Nancai Quick Review: Pension services that return to the community should compensate for informal care

On February 9, the Information Office of the State Council introduced the relevant situation of the "14th Five-Year Plan for the Construction of Urban and Rural Community Service System". In response to the relevant issues of "one old and one small", the relevant person in charge stressed that "old-age care and childcare are an important part of community services", and it is necessary to "let the masses enjoy better old-age and childcare services at the doorstep of their homes", and the government pays special attention to "empty nests, left-behind, elderly elderly and severely disabled people", and will "vigorously develop community meal assistance, cleaning assistance, bathing assistance, medical assistance and other services".

When it comes to the issue of old-age care, many families with elderly people in their homes will worry about one thing: how to find a nursing home that can satisfy the elderly? Many times this is not entirely a matter of money, mainly because the elderly are reluctant to go. But have you ever thought that the pension should actually stay in your own community.

It is worth noting that the related service planning is changing in the direction that the elderly are happy to accept.

If you pay attention to the planning documents issued by several relevant departments in the past decade, it is not difficult to see that the relevant wording has gradually changed from emphasizing "institutional pension" to paying more attention to community services. This is related to the fact that policy makers have a deeper understanding of the development of old-age services, after all, the vast majority of the elderly just want to stay at home and grow old. A more objective reality is that many cities have built new nursing homes in batches over the past decade, but the actual occupancy rate is not high. The planning document emphasizes the community pension, which is objectively conducive to stopping the impulse to blindly develop nursing homes.

From the perspective of society as a whole, the return of old-age services to the community is not only in line with the wishes of the elderly, but also in line with economic benefits - whether there is a need to go to a nursing home to get a bed, many families are difficult to support for a long time. After all, formal care in nursing homes provided by full-time nurses and nurses is expensive. Returning to the community can rely more on informal care, mainly referring to various supports from family members and community neighbors, plus living at home without paying for beds, which is more economical for families and society.

However, it is important to note that not every family has a newly retired elderly person who has the time to care for the elderly, and not all communities can organize enough volunteers to provide permanent services for the elderly. Even if the public welfare price is provided, there will be a fee for services such as bathing and medical assistance, and the lack of preferential charges for meals is often the reason why the elderly give up using them. In the end, the burden may still fall on children of working age. In other words, informal care requires some compensation, so where does the money come from?

From the perspective of the overall reform of the mainland pension service, community pension is one of the main contents of the service field, and long-term care insurance is the core content of the financing field. In dozens of cities across the country that pilot long-term care insurance, Guangzhou and Tianjin have set up part-time nursing staff, so that the families of the disabled elderly who care for the elderly at home can obtain a small amount of income in the form of part-time work, realizing compensation for informal care. This not only satisfies the desire of the elderly to stay in the community and grow old at home at a low cost, but also reduces the dilemma between children's work and filial piety. If the financing reform can be organically combined with the reform of community pension in more cities, the return of community pension services will reflect the warmest sunset in aging China in this era.

(The author is an associate professor at the School of Government Affairs, Sun Yat-sen University)

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