At present, 48.5% of the elderly in China's cities have a variety of realistic needs for elderly services, while the current total satisfaction rate of their services is only 15.9%. China's population aging relatively ahead of the economic and social modernization, the social capacity of the elderly is extremely limited, the elderly care infrastructure and related services can not keep up with the increasing demand for care of the elderly, the care of the elderly has become an urgent problem in the work of old age security. At present, China has not yet considered the integration of individuals, families and communities into the system of care for the elderly as a policy measure, leaving these three fundamental levels of support policy absent or insufficient. Therefore, the government must increase its efforts in improving the legislative protection of elderly services, institutional innovation and main incentives, policy support and financial support to ensure the healthy and orderly operation of the elderly service system.
I. Strengthen the construction of laws and regulations to ensure the healthy operation of the elderly service system
(a) Define the legal status of the elderly service industry
The development of the elderly service industry is an effective way to improve employment and promote social stability and economic development. Therefore, the legislature should amend the Law of the People's Republic of China on the Protection of the Rights and Interests of the Elderly to highlight the legal status of the elderly service industry, and clearly stipulate the responsibilities and obligations of the government, non-governmental organizations, communities and families in the process of promoting elderly services.
(B) Promote the construction of the legal system of old-age social security
China's existing legislation on social security regulations at a low level, the implementation of social security laws and regulations, weak mechanism, so far China has not been used to adjust the social security relationship of the basic law. The legislature should urgently introduce important laws and regulations such as the Pension Protection Law and the Medical Protection Law, so as to legally provide systematic protection for the elderly population in terms of economic income, medical care and other aspects, to alleviate the burden of their lives and improve their living standards and quality of life.
(C) Formulate regulations to unify elderly services
Elderly services need to have unified standards to ensure the quality of services. Our government should standardize the service standards of the elderly service industry through laws and regulations. In addition, it should also clarify the content of a service project and determine the rights and obligations between the elderly and the service personnel, so that there is a corresponding basis for delineating the legal responsibilities of both parties in the event of disputes between the elderly and the service personnel.
Second, through the service system innovation and care of the main incentives to promote the construction of the elderly service system
(a) Strengthening the leadership of the elderly service business leadership
Aging is a social problem, the solution to the problem of elderly service involves finance, social insurance, education, health and other areas, and China currently does not have the authority of the management of the elderly service affairs. Therefore, it is recommended that a working committee on the elderly be set up, which will take full charge of all the work in the area of elderly services. The committee should be responsible for formulating plans for the development of elderly services, drawing up budgets and submitting them to the National People's Congress for approval, providing the necessary financial support for the participation of nongovernmental organizations in the development of elderly services, identifying problems in the process of the development of elderly services and proposing effective plans for their improvement; at the same time, it should provide a certain degree of subsidy for the services of the elderly who are in difficulty in their lives and who have an urgent need for elderly services; and it should introduce various measures to promote the participation of nongovernmental organizations in the development of elderly services. It should also introduce incentive policies to promote the participation of non-governmental organizations in the development of elderly services, and provide the necessary policy support for the professionalization and industrialization of elderly services; it should cooperate with the legislature in the introduction of relevant laws, and coordinate with various government departments in the planning of budgets and the formulation of policies and the monitoring of their implementation.
(2) Accelerate the institutional innovation of elderly services
Socialization, industrialization and legalization is the inevitable trend of the development of elderly services, we should make full use of the market mechanism and a variety of preferential policies to guide and mobilize all aspects of the community to participate in the construction of the elderly services, the elderly services run by the community to carry out the necessary regulation, standardization, guidance and supervision, and gradually form the government to guide and macro-management, social organizations or the macro-management, social organizations or the supervision. The system of government guidance and macro-management, social organizations or enterprises to operate independently should be formed gradually.
(C) Establishing a sound incentive mechanism for subsidizing family care for the elderly
As the tradition of family care for the elderly will continue to exist for a long time, the family is still the main place where the elderly are cared for. According to the 2009 Survey on the Basic Situation of Elderly People Aged 65 in Jilin Province, the elderly have a strong desire to be cared for in the family, and 98.98% of them want to age at home and are unwilling to leave their families. This is because, compared with other forms of old-age care, family care has the incomparable advantages of spiritual comfort and affectionate experience. Facts show that family members are still the main force to solve the problem of old age care, and should pay attention to the function of family old age.
Many countries subsidize families supporting the elderly through tax breaks, priority housing, and priority loans. For example, Singapore, Japan and other economically developed countries, the proportion of elderly people living with their children are more than 70%, in addition to the traditional "filial piety" cultural factors, and the government's efforts to promote and advocate is inseparable. In 1989, the Korean Government again revised its provisions on "old-age welfare", and later amended the Family Inheritance Act to stipulate that children who serve their parents should inherit 50 per cent more property than other children. This kind of incentive mechanism established by legislation has, on the one hand, to a certain extent reduced the financial burden of families caring for the elderly; on the other hand, it is the recognition and affirmation of the value of their care work, which has a great incentive effect. China should learn from foreign experience, the elderly family to give economic support, while further play the role of the government, in the tax, credit and other aspects of closely related to family life, such as housing, economic income and other issues to give preferential treatment and tilt, to provide institutional support for the family old age.
(4) Vigorously develop community services for the elderly
According to a series of surveys on the needs of 10,000 elderly people in Shanghai in 2009, when faced with the needs of daily life care, illness care, daily worries and financial management, the respondents preferred to turn to their spouses. spouse", followed by "children or their spouses". In the case of daily life care and sick care, the proportion is as high as over 90%. However, most of their children are middle-aged, with heavy workloads and difficult family financial situations, making it difficult for their children to cope with their elderly and sick parents in need of care. At the same time, for their children, the time and energy spent on family caregiving will inevitably affect their work efficiency and performance, thus affecting their income, while long-term fatigue will inevitably affect their health, which in turn will affect the quality of care for the elderly. Therefore, community-based elderly care services should be vigorously developed, and a sound community service support system should be established to alleviate the pressure of family old-age care and improve the quality of care for the elderly.
Comprehensive and multi-functional service stations should be set up in the community to support family members' care services in the form of door-to-door services and fixed-point services, and to carry out programs such as nursing care and housework services. Standardized and institutionalized community services on the one hand alleviate the pressure on family caregivers, can meet the care needs of the elderly, improve the quality of life of the elderly who can not take care of themselves, to a large extent, is an effective means of support for the family old age; on the other hand, with the increasingly fierce competition in the market, the increase in the number of laid-off workers in the city, the pressure on employment, the development of community care services is also an effective means of solving the problem of employment. In addition, since most community service entities are small in scale, make little investment and operate at a marginal profit, the Government should, on the one hand, provide preferential policies on credit and taxation for the community service industry for the elderly; and, on the other hand, it should adopt a variety of means to create a relaxed environment for its development. For example, to apply for the elderly service industry enterprises and individuals, the business sector should simplify the registration procedures and procedures, relax the registration conditions, and provide exemptions from the registration fee and other preferential policies. For
Settlement of laid-off, unemployed people of the elderly service enterprises, the government should give support and encouragement, and according to solve the number of laid-off, unemployed people employment to give appropriate incentives or policy concessions. At the same time, in order to improve the quality of the staff of the aging service industry, the government can give subsidies for training costs and on behalf of the training and other preferential policies.
Third, preferential policies to promote the development of elderly service system
(a) land preferential policies
The government in the preparation of the overall land use planning and annual plan to coordinate the arrangement of elderly service facilities and activities of land. The civil affairs department has approved the construction of elderly service institutions, facilities land should be given priority. Under the conditions permitted by laws and regulations, where land can be supplied by means of allocation, priority shall be given to allocating land; where land needs to be supplied by means of compensation, land premiums and land use taxes shall be appropriately reduced or waived. The land administration departments at all levels should simplify the approval procedures for the elderly service organizations and give priority to apply for land use certificates for them.
(ii) Tax incentives
The government should increase the tax incentives on the basis of the existing incentives. Qualified by the validation and issuance of business licenses for elderly service institutions, can be exempted from the business tax of elderly service projects; by laid-off workers to set up elderly service enterprises, laid-off workers and welfare enterprises in accordance with the implementation of the relevant tax incentives; approved by the civil affairs department to set up elderly service institutions to settle the proportion of urban laid-off workers in line with the relevant provisions of the relevant provisions of the tax concessions to enjoy re-employment projects; on the import for the construction of elderly service institutions and facilities Institutions importing equipment for the construction of senior care service institutions and facilities, professional medical rehabilitation equipment and other specialized supplies will be given tariff concessions in accordance with the relevant state regulations. In addition, in order to encourage all sectors of society to contribute to the cause of elderly services, the government can give tax concessions to donors.
(C) the policy of diversification of the main body of investment in elderly care
Breaking the pattern of the government and welfare institutions to run the elderly care business, encourage social organizations, enterprises and individuals *** with the participation of investment in socialized, market-oriented elderly care institutions, the formation of multi-channel, diversified investment pattern. Through low-interest loans and tax relief policies, civil organizations are encouraged to participate in community-based elderly care services; the increase or decrease in the amount of funding reflects the focus of government attention and serves the purpose of controlling the behavior of associations. The government should also conduct extensive mobilization to absorb more social capital to provide services for the elderly in the community. Therefore, the basic principle of raising funds for community elderly services is government guidance, community mobilization, and social capital support.
(D) Pension security policy
Expand the coverage of pension security, urban flexible employment, self-employed businessmen and other people into the scope of pension security; reform of the enterprise pension insurance system, and strive to narrow the gap between the pensions of institutions and enterprises, and promote the distribution of fairness; the establishment of a minimum pension system in accordance with China's actual situation in order to ensure that low-income earners basic life after retirement, so that the pension security policy benefits the elderly. The pension security policy will benefit more elderly people.
(V) Medical security policy
Improve the medical and health policy for the elderly, and implement the new medical reform program with all our strength; raise the preferential standard of medical insurance, especially to reduce the medical burden of the elderly in poorer health condition and difficult life, and reduce the medical cost of the elderly by including all the basic medicines in the reimbursement of medical insurance drugs, and including the coordination of the major illnesses into the scope of medical insurance. A reasonable level of funding and protection standards should be set according to the affordability of the government, enterprises and institutions, and individuals, in order to transform the situation of "expensive and difficult access to medical care" and "poverty caused by illness". Community health care service organizations should implement the two lines of income and two lines of expenditure business model. The development of various forms of supplementary medical insurance, and gradually establish a multi-level medical security system, the real realization of the "old have medical care.
(F) Encourage the construction of elderly care insurance system policy
The high cost of professional care and medical costs are prohibitive for the elderly, so it is necessary to introduce a policy to encourage the establishment and implementation of long-term care insurance system for the elderly. The system should be mandated by the state and operated specifically by each local government, with insured persons enrolled regardless of their physical condition. The funds raised should consist of premiums paid by the insured and subsidies provided by the State and local governments, and be operated in the form of a fund. The correlation between the premiums paid by the insured and the benefits should not be too strong. Long-term care insurance for the elderly uses nursing services as the main form of payment, supplemented by cash payments. The majority of the insured person's care costs are borne by the old-age long-term care insurance fund, while the individual pays only a small portion. The premiums paid by individuals should be calculated according to the national standardized rate, with different rates for different levels of care, and the benefits should be determined according to the individual's actual health condition and level of care. Premiums can be deducted proportionally from an individual's monthly income. As a powerful supplement to the pension and medical insurance policies, the implementation of the long-term care insurance policy for the elderly can reduce the financial pressure on individuals, families and the society in terms of elderly care.
IV. Supporting the operation of the elderly service system with effective financial input
(I) Subsidizing elderly service institutions
The government should provide necessary subsidies to newly built community-based elderly service institutions and facilities in accordance with the development plan for the elderly service business, in order to help these service institutions to reduce the cost of up-front investment. With the financial support of the government, the service organizations should gradually improve their community elderly service programs according to the principles that the content of the services should be from easy to difficult, the order of the services should be from urgent to slow, and the service programs should be from less to more.
(B) Subsidies for the elderly living at home
The government should give monetary subsidies to the elderly living at home who are in difficulty in order to help them get out of their difficult life situations; and provide financial subsidies to the elderly living in difficulty who are in poorer health and have urgent needs for elderly care services, as well as to those who have made outstanding contributions to the society, through the issuance of "elderly care service vouchers. "The government should also continue to expand the types of elderly services purchased by the government and expand the number of beneficiaries.
(C) Subsidies for elderly service personnel
In order to strengthen the construction of the elderly service team and improve the professional level of service personnel, the organization of service personnel training is very necessary. The training costs if borne by the community alone will add a great burden to the community building, if alone by the service organization to bear this part of the cost will cause a heavy burden to its operation, if completely by the service personnel to bear and will greatly dampen their enthusiasm for work. Therefore, the training costs should be borne by the government finances, communities, service organizations and service personnel to **** the same principle, which can not only reduce the pressure on the community, service organizations, and enhance the enthusiasm of service personnel, but also to avoid increasing the financial burden on the Government. In order to speed up the pace of professional construction of the service team, service personnel can enjoy government subsidies during the training period, on the one hand, can encourage service personnel to receive professional training to improve their own quality; on the other hand, can absorb more high-quality talents engaged in the cause of elderly services, and enhance the service team's overall work enthusiasm.
(D) Increase the investment in information technology for elderly services