长期照护保险财务制度的国际经验与借鉴.docVIP

长期照护保险财务制度的国际经验与借鉴 张俊良 杨成洲 西南财经大学中国西部经济研究中心 X 关注成功！ 加关注后您将方便地在 我的关注中得到本文献的被引频次变化的通知！ 新浪微博 腾讯微博 人人网 开心网 豆瓣网 网易微博 摘????要： 本文以理论研究和案例研究的方法, 对国际上已开展长期照护保险的国家 (或地区) 的财务制度设计进行了系统研究。比较了税收制、保险制两种资金筹措方式及现收现付制、完全基金累积制和部分基金累积制三种财务运作模式在各国的实践及其优劣, 结合国际案例对长期照护保险的收入、支出与费率的决定与精算, 如何维持财务安全与永续的安全准备机制、费率调整机制、费率调整预警机制进行深入剖析。研究发现, 虽然各国 (或地区) 基于不同价值理念、经济实力、制度体系等因素而选择了不同的财务制度, 但这些经验为我国将来构建长期照护保险财务制度顶层设计提供了有益的借鉴和指引。 关键词： 长期照护保险; 财务制度; 国际经验; 基金：中央高校基本科研业务费专项资金资助重点研究基地项目“人口与可持续发展研究中心”支持 (JBK150402) Research on Financial System of Long-term Care Insurance:International Experience and Reference ZHANG Junliang YANG Chengzhou Abstract： This thesis conducts a systematic study on the financial systems of the countries or regions worldwide that have been practicing long-term care insurance by theoretical analysis and case studies. A comparison and contrast is made between raising fund via tax and insurance. The advantages and disadvantages of three different financial systems, namely, pay-as-you-go, full funding and partial funding, are also covered in the current paper. Through various international case studies, it looks into the revenue, expenditure as well as rate calculation of long-term care insurance. It further analyzes how to maintain a safe and sustainable reserve system, the rate adjustment mechanisms and the risk-alert system. It finds that, though different financial systems are adopted due to the different values, economic strength as well as social systems of the countries and regions, these existing international practices provide China with a valuable and beneficial reference and guidance in building the long-term care insurances top-level design in terms of the financial system. Keyword： long-term care insurance; financial system; international experience; 在社会变迁、医疗技术进步背景下, 人口结构迅速转变, 并形成四个基本的人口特征:一是人口老龄化趋势不断加重;二是人口总和生育率下降并将长期处于低水平, 少子化现象严重;三是家庭结构与形态持续变迁, 家庭规模缩减, 家庭户人口趋于减少;四是女性人口的劳动参与率持续上升, 家庭中的照顾人力不足, 导致传统家的庭照顾功能逐渐弱化。[1]由于长期照护需求与年龄高度相关, 随着老龄化的加速和慢性疾病的发生几率增加, 未来失去独