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老年人的“留”与“流”:城镇化进程中特殊老年群体研究

李芳[著]

农村 老年人 社会保障体制 研究 中国

2017-05-01

978-7-5203-0616-4

335

12

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内容简介

积极应对人口老龄化
人口老龄化是经济社会发展进步的产物,也是21世纪全球面临的共同问题。党和国家高度重视老龄工作。党的十八大和十八届三中、四中、五中全会,国家“十三五”规划纲要都提出了积极应对人口老龄化的战略任务。
我国于1999年迈入老龄社会,人口老龄化迅猛发展。2015年年底,60周岁以上老年人口已达2.22亿,约占总人口的16.1%。据预测,到21世纪末,人口老龄化都在高位运行。人口老龄化不仅带来了老年人的赡养、医疗、照护、精神生活等方面的问题,而且带来了全社会的政治、经济、社会、文化、生态等方面的问题。因此,应对人口老龄化的成效,“事关国家发展全局,事关百姓福祉”。
“十三五”时期,既是全面建成小康社会的决胜阶段,也是推动老龄事业改革发展的重要战略机遇期。当前和今后一个时期,应对人口老龄化,要紧紧围绕党和国家中心任务,切实抓好以下几个方面的工作。
第一,树立新理念和新思维。一是全社会树立全生命周期养老准备的意识。从个体来看,前老年时期积累的健康、经济、人脉、生育等养老资源,是老年人应对老年期问题最重要的个人资源和社会资源,是老年人的养老本钱。从社会整体来看,全生命周期的过程涵盖各年龄人口群体,基于代际公平和全人口视角为老龄化做准备。如养老金的准备通过提高年轻人的劳动生产率和老年人的经济参与率来进行,老年人的医疗保健支出通过对全人口的健康投资来改善。二是全社会树立健康老龄化观念。健康老龄化,不仅指身体健康,还有更丰富的内涵,既包括身体、心理和道德三方面有机组合的生命健康,也包括生存环境、遗传基因和生活方式三因素有机组合的生态健康,还包括全人口的全民健康。健康是自理自立的基础,意义十分重大,既可以减少人口老龄化条件下经济社会运行的成本,还是人力资源有效开发的保障。三是全社会树立积极应对老龄化思想。要积极看待老龄社会,积极看待老年人和老年生活,努力挖掘人口老龄化给国家发展带来的活力和机遇。积极应对老龄化,对老年人个体来说,就是实现老有所为、老有所用、老有所成;对社会来说,则是积累老年人力资本、开发老年人力资源、收获老年人口红利。积极应对老龄化表达了一种新的老年观,态度积极、身心健康、有一定知识、技能和经验的老年人,始终是社会和家庭的宝贵财富,不能把老年人口完全看作是负担、包袱和问题。
第二,坚持把立足国情与借鉴国外经验统一起来。人口老龄化是世界性问题。2011年联合国报告指出,65岁及以上老年人口比例超过7%的国家有76个,到2050年则可能超过150个,人类社会将全面进入老龄化阶段。我国正处于快速人口老龄化阶段,现有的诸多问题还只是老龄社会矛盾的“冰山一角”。欧美日等发达国家进入老龄社会早,也面临诸多问题。可以说,迄今为止,全世界还没有一个美好、理想的应对老龄化社会样板,仍需要全人类共同努力去探索。我国应对人口老龄化,必须把立足国情和借鉴国外经验统一起来。一是正确把握我国的人口国情。其中,有四个方面尤为值得重视:(1)绝对数量多。预计到2053年时,我国老年人口总数比发达国家老年人口的总和还要多出1亿人。(2)发展速度快。我国人口老龄化程度从10%提高到30%约用41年,走完欧美发达国家上百年才走完的人口老龄化历程。(3)传统养老文化。爱老敬老、养儿防老的文化传统与西方文化迥异,成为破解老龄社会问题的文化力。(4)未富先老、未备先老。这些特殊的人口国情,既是我国应对人口老龄化必须充分考虑的,也是研究借鉴国外经验的“普照之光”。二是充分利用后发优势,加强与国际对话。密切关注全球迈入老龄化时代发达国家面临老龄化风险的形势;全面分析发达国家人口老龄化的过程,正确评估各个时期的关键应对之策,以吸取其经验和教训。探索在全世界范围内合理分散我国老龄化风险的有效对策。
第三,在统筹贯彻“五位一体”建设总体布局中抓好关键工作。中国特色社会主义是全面发展的社会主义,要促进现代化事业各方面协调发展。人口老龄化意味着我国现代化建设的主体结构会发生根本性变化,将给现代化建设的各个方面带来深刻影响。因此,在“五位一体”建设总体布局中抓好关键工作,是推动人口老龄化条件下中国可持续发展的必由之路。
在政治建设领域,日益增多的老年人形成基于年龄的庞大群体,会对国家职能、政党制度、政治参与、政治力量格局等产生不容忽视的影响。因此,要做好三项关键工作:一要建立权威的常态统筹机构。整合人口计生、民政、公安、卫生、人力资源与社会保障等部门的相关职能和资源,为统筹应对人口老龄化提供重要的体制、组织和资金保障,切实提高顶层设计水平和统筹谋划力量。二要完善党委领导、政府主导、社会参与、全民行动的老龄工作机制。厘清党委、政府、社会、市场、家庭、老年人各主体的责任边界,其中最重要的是发挥政府的主导作用,同时各主体协同参与、凝聚合力。三要加强老龄法治建设。注重和善于运用法治思维和法治方式推动老龄工作;从法律上进一步丰富、充实积极应对人口老龄化的相关内容,进一步强化老年公民基本权利的法律保障;认真贯彻落实《老年人权益保障法》,加快配套法规制度的制定和实施,建立比较完备的老龄法治体系。
在经济建设领域,人口老龄化对我国经济增长潜力与活力、经济运行成本、宏观经济安全等会形成冲击。因此,一要深入研究人口老龄化对经济发展带来的全面而动态的影响;探索人口老龄化条件下的经济结构优化和持续经济发展之路。二要大力发展老龄产业。我国老龄产业市场潜力巨大,但基础薄弱。要重点发展健康、宜居、金融、文化等主体产业;高度重视研发核心老龄科技,抢占全球老龄产业市场份额;提高老年人支付能力,完善老龄产业发展环境,精准扶持重点产业,优化老龄产业结构,推动老龄产业健康快速发展。三要开发大龄和老年人力资源,将低龄健康老年人力资源开发纳入人才强国战略。老年人力资源是老龄化社会赖以发展的重要资源。通过加强老年教育和继续教育,创造良好的政策环境和社会氛围,为老年人的社会参与搭建广阔平台,帮助他们实现自我价值,释放老年人口红利,促进经济社会健康发展。
在社会建设领域,人口老龄化带来老年型人口结构与年轻型社会结构的失衡,对家庭结构、文化教育结构、社会治理结构等形成冲击,还会弱化家庭功能、加剧代际矛盾、加重社会保障和公共服务负担等。因此,一要完善养老、医疗保障制度,重点建立长期照护社会保障制度,以应对个体老年期的贫困、疾病和失能风险。充分利用2025年前的战略机遇期,建立和完善养老、医疗和长期照护三项制度,确保适应中重度老龄社会的要求。二要构建居家为基础、社区为依托、机构为补充、医养融合的养老服务体系;发挥社区养老服务对居家养老的支持功能,建立完善居家养老的支持政策;养老服务应该包括相当比例的福利供给和公益服务,彰显社会主义本质,也包括一定比例的市场选择的老龄产业,“政府之手”托底救急,“市场之手”优化供给,两者形成互补共赢格局。三要完善家庭养老支持政策。进一步巩固家庭养老的基础性地位;探索建立以家庭为中心的基本公共服务体系,通过税收、津贴、弹性就业、住房等优惠政策支持家庭养老,减轻家庭养老负担;鼓励和支持老年人随子女迁移或流动,一方面完善户籍政策,适当放宽父母投靠子女的落户条件;另一方面对于没有迁移户籍的流动老人,可纳入流入地社区管理对象,开展针对特殊困难的流动老人家庭的帮扶服务;加强家庭美德教育,促进互敬、互爱、互助家庭氛围的形成。四要推进代际关系和顺。统筹解决好未成年人、成年人和老年人三大年龄群体间的主要问题,建立科学有效的代际利益协调机制、矛盾调处机制、权益保障机制,促进不同年龄群体平等分享社会资源,共享社会权利,共担社会责任。五要加强老年群体的社会治理,推进人口老龄化条件下社会治理体系和治理能力的现代化。六要加强老年宜居环境建设。按照老年友好型建筑设施要求进行居住环境的适老性改造,以及开展新的城乡建设规划。
在文化建设领域,人口老龄化条件下代际文化冲突不断加剧,弘扬养老文化和孝文化面临诸多困难,文化服务体系也面临诸多压力。因此,一是培养与科学老龄观相适应的积极老龄文化。重点培养适应老龄社会和战胜相关风险的正向社会心理。二是把弘扬孝亲敬老纳入社会主义核心价值观宣传教育,建设具有民族特色、时代特征的孝亲敬老文化。三是繁荣和发展老龄文化。重点为老年群体提供质优量多的文化设施和文化产品,吸引老年人积极参与文化活动,繁荣社会主义文化。
在生态建设领域,生态环境对人的健康影响很大。历经粗放发展期生态破坏的全体人口在老年期面临的疾病风险会在人口老龄化条件下不断放大。因此,一要建立国民健康体质监测体系,对主要由生态问题引起的常见老年疾病建立研发、预防和治疗的支撑体系。二要树立绿色发展理念,治理环境污染,建设生态文明,使全人口尽可能享有更长的健康老年时期。
夕阳无限好,人间重晚情。面对人口老龄化给国家发展带来的机遇与挑战,要着眼全局,谋划长远,加强研究,科学决策,聚智聚力,确保人口老龄化条件下我国经济社会的可持续发展,为全面建成小康社会,加快社会主义现代化,实现中华民族伟大复兴的中国梦奠定坚实基础。
李芳在北京师范大学做博士后研究时关注留守老人问题研究,出站后延续这一研究论题,从城镇化视角研究留守老人和流动老人这对具有一定关联性的特殊老年群体。作为李芳的博士后合作导师,我非常高兴地看到这一凝结她多年研究成果和心血的著作顺利出版,也希望她继续发扬博士后工作期间勤奋努力、潜心研究、勇于创新的精神,多出科研成果,出更好的科研成果。
本书付梓之际,应李芳之邀,我欣然写下以上这些话,是为序。
2016年7月

Actively coping with population aging is a product of economic and social development and progress, and it is also a common problem facing the world in the 21st century. The party and the state attach great importance to the work of the elderly. The 18th National Congress of the Communist Party of China, the 3rd, 4th and 5th Plenary Sessions of the 18th CPC Central Committee, and the national "13th Five-Year Plan" all put forward the strategic task of actively coping with the aging of the population. China entered an aging society in 1999, and the aging of the population has developed rapidly. At the end of 2015, there were 222 million elderly people over the age of 60, accounting for about 16.1% of the total population. It is predicted that by the end of the 21st century, the aging of the population will be running at a high level. Population aging has not only brought about problems in the maintenance, medical treatment, nursing and spiritual life of the elderly, but also brought about political, economic, social, cultural and ecological problems in the whole society. Therefore, the effectiveness of coping with the aging of the population "has a bearing on the overall development of the country and the well-being of the people." The "Thirteenth Five-Year Plan" period is not only a decisive stage for building a moderately prosperous society in an all-round way, but also an important strategic opportunity period to promote the reform and development of the cause of the elderly. At present and for some time to come, in order to cope with the aging of the population, we must closely focus on the central tasks of the party and the state and earnestly grasp the following aspects of work. First, establish new ideas and new thinking. First, the whole society establishes the awareness of the whole life cycle of old-age preparation. From an individual point of view, the health, economy, network, fertility and other pension resources accumulated in the pre-old age period are the most important personal and social resources for the elderly to cope with the problems of old age, and are the pension capital of the elderly. From a society perspective, the whole life cycle process covers all age groups and prepares for ageing based on intergenerational equity and a whole-population perspective. For example, pension preparation is carried out by increasing the labor productivity of young people and the economic participation rate of the elderly, and health care spending by the elderly is improved by investing in the health of the entire population. The second is to establish the concept of healthy aging in the whole society. Healthy aging not only refers to physical health, but also has richer connotations, including the life and health of the organic combination of physical, psychological and moral aspects, as well as the ecological health of the organic combination of living environment, genetics and lifestyle, and the national health of the entire population. Health is the foundation of self-care and self-reliance, which is of great significance, which can not only reduce the cost of economic and social operation under the condition of population aging, but also guarantee the effective development of human resources. The third is to establish the idea of actively responding to aging. It is necessary to take a positive view of the aging society, the elderly and the life of the elderly, and strive to tap the vitality and opportunities brought by the aging population to the development of the country. Actively coping with aging, for the individual elderly, is to achieve old age, old age, and old age; For society, it is to accumulate the human capital of the elderly, develop the human resources of the elderly, and harvest the lip dividends of the elderly. Actively responding to aging expresses a new view of ageing, and the elderly with positive attitudes, physical and mental health, and certain knowledge, skills and experience are always valuable assets for society and families, and the elderly population cannot be regarded as a burden, burden and problem. Second, persist in unifying basing ourselves on national conditions with drawing on foreign experience. Population ageing is a worldwide problem. According to a 2011 United Nations report, there are 76 countries with more than 7% of the elderly population aged 65 and over, and it may exceed 150 by 2050, and human society will fully enter the stage of aging. China is in the stage of rapid population aging, and many existing problems are only the "tip of the iceberg" of the contradictions in the aging society. Developed countries such as Europe, the United States and Japan have entered the aging society early and also face many problems. It can be said that so far, there is no beautiful and ideal model for coping with aging society in the world, and it still needs the joint efforts of all mankind to explore. In response to the aging of the population, China must unify basing itself on national conditions and learning from foreign experience. First, we must correctly grasp the national conditions of China's population. Among them, four aspects are particularly worthy of attention: (1) the absolute number. It is estimated that by 2053, the total number of elderly people in China will be 100 million more than the total elderly population of developed countries. (2) Fast development speed. It takes about 41 years for China's population aging to increase from 10% to 30%, completing the process of population aging that developed countries in Europe and the United States have completed for hundreds of years. (3) Traditional pension culture. The cultural traditions of loving and respecting the elderly, raising children and preventing aging are very different from Western culture, and have become a cultural force to solve the problems of aging society. (4) Grow old before getting rich, and grow old before you prepare. These special population conditions are not only what China must fully consider in coping with the aging of the population, but also the "shining light" for studying and drawing on foreign experience. The second is to make full use of the latecomer advantage and strengthen dialogue with the international community. Pay close attention to the situation of aging risks faced by developed countries in the era of global aging; Comprehensively analyze the process of population aging in developed countries, and correctly assess the key response measures in each period to learn from their experience and lessons. Explore effective countermeasures to reasonably disperse the risks of aging in China around the world. Third, grasp the key work in the overall layout of the "five-in-one" construction. Socialism with Chinese characteristics is a socialism with all-round development, and it is necessary to promote the coordinated development of all aspects of modernization. The aging of the population means that the main structure of China's modernization will undergo fundamental changes, which will have a profound impact on all aspects of modernization. Therefore, grasping the key work in the overall layout of the "five-in-one" construction is the only way to promote China's sustainable development under the condition of population aging. In the field of political construction, the increasing number of elderly people forming a large group based on age will have a non-negligible impact on state functions, party system, political participation, and political power pattern. Therefore, we must do a good job in three key tasks: First, we must establish an authoritative normal coordinating body. Integrate the relevant functions and resources of population and family planning, civil affairs, public security, health, human resources and social security, provide important system, organization and financial guarantee for the overall response to population aging, and effectively improve the top-level design level and overall planning force. Second, it is necessary to improve the working mechanism for the elderly under the leadership of the party committee, led by the government, with social participation and action by the whole people. Clarify the responsibility boundaries of the party committee, government, society, market, family, and the elderly, the most important of which is to give play to the leading role of the government, and at the same time all subjects participate in and cohesion. Third, it is necessary to strengthen the construction of the rule of law for the elderly. Pay attention to and be good at using rule of law thinking and methods to promote the work of the elderly; Further enrich and enrich the relevant content of actively responding to the aging of the population, and further strengthen the legal protection of the basic rights of senior citizens; Conscientiously implement the Law on the Protection of the Rights and Interests of the Elderly, accelerate the formulation and implementation of supporting laws and regulations, and establish a relatively complete legal system for the elderly. In the field of economic construction, the aging of the population will have an impact on China's economic growth potential and vitality, economic operating costs, macroeconomic security, etc. Therefore, first, it is necessary to deeply study the comprehensive and dynamic impact of population aging on economic development; Explore the path of economic structure optimization and sustainable economic development under the condition of population aging. Second, we should vigorously develop the aging industry. China's aging industry market has great potential, but the foundation is weak. It is necessary to focus on the development of health, livability, finance, culture and other main industries; Attach great importance to the research and development of core aging technology to seize the market share of the global aging industry; Improve the ability of the elderly to pay, improve the development environment of the aging industry, accurately support key industries, optimize the structure of the aging industry, and promote the healthy and rapid development of the aging industry. Third, it is necessary to develop human resources for the elderly and the elderly, and incorporate the development of human resources for the young and healthy elderly into the strategy of strengthening the country with talents. Elderly human resources are an important resource for the development of an aging society. By strengthening education and continuing education for the elderly, create a good policy environment and social atmosphere, build a broad platform for the social participation of the elderly, help them realize their self-worth, release the lip dividends of the elderly, and promote healthy economic and social development. In the field of social construction, population aging brings about the imbalance between the elderly population structure and the young social structure, which has an impact on the family structure, cultural and educational structure, social governance structure, etc., and will also weaken family functions, aggravate intergenerational conflicts, and increase the burden of social security and public services. Therefore, first, we must improve the old-age and medical security systems, focusing on the establishment of a long-term care social security system to cope with the risk of poverty, disease and disability in individual old age. Make full use of the strategic opportunity period before 2025 to establish and improve the three systems of old-age, medical care and long-term care to ensure that they meet the requirements of a moderately severe aging society. Second, it is necessary to build an old-age service system based on home, relying on the community, supplementing institutions and integrating medical and elderly care; Give full play to the support function of community elderly care services for home care, and establish and improve support policies for home care for the elderly; Old-age services should include a considerable proportion of welfare supply and public welfare services, highlighting the essence of socialism, and also include a certain proportion of market-selected aging industries, "government hands" to support emergency relief, "market hands" to optimize supply, the two form a complementary and win-win pattern. Third, we must improve family old-age support policies. Further consolidate the basic position of family pension; Explore the establishment of a family-centered basic public service system, support family pension through preferential policies such as taxation, subsidies, flexible employment, and housing, and reduce the burden of family pension; Encourage and support the elderly to migrate or move with their children, on the one hand, improve the household registration policy, and appropriately relax the conditions for parents to settle in their children; On the other hand, for the migrant elderly who do not have a migrant household registration, they can be included in the management targets of the community in the place of arrival, and help services for the families of the migrant elderly with special difficulties can be carried out; Strengthen education in family virtues and promote the formation of a family atmosphere of mutual respect, love and mutual assistance. Fourth, it is necessary to promote intergenerational relations and smoothness. Make overall plans to solve the main problems among the three major age groups of minors, adults and the elderly, establish scientific and effective mechanisms for coordinating intergenerational interests, mediating conflicts, and protecting rights and interests, and promote equal sharing of social resources, social rights, and social responsibilities among different age groups. Fifth, we should strengthen the social governance of the elderly group and promote the modernization of the social governance system and governance capacity under the condition of population aging. Sixth, it is necessary to strengthen the construction of a livable environment for the elderly. Carry out age-friendly renovation of the living environment in accordance with the requirements of age-friendly building facilities, and carry out new urban and rural construction planning. In the field of cultural construction, intergenerational cultural conflicts are intensifying under the condition of population aging, and the promotion of old-age culture and filial piety culture is facing many difficulties, and the cultural service system is also facing many pressures. Therefore, the first is to cultivate a positive aging culture that is compatible with the scientific concept of aging. Focus on cultivating a positive social psychology that adapts to the aging society and overcomes the associated risks. The second is to incorporate the promotion of filial piety and respect for the elderly into the propaganda and education of the core socialist values, and build a culture of filial piety and respect for the elderly with national characteristics and the characteristics of the times. The third is to prosper and develop the culture of aging. Focus on providing high-quality and quantitative cultural facilities and cultural products for the elderly, attract the elderly to actively participate in cultural activities, and prosper socialist culture. In the field of ecological construction, the ecological environment has a great impact on human health. The disease risk faced by the entire population in the old age of the entire population that has undergone extensive development and ecological damage will continue to expand under the condition of population aging. Therefore, first, it is necessary to establish a national health monitoring system, and establish a support system for research and development, prevention and treatment of common geriatric diseases mainly caused by ecological problems. Second, we should establish the concept of green development, control environmental pollution, build ecological civilization, and enable the whole population to enjoy a longer period of healthy old age as much as possible. The sunset is infinitely good, and the world is full of evening love. In the face of the opportunities and challenges brought by the aging of the population to the development of the country, it is necessary to focus on the overall situation, plan for the long term, strengthen research, make scientific decisions, gather wisdom and efforts, ensure the sustainable development of China's economy and society under the conditions of population aging, and lay a solid foundation for building a moderately prosperous society in an all-round way, accelerating socialist modernization, and realizing the Chinese dream of the great rejuvenation of the Chinese nation. Li Fang paid attention to the research of the left-behind elderly when she was doing postdoctoral research at Beijing Normal University, and continued this research topic after leaving the station, studying the special elderly groups with certain correlation from the perspective of urbanization. As Li Fang's postdoctoral co-supervisor, I am very happy to see the successful publication of this book that condenses her years of research results and painstaking efforts, and hope that she will continue to carry forward the spirit of hard work, conscientious research and innovation during her postdoctoral work, and produce more scientific research results and better scientific research results. On the occasion of the completion of this book, at the invitation of Li Fang, I gladly write these words for the preface. July 2016(AI翻译)

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