Li Fengyue, Otani Junko
College of Marine Culture and Law, Shanghai Ocean University, Shanghai, China.
Graduate School of Human Sciences, Osaka University, Osaka, Japan.
Int J Health Plann Manage. 2018 Apr;33(2):479-488. doi: 10.1002/hpm.2488. Epub 2018 Jan 12.
Confronted by accelerated population aging, China is establishing a long-term care (LTC) system. This study discusses challenges and recommendations for financing China's LTC system. On the basis of the data on elderly people's self-care ability from the Chinese Longitudinal Healthy Longevity Survey, we calculate the size of the elderly population that need LTC for the period from 2015 to 2030 and analyse the increasing tendency of LTC expenses by considering the impact of price increase. We also analyse the local governments' financial capacity for LTC support by comparing the expense level to the fiscal revenue. The study found that aging will double the LTC expenses by 2030. Therefore, this study suggests the establishment of an LTC insurance system that allocates LTC expenses, which are currently borne by individuals and families, more fairly among the government, individuals, and families. Moreover, with the current LTC reforms, implemented primarily by local governments in China, we believe that the central government should bear some of the fiscal responsibility by conducting fiscal transfers to partially support undeveloped regions that are establishing an LTC system.
面对人口老龄化加速,中国正在建立长期护理(LTC)体系。本研究探讨了为中国长期护理体系融资的挑战及建议。基于中国健康与养老追踪调查中老年人自理能力的数据,我们计算了2015年至2030年期间需要长期护理的老年人口规模,并通过考虑价格上涨的影响分析了长期护理费用的增长趋势。我们还通过将费用水平与财政收入进行比较,分析了地方政府支持长期护理的财政能力。研究发现,到2030年老龄化将使长期护理费用翻倍。因此,本研究建议建立长期护理保险体系,将目前由个人和家庭承担的长期护理费用在政府、个人和家庭之间更公平地分配。此外,鉴于目前主要由中国地方政府实施的长期护理改革,我们认为中央政府应承担部分财政责任,通过进行财政转移支付来部分支持正在建立长期护理体系的欠发达地区。