elderly care services to intervene early and fully participate in the construction of entrusted elderly care institution projects, and support large-scale and chain operation. Improve the mechanism for forming inclusive pricing for elderly care services, and achieve a significantly lower price level for inclusive services compared to market-oriented institutions at the same level. Implement a special action plan for inclusive elderly care, leverage the investment guidance and leverage within the central budget, guide local governments to develop supportive "policy packages", drive enterprises to provide inclusive "service packages", and promote the construction of a number of convenient, affordable, and quality guaranteed elderly care service institutions. Strengthen the effective supply of central state-owned economy in the field of elderly care services, and enhance the layout of local state-owned economy in the field of elderly care infrastructure. What are the experiences and practices of various regions in developing inclusive elderly care services to meet the multi-level high-quality elderly care needs? State Council Development Research Center for Public Management