2022-02-23
The four ministries and commissions answered reporters' questions on the national plan for the development of the cause of aging and the elderly care service system during the 14th five year plan
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Recently, the State Council issued the national plan for the development of the cause of aging and the elderly care service system during the 14th five year plan (hereinafter referred to as the plan), which is a comprehensive, basic and guiding document to promote the development of the cause of aging and the construction of the elderly care service system in the future. The heads of the national development and Reform Commission, the Ministry of civil affairs, the National Health Commission, the national medical insurance bureau and other relevant departments answered reporters' questions.
Q: during the 14th Five Year Plan period, China has comprehensively embarked on a new journey of building a modern socialist country. What are the development foundations and requirements in the field of the development of the cause of the elderly and the elderly care service system?
A: under the strong leadership of the CPC Central Committee and the State Council, the national development and Reform Commission, the Ministry of civil affairs, the National Health Commission and other departments have implemented the national strategy to actively respond to population aging, and a series of new achievements have been made in the development of the cause of aging and the construction of the elderly care service system. First, diversified social security has been continuously strengthened. The coverage of basic social insurance was further expanded, and commercial endowment insurance and commercial health insurance developed rapidly. Second, the elderly care service system has been continuously improved. We will initially form an elderly care service system in which home-based community institutions are coordinated and medical care and health care are combined, and continue to strengthen the supply of basic, inclusive and diversified elderly care services. Third, the health support system has been continuously improved. The combination of medical care and nursing services has been developed in an orderly manner, health management services for the elderly have been fully covered, and the average life expectancy has been increased to 77.9 years. Fourth, the social integration of the elderly is deepening. Educational and cultural activities, sports and entertainment, health tourism and other activities for the elderly have been continuously enriched, the ways of social participation of the elderly have become more diverse, and the soft and hard, virtual and real social environment such as living and travel, intelligent technology and rights and interests protection of the elderly have been continuously optimized and improved. Fifth, the silver economy continued to develop. The transformation and upgrading of the manufacturing and service industries for the elderly have been accelerated, the industrial scale and scientific and technological level have been continuously improved, and new business forms have been emerging.
Of course, we should also see that China's elderly population is large and aging is fast. There are still unbalanced and insufficient fields in the cause of aging and elderly care services, and the coordinated development of undertakings and industries needs to be improved. Under the new situation, the development of the aging cause and the construction of the elderly care service system should adapt to the process of population aging, the goal of China's socialist modernization and the growing material and service needs of the people. Therefore, it still needs systematic planning and continuous promotion.
Q: the plan proposes to steadily establish a long-term care insurance system. What is the progress of the pilot of long-term care insurance system in China? What are the development goals during the 14th Five Year Plan period?
A: according to the decision-making and deployment of the Party Central Committee and the State Council, the national medical insurance bureau took the lead in promoting the pilot work of the long-term care insurance system, exploring the establishment of a policy framework of the long-term care insurance system to adapt to China's economic development level and the development trend of aging, and guiding the pilot places to explore the policy system, standard system, management methods, operation mechanism and other aspects. At present, the pilot work is progressing smoothly and has achieved phased results. The institutional and policy framework has been preliminarily established. The multi-party financing mechanism, fair and appropriate treatment guarantee mechanism, coordinated payment mechanism, standard system and management methods have been basically established. Social forces have been actively introduced to explore the socialized handling mode. The objectives of the system have been basically achieved, effectively reducing the family economic and business burden of disabled persons, and playing a positive role in promoting the development of the elderly care service system and promoting the reform of the labor supply side. So far, there are 49 pilot cities, 140 million people have participated in the insurance, and 1.6 million people have enjoyed the treatment in total.
In the next step, in accordance with the strategic deployment of the CPC Central Committee to actively respond to population aging, we will strengthen exploration, earnestly grasp the pilot, summarize and form replicable and replicable experience, and strive to basically form an institutional framework suitable for China's national conditions during the 14th Five Year Plan period.
Q: the plan proposes to build a comprehensive pension service network. What are the contents of it? What is the development basis of China's comprehensive elderly care service network?
A: the plan proposes to build a comprehensive pension service network, which will be deployed from three aspects: first, improve the basic pension service policy system. Establish a list system of basic elderly care services, clarify service standards and provide classified services for the elderly. Second, give full play to the role of public pension institutions in providing comprehensive security. On the premise of meeting the centralized support needs of the elderly in extreme poverty, we will focus on providing services for the elderly in empty nests (living alone), left behind, disabled, disabled and elderly with economic difficulties, as well as the elderly in special family planning families. By 2025, the construction rate of support and service facilities for the extremely poor at the county level will reach 100%. Third, accelerate the development of rural elderly care services. Build a mutual aid elderly care service network based on rural happy homes. Establish a regular visit system for the elderly with special difficulties to prevent basic life safety risks. By 2025, the monthly visit rate of the elderly with special difficulties will reach 100%.
There is a good practical basis for achieving the above planning objectives and tasks. In recent years, the Ministry of civil affairs, together with the national development and Reform Commission and other relevant departments, has earnestly implemented the decisions and arrangements of the Party Central Committee and the State Council, and constantly consolidated the foundation for the development of a comprehensive elderly care service network. First, improve the basic pension service policy system. Formulate and issue relevant policy documents such as welfare subsidies for the elderly and ability evaluation standards for the elderly, and strengthen the policy connection with long-term care insurance and other fields. Second, strengthen the ability of public pension institutions to provide comprehensive security. According to preliminary statistics, by the end of 2021, there were 22000 public pension institutions across the country, and the elderly in extreme poverty had achieved "all they should support". Third, improve the county-level rural elderly care service network. By the end of 2020, there were 17000 rural nursing homes and 133000 rural mutual aid elderly care facilities in China. The care and service system for the elderly left behind in rural areas has been basically established. Fourth, continuously increase financial support. During the 13th Five Year Plan period, the investment in the central budget was expanded year by year, and a total of 18.6 billion yuan was allocated to support the construction of the elderly care service system. In 2020, the country spent 38.57 billion yuan on welfare for the elderly and 13.13 billion yuan on elderly care services.
In the next step, the Ministry of civil affairs will work with relevant departments to earnestly implement the deployment of the plan, better perform the responsibility of ensuring basic people's livelihood, firmly grasp the bottom line of basic life safety for the elderly, and let them enjoy a happy old age.
Q: in 2019, the national development and Reform Commission took the lead in carrying out the "special action of urban enterprise linkage for inclusive elderly care". The plan also proposed to expand the coverage of inclusive elderly care services. What important measures will the state take in the supply of inclusive elderly care services?
A: since 2019, the national development and Reform Commission, together with the Ministry of civil affairs and the National Health Commission, has carried out the "special action of urban enterprise linkage for inclusive elderly care", and made positive progress. Over the past three years, the central budget has invested more than 6 billion yuan, driving the construction of more than 300000 elderly care service beds across the country. We will support the transformation of Party and government organs, state-owned enterprises and institutions, training and nursing institutions, develop elderly care service facilities, promote the transformation of more institutions, and focus on providing inclusive elderly care services to the general public. We will support about 30000 transformed beds in 2021. At the same time, driven by the special action, the central local coordination and urban enterprise linkage have been realized, and the investment for mechanism has been realized to drive the development of key types such as "community, medical care, learning and residence". The special action has played a role in condensing social consensus and forces of all parties, and realized the original policy intention of providing inclusive elderly care services for the majority of the elderly.
The plan further defines the task of expanding the coverage of inclusive elderly care services. Continue to cultivate and develop community elderly care service institutions and extend services to families by operating family elderly care beds. Promote the complementary functions of regional elderly care service centers at the township and street levels and community institutions, and jointly build a "quarter hour" home-based elderly care service circle. At the same time, focus on supporting the construction of nursing elderly care service facilities. In terms of the capacity-building of inclusive services, it focuses on the supporting standards and smooth operation of community service facilities, while mobilizing local governments and enterprises, especially state-owned enterprises, to play a role in providing high-quality and reasonably priced elderly care services for the masses.
Next, the national development and Reform Commission will continue to promote inclusive elderly care services into families, communities and institutions, and bring the benefits of inclusive elderly care to the majority of the elderly and their families.
Q: home based community care covers the largest number of the elderly. We are concerned that the plan has considered the elderly meal assistance service, bath and cleaning assistance, patrol care service, etc. could you describe the picture of home-based community care services for the elderly during the 14th Five Year Plan period?
A: the 14th Five Year Plan period is an important strategic opportunity for the development of elderly care services. In response to the expectation and demand of the elderly for home-based and nearby elderly care, the Ministry of civil affairs, together with relevant departments, will strive to solve the problem of "the last mile" of elderly care services and promote home-based and community elderly care services to enter the "2.0" version of high-quality development:
First, we will optimize the layout of facilities in the direction of "where there are many elderly people, we will set up elderly care service institutions". We will vigorously promote the construction of supporting community elderly care service facilities in new urban areas and new residential (small) areas, and the compliance rate will reach 100%. We will promote old urban areas and built residential (small) areas to basically supplement community elderly care service facilities. Promote the construction of a "quarter of an hour" home-based elderly care service circle in urban communities, improve rural areas, and form a county-level and rural three-level service network.
The second is to innovate service forms in the direction of "what the elderly need, we will provide what services". We will further standardize and promote more mature new home-based community elderly care services such as family elderly care beds, elderly dining tables, mutual aid happy homes, embedded elderly care service institutions, patrol care and aging adaptation, and explore new services such as elderly care consultants, time banks and smart elderly care, so as to benefit more home-based elderly people.
Third, we will increase and optimize the supply of services for the elderly in the direction of "what the elderly care about, we will solve what problems". Guide community elderly care service institutions to provide integrated medical care services by signing contracts and cooperation and building adjacent to medical institutions, so as to meet the dual needs of the elderly for elderly care services and medical and health services. Promote the innovation and upgrading of articles for the elderly and meet the needs of the elderly for the use of articles for the elderly. Carry out public welfare intelligent technology training for the elderly through community elderly care service institutions and service organizations for the elderly, so as to meet the needs of the elderly to understand new things and use new technologies, and share the achievements of reform and development.
In short, during the "14th five year plan" period, we will promote home-based community elderly care services to be richer, more convenient and more quality, so that the elderly can provide elderly care at home and in the community more at ease, more comfortable and more at ease.
Q: we have noticed that the elderly health service is one of the most concerned services for the elderly. What are the new highlights of the plan in terms of the health support system for the elderly?
A: in recent years, the National Health Commission, together with the national development and Reform Commission, the Ministry of civil affairs and other departments, has further promoted the combination of medical care and maintenance, optimized elderly health services and improved the level of healthy aging. The "plan" set up a special chapter on "improving the elderly health support system", and proposed to strengthen elderly health education and preventive health care, develop elderly medical care, rehabilitation care and hospice care services, further promote the combination of medical care and nursing, and strengthen the epidemic prevention and control of the elderly.
In terms of strengthening health education and preventive health care for the elderly, we should focus on improving health education and health management. Make sure that family doctors for the elderly sign up for services. Implement the elderly health promotion project. Carry out actions on oral health, nutrition improvement, prevention and treatment of Alzheimer's disease and psychological care for the elderly. Give full play to the advantages and role of traditional Chinese medicine in the prevention and treatment of senile diseases and chronic diseases.
In the development of geriatric care, rehabilitation care and hospice care services, the focus is to enhance the service capacity of medical and health institutions for the elderly. Strengthen the construction of geriatrics department in general hospitals. Support areas with rich medical resources to transform some public medical institutions into nursing homes and rehabilitation hospitals. Accelerate the construction of friendly medical institutions for the elderly to facilitate the elderly to see a doctor. Promote the extension of medical services to home communities. Encourage social forces to set up community nursing stations. Actively carry out community and home-based traditional Chinese medicine health services. Steadily expand the pilot of hospice care, and support the development of community and home hospice care services. Strengthen life education for the public.
In terms of further promoting the combination of medical care and elderly care, the focus is to encourage large-scale or elderly care institutions that mainly receive disabled elderly people to set up medical and health institutions, and bring the medical and health institutions in elderly care institutions into the management of the medical consortium. By 2025, elderly care institutions will generally have the ability to combine medical care and elderly care. Implement the action to improve the ability of community medical care integration. Promote Internet plus medical Internet plus nursing Internet plus rehabilitation services, and develop smart home care services for home, community and institutions.
In terms of strengthening the epidemic prevention and control of the elderly, in accordance with the requirements of the current normalization of epidemic prevention and control, the focus is to formulate emergency response plans and guidelines for public health emergencies for the elderly, classify and improve the epidemic prevention and control measures for the elderly at home, in communities and in elderly care institutions. In the emergency response of the epidemic situation, we should provide medical help, life care, psychological comfort and other services for the elderly with special difficulties. Strengthen the epidemic prevention and control system and capacity-building of elderly care institutions.
Q: we have noticed that a special chapter in the key tasks of the plan proposes to "vigorously develop the silver economy", which is the first time in the five-year development plan for the elderly. How to understand the relationship between the development of silver economy and the development of the cause of aging? In what areas will the silver economy enjoy during the 14th five year plan?
A: the task of developing the silver economy put forward by the party and the state during the 14th Five Year Plan period is the first time, but it is not sudden. On the supply side, the policy has always encouraged and promoted the development of markets and business formats in the field of aging. The national development and Reform Commission and other departments reported to the State Council for printing and distributing policy documents such as several opinions on accelerating the development of elderly care service industry. All departments, provinces and cities have intensively issued policy opinions to support the development of aging industry, and the investment enthusiasm of state-owned and private capital in aging industry projects has continued to rise. From the demand side, during the "14th five year plan" period, the elderly population structure and economic and social conditions have changed. The demand structure of the elderly is changing from survival type to development type. The change on the demand side makes the development conditions of silver economy more and more mature.
To develop the silver economy with Chinese characteristics, we should give full play to the dual advantages of a promising government and an effective market: on the one hand, we should adhere to the government's basic and bottom line functions, provide equally accessible services and products for the elderly with special difficulties, and promote the elderly care service system with Chinese characteristics to benefit every elderly; On the other hand, give full play to the role of different capital such as state-owned capital and social capital, and different organizations such as enterprises and private non enterprise units in expanding supply scale, improving supply quality and meeting multi-level people's livelihood needs, so as to promote the formation of a strong domestic market. Promoting the healthy, steady and sustainable development of the silver economy through the establishment of systematic and integrated industrial development policies will be the only way for a large country with a population of 1.4 billion to show the world the "China model" of actively coping with population aging.
During the "14th five year plan" period, the national development and Reform Commission will actively act together with relevant departments: first, strengthen planning guidance. Implement the deployment of the plan, and focus on promoting the elderly products industry related to the silver economy, scientific and intelligent upgrading, elderly care service system, health support system and other fields. Second, optimize the business environment. We will deepen the reform of "decentralization, regulation and service", create an inclusive and open development environment, improve convenient and efficient regulatory services, and make market players flourish and the silver economy full of vitality. Third, support product innovation. Formulate the catalogue and quality standards of articles and services for the elderly, increase the R & D and manufacturing of products for the elderly, and actively develop intelligent products suitable for the elderly. Fourth, cultivate service brands. Build a number of "high-quality brands serving the elderly" with strong innovation, high quality and standard norms and national influence, and guide the development of aging industrial clusters.
Q: practicing the positive concept of aging is of great significance to population aging. What are the implementation measures of the plan?
A: the plan has set up a special chapter on "practicing a positive outlook on aging", which includes the innovative development of elderly education, encouraging the elderly to continue to play a role, and enriching the sports and leisure life of the elderly. The National Health Commission, in conjunction with relevant departments, adheres to the combination of coping with population aging and promoting economic and social development, and the combination of meeting the needs of the elderly and solving the problem of population aging, so as to promote the comprehensive, coordinated and sustainable development of the cause of aging.
In terms of innovative development of elderly education, it is proposed to accelerate the development of elderly education in urban and rural communities, support all kinds of qualified schools to hold universities (schools) for the elderly and participate in elderly education. Support community elderly care service institutions to build learning points. Relying on the National Open University to prepare for the establishment of the National University for the elderly. We will promote local open universities to hold "open universities for the elderly" and encourage elderly education institutions to carry out online elderly education.
In terms of encouraging the elderly to continue to play a role, it is proposed to strengthen employment services for the elderly and encourage all localities to establish an information database of elderly talents. We will improve relevant laws, regulations and policies to protect the rights and interests of the elderly in employment and entrepreneurship. Encourage the elderly to participate in society and advocate a positive outlook on aging in the whole society. Actively carry out the "silver age action" to support the elderly to participate in civilized practice, public welfare and charity, voluntary service, science, education, culture and health and other undertakings. Build a high-level think tank for senior talents. Encourage and guide the elderly to establish grass-roots elderly social organizations such as grass-roots elderly associations in urban and rural communities.
In terms of enriching the recreational and sports life of the elderly, it is proposed to expand the supply of cultural services for the elderly, and reconstruct, expand or build a number of public recreational and sports venues for the elderly. Strengthen the creation of artistic works that carry forward the virtues of filial piety and respect for the elderly. Build an exchange and exhibition platform for cultural activities for the elderly. Support the elderly to participate in physical fitness. Guide all kinds of scenic spots and resorts to strengthen the construction and transformation of aging adaptation, and build a healthy tourism base. Encourage enterprises to develop special tourism products for the elderly.
Q: the development element support system in the plan was first proposed in the five-year development plan for the elderly. What are the main elements of development and what supporting effect should the element support system achieve?
A: in fact, the development elements cover the material guarantee needed to support the smooth implementation of the plan, that is, the support on the supply side, including land, funds, talents, etc. The reason for setting up a separate chapter of the element support system in the plan is that the coordinated development of aging undertakings and industries and the increasing requirements for improving the elderly care service system require the continuous increase of the support of development elements, the upgrading of the number, structure and quality of elements, and the formation of an efficient synergy mechanism between elements in order to promote the development of undertakings and improve services, In order to better connect the upgrading of the demand side and meet the growing material and service needs of the masses.
The national development and Reform Commission will work with relevant departments to thoroughly implement the specific measures proposed in the plan to support the reform and transformation of training and treatment institutions, land facilities, finance, talents and other aspects, including promoting the transformation and development of elderly care services in relevant training and rehabilitation institutions, and identifying 10 key contact cities. It is planned to lay out about 10 high-level silver hair economic industrial parks and build a number of silver hair economic benchmark cities. The land for elderly care service facilities shall be included in the annual land use plan, and the new construction land shall be given priority. The land type of existing houses shall not be changed within five years. Since 2022, no less than 55% of the welfare lottery public welfare fund will be used to support elderly care services and explore diversified financing modes of elderly care institutions. Implement the action of talent team construction and cultivate the talent team of elderly care services and geriatric medicine.
We believe that planning should be based on elements. Through strong factor support, promoting the reform and transformation of stock factors and increasing the supply and investment of incremental factors, the aging industry can achieve efficient and coordinated development for the benefit of the majority of the elderly.
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