美国长期照护服务的筹资改革及启示

商业性长期照护保险在美国早已建立,但从支出的角度看,以美国医疗救助（Medicaid）为主的社会政策承担着主要的长期照护服务财务支持。在照护需求日益增长的背景下,现有的基金面临着巨大的冲击,急需对长期照护筹资机制进行改革。但受价值观影响,各方利益主体尚未形成责任共担的共识,独立筹资的社会化长期照护制度难以建立。

Commercial long-term care insurance has long been established in the United States, but from the view of expenditure, Medicaid- based social policy takes the main responsibility of paying for long-term care (LTC) in the U.S. Nowadays, an enormous deficit will appear because of the increasing demand for care. Therefore, it is an emergency to reform the financial mechanisms in the long-term care (LTC) system to make it sustainable. But affected by the values, the interests of all parties have not yet formed a consensus on sharing responsibility, the independent financing of LTC system is difficult to obtain mainstream support.