日本护理保险财政困境及应对措施

日本护理保险制度建立于2000年,是与国民医疗保险、养老保险具有同样性质的社会保险制度,经过近20年的发展已经比较成熟。随着日本人口老龄化的不断加剧,需要护理的老年人口数量持续上升,护理保险支出明显增多,给国家财政带来不小的压力。如何应对护理保险面临的财政困境,并维持制度的可持续性是日本面临的重要课题。日本通过增加个人负担比例、增设预防服务、设立财政稳定化基金等方式调整护理保险收支不平衡问题,缓解护理保险的财政来源。可为中国建立适合国情、保证财政可持续的护理保险机制提供一些借鉴。

The Financial Difficulties of Nursing Insurance and Countermeasures in Japan

Japanese nursing insurance system was established in 2000. It is of the same nature as the national medical insurance,pension insurance and social insurance system,and has relatively matured after 18 years of development. As population aging in Japan continues to worsen,the number of elderly people in need of care continues to rise,and the expenditure on nursing insurance has been significantly increased,which brings great pressure to the national finance. How to deal with the financial difficulties faced by nursing insurance and maintain the sustainability of the system is an important issue. Japan adjusts the imbalance of the income and expenditure of nursing insurance by increasing the proportion of personal burden,adding preventive services,setting up financial stabilization fund and other ways to alleviate the financial source of nursing insurance.