The pilot of the long-term care insurance system (hereinafter referred to as "long-term care insurance") in 49 cities in China has benefited many disabled elderly people. According to the statistics of the National Health Insurance Administration, as of the end of June 2023, the number of people insured in the long-term care insurance system is about 1700 million people, with a cumulative expenditure of about 65 billion yuan, and an annual per capita burden reduction of about 140,000 yuan, the long-term care insurance system is of great significance to deal with the aging of the population, the reporter recently visited two pilot places of long-term care insurance, and talked to scholars who have been concerned about long-term care insurance for a long time.
Auntie, I'm here to take care of you!One day in November, elderly care worker Jing Shumin came to Zhang Xiurong's house in Gucheng Street, Shijingshan District, Beijing. Seeing Jing Shumin coming as scheduled, 93-year-old Zhang Xiurong was overjoyed, and hurriedly asked his daughter Hao Shuyuan to help him sit up from the bed. "Don't rush, take your time. Jing Shumin stepped forward in small steps, carefully helped Zhang Xiurong to sit on the seat next to the bed, and quickly measured Zhang Xiurong's body temperature, washed his face and feet, and did personalized care such as limb function training.
Zhang Xiurong is a patient with Alzheimer's disease, coupled with high blood pressure, heart disease and other diseases, he is old, has difficulty moving, and is often bedridden. Hao Shuyuan told reporters that two years ago, her mother accidentally fell and broke her leg, and she became silent for a long time. After Xiao Jing came, the old lady became active, loved to talk and sing, and was amused to laugh from time to time, but she was happy, and the symptoms of dementia were also reduced. ”
Jing Shumin is a caregiver of long-term care insurance (hereinafter referred to as "long-term care insurance") in Shijingshan District, Beijing. Long-term care insurance is known as the "sixth insurance" in addition to the five types of social insurance, such as pension, medical care, work-related injury, unemployment and maternity, and refers to the social insurance system that provides funds or service guarantees for the basic life care and medical care closely related to the basic life of the long-term disabled. In June 2016, the Ministry of Human Resources and Social Security issued the "Guiding Opinions on Carrying out the Pilot of the Long-term Care Insurance System", and the first 15 pilot cities such as Shanghai, Guangzhou and Qingdao have successively carried out the pilot work of long-term care insurance.
In 2018, Shijingshan District, Beijing launched an initial pilot project of small-scale long-term care insurance. In September 2020, the National Health Insurance Administration, together with the Ministry of Finance, issued the "Guiding Opinions on Expanding the Pilot of the Long-term Care Insurance System", which expanded the long-term care insurance pilot to 49 cities, including Tianjin, Fuzhou, Shijingshan District of Beijing and other places, making Shijingshan District the only national policy-based long-term care insurance system pilot area in Beijing.
In terms of insurance objects, urban employees and urban and rural residents (excluding students and children) will be included in the scope of medical insuranceIn terms of the scope of protection, the focus is on the protection of severely disabled persons. Li Fengqin, director of the Shijingshan District Medical Security Bureau, told reporters that at present, through home care, nursing institution care and home care in nursing institutions, Shijingshan District has provided nursing services for 4,387 severely disabled people.
Zhang Xiurong is one of them, in 2021, Zhang Xiurong passed the application and has been enjoying long-term care insurance treatment for two years. The insurance fee is 180 yuan per year (90 yuan for the unit or ** subsidy), you can enjoy 12 hours of on-site nursing services per month, and you can choose a total of 32 services in four categories: life care, ** sexual care, risk prevention, and functional maintenance. In addition, a monthly subsidy of 1,044 yuan for family care services can be obtained, and the overall treatment level is nearly 3,000 yuan per month.
According to Li Fengqin, as of October this year, the number of people participating in long-term care insurance in Shijingshan District was 4280,000 people, 78 designated service institutions, and more than 500 door-to-door nursing staff. From 2021 to 2022, the total revenue of long-term care insurance** in Shijingshan District will be about 1500 million yuan, expenditure 1200 million yuan, to achieve a balance of revenue and expenditure.
Home care and cash subsidies reduce the burden on families of disabled elderly people
Jing Shumin's intimate care for her mother, Hao Shuyuan saw it all, and when she got along day and night, Jing Shumin was already "not a relative but a relative". Once, because the mother had difficulty defecating on the fire, Jing Shumin put on gloves and used Kaiser Lu to "get started" directly, and washed and changed clothes for the elderly from the inside out. Jing Shumin is not afraid of dirt or hardship, and Hao Shuyuan was moved by her careful care of her mother, "We as children can't do this, thank you so much!."”
The first time he saw Zhang Xiurong, Jing Shumin still remembers that he greeted and chatted with the old man warmly, but did not get any response, and this stalemate lasted for several months. Seeing that the old man with Alzheimer's disease was depressed, Jing Shumin was worried but not discouraged. Every week, she takes care of the elderly carefully and patiently, helps them recover their physical functions, and plays songs to the elderly from time to time.
Once, after wiping the body of the old man, the old man suddenly said "thank you", which surprised Jing Shumin. In the days that followed, the interaction between the two became more and more frequent, the elderly were willing to express their needs, and Jing Shumin also knew better how to take better care of the elderly. Sometimes Jing Shumin will also teach the old man to sing Peking Opera, and after a long time, the old man can still sing a complete paragraph. This made her very gratified: "I am happy to see that my aunt is getting better and better, just like my own mother, I have feelings after a long time." ”
Bathing, feeding, exercising, ......Jing Xuanmin's movements are skillful and agile, and after two years of careful care, Zhang Xiurong's health level has improved a lot. Seeing that her mother's complexion was getting better and better, Hao Shuyuan gradually felt relieved. She told reporters that in addition to taking care of her mother, Jing Shumin will teach herself a lot of basic nursing knowledge every time she comes to the door. "My parents died early, and facing these old people is like facing my parents. Jing Shumin, who has been working as a long-term care insurance caregiver for 3 years, hopes to help more disabled elderly people with services and care.
This policy is particularly good, it is the gospel of the elderly, the cost of diapers for the elderly is quite large, and the monthly subsidy of 1044 yuan for long-term care insurance can greatly alleviate the economic burden, and the care of nursing staff is also particularly in place. Hao Shuyuan said that she has experienced the intuitive changes brought by long-term care insurance to her life: the pressure of care has been relieved, the financial burden has been reduced, and the quality of life of mothers has also improved. Nowadays, when she learns that there are disabled people in the family of relatives and friends, Hao Shuyuan will enthusiastically contact the other party's family members to share how to apply for long-term care insurance, hoping to help them improve the dilemma of "one person is disabled, the whole family is out of balance".
9 long-term care insurance handling windows are convenient for the masses to "do it nearby".
Mr. Wang, 64, is also a beneficiary of the long-term care insurance pilot in Shijingshan District. At the age of 31, an accident caused him to be paraplegic, incontinent, with a urine bag on his body, and he relied entirely on a wheelchair to travel and needed 24-hour care. Scrub Mr. Wang, turn over, pat his back, change the urine bag ......Over the past 33 years, my wife, Ms. Liu, has never left her and taken care of her day after day.
What is long-term care insurance?Can you help my wife?Once, Ms. Liu learned about long-term care insurance from the community neighborhood committee, and learned that if her wife passed the disability assessment, she could enjoy nursing services and economic subsidies.
After listening to the staff at the window introduce the application conditions and process of long-term care insurance in detail, Ms. Liu carefully filled in the application materials. To her delight, it didn't take long for the disability assessment staff to come to the door for assessment, and the wife became the target of long-term care insurance through the disability assessment, and the nursing institution developed personalized care services for Mr. Wang.
Today, 9 street government service halls in Shijingshan District have set up long-term care insurance handling service windows to facilitate the community to handle it nearby, open up the "last mile" of long-term care insurance business, and enable the needs of the disabled to be responded to in a more timely manner.
After decades of work, I can finally take a break and catch my breath. In recent years, long-term care insurance caregivers have come to take care of her husband every week, and Ms. Liu is very grateful. My frail wife, who used to be frail, had to go to the hospital as soon as she had a cold and fever, and the medical expenses made the family even worse. Today, the long-term care insurance not only alleviates Ms. Liu's fatigue and allows her wife to receive special care at home, but also makes the old couple feel that the economic burden on their shoulders is much lighter.
So many people care about me, my heart is very open, quite content, I used to be depressed, but now I am very happy. Mr. Wang told reporters that long-term care insurance is like building a bridge between him and the outside world, and he hopes that in the future, long-term care insurance can be promoted in Beijing and the whole country to help more disabled people.
Innovate and develop long-term care insurance to warm more families of disabled people
Since the pilot of long-term care insurance in Shijingshan District, various institutions have been guided to regularly organize more than 500 training and assessment sessions for nursing staff and family members of severely disabled persons to carry out business knowledge Xi and care skills, and the number of trained personnel has exceeded 7,000. Li Fengqin said that the Shijingshan District Medical Insurance Bureau signed two commercial insurance agencies to give full play to its advantages and efficiently promote the long-term care insurance treatment audit, nursing staff training, nursing service supervision, file electronic management, through daily guidance, semi-annual supervision, annual assessment and other ways to supervise and inspect the whole process.
If you live near the pilot community and are willing to provide nursing services for the elderly, you can participate in professional training, and after passing the assessment, you can provide services for the elderly. Li Fengqin introduced that the Shijingshan District Medical Insurance Bureau innovated a new model of "neighborhood mutual assistance" nursing services, encouraged neighbors in the pilot area to provide long-term care insurance services for the severely disabled elderly, and improved the accessibility of home and community services. At present, four residents of the jurisdiction have been professionally trained to provide home care services for the severely disabled in the neighborhood.
Since the pilot of long-term care insurance in Shijingshan District, while it has been progressing smoothly, there are still shortcomings, such as strong limitations in the pilot area, difficulties in supervision, and policy publicity that needs to be improved. Li Fengqin said that in the next step, the Shijingshan District Medical Insurance Bureau will explore the establishment of a special training base for nursing services to promote the cultivation of talentsExplore the introduction of family doctor teams to participate in disability assessment and provide medical care, improve the accuracy of assessment results, and enhance the safety of nursing servicesEstablish and improve the supervision system of long-term care insurance, and maximize the efficiency of the use of long-term care insurance.
* |China Youth Daily.
Edit |Fu Meiru Liu Xinyu.
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