In the early morning of summer, Song Jinhui, a nurse, came to Xianlin New Village early in the morning to help Uncle Xu, a resident with Alzheimer’s disease, wash, feed and change his medicine. "Fortunately, with long-term care insurance and professional care services and cost subsidies, the pressure on us to take care of the elderly is much less." Uncle Xu’s daughter said gratefully.
The long-term care insurance system is an important decision-making arrangement made by the CPC Central Committee and the State Council to actively cope with the aging population, and it is also an important institutional arrangement to make up for the shortcomings of the social insurance system. The Party’s Report to the 20th CPC National Congress proposed to establish a long-term care insurance system. In recent years, China has actively carried out the pilot work of long-term care insurance, constantly expanding the scope of the pilot, providing nursing services for the disabled elderly and increasing living security. By the end of 2022, the number of people participating in long-term care insurance had reached 169 million, with a total of 1.95 million people enjoying treatment and a total expenditure of 62.4 billion yuan. What role has long-term insurance played in better realizing "a sense of security for the elderly"? How to promote the high-quality development of long-term insurance? The reporter conducted a survey and interview.
The pilot project of long-term insurance is progressing smoothly, effectively reducing the financial burden of disabled families.
Early in the morning, in Changqing Nursing Home in Fuzhou, Fujian Province, nurse Huang Changxiu helped Wu Apo, a paraplegic, get up, change clothes and have breakfast. In the evening, push the old man to the garden to relax and chat; At night, every two hours, I will help Wu Apo turn over in her sleep … … This kind of day and night companionship made Wu Apo praise Huang Changxiu.
"There are three old people living in this room, and they usually rely on Xiao Huang to take care of them. After a long time, she knows our living habits like the back of her hand, and it’s not good for anyone else. " Wu Apo said.
Wu Apo, a native of Fuzhou, is in her 70s this year. A few years ago, she accidentally suffered from spinal cord disease, so she couldn’t take care of herself after operation and lived in a nursing home. Although life is always taken care of, the nursing expenses of several thousand yuan also make Wu Apo and her family feel a lot of pressure.
When she read a newspaper, she learned that a pilot project of long-term care insurance was being carried out in the local area, and disabled people could enjoy compensation for nursing expenses. Wu Apo’s family immediately consulted China Life Insurance Fujian Branch, a long-term insurance agency, and submitted the application materials.
"A few days later, the staff came to the nursing home to evaluate my physical condition. After identification, the agency confirmed that I met the conditions for long-term insurance payment, provided me with compensation of 1,350 yuan per month after deducting relevant expenses, and paid the nursing fee directly to the nursing institution. " Wu Apo said with a smile, "This good policy not only reduces the nursing expenses of disabled people, but also makes us feel the care of society and our belief in living a good life is more firm."
Disabled elderly people who care at home can also enjoy the long-term insurance policy. Zhou Apo, an 88-year-old Fuzhou resident, was bedridden after accidentally falling down. At the beginning of February this year, her family applied to the relevant departments of Fuzhou for long-term insurance treatment. After identification and publicity, at the end of February, Zhou Apo began to enjoy customized professional nursing services and cost subsidies.
"I am old myself, and taking care of the elderly feels powerless." Zhou Apo’s daughter told the reporter that thanks to the long-term insurance policy, the nursing staff came to the door every day to massage and change the medicine for her mother, and also enlightened her to maintain a good mood. "Because of diabetes, the old man’s feet were once severely ulcerated, and now they have basically healed. The old man is very happy and our whole family is very satisfied."
Long-term care insurance mainly provides basic nursing guarantee and economic compensation for severely disabled people, which not only helps the elderly to improve their quality of life, but also reduces the family burden. In 2016, the Guiding Opinions on Piloting the Long-term Care Insurance System identified the first batch of 15 pilot cities for long-term care insurance. Up to now, the number of pilot cities has expanded to 49.
It is understood that Fuzhou officially launched the pilot project of long-term insurance in 2021, relying on medical insurance funds, personal account transfer and other financing, handled by commercial insurance companies, and purchasing professional services from designated nursing institutions. As of April 17, 101 designated nursing institutions have joined the pilot project of long-term care insurance, and 4312 people have enjoyed long-term care insurance treatment.
According to the relevant person in charge of the National Medical Insurance Bureau, at present, the pilot project of long-term insurance is progressing smoothly and has achieved phased goals. First, it has effectively reduced the financial burden of disabled families. Second, it promoted the development of the service system, and the number of service institutions in the pilot areas reached 7600, four times that of the original. The third is to solve the employment problem, and the number of nursing staff has increased from more than 30,000 to 330,000.
Kevin·Z, director of the Department of Risk Management and Insurance in Peking University, said that the establishment of the long-term care insurance system has played a positive role in implementing the national strategy of actively coping with the aging population and better realizing the "sense of security".
Explore the expansion of long-term care insurance coverage and continuously improve the supply level of nursing services.
To promote the better development of long-term insurance, all localities and departments are actively exploring and practicing in expanding coverage and improving service level.
— — The service tentacles extend to the countryside, and policy innovation promotes the coverage of long-term insurance to increase steadily.
"There are also long-term insurance in the village, and life in later years is more secure." Li Chenghong, an old man from Baihe Village, Baihe Town, Qingpu District, Shanghai, said that local cadres came to introduce the long-term insurance policy, which made him feel very warm and provided tangible help.
In recent years, many long-term insurance pilot cities have made great efforts to improve the service capacity of rural nursing insurance, and rural residents who meet certain standards of disability and dementia can also enjoy the same care services as urban insured workers.
"The long-term insurance service extends to the countryside, which is conducive to filling the shortcomings of rural old-age services and establishing a more equal urban and rural social security system." Kevin·Z said.
It is noteworthy that the "Notice on Launching the Pilot Business of Responsibility Switching between Life Insurance and Long-term Care Insurance" issued by the former China Banking and Insurance Regulatory Commission proposed to launch the pilot business of switching from May 1 this year. At present, many insurance companies have identified products that can carry out conversion business.
According to industry insiders, switching business refers to changing the responsibility of death or expiration payment in life insurance policies into the responsibility of nursing payment. When the insured enters the agreed nursing state due to specific diseases, accidental injuries, etc., he can get the insurance payment in advance. Piloting the conversion between life insurance and long-term care insurance can effectively improve the supply capacity of long-term care insurance in a short time and alleviate the pressure of nursing expenses for disabled people.
According to Zhu Ming, director of the Center for Health Economy and Medical Security Research of Nankai University, this conversion can be regarded as a prepayment mechanism of life insurance benefits, which is more conducive to meeting the needs of disabled elderly people for nursing security in a timely manner than paying compensation after the death of the insured, and is more meaningful to the elderly and their families. "The insurance density and depth of life insurance products are relatively high. Making full use of existing life insurance products to carry out conversion business can effectively improve the supply capacity of long-term insurance." Zhu Ming said.
— — Take multiple measures to improve the supply capacity of nursing service.
"The old man in the wheelchair stood up again, the old man with cognitive impairment suddenly called out my name, and the old man in poor health ate half a bowl of rice … … These moments make me feel that my work is very valuable. " Shi Yumeng, a nurse in Xicheng District, Beijing, said.
Only by being professional and attentive can the nursing staff exchange for the warmth of the elderly. In recent years, various localities have introduced measures to support personnel training in the field of old-age care. Henan has included the majors of aged care service and management, and the manufacturing of rehabilitation AIDS in vocational colleges into the scope of vocational education support; Shijiazhuang, Hebei Province will raise the subsidy standard for first-line on-the-job nursing staff who have obtained the vocational skill appraisal certificate; Many places hold nursing skill competitions to encourage nurses to do "ordinary things" with the power of example.
Nursing institutions "pass on help" and cultivate more "caring people". Shandong has launched the service model of "institutional guidance+family care", relying on nursing institutions to include the families, relatives and neighbors of disabled people into the nursing service team, and provide professional guidance and teach service skills at regular visits. These trained nurses can cooperate with the on-site professional care provided by nursing institutions, extend the time for disabled people to obtain standardized services, and effectively alleviate the contradiction between supply and demand of nursing services.
The reporter found that in order to provide better care services, relevant departments and agencies in the pilot areas strengthened supervision of care services and urged them to improve their quality. For example, by establishing an "online+offline" supervision and inspection method for care services, we can ensure that policies are put in place.
Strengthen cooperation in various fields and continue to promote the development of disability protection.
Experts said that to provide long-term care for the wider population, it is necessary to improve the coverage level of long-term care insurance through policy innovation, and at the same time further strengthen the top-level design, and all departments and fields work together to solve the difficulties that restrict the high-quality development of long-term care insurance.
"In promoting the system, we should pay attention to grasping the relationship between local pilot projects and higher-level promotion and implementation. While conducting practical exploration through regional pilots, we should pay attention to summing up experience in a timely manner and rationally study and formulate relatively unified disability and dementia assessment standards and nursing service standards. " Kevin·Z suggested that the assessment criteria for disability levels that have been clearly defined at the national level should be promoted to be implemented in local areas.
The financing mechanism needs to be optimized and improved urgently. "From the pilot situation in various places, there are great differences in financing channels and financing standards, and a reasonable and unified institutional framework should be promoted in a timely manner." Zhu Ming said.
The value of long-term insurance lies not only in economic compensation, but also in service guarantee, which is inseparable from the coordination of various fields. Yu Hua, secretary of the Party Committee and president of the Insurance Association, said that the insurance industry should implement the national strategy of actively responding to the aging population, start with solving the contradiction between supply and demand, strengthen cooperation with industries such as medical care, nursing and health services, and continue to promote the development of service guarantee for the elderly in China.
Kevin·Z believes that to establish a long-term care insurance system that meets the actual needs of the people, we should pay more attention to the development of a matching long-term care service system, pay attention to both "soft power" and "hard conditions", and make continuous efforts in the training of professional talents, the construction of supporting facilities and the supply of auxiliary equipment.
Zhu Minglai suggested that to develop long-term care insurance, it is necessary to vigorously develop the nursing industry. The pilot area of long-term care insurance system should be equipped with enough nursing service institutions and personnel.
The pilot work of responsibility conversion between life insurance and long-term care insurance has just begun. How can insurance institutions better promote this work?
"In the process of switching business, insurance institutions should put the protection of consumers’ rights and interests in an important position, fully explain to consumers the changes in policy protection before and after switching, avoid misunderstandings and disputes, and really do a good job." Kevin·Z said.
The relevant person in charge of the financial management department said that the next step will be to pay close attention to the pilot development and guide and urge life insurance companies to take effective measures to improve their operating procedures and internal control systems; Summarize the pilot experience in time and study and expand the product range applicable to the conversion business.
Insiders said that to realize the healthy and sustainable operation of long-term insurance, it is necessary to strengthen supervision through the application of scientific and technological means. "It is necessary to improve the online monitoring ability of the whole process of evaluation, verification and supervision, better meet the needs of business management and customer service, and reduce ‘ False disability ’ ‘ Fake service ’ As well as the lack of connection between disability assessment and nursing needs, care resources are provided efficiently and accurately to people who really need them. " The relevant person in charge of China Life Insurance Fujian Branch said.