본 연구의 목적은 2004년 8월에 발표되어 최근에 이슈가 되고 있는 「노인요양보장체계 시안」을 중심으로 그 문제점을 분석하고 그에 따른 정책적 과제를 제시하는 데에 있다. 단, 문제점 분석에 있어서 노인요양보험제도는 일본의 개호보험제도와 유사한 특징을 가지고 있어 개호보험제도도입과 시행과정에서 나타난 경험에 기초하여 논의하였다. 본 논문에서는 시급하게 검토되어야 할 문제점과 과제를 6가지 측면으로 나누어 제시하였는데 첫째는 노인요양보험 제도를 도입함에 있어서 제도의 기반이 되는 기본이념에 관한 문제점을 지적하였다. 둘째로는 요양보호(요양보호가 필요한 상태)의 개념과 관련하여 요양급여의 범위와 평가판정기준과의 관계를 논하였고, 셋째는 서비스의 기반정비에 있어서 시설과 재가서비스의 인프라 문제를, 넷째는 저소득층에 대한 대책과 이용자부담문제를 거론하였다. 다섯째는 가족의 요양보호에 대한 현금급여 인정문제를 살펴보았고, 마지막으로는 케어매니져 제도 도입에 있어서 자격조건에 따른 문제점과 과제를 지적하였다.

The purpose this study is to discuss problems of preliminary policy of long-term care insurance that was presented in August, 2004. Since the proposed policy shares many features with care management system of Japan, the present discussion was based on the implementation process of the care management system in Japan. This study examined the proposed policy in terms of six aspects. First, the focus was on the fundamental ideas underlying the long term care system. Second, the relationship with the range of benefits and service identification was discussed. Third focus was on the issue of the establishment of infra structure which was followed by the issue on low-income people and user payment. Fourth, the issue on cash payment for family care system was analyzed. Last, problems regarding eligibility in the implementation the care management system was discussed.

The purpose this study is to discuss problems of preliminary policy of long-term care insurance that was presented in August, 2004. Since the proposed policy shares many features with care management system of Japan, the present discussion was based on the implementation process of the care management system in Japan. This study examined the proposed policy in terms of six aspects. First, the focus was on the fundamental ideas underlying the long term care system. Second, the relationship with the range of benefits and service identification was discussed. Third focus was on the issue of the establishment of infra structure which was followed by the issue on low-income people and user payment. Fourth, the issue on cash payment for family care system was analyzed. Last, problems regarding eligibility in the implementation the care management system was discussed.

long-term care insurance, care managers, family care, cash payment