[Editor's Note]
Countermeasures for the Sustainable Development of Private pension Institutions comprehensively and profoundly analyzes the forms of pension in China from the current situation of socialized pension services to the difficulties in the development of private pension institutions, and then to the countermeasures for the development of private pension institutions. Point out the development direction of pension institutions, especially private pension institutions.
The stone of another mountain can attack jade. Referring to the countermeasures in this paper and reviewing the development status of medical, health and nursing integration in Jinmingyu Hospital of our Group, it is not difficult to see that we are on the right path, and the objective conditions have been met, the key is to vigorously implement on this basis. As long as we dive down, work hard and work skillfully, and make sure that there are marks on the iron and marks on the stone, our medical health care integration and smart pension enterprise will certainly be in the forefront of the province. According to the seventh National census, as of November 2020, China's population aged 60 and above accounted for 18.70 percent of the total population. Among them, 13.50 percent are aged 65 and above. Between 2010 and 2020, the proportion of people aged 60 and above increased by 5.44%, further deepening the aging degree of China's population.
According to the United Nations, a country is considered an "aging" society when more than 10 percent of its population is 60 or older, and when more than 7 percent of its population is 65 or older. When these two indicators double (that is, the proportion of the population aged 60 and over exceeds 20 per cent, or the proportion aged 65 and over exceeds 14 per cent), a country is considered to be an "aged" or "moderately aged" society.
According to the results of the fifth national census in 2000, the population aged 65 and above accounted for 6.96% of the total population, indicating that China had entered an "aging" society that year according to the above UN standards. According to some recent projections, China will enter a "moderately aging" society by 2025.
The coming of the moderately aged society means that China should take a more active attitude, active policies and active strategic actions to deal with the aging population.
Current situation of socialized old-age service
Since the "13th Five-Year Plan" period, China's socialized pension service supply pattern has gradually formed, institutional pension from "supplement", "support", and then to "coordination with home community", its positioning has become increasingly clear, the role has been increasingly prominent.
At present, China's pension institutions are mainly divided according to the registration departments, which are public institutions, private non-profit institutions and private for-profit institutions.
Public pension institutions to "keep basic out line" for the purpose, to "3 without" the elderly (without labor ability, without source of income of urban residents, without support and maintenance, or its support and bring up person lacks the ability to support or maintenance of 60 years old and above) in the elderly and disabled elderly home object provides support services free of charge, The service content is mainly daily care and basic nursing.
The residents of private non-profit institutions are the disabled and semi-disabled elderly, with the main purpose of "nursing care" and taking care of some active elderly. Nationally, the service price of such institutions is slightly lower than that of the market, and institutions can enjoy bed subsidies or construction subsidies from the government while accepting the elderly.
Privately-run for-profit organizations have capital advantages and are characterized by the combination of medical care and health care services. Their service targets are all the elderly and they are more professional in service level and quality. In the context of fully opening up the pension service market, the government has cancelled the establishment permit for private pension institutions and implemented the policy of equal preferential treatment for private public pension institutions.
By the end of the first quarter of 2021, China had 330,000 institutions and facilities for the elderly, up 60.9 percent year-on-year, according to the Ministry of Civil Affairs. There were 8.172 million beds for the elderly, up 4.8 percent year on year. All kinds of elderly care institutions are booming, providing differentiated care services for different elderly people.
In June 2021, the National Development and Reform Commission and other three departments issued the Implementation Plan of the 14th Five-year Plan to Actively Respond to the Aging Of The Population and the Construction of Childcare. Under the guidance of this plan, local governments are actively carrying out the action of "Caring for the elderly and enjoying happiness".
Standing on "difference" (2021-2025) and the start of the implementation of open all-round construction of socialism modernization country new journey, to one hundred the second goal of the starting point of the first five years, private pension institutions should be rational to face the development dilemma, save for a rainy day, digging their own potential, toughness, and room for manoeuvre, to achieve its sustainable development.
The development dilemma faced by private pension institutions
With the aggravation of population aging, the demand for life care and long-term care services for empty-nesters, senior citizens and disabled elderly people continues to increase. In contrast to this background, the development of private pension institutions in China is facing the following difficulties:
First of all, the organization positioning is not clear, the service content lacks precision. Private pension institutions are not clear about their own development and cannot meet the differentiated needs of the elderly for pension services. On the one hand, the young and healthy elderly prefer home-based community pension and "show resistance" to the institutional pension model that provides daily care, so they cannot become the target customer group of private pension institutions. Moreover, some private institutions have vacant beds, which is in sharp contrast to the "difficult to find a bed" in public institutions.
On the other hand, the construction and operation costs of the home care service centers, which rely on the government to purchase the services of private pension institutions for a long time, are all borne by the financial sector. Their functions mainly focus on sports and entertainment, and they generally lack professional and systematic care for the disabled home elderly.
Secondly, the combination degree of medical care is low, and the combination is difficult to promote. At present, the combination of medical care and nursing care in private pension institutions is generally low. On the one hand, the infirmary and nursing station in the institution have problems of insufficient investment funds, lack of personnel, high investment in fixed assets, long payback period and low efficiency. According to the survey, if medical clinics of private pension institutions are equipped with professional medical staff, they need to pay more than 100,000 yuan for the salary of medical staff every year, in addition to water, electricity, heating and other costs. If institutions pass on fees to the elderly, it will lead to unaffordable for most of the elderly, and it will be difficult for the institutions to continue to operate.
On the other hand, due to the shortage of medical and health resources, medical and health institutions themselves lack the dynamic mechanism to realize two-way green channel of referral with private pension institutions.
Third, the development of smart elderly care is limited and the innovation power is insufficient. First, the cost is high. The development of smart pension products or services requires a high cost. Most of the elderly are willing to accept smart pension services, but are not willing to bear the cost, especially the high cost behind personalized and high-quality services. Second, the low penetration rate. The elderly are less likely to use smart products due to their knowledge level, memory, traditional living habits and other reasons, and institutions lack the motivation mechanism to introduce smart elderly care. Third, lack of professional team management. Lack of experience in the design, construction, operation, publicity and promotion of smart elderly care, and lack of overall innovation.
Fourth, funding sources are insufficient and government incentives are limited. Survey, enjoy the national and provincial financial subsidies to the agency more than half, but basically in a state of passive "subsidised", most organizations reflect know less about subsidies, compared with public institutions, private pension institutions mainly through afterwards "repair" of the head of a bed or fill "head" apply to the government subsidies, the application process cumbersome.
In terms of financing, private pension institutions face difficulties in funding sources due to their inability to obtain bank loans and share out profits, which further affects hardware and software construction and service capacity.
The solution to the dilemma
The operation of private pension institutions is characterized by high investment, high risk, low return and long cycle. This requires private pension institutions to accurately grasp the factors affecting their own sustainable development ability while realizing social responsibility and coping with aging risks, and cultivate new growth points of pension service industry with nursing service as the focus and combination of medical care as the core, so as to ensure sustainable operation of institutions.
In view of the difficulties faced by the development of private pension institutions from the above survey, specific countermeasures are proposed as follows:
First of all, private pension institutions should clarify their core positioning as "nursing institutions" and make full use of smart pension to provide accurate services for the elderly.
The development of private pension institutions should effectively meet the increasing nursing needs of the elderly, take "nursing institutions" as the core business, provide relatively perfect and supporting disability nursing services for the elderly discharged from hospital with serious illness and long-term disability, and ensure the quality of life of the elderly living with long-term illness.
On this basis, private pension institutions should develop into diversified and integrated businesses, provide the elderly with various pension service needs that meet their whole life cycle, enrich the service content, optimize the service mode and accurately meet their needs. On the basis of giving priority to meeting the nursing needs of the elderly in the institution, we make full use of the smart pension platform, accept the contents of government purchase of pension services, provide professional and standardized services to the elderly in the surrounding communities, and constantly establish a long-term mechanism for sustainable development.
In addition, we can explore the establishment of long-term care insurance home payment method, pilot the first, to provide professional and inclusive care services for the elderly in home communities. On this basis, give full play to the supporting role of private pension institutions, further promote the coordinated development of home-based community pension services, and improve the utilization rate of pension service resources.
Secondly, at the level of government policy, we should adhere to the principle of "health and old-age care + stratification and classification" to promote the organic combination of medical care.
On the one hand, with capital policy orientation as the breakthrough point, state-owned medical and health institutions and private pension institutions are encouraged to cooperate in various forms to provide diversified and multi-level medical and nursing services. We will support private elderly care institutions to equip them with clinics and nursing stations to improve their internal medical and health care capacity.
On the other hand, efforts will be made to solve the quality of care for the disabled elderly, encourage medical practitioners to provide services in private pension institutions, and establish a supporting promotion mechanism. Private pension institutions are encouraged to establish a strict assessment mechanism for the elderly in accordance with the requirements of civil affairs and medical insurance departments, and on this basis actively apply for the qualification of designated institutions for long-term care insurance, so as to meet the care needs of the disabled elderly.
Third, the government should focus on implementing the financing mechanism of "special finance + mutual insurance + payment for the elderly" to stabilize the source of funds for private pension institutions.
Elderly care services are quasi-public goods. We should give priority to public welfare, and establish institutional elderly care services of "affordable cost, convenient and reliable quality" so that the elderly can "afford" and "live in" them. Local governments should list subsidies for pension institutions as special expenditures, appropriately simplify the conditions and methods for receiving them, and treat public and private pension institutions the same. To adhere to the "sixth insurance" attribute of long-term care insurance, it is necessary not only to continuously enhance social insurance capacity with the improvement of economic development level, but also to fully consider the phased characteristics of development and financial bearing capacity, reasonably guide social expectations, and establish the improvement of insurance level on the basis of sustainable economic and financial growth. At the same time, elderly people who can afford to buy commercial insurance for long-term care will be encouraged to promote efficient interaction between social insurance and commercial insurance, so as to provide high-quality medical and nursing services for the elderly.
The "14th Five-year Plan" period is the strategic window period for China to actively respond to the aging of population. The strategic focus should include deepening the reform of public pension institutions, improving service capacity and service level, strengthening policy support for nursing private pension institutions, and building community home-based pension service network. As an indispensable part of the pension service system, institutional pension service should form a multi-level supply pattern with reasonable layout, so as to make full use of pension resources, balance the supply and demand structure of pension service, and better cope with the care challenges brought by aging population.
