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The root of the dilemma of providing for the aged
Lack of sociality and welfare of social security. Although modern social endowment insurance emphasizes strengthening the self-protection consciousness of individual participation, it still needs the participation of the state, the collective and all aspects of society. China implements a basic old-age insurance system that combines social pooling with individual accounts. However, judging from the reform practice in recent years, the "unified account combination model" has not really been realized. According to the basic plan of county-level rural social endowment insurance, the rural social endowment insurance adheres to the principle of "individual contributions are the main part, collective subsidies are supplemented, and the state gives policy support" in raising funds. However, most collectives are unable or unwilling to give subsidies to rural social endowment insurance, and some places even further change "individual contribution is the main" to "individual full contribution" in the implementation. This makes the current rural social endowment insurance actually an encouraging deposit, so it is impossible to force farmers to participate. And "compulsory" has always been regarded as the inherent attribute of social insurance. Without compulsory social insurance, it is difficult to implement and lose its sociality.

The system is unstable, and the rural social endowment insurance measures in various places are basically formed on the basis of the Basic Plan promulgated by the Ministry of Civil Affairs, and these measures generally lack legal effect. Therefore, the collection and application of insurance benefits and the distribution of pensions in various places are only carried out according to the wishes of local government departments and even some officials, which is not a lasting contract between farmers and the government, so it is very unstable.

The coverage is small, the level of protection is too low, and the participation rate of the school-age population in the country is quite low, and the coverage is very narrow, which leads to poor mutual assistance of insurance. Statistics from the Ministry of Labor and Social Security show that by the end of 2005, only 55 million farmers in China had participated in the old-age insurance, accounting for 5.8% of the total farmers in China. On the level of security, the basic plan stipulates that when farmers pay insurance premiums, they can pay them in 2 yuan to 20 yuan 10 grades according to the actual situation. Farmers in most areas have chosen the insurance grade of 2 yuan/month with the lowest premium. Without considering inflation and other factors, if farmers start to receive pensions after paying 10 years, they can receive 4.7 yuan and 9.9 yuan every month after 15 years, which hardly plays any role in providing for the aged. Even if farmers are insured in 4 yuan, 6 yuan and even 20 yuan every month, it is still difficult to play the role of old-age security.

It is difficult to maintain and increase the value of endowment insurance funds. The basic plan stipulates that "the fund is managed in a unified way by county, mainly by purchasing high-interest bonds issued by the state finance and depositing them in banks to preserve and increase value". Because the management is based on the county, the related costs can only be shared within the county, and the marginal costs only move on a small value, so the scale is uneconomical. In addition, in the actual operation process, due to the lack of suitable investment channels, relevant departments generally take the form of bank deposits. 1996 since the second half of the year, the bank interest rate has been continuously lowered, and with the influence of inflation and other factors, it is difficult for rural endowment insurance funds to maintain their value, let alone increase their value. On the one hand, the government's burden increases, and the more people participate in the insurance, the greater the national loss. On the other hand, in order to make the funds run in a balanced way, the interest rate of the old-age insurance account promised by the state had to be lowered, resulting in the actual income of the insured being significantly lower than that of the old-age pension calculated with high interest rate in the past, which made people's confidence in rural social old-age insurance decline. China has entered an aging society in 2000. By 20 10, the number of urban retirees will reach 70 million, and it will exceed 1 100 million in 2020. By 2030, it is estimated that the proportion of people over 60 in China will reach 24.46%, which is about 8.5 percentage points higher than the world average. The Forecast Report on the Development Trend of Population Aging in China issued by the National Office for Ageing introduces the current situation and development trend of population aging in China in three parts:

The first stage, 200 1 to 2020, is a stage of rapid aging. At present, China will add an average of 5.96 million elderly people every year, with an average annual growth rate of 3.28%. By 2020, the elderly population will reach 248 million, and the aging level will reach 654.38+076.5438+07%. Among them, the number of elderly people aged 80 and above will reach 30.67 million, accounting for 654.38+02.37% of the elderly population.

The second stage, 202 1 to 2050, is to accelerate the aging stage. With the second baby boom from the 1960s to the mid-1970s, the number of elderly people in China began to accelerate, with an average annual growth of 6.2 million. By 2023, the elderly population will increase to 270 million, equivalent to the number of children aged 0- 14. By 2050, the total number of elderly people will exceed 400 million, and the aging level will reach over 30%, among which the number of elderly people aged 80 and over will reach 94.48 million, accounting for 2 1.78% of the elderly population.

The third stage, from 205 1 to 2 100, is a stable stage of severe aging. In 20051year, the elderly population in China will reach a peak of 437 million, about twice the number of children. At this stage, the scale of the elderly population will be stable at 300-400 million, the aging level will be basically stable at about 3 1%, and the proportion of the elderly aged 80 and above in the total elderly population will remain at 25-30%, entering a highly aging platform.

According to the report, there are six main characteristics of population aging in China: large-scale elderly population, rapid aging development, unbalanced regional development, obvious upside-down between urban and rural areas, more elderly women than men, and aging ahead of modernization. Looking at the trend of population aging in China, it can be summarized into four main conclusions: First, population aging will accompany 2 1 century. Second, 2030-2050 is the most severe period of population aging in China. Third, serious population aging and aging will become increasingly prominent. Fourthly, China will face the dual pressures of aging population and overpopulation. After the reform and opening up, with the intervention of the market economy, "unit people" have evolved into "social people", the phenomenon of enterprises running society has disappeared, and the welfare benefits of units have become less and less. After the restructuring of many enterprises, employees have completely lost the opportunity to enjoy the benefits of the unit, and socialized management is implemented after retirement. At this point, the era of relying on units to provide various old-age services is gone forever, replaced by old-age services provided by communities, enterprises and various organizations. At the same time, due to the implementation of the family planning policy, the family function that has played a major role in the old-age service so far has gradually weakened. In China, family pension is an institutionalized tradition with a long history, and it is still the mainstream way of providing for the aged. However, with the influence of economic development, social transformation, demographic changes and many other factors, this approach is facing unprecedented challenges. As China is in a transitional period, the government that should bear the most responsibility is unprepared in terms of system, policy and financial resources. The contradiction between public demand and the government's ability to provide public goods and services is prominent.

To sum up, with the rapid changes of social structure such as population, economy, politics and culture, the social foundation on which the original old-age care service depends no longer exists. In order to meet the requirements of the times, it is imperative to reconstruct the old-age service system and system. Family support for the aged This is a kind of "feedback-feeding" support mode within the family with blood relationship as the link. However, family support for the aged lacks institutional guarantee, and family conflicts and intergenerational conflicts are easy to occur due to the family structure in which several generations live together.

Home-based care for the elderly is funded by family members or the elderly themselves, and professional home-based service companies train home-based service personnel to enter the elderly's families through dispatch and engage in home-based care for the elderly.

Apartment for the elderly is a new living mode for the elderly with comprehensive management ability. However, like domestic care for the elderly, this model is not perfect in terms of laws and regulations, and the quality of domestic attendants needs to be improved.

Home-based care for the aged refers to a socialized care service model with family as the core, community as the support and professional services as the support, which provides life care, medical care, spiritual comfort and solutions to daily life difficulties for the elderly who live at home, focusing on solving the worries of the frail, elderly and empty nest elderly families in the community.

Community care for the aged refers to the establishment of facilities such as nursing homes, day care rooms, restaurants, nurseries, small family nursing homes, cultural and fitness activity rooms in the community according to the number and needs of the elderly in the community, and provides old-age services for the elderly through the mode of "participating in community activities during the day and caring for the elderly at home at night". Its disadvantage is that some community institutions have limited facilities, insufficient manpower and single content.

Institutional pension refers to the establishment of pension institutions such as nursing homes and elderly care centers with funds provided by the state or the private sector. By concentrating the elderly in various pension institutions, the contradiction of insufficient human resources for family pension is solved. In the process of promoting institutional pension in China, several investment and business models have been formed, such as state or collective establishment, fund-raising establishment, joint venture between government and non-profit organizations, and private capital establishment, which are constantly being explored and practiced.

Home-based care for the aged is a model initiated by Shanghai women's housekeeping. It arranges the elderly in urban areas to be fostered by foreign domestic workers who have received professional training in "women's service" and obtained pension certificates in suburbs (Chongming and Jiading, Shanghai), thus alleviating the pressure of home-based care for the elderly in cities.

This model is an old-age service by integrating commercial real estate resources. For example, the "covered bridge dream" experience club for the elderly set up by female domestic workers in Thames Town, a suburb of Shanghai, integrates the advantages of home-based and institutional pension.

The combination of medical care and nursing care is a new model to integrate medical resources and old-age resources. Combining medical care with nursing care, the elderly can meet the needs of medical care and maintenance without leaving home. For example, Yu He Nursing Home and Yu He Rehabilitation Home under Beijing Tianxi Yu He Hospital Investment Co., Ltd. provide medical rehabilitation and life care services for the elderly.

With the continuous release of the demand for old-age care, some new old-age care models have emerged. For example, in the above-mentioned Kangyang community, the project combines membership-based pension apartments with property-based parent-child care products, and relies on all supporting facilities to realize the life concept of parents and children living under the same roof for two generations, so as to build a community suitable for all ages in it runs in the family. In addition, according to three different types of nursing needs, Ping An Group has laid out one-stop pension modes in the whole community, such as parent-child pension apartments, non-nursing pension apartments and semi-nursing pension apartments.