中国长期护理保险立法审视  

Examining Legislation on Long-Term Care Insurance in China

作　　者：戴卫东 Dai Weidong(School of Public Administration,Zhejiang University of Finance and Economics;The New Type Key Think Tank of Zhejiang Province"China Research Institute of Regulation and Public Policy",Hangzhou 310018,China)

机构地区：[1]浙江财经大学公共管理学院 [2]浙江财经大学浙江省新型重点专业智库“中国政府监管与公共政策研究院”

出　　处：《社会保障评论》2024年第1期59-73,共15页Chinese Social Security Review

基　　金：国家社会科学基金重点项目“‘兜底性’失能老年人养老服务体系建设研究”(20AZD082);浙江省高校重大人文社科攻关计划项目“浙江省长期护理保险试点评估、政策优化、关键机制与推广路径研究”(2023GH030)。

摘　　要：长期护理保险立法是我国积极应对人口加速老龄化和保障失能弱势群体基本生存权的一项基础工程,属于社会法的调整范畴。长期护理保险制度49个国家试点城市政策“碎片化”和试点指导法规位阶偏低阻碍了制度推进和定型。立法需要遵循找准时间节点、先综合性立法后单行立法、创设性立法与授权性立法有机结合、尽早规范程序性立法内容等四个“尊重”基本原则。基于保险关系、服务购买关系与护理服务关系三个层面的各参与主体权利与义务的定位是立法的核心。保险人与保险辅助人在基金管理、经办管理、信息化管理和质量管理中角色地位的立法确认是制度健康、可持续运行的重要保障。其中,长期护理保险建制实行省级统筹,独立于医疗保险运行,委托市场第三方经办,以及统一管理与服务标准是管理机制立法的重中之重。制度参与主体尤其是保险辅助人的违法责任规范越详细具体越能规避道德风险。保险人、投保人、被保险人以及保险辅助人多主体之间可能存在的诸多权责纠纷,依据现行相关法律和可能的法律创新,处理适用的法律关系立法需进一步健全规范。The legislation of long-term care insurance stands as a fundamental initiative for China to proactively address the accelerated aging of its population and safeguard the basic survival rights of disabled and vulnerable groups.This legislation falls within the domain of social law.However,the fragmentation of policies across 49 pilot cities and the comparatively low legislative status of pilot regulations have hindered the advancement and fi nalization of the system.Legislative eff orts should adhere to fundamental principles,including identifying the appropriate time point,initiating comprehensive legislation before separate legislation,integrating substantive legislation with delegated legislation,and promptly standardizing procedural legislative content.At the core of this legislation is the establishment of the rights and obligations of each participant based on the three levels of the insurance relationship,service purchase relationship,and care service relationship.Confi rming the roles and positions of insurers and insurance assistants in fund management,information management,and quality management is crucial for the healthy and sustainable operation of the system.Prioritizing the establishment of a provincial-level fund pool,independent of the operation of medical insurance,implementing third-party management by market entities,and enforcing unifi ed management and service standards are essential components of management mechanism legislation.Detailed and specifi c provisions regarding the liability for violations,especially for insurance assistants,can mitigate moral hazards.To address potential disputes over rights and responsibilities between insurers,policyholders,insured persons,and insurance assistants,continuous improvement of applicable legal relationship legislation is necessary based on current relevant laws and potential legal innovations.

关 键 词：长期护理保险立法 立法原则 权利义务 违法责任 权利救济 

分 类 号：D922.182.3[政治法律—宪法学与行政法学]