Zhejiang Daily Observation 丨 Zhejiang introduced the province's unified long -term care insurance policy in the province

Zhejiang News Client reporter Zheng Wen

Data map.

The 15th Party Congress of the Provincial Party proposed to explore the establishment of a long -term nursing insurance system. Long -term care insurance is called the "sixth insurance" other than five social insurances including pension, medical, work injury, unemployment, and fertility.

Recently, the Zhejiang Provincial Medical Security Bureau and the Provincial Department of Finance issued the "Guiding Opinions on Deepening the Pilot of Long -term Nursing Insurance System" (hereinafter referred to as "Opinions"). This is a long -term care insurance policy introduced at the provincial level. The pilot work is scattered in the province in the 1.0 phase, and each explores, and enters the 2.0 stage.

How to keep the elderly more secure for the care of the elderly, what stages of results have been achieved in Zhejiang pilot, and what other problems to be resolved? The reporter interviewed the Provincial Medical Insurance Bureau and related pilot areas.

Old disabled, how to be decently caring for?

"Now the province's centralized pilots in the 2.0 stage have overcome the disadvantages of institutional fragmentation and imbalance between regional policy, and truly realize the province's pilot 'one game." Zhou Jian, director of the Reform and Development Department of the Provincial Medical Insurance Bureau, told reporters that this time One of the highlights of policies is that the fundraising standards, treatment standards, and identification standards of 5 pilot areas in the province are unified, adhered to urban -rural integration, covered by insurance, and reflecting the fairness and inclusiveness of the system in the context of common prosperity. Zhejiang took the lead in exploring the pilot to upgrade the confidence, which was inseparable from the successful experience of practical accumulation and the positive social effects achieved.

As early as 2016, the long -term nursing insurance system pilot was launched nationwide, and Ningbo was included in the first batch of pilots. On this basis, pilot work has been carried out in Tonglu County, Jiaxing City, Yiwu City, Wenzhou and other places, and conducted useful attempts in institutional framework, policy standards, operating mechanisms, and management measures.

Zhong Guanfu, a 76 -year -old man in the rejuvenation community of Jiaxing City, is the beneficiary of the long -term danger system. Six years ago, the elderly had a sudden cerebral infarction, causing half paralysis of the body and losing their ability to move. In 2018, his family applied for him to enjoy the support of the mayor of Jiaxing. Since then, Chen Xuerong, a nursingist at the elderly support center of Kiss's Homeland, provides on -site care services twice a week, including relaxation, massage, foot washing, nails, and body of joint muscles. "It's really a charcoal in the snow, and we feel relieved when you see the old man comfortable." Zhong Guanfu's family members were deeply touched. As of the end of May this year, the elderly had accumulated on -site services worth about 23,000 yuan, close relative care fees and consumable fees of about 27,000 yuan, which greatly reduced the burden on the family.

Human scarcity, increased economic pressure, decreased quality of life, and long -term hospitalization consume a large amount of medical resources ... "One person is disabled, the whole family imbalances" is a realistic problem faced by many disabled person families. The promotion of long protection not only meets the care needs of the elderly for the elderly, so that they can enjoy their old age more decent and dignified, but also alleviate the pressure of the elderly family members, especially their children.

At present, the province's pilot areas covers the number of insureds 11.18 million, with a total of 58,600 benefits, the total expenditure of the fund is 1.017 billion yuan, and the people who have been treated with each year to enjoy the treatment of 15,600 yuan.

Where does the funds come from?

Some people are worried that will the long -term escort will bring additional burden on employees and enterprises?

Zhou Jian told reporters that when formulating policies, our province fully considers the disposable income of residents and starts with the principle of low levels of funding standards. According to the requirements of the Opinions, the standard for the protection of our governor is 90 to 120 yuan per person per year, and the individual and unit of urban employees shall share 1: 1, and the individual and personal and finance of urban and rural residents shall pay 1: 2. According to the practical experience of various pilot areas, this cost is far lower than other types of insurance, which has a lighter impact on individuals and enterprises, and has little financial pressure at all levels.

"We hope to use a lower level of fundraising to help solve a big burden on a family." Zhou Jian said that it is not only one person, but also a family. Residents seem to pay more insurance, but in fact The overall burden may decline.

Wang Baoguo, deputy director of the Jiaxing Medical Insurance Bureau, showed reporters a data: 387 cases of random selection of randomly selected for long -term protection for 1 year of survey results showed that the number of annual hospitalizations per capita after enjoying the long -term protection of long protection declined by 31 %, The per capita inpatient medical insurance fund expenditure dropped by 31.4%.

With the treatment of long -term care, many elderly people have lived in a professional pension care institution, and the elderly at home can also be carefully taken care of, and the quality of life has improved significantly. Since the pilot of September 2017, Jiaxing's long -term protection has covered all those who participate in basic medical insurance, and have paid a total of 581,600 people. At present, the city's 21,500 severe disabled persons are enjoying long -term protection. "In the context of deepening aging, long -standing for long -term protection has been on a shortcoming of social security, which is welcomed and recognized by the masses." Wang Baoguo said.

How to ensure sustainability for the whole people?

More than 1110 million people, this is the total number of long -term security participants in the province. In accordance with the total target of "long -term nursing insurance insured persons reached 15 million people", 74%have been completed.

In terms of long -nursing insurance benefits, in accordance with the requirements of the Opinions, the percentage of home care and institutional nursing service expenses funds is 80%and 70%, respectively.

On the one hand, there is a considerable number of insureds, and on the other hand, there is a low payment ratio. In this way, this fund expenditure is not small -long -term protection, can it achieve sustainable development?

"Our fundraising is not simply transferred the medical insurance fund to the long -term protection fund, but the responsibility of individuals, units, finance, and medical insurance funds shared together to form a diversified independent funding mechanism. The rights and responsibilities are correct. "Zhou Jian said that such a fundraising model laid the foundation for the sustainable development of the long -term protection fund, and in the long run, it can ensure its stable operation. The long -term protection provides services, and the question of "who cares" is also very critical. The reporter noticed that problems such as large gaps and poor professionalism are more prominent in various places.

"A problem in front of us is how to build a professional nursing talent team." Zhou Jian admitted that the number and quality of nurses now cannot meet the needs of pension services in various places. In order to increase the construction of the nursing talent team, the Provincial Medical Insurance Bureau is exploring and studying the training plan for the home caregiver with relevant functional departments. I hope to help relatives or volunteers of disabled personnel or serve volunteers through skills training, so that the nursing staff team will gradually grow stronger In the future, you can extend to neighborhood care and community care on the basis of home care, and finally form a care service network.

In addition, our province also plans to carry out long -term commercial insurance exploration in non -pilot areas, using the "Opinions" as a blueprint to guide commercial insurance institutions to study and develop commercial insurance products suitable for home care, community care and institutional care.

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