我国基本养老保险实现全国统筹的方案设计

实现基本养老保险全国统筹是我国养老保险制度的内在要求,也是我国养老保障体制改革的发展方向和必然趋势。在目前各区域差异明显和业已形成的地方利已主义行为,已严重阻碍了基本养老保险统筹层次的提高。本文针对各区域间差距的情况,设计出基本养老金计发方案,以减少基本养老保险实现全国统筹的障碍与阻力;针对各主体利益行为,设计出“统帐全分,分开管理”的基本养老保险全国统筹模式,以划清中央与地方的权利与责任范围;针对各种方案实施阻力大小,给出最优方案选择。以期为我国基本养老保险尽快实现全国统筹提供对策参考。     

基本养老保险实现全国统筹的区域障碍及策略研究

目前我国基本养老保险统筹存在层次上的区域障碍,不同地区在经济水平、基本养老保险历史债务和现状等方面的巨大差距严重制约着基本养老保险统筹层次的提高,因此,适当降低地区间收入再分配的幅度,需要对在岗职工平均工资进行较长时期分步调节,以实现较小幅度的收入转移代价,这将有利于减小基本养老保险全国统筹实现的阻力。     

基本养老保险全国统筹即将成为现实

基本养老保险实现全国统筹，是这一制度的内在要求，也是我多年来的主张。因为只有实现全国统筹．才能真正实现劳动力的自由流动并增进这一制度的公平性与可持续性。其实，在党的十六届三中全会审议通过的《关于完善社会主义市场经济体制若干问题的决定》中，就明确提出要逐步“实现基本养老金的基础部分全国统筹”，此后党中央的多次决议与中央政府的多份重要文献都再三明确提出养老保险全国统筹的目标。     

“十二五”养老关键词：全国统筹、全覆盖、提标准

3月5日提请十一届全国人大四次会议审查的“十二五”规划纲要（草案）提出：实现城镇职工基础养老金全国统筹。城镇参加基本养老保险人数新增1亿人。城镇职工基本养老金稳定增长,城镇60岁以上非就业居民享受基础养老金待遇。实现新型农村社会养老保险制度全覆盖,提高基础养老金水平。     

养老金如何才能不贬值

目前的养老保险体制是社会统筹和个人账户相结合的模式。但目前来看，这个模式确实遇到了不少困难，也因此引发一连串问题。 比如，目前养老保险统筹层级很低，全国大部分地方基金管理层次还是县市一级，算起来有2000多个统筹管理主体。统筹层级低给养老金投资运营带来困难，个人账户空账问题也比较严重。     

13个省区市实现养老保险省级统筹

人力资源和社会保障部近日公布的2007年全国社会保险情况表明：截至2007年底，全国共有北京、天津、吉林、黑龙江、上海、福建、重庆、云南、陕西、甘肃、青海、宁夏、新疆13个省区市实现了养老保险省级统筹。同时，河南、湖南、江西、西藏4个省区和新疆生产建设兵团出台了养老保险省级统筹办法。     

社保“双轨制”终将合并

当前，我国的养老保险已经实现了制度上的全覆盖，但不同人群待遇差别较大。这种差别是如何形成的，怎样才能弥合？随着改革开放的逐步推进，从1985年起（少数地区从1984年起），各地纷纷开展了重建养老保险社会统筹制度的试点。1991年，国务院颁布了《关于企业职工养老保险制度改革的决定》，在全国建立养老保险社会统筹制度。由此，逐步形成了养老金的“双轨制”。     

30年实现社保全国统筹是否太漫长

《全国统一的社会保险关系转续办法研究》课题组牵头人、国家发改委社会发展研究所所长杨宜勇日前表示，中央最快年内将出台社会保险关系异地转续办法。据悉，社保关系将在“不转移统筹基金的前提下”，实现跨地区转续。如基本养老保险，采取“分段计算”模式——工作地缴费，分段记录，退休地方发放，“各省根据劳动者劳动服务记录和相应本省基数单独核算，最后互不干扰汇入同一账户”。（《广州日报》9月5日）     

以县城为起点推进城乡社会保障一体化

一、城乡社会保障制度应该首先在县域对接 城乡社会保障一体化是二元经济一体化不可或缺的组成部分,它的实现需要经历一个漫长的过程.由于全国各地的社会经济发展水平存在较大差异,因此马上推行全国城乡社会保障一体化的可能性几乎为零.当前,最重要的是先要找到一个起点或是一个切入点,然后分阶段采取措施来逐步推进城乡社会保障一体化.然而在很多省份还没有实现城镇基本养老保险的省级统筹,城镇社会保障其他领域的省级统筹也还没有摆上日程的情况下,若想在近期实现各省城乡社会保障一体化是不现实的.     

新型城镇化背景下完善我国农业转移人口的社会保障制度

我国农业转移人口社会保障制度建设各地区步调不一致、模式多样,短期内实现全国跨区转移接续和城乡统筹较为困难。现阶段,要以建立全国统一的强制性养老保险为重点完善社会保险体系,保障农业转移人口的基本生活;逐步建立起以与市民享受同等最低生活保障为核心的社会救助制度,保障农业转移人口的最基本生活;根据地区发展条件,适时推进建立农业转移人口福利制度,以提高其生活质量,在保障措施上,加快构建部门和地区统筹协调机制和夸地区有序转移接续机制,形成多元化社保资金筹措渠道,完善各项配套制度。     

Households’ precautionary behaviors—the effects of the introduction of National Health Insurance in Taiwan

By reducing risk of large out-of-pocket medical expenses, comprehensive social health insurance may reduce households’ motivation to engage in precautionary behaviors such as saving, procurement of private insurance, and spousal labor-force participation. We use the natural experiment provided by the 1995 introduction of National Health Insurance in Taiwan to examine these effects, using pre-existing differences in access to health insurance (tied to the household head’s and spouse’s joint employment status) to identify the effects of increasing insurance coverage. We find that comprehensive health insurance has a statistically significant and large effect on household savings, but no significant effects on purchase of private accident insurance and spousal employment.

The Making of National Health Insurance in Britain and Canada: Institutional Analysis and its Limits

Scholars examining the development of health insurance reform programs from an institutionalist perspective have drawn attention to the importance of state structures and administrative capacities in shaping social policy outcomes. Focusing on the introduction of the British National Health Insurance Act of 1911 and the Canadian Hospital Insurance Act of 1957, I suggest that institutionalist analysis can obscure the historical record in three ways. Analysts may ignore the multiple institutional mechanisms that were available to policy makers at the time; they may overlook the contentiousness of policy battles; and they may underestimate the extent to which similar institutions have functioned in very different ways. In the case of Britain, I argue that national health insurance was part of a package of social reforms designed to halt the slide of Britain from a position of preeminence in the world economy. The introduction of Canadian health insurance coincided with an increased role for local and federal states in fostering economic development within the nation. Institutional structures, cultural values, and political power were all resources used within both states to create a consensus behind the new national agenda.     

High quality private long-term care insurance: can we get there from here?

The private long-term care insurance market has undergone rapid change in the last several years. Although the quality of policies has generally improved, problems remain. Consumer protection issues include the lack of adequate inflation protection features, how activities of daily living are measured, potentially high lapse rates and lack of nonforfeiture values, how home care benefits are defined, and the appropriate loss ratio standards. The concerns of consumer and elderly advocates about the quality of private long-term care insurance have prompted congress to consider the need for federal intervention. While there are numerous approaches that the federal government could take, mandatory standards substantially higher than the current model standards of the National Association of Insurance Commissioners may prove the most effective in improving the quality of policies on a nationwide basis.     

High Quality Private Long-Term Care Insurance

The private long-term care insurance market has undergone rapid change in the last several years. Although the quality of policies has generally improved, problems remain. Consumer protection issues include the lack of adequate inflation protection features, how activities of daily living are measured, potentially high lapse rates and lack of nonforfeiture values, how home care benefits are defined, and the appropriate loss ratio standards. The concerns of consumer and elderly advocates about the quality of private long-term care insurance have prompted Congress to consider the need for federal intervention. While there are numerous approaches that the federal government could take, mandatory standards substantially higher than the current model standards of the National Association of Insurance Commissioners may prove the most effective in improving the quality of policies on a nationwide basis.     

中国基本医疗保险的实际参保率及其分布特征:基于多源数据的分析

全民覆盖是基本医疗保险降低国民医疗费用负担的前提条件。中国基本医疗保险是否实现了全民覆盖仍存在争议。本文利用多源调查数据,分析了我国基本医疗保险实际参保率及其分布特征。不同来源的数据基本证实,2015-2016年,中国仍有超过10%的国民没有参加任何一项基本医疗保险制度。其中,城镇居民、非农户口和没有户口的居民、东北地区、年轻人、儿童、未就业人群、低收入人群、在校学生以及流动人口基本医疗保险实际参保率更低。城乡居民实行自愿参保,因管理部门分割、信息系统不统一导致的重复参保以及因财政补贴制度导致的户籍地参保等制度设计,是导致基本医疗保险未能实现全民覆盖的根源。要实现基本医疗保险全民覆盖,解决国民医疗后顾之忧,未来我国基本医疗保险应实行强制参保、以家庭为单元参保、常住地参保,建立全国统一的基本医疗保险信息系统,并鼓励发展补充性医疗保障制度。     

Enabling informed consumer choice in the long-term care insurance market.

Provisions in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) may increase private long-term care insurance sales without imposing substantially more stringent consumer-protection features. The ability of consumers to make informed choices when purchasing this complex product is examined in light of these changes. Data were collected through detailed examinations of policies and interviews with industry experts, insurance companies, agents, consumer groups, and regulators. Because of the complexity of this product, the goals of expanding, consumer choice and ensuring that consumers are able to make informed decisions often work against each other. Mechanisms are discussed through which the government can facilitate informed choice and improve consumer protection. The authors contend that, because the government is providing tax incentives that encourage consumers to purchase the product, it has the responsibility to ensure that consumers understand the long-term care insurance they purchase.     

Enabling Informed Consumer Choice in the Long-Term Care Insurance Market

ABSTRACT

Provisions in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) may increase private long-term care insurance sales without imposing substantially more stringent consumer-protection features. The ability of consumers to make informed choices when purchasing this complex product is examined in light of these changes. Data were collected through detailed examinations of policies and interviews with industry experts, insurance companies, agents, consumer groups, and regulators. Because of the complexity of this product, the goals of expanding consumer choice and ensuring that consumers are able to make informed decisions often work against each other. Mechanisms are discussed through which the government can facilitate informed choice and improve consumer protection. The authors contend that, because the government is providing tax incentives that encourage consumers to purchase the product, it has the responsibility to ensure that consumers understand the long-term care insurance they purchase.     

‘Scarier than another storm’: values at risk in the mapping and insuring of US floodplains

How do people respond to the ways in which insurance mediates environmental risks? Socio‐cultural risk research has characterized and analyzed the experiential dimension of risk, but has yet to focus on insurance, which is a key institution shaping how people understand and relate to risk. Insurance not only assesses and communicates risk; it also economizes it, making the problem on the ground not just one of risk, but also of value. This article addresses these issues with an investigation of the social life of the flood insurance rate map, the central technology of the U.S. National Flood Insurance Program (NFIP), as it grafts a new landscape of ‘value at risk’ onto the physical and social world of New York City in the aftermath of Hurricane Sandy. Like other risk technologies, ubiquitous in modern societies as decision‐making and planning tools, the map disseminates information about value and risk in order to tame uncertainty and enable prudent action oriented toward the future. However, drawing together interview, ethnographic, and documentary data, I find that for its users on the ground, the map does not simply measure ‘value at risk’ in ways that produce clear strategies for protecting property values from flooding. Instead, it puts values‐beyond simply the financial worth of places‐at risk, as well as implicates past, present, and future risks beyond simply flooding. By informing and enlarging the stakes of what needs protecting, and from what, I argue that plural and interacting ‘values at risk’ shape how people live with and respond to environmental risks that are mediated by insurance technologies.     

Aged Care Service Delivery in Japan

Summary

The implementation of Japan's Long-Term Care Insurance Scheme in early 2000 presaged many changes in service delivery and much debate among service providers, different levels of government, academic analysts, and major media interests. The first part of this paper gives an account of the major changes in the organization of service delivery that have increased opportunities for private sector providers, including large corporations, and restructured contractual relationships between municipalities and providers in all sectors. New arrangements for client assessment, classification, care management, and extended service types are then outlined. An assessment is then made of the likelihood that the expected outcomes of the scheme will be realized, with the concerns of welfare professionals that the public welfare system is under threat juxtaposed with bureaucratic goals of liberalizing the provision of long-term care.