如何将困难群体纳入长期护理保险？——制度设计与财政负担

何梓彤; 张慧; 陈鹤

引用本文：何梓彤, 张慧, 陈鹤.如何将困难群体纳入长期护理保险？——制度设计与财政负担[J].中国卫生政策研究,2024,17(11):19-25

如何将困难群体纳入长期护理保险？——制度设计与财政负担

投稿时间：2024-08-16 修订日期：2024-11-09 PDF全文浏览 HTML全文浏览

何梓彤¹, 张慧¹, 陈鹤²

1. 中山大学公共卫生学院广东广州 510080;
2. 中国人民大学公共管理学院北京 100872

摘要:将困难群体纳入长护险是关系到制度全覆盖与公平性的重要议题。本研究在梳理851份长护险政策文件后发现，超过40%(20个)试点已实施了困难群体补贴政策，但在补贴环节、对象和水平方面存在明显差异，其中，参保缴费补贴最为常见。基于政策实践与文献，本研究提出了将困难群体纳入长护险的不同制度设计，综合利用微观和宏观数据对全国实施长护险情境下各种制度设计的财政负担进行了测算。本研究建议从参保缴费补贴起步，支持困难群体参加长护险，相应财政负担为15.8亿~32.0亿元；在条件允许时，进一步在待遇评估、享受环节给予困难群体补贴；拓宽补贴筹资渠道，促进困难群体相关财政的跨部门使用。

关键词:长期护理保险困难群体制度设计财政负担

基金项目:国家自然科学基金项目(72274225)；中国人民大学科学研究基金(中央高校基本科研业务费专项资金资助)项目(21XNA004)

How to include disadvantaged group in Long-term Care Insurance: Scheme design and fiscal burden

HE Zi-tong¹, ZHANG Hui¹, CHEN He²

1. School of Public Health, Sun Yat-Sen University, Guangzhou Guangdong 510080, China;
2. School of Public Administration and Policy, Renmin University of China, Beijing 100872, China

Abstract:Including the disadvantaged individuals in Long-term Care Insurance (LTCI) scheme is crucial for ensuring universal coverage and equality. This study, after reviewing 851 LTCI policy documents, found that more than 40% LTCI pilots (20) have already implemented subsidy policies targeting this group. However, there are significant differences among the pilots in terms of subsidy content, target population, and subsidy levels, with premium subsidies being the most common. Furthermore, based on policy practices and existing research, this study proposes multiple scheme designs to include the group in LTCI. Based on estimation using microdata and macrodata, this study estimated the fiscal burden of these designs under the nationwide LTCI implementation scenario. First, starting with premium subsidies to support the disadvantaged group in participating in the LTCI scheme. The fiscal burden is estimated to range from 1.58 billion to 3.2 billion yuan. Second, when conditions permit, further subsidies should be provided for the group during the eligibility assessment and benefits co-payment stages. Third, funding channels for subsidies should be broadened and the inter-departmental use of related fiscal resources should be promoted.

Key words:Long-term Care Insurance Disadvantaged group Scheme design Fiscal burden

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