We should learn from the experience of some other countries and formulate more specific policy measures for long-term care insurance to alleviate the "shortage of caregivers".
In order to actively respond to the aging of the population and cultivate new momentum for economic development, the "Opinions on Developing the Silver Economy and Improving the Well-being of the Elderly" (hereinafter referred to as the "Opinions") was recently promulgated. The "Opinions" put forward to "escort" the silver economy by strengthening the guarantee of factors and optimizing the development environment, among which it is particularly important to promote the construction of talent team.
Cultivating industries related to the silver economy and providing high-quality services ultimately depend on the quantity and quality of elderly care practitioners, so solving the increasingly severe problem of "nursing shortage" in reality is the key to promoting the development of the silver economy.
As the population ages, most countries are facing a huge demand for aged care practitioners. For example, the United States is expected to have 1.2 million new jobs for aged care workers between 2020 and 2030, the highest number of jobs in any other industry, and the same is true in OECD countries. However, the level of wages and remuneration for elderly care is low, which is not attractive to practitioners. For example, in 2021, the median salary compensation for aged care workers in the United States was 14$27 per hour, which is only 45 percent of the nonfarm payrolls43%；In 2021, the wages and remuneration of elderly caregivers in OECD countries were around the minimum wage level of the whole society. Clearly, the gap between the supply and demand of aged care practitioners has led to a "caregiver shortage".
China is no exception, due to the inconsistent statistical caliber of data, the specific measurement of the supply of elderly care practitioners from all walks of life varies, but it is unanimously agreed that there is a shortage of supply. For example, the Ministry of Human Resources and Social Security has pointed out that in 2019, there were about 300,000 elderly care practitioners in China, which is a huge supply gap compared with the huge disabled and semi-disabled population. In 2016, China began to explore a long-term care insurance (hereinafter referred to as "long-term care insurance") system to provide services or financial protection for people with long-term disabilities (mainly the elderly), and as of 2023, there are 49 pilot cities with a total of 1700 million people have participated in the insurance, and more than 2 million people have enjoyed treatment. Obviously, the sustainable development of this system is closely related to the adequacy of the supply of aged care practitioners.
Theoretically, long-term care insurance has stable financing**, which can reduce the operational risks and uncertainties of care institutions, allow them to obtain stable compensation for care service costs, and enhance the ability to compensate for the wages and remuneration of elderly care practitioners, so as to attract practitioners to enter the industry. However, the empirical evidence from some countries does not support the above conclusions, so we should learn from the experience of some other countries and formulate more specific policy measures for long-term care insurance to alleviate the "shortage of caregivers".
First of all, the payment policy of long-term care insurance to the supplier side should be adjusted to take into account the salary and remuneration (labor cost) of elderly care. At present, China's long-term care insurance pilot areas adopt the rule of paying according to the service item for the supplier, and reimburse according to a fixed proportion, but there is no detailed provision for the proportion of elderly care wages and remuneration (labor costs) in the total cost of care services. In the future, a cost-of-service-based reimbursement ratio similar to that in the United States could be adopted, and labor costs could be included in this reimbursement ratio. At the same time, we can also refer to the "wagepass-throughpolicy" policy in the United States, which directly subsidizes the wages and remuneration of elderly care practitioners, which is considered to be the most direct and effective policy. In addition, we can learn from the practice of Japan and determine the difference in labor costs in each region when adjusting the long-term care insurance care project services**. In general, in the future, when designing and implementing the payment policy of long-term care insurance to the provider, it is necessary to have more detailed provisions on the compensation of wages and remuneration for elderly care, so as to improve the salary and remuneration level of practitioners.
Second, long-term care insurance should increase the encouragement of institutions to use high-tech means to participate in care, and improve the productivity of elderly care labor. Because the care industry is a labor-intensive industry, the substitution of labor by technology and capital is very limited, and it is prone to diseconomies of scale, which leads to slower growth of labor productivity and weak growth of wages and remunerations. However, with the rise of artificial intelligence and other technologies, high-tech products such as elderly care robots and health bracelets can be used to effectively increase the scale of each elderly care practitioner to care for the elderly per unit time, improve the labor productivity of care, reduce the cost of elderly care, and ultimately improve the salary and remuneration of practitioners. The administrative department of long-term care insurance may cooperate with other departments to formulate relevant preferential tax policies for the purchase of relevant high-tech products.
Thirdly, long-term care insurance promotes the large-scale and branded operation of institutions through cross-regional fee settlement. The large-scale operation of care institutions can optimize the allocation of resources as an element of elderly care practitioners, especially the cross-regional deployment of staff by large chain brand care institutions, which is very likely to improve the labor productivity of such personnel. At present, the Yangtze River Delta region has carried out a pilot project for the extension of the settlement of long-term care insurance care service costs, and some chain brand pension institutions provide care services for the elderly in other places, and can obtain cross-regional settlement fees for long-term care insurance. In the future, long-term care insurance should provide corresponding expense settlement convenience to institutions operating across regions, which is conducive to improving the labor productivity and wage remuneration of employees while promoting the chain operation of institutions and brand management.
In addition, as a third-party payment, long-term care insurance has a strong market voice, and can urge care institutions to strengthen the supervision of the quality of care for practitioners through specific measures such as reimbursing care costs according to the level of care quality, so as to ultimately reduce social "discrimination" against this industry and attract more high-quality practitioners to enter.
Original title: With the help of long-term care insurance, we should deal with the "shortage of caregivers" in the silver economy
* |CBN.
Edit |Yang Zixuan bought Xiaofei.
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