社会保障评论

党的二十届三中全会决定加快建立长期护理保险制度，这是对我国人口结构加速老化、社保改革持续深入、扩大国内消费需求等现实要求的主动回应。在社会互助共济的福利文化、全体人民共同富裕的政治要求、高质量起步的制度条件、解决社会性住院的时代紧迫性的前提下，我国选择社会保险型长期护理保障模式，经过8年多试点，在制度覆盖、筹资待遇、保障范围、实施进度、制度重点等方面仍然存在较多差异。针对当前推出长期护理保险制度面临认识不统一、筹资机制、失能等级评估和护理服务递送等方面的堵点难点，本文提出加强顶层设计、实施应保尽保、创新机制手段、坚持实事求是等基本遵循，并对系统协同推进长期护理保险制度高质量发展提出措施建议。

The Third Plenary Session of the 20th Central Committee of the Communist Party of China resolved to accelerate the establishment of a long-term care insurance(LTCI) system—an active response to the realities of accelerated population aging, deepening social security reforms, and growing domestic consumption demand. Anchored in a welfare culture that values mutual support,aligned with the political vision of common prosperity, supported by institutional foundations for a high-quality start, and driven by the urgent need to address hospital admissions for non-medical(social) reasons, China has chosen a social insurance-based model for its LTCI system. After more than eight years of pilot implementation, considerable variation remains across regions in terms of coverage, financing mechanisms, benefit design, implementation pace, and policy focus. In light of ongoing challenges—including divergent understandings, difficulties in financing design, disability assessment, and care service delivery—this paper proposes four guiding principles: strengthening toplevel design, ensuring full eligibility coverage, innovating institutional mechanisms, and upholding a pragmatic, fact-based approach. The study also of fers recommendations to promote the high-quality development of China's LTCI system through systemic coordination and improvement.