日本长期照护政策及对我国的启示

摘要

This paper reviews the long-term care policy in Japan and discusses successes and challenges in order to provide policy guidelines for China. All Japanese adults aged 65 or over are covered by the long-term care in-surance ( LTCI) program and are eligible for both in-home and institutional-care services following a thorough, sys-tematic care certification process. The program is financed by a mix of general tax revenues from the three levels of gov-ernment , income-tested premiums, and standardized co-payments. A key success of the policy is its universal and compre-hensive coverage. Notwithstanding this success, increasing costs remain a challenge as Japan’s population ages and the number of LTCI users increases. Learning from the experience of Japan, China should establish a long-term care system, which covers all the aged population, mainly focuses on in-home care, and qualifies social funding to invest.%本文综述了日本长期照护政策的发展历程、现状、成就和挑战，为我国建立长期照护保险制度提供借鉴。日本长期照护保险覆盖65岁及以上老年人，申请人通过需要照护水平的认证后可获得居家和机构照护两种服务。保险筹资包括政府财政投入、保费筹集和使用者共付三大来源。日本长期照护保险最主要的特点是实现了全面覆盖，但随着日本老龄化和需照护老年人的增多，日本长期照护保险面临费用持续上涨等挑战。最后，建议借鉴日本经验，我国应该建立覆盖所有老年人、以居家照护为主体、社会资本参与的长期照护制度。