长护险试点九年为何“试而不定”？

Core Viewpoint - The Long-term Care Insurance (LTCI) system in China, initiated in June 2016, has expanded to 49 cities but has not yet achieved nationwide implementation, raising questions about funding, system design, regional disparities, and social awareness [1][2]. Group 1: Background and Current Status - The LTCI aims to address the challenges posed by an aging population, with projections indicating that by the end of 2024, there will be 310 million individuals aged 60 and above in China, accounting for 22% of the total population [2]. - As of now, over 180 million people are insured under the LTCI, with more than 2.6 million receiving various forms of long-term care services [1][2]. Group 2: Challenges Facing LTCI - Four main issues hinder the nationwide rollout of LTCI: inconsistent pilot programs across regions, lack of a sustainable funding model, shortage of care service providers, and unstandardized disability assessment criteria [3][4][5]. - The funding structure currently relies heavily on medical insurance funds, which cover 70% of costs, with government subsidies at 20% and personal contributions at only 10% [4]. - There is a significant shortage of care personnel, with a need for over 10 million caregivers, while only about 300,000 are currently available in the pilot cities [4][5]. Group 3: Policy Developments and Future Directions - Recent policy signals indicate a push towards establishing a unified LTCI system across the country, with the 2024 government work report emphasizing the acceleration of this initiative [6][9]. - Experts suggest that establishing an independent funding channel and a multi-party contribution model is crucial for the sustainability of LTCI [8][9]. - The LTCI system is expected to evolve to cover a broader population, addressing the needs of both severely disabled individuals and those with moderate disabilities [7][9].