Constructing Utopia Elderly Care Model : A Case Study of the Social Economic Governance Innovation in Bodhi Chang Ching Village

[[abstract]]面對全球化的競爭，資本快速流動移往對本身產業發展有利的經濟環境，我國政府必須要推動更多租稅優惠政策，以期望能夠留下全球化資本，然而相對帶來的是政府稅收的減少；加上我國人口結構的快速老化，少子高齡已是我國未來必須面對的人口結構困境。面對自由經濟與少子老化社會的來臨，政府未來將不再有足夠的稅收足以因應老化的社會福利支出，加上資本主義的市場經濟，在近年來逐步出現許多市場經濟失靈的現象，長期照顧政策在前述背景下，始終擺脫不了「老人商品化」的標籤。而政府面對如此多元的困境下，持續再以市場經濟式的社會福利政策方向，是否還能夠因應未來的台灣老化照顧需求，亦或者有其他體制的照顧模式，能夠提供給政府未來因應老化社會現象時有所參照。本研究從社會經濟途徑出發，並輔以行動參與的個案—「菩提長青村」，嘗試以行動研究的經驗，彙整出若干社會經濟的老人安養照顧模式之經驗，以提供未來我國推動長期照顧政策之參照。 本研究將社會經濟組織的運作經驗分析以「公民的身份資格認定」、「平等的公民參與」、「體制的生產方式」、「體制的交換媒介」及「資源分配的方式」等五大面向，輔以菩提長青村的行動個案，進行現行市場經濟體制的反思與社會經濟組織運作經驗的分析。主要的研究發現有：社會經濟的體制在參與者的身份資格認定上，由市場經濟體制的「貧窮線」轉為「需求線」；在參與體制上，社會經濟體制所建構的是以「老有所用」取代「老有所養」的參與模式；而社會經濟體制因為基於「老有所用」的價值實踐，其生產模式是以老人為主體的生產模式；在生產出財貨後，社會經濟體制並不會直接投入市場經濟中換取貨幣，而是建構一個不與貨幣做第一連結的交換網絡，以降低體制對於貨幣的依賴；最後，在社會經濟體制的資源分配上，社會經濟組織並不追求利益極大化，而是追求利益最適化，以「夠用就好」的價值，落實於體制的資源分配上。本研究從個案的行動經驗中，歸納出五大面向的體制運作要素，嘗試提出不同於市場經濟體制思維的模式，期望能夠作為未來以市場經濟體制模式為主的長照體系，能夠有補充性的老人照顧模式選擇，以解決現行市場經濟體制中無法克服的困境。[[abstract]]Recent declines in fertility rates and increases in life expectancy will transform the age pyramid in Taiwan, resulting in an older population composition. Ageing will be the main driving force of the growth of the Taiwan government spending. Combined with the dynamic evolution of globalization and significant shift in the age structure are causing an impact on the function of social welfare policy particular in issue of long-term care. “Long-term care commercialization” of market-oriented economy is highly contested, because of well-understood market failures and because of ethical commitments to access to care that emphasizes universal service provision and government engagement in care. However, the health and long-term care needs of this growing elderly population will result in soaring care costs, whether the Taiwan government will be able to allocate enough expenditure to meet these rising expenses remains as a major concern. The aim of this study is to explore a specific long-term care service model integrated with operation-mode of social economy for the elderly caring, we conducted an action research analysis using a case study of “Bodhi Chang-Ching Village”, which is a non-profit and community organization and was established after the 921 Earthquake in Pu-Li. The results of this study consequently suggest five characteristics that derived from the novel form of long-term care program: (a) “Demand Instead of Poverty” for assessment of eligibility; (b) “Using Capability of Elderly” for healthy elderly take care frail elderly; (c) “Elderly Manpower” for production and processing; (d) “Prioritize Barter Economy rather than Money Economy” for avoid monetizing and transacting with a currency; (e) “As Long As Enough Resource“ for optimization rather than maximization of resource. The modernized model of long term service can be used to provide an alternative option for the design of long-term care policy.[[note]]博