摘要
长期护理社会保险是为了化解老年人等的护理需求这一新型社会风险而建立的制度。此风险具有二重属性,既对个人的生活、健康等造成风险,也给其家庭成员带来成本负担。风险的二重属性决定了制度建构的两个层面:第一个层面是为护理需求者获得符合人性尊严之基本生活状态而提供支持,促进个人生活能力;第二个层面是使其家庭成员免受重大负担或损失,提升家庭护理能力。为了实现这两个层面的目标,制度建构应从单一的“保护被保险人权利”转向“保护被保险人兼顾支持家庭”的二阶结构。在筹资上,应区分年龄段设置不同的参保对象,建立多元筹资机制。在给付上,除了将重度失能、失智被保险人作为给付对象之外,还应为承担护理责任的家庭成员提供经济补偿、护理休假及服务支持等支持性给付。
With the acceleration of China's population aging,the difficulty of adequately meeting the care needs of the elderly has become a social problem that needs to be urgently addressed.In response,China has been actively exploring the establishment ofalong-term care insurance systemand has launched long-term care insurance pilots in 49 cities nationwide.In the future,a unified long-term care insurance system will inevitably be implemented through legislation.However,existing studies have focused on analyzing the legal relations and rule design of the system at the micro level,and there is a lack of research on the basic theory of the system.There is still a lack of in-depth discussion of the theoretical logic and the design of the path for the introduction of the system by legislation.Based on the social background and legitimacy of the construction of the system,this paper introduces the results of sociological research,analyzes existing problems in the current pilot policy documents and pilot practice,and clarifies the system's objectives and functions.At the same time,it adopts the comparative method,and analyzes the rule of law paths of the construction of the system from two major aspects of financing and benefits in light of China's actual national conditions.Compared with previous research,the innovation and expansion of this paper is mainly reflected in the following two aspects.Firstly,it explores the attributes and content of care needs as a new type of social risk,and demonstrates the legitimacy,reasonableness and necessity of constructing such an independent social insurance system in China in the new period.Secondly,it breaks through the shackles of traditional social insurance theories and constructs a new system that is different from the traditional social insurance system from the perspective of the characteristics of the risk of care needs.This paper argues that care needs are a new type of social risk different from conventional social risks,whose risk-bearers include both individuals and families.The goal of system construction should be divided into two levels:The first level is to provide support for the care demanders to obtain a basic life in line with the dignity of humanity,and to promote their self-reliance.The second level is to protect their family members from major losses and enhance the family's ability to provide care.In addition,it is necessary to break through the shackles of traditional social insurance theory,and shift from a single perspective of protection to a broader perspective of second-order protection.This paper argues that the path of system construction should be shifted from the conventional“protection of the rights of the insured”to the second-order structure of“protection of the insured and support for the family”.While protecting the individual needs of the care demanders,it should also take into account the need to reduce the burden on families.Specifically,in terms of financing,middle-agedand elderly people should be taken as the target of insurance coverage,and a diversified financing mechanism should be established that includes individuals,employers and the government.In terms of benefits,insurance should be provided for the care needs of insured persons with severe incapacity or dementia,and at the same time,family members who care for the insured persons should be provided with supportive benefits,such as financial compensation,nursing vacations and service support.
出处
《暨南学报（哲学社会科学版）》
CSSCI
北大核心
2024年第3期148-164,共17页
Jinan Journal(Philosophy and Social Sciences)
基金
国家社会科学基金青年项目“全面建成小康社会背景下构建长期护理保险法律制度研究”(17CFX042)。
关键词
长期照护
长期护理保险
养老需求
护理需求
保险给付
long-term care
long-term care insurance
old-age security
care needs
insurance benefits
