PopulationAgingandLong-TermHealthCareinthe.PDFVIP

议 建 与 察 观 Population Aging and Long-Term Health Care in the Peoples Republic of China 中国人口老龄化和长期老龄护理 NO. 2010-3 Observations Suggestions 观察与建议 Abstract 摘 要 • The rapid aging of the population of the Peoples Republic of China (PRC) is exerting financial pressure on the provision of health care services and, in particular, long-term health care. The elderly poor are particularly vulnerable. 中国人口的快速老龄化，正在给医疗服务，尤其是长期老龄护理服务供给带来越来越大的资金压力。在这种 情况下，贫困的老年人是一个特别脆弱的群体。 • Although the PRC has recently made significant progress in extending health insurance coverage, out-of-pocket payments still account for about 45-50% of total health expenditure, exacerbating the vulnerability of the elderly in rural areas. In order to minimize financial barriers, it is recommended to further expand health insurance coverage, reduce co-insurance rates, introduce ceilings on maximum out-of-pocket payments, and regulate the provision of health care services. 尽管中国已经在扩大医疗保险覆盖率方面取得了长足进步，但在医疗总支出中，自费支出的比例仍然 高达45%-50% ，这使得农村老年人以及城市中的贫困人群更难享受到合适的医疗服务。为了尽可能地 减少他们的支付能力不足问题，我们建议在进一步扩大医疗保险的覆盖面的同时，建立一个低成本的 简单有效的老龄护理服务体系，对贫困人群降低医保缴费率，设定自费支付最高限额，严格监管医疗 服务供给体系。 • Changes in cultural norms of filial piety and the one-child policy make it difficult to rely on children to provide care to their parents. It is recommended that the long-term care delivery system be expanded by constructing more long-term care facilities and by training sufficient long-term care personnel. 由于中国传统孝道观念正在逐步改变，加之计划生育政策的影响，中国社会很难继续完全依靠子女为 父母提供养老保障。我们建议中国通过建设更多的低成本的简单有效的长期医疗护理设施、培养充足 的长期医疗护理人员，建立健全长期医疗护理服务供给体系。 • There are various options to address the financing of long-term care. One approach would be to target beneficiaries and prioritize assistance for the elderly poor and for