Long term care insurance: 49 cities pilot to protect more disabled elderly
2022-07-22
Recently, Chengdu, Sichuan Province issued the implementation opinions on carrying out a new round of long-term care insurance reform, which made it clear that the insured persons of basic medical insurance for urban workers and basic medical insurance for urban and rural residents were included in the scope of protection. As a social insurance system, long-term care insurance provides care security and economic compensation for disabled people, benefiting a large number of disabled elderly people. The pilot project was launched in 2016, and has now covered 145 million people in 49 cities across the country. This policy, which is progressing steadily, enables more disabled elderly people to enjoy dignified and quality care in their later years. The pilot project has covered 145million people for six years. The 86 year old Kou Sujing, who lives in Changchun City, Jilin Province, is unable to take care of herself due to cerebral thrombosis. The elderly and their children are unable to take care of their mother for a long time. The elderly were admitted to a designated medical care institution in 2021, and their daily life was taken care of. According to the Changchun mayor's insurance policy, the monthly nursing service fee of more than 5000 yuan, the long-term insurance fund paid nearly 3000 yuan, and she paid more than 2000 yuan herself. At present, there are about 40million disabled and semi disabled elderly people in China. Long term care insurance is an institutional arrangement for disabled people, which provides care security and economic compensation for the insured when he loses the ability to live daily. People with severe disability such as Kou Sujing are the priority target of long-term insurance. In September 2020, the national medical insurance bureau and the Ministry of Finance issued the guiding opinions on expanding the pilot of long-term care insurance system. On the basis of the first pilot of long-term care insurance system launched in 2016, 14 pilot cities (districts) were added, with 49 pilot cities. Fanweidong, director of the treatment and Security Department of the National Medical Insurance Bureau, said that in the past six years, the pilot of long-term care insurance has covered 145million people nationwide, with a cumulative number of people enjoying treatment of about 1.72 million. The per capita reimbursement level is about 16000 yuan per year, and the fund payment accounts for about 70% of the burden of personal basic care expenses. Provide living care and medical care services. In pilot cities, long-term care insurance financing mainly includes proportional financing and quota financing. It is understood that in the early stage of the pilot project, nearly 90% of the total funds raised by the pilot areas were medical insurance funds. In the pilot process, all localities, under the guidance of the National Medical Insurance Bureau, fully consider factors such as fund carrying capacity in the treatment setting, and optimize and adjust the financing structure. Now the proportion of funding in the pilot areas has dropped to about 60%. The reporter found that the long-term care insurance in the pilot areas mainly provides two kinds of insurance services for long-term disabled people, including basic living care and medical care closely related to basic living care. With the gradual maturity of the long-term insurance operation, the pilot areas are also actively adjusting the service items covered by the long-term insurance. The reporter learned from interviews in many places that the pilot of long-term care insurance has provided policy and financial support for nursing institutions, promoted the transformation and development of primary and secondary medical institutions, and optimized the allocation of existing medical resources. Fan Weidong said that according to incomplete statistics, in recent years, nearly 5000 institutions nationwide have provided services for long-term insurance. At the initial stage of the pilot, there were less than 80000 employees, and now nearly 300000 employees directly provide long-term care services. After years of exploration and practice, the pilot work of long-term insurance has achieved remarkable results, but it still needs to be optimized in terms of multi-channel financing mechanism, the implementation of evaluation standards, and the effective supply of services. Most pilot cities in China have established multi-channel financing mechanisms such as units, individuals, medical insurance funds and finance, but medical insurance funds are still heavily relied on, and the financing level varies significantly between regions, which needs to be further standardized at the national level. The evaluation standard of disability level of long-term insurance is an important basis for long-term insurance treatment enjoyment and fund payment. The national medical insurance bureau and the Ministry of Civil Affairs issued the evaluation standard of long-term care disability rating (Trial) in August 2021 and the supporting operation guidelines in January 2022, laying a solid foundation for promoting the establishment of a national unified evaluation standard of long-term care disability rating and unifying standards such as nursing rating and service quality evaluation. It is a systematic project to solve the problem of care for the disabled elderly. This requires not only giving full play to the strategic purchasing role of the fund, but also the market to provide professional and high-quality care services. Experts suggested that the national unified long-term care insurance service items list and guidance catalogue, long-term care insurance service quality evaluation standards should be formulated as soon as possible, and the contents and standards of service items should be clarified and standardized. At the same time, the pilot areas are encouraged to include urban and rural residents in the scope of long-term insurance protection, and with the help of the power of third-party regulators, strengthen the effective evaluation of the use of insurance funds and service quality. (outlook new era)
Edit：sishi Responsible editor：xingyong
Source：http://paper.people.com.cn/rmrbhwb/html
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