Source: Associated Press of Finance
The operation of China's medical insurance fund is facing multiple challenges such as economic downward pressure, aging population and rapid urbanization. As an important supplement to basic medical insurance, how does China's commercial medical insurance supply meet the diversified medical security needs of residents?
On May 23, Zhu Minglai, director of the Health Economics and Medical Security Research Center of Nankai University, said in an interview with the Associated Press of Finance and Economics: "In 2022, the premium scale of China's commercial medical insurance will reach 389.4 billion yuan, achieving nearly three times the leap forward development in five years. However, up to now, the role of commercial medical insurance in reducing the burden of residents' health expenditure is still limited, the adjustment of market supply still lags behind the change of residents' demand, and the mismatch between supply and demand leads to weak market growth ".
According to the latest Blue Book of China Commercial Medical Insurance Development Research (hereinafter referred to as the Blue Book) released by the industry, data from 2317 questionnaires and interviews show that more than 40% of consumers believe that the deductible amount of commercial medical insurance is high, and more than 60% of consumers expect to improve the level of liability protection inside and outside the medical insurance catalog. Especially in terms of product development, design and service development of the commercial medical insurance industry, consumers expect the industry to launch commercial medical insurance focusing on disability income loss in the future.
More than 40% of consumers think that the deductible of commercial medical insurance is high, and it is difficult to reimburse minor diseases
In 2016, with the help of the Internet platform economy, millions of medical insurance has ignited the market once it was launched. One of its most eye-catching product designs is the "10000 deductible".
That is, when an insurance accident occurs, the insured shall first bear the medical expenses of 10000 yuan, and then the insurance company shall compensate the part exceeding 10000 yuan. It is through the product design of "10000 deductible" that insurance companies have successfully opened the domestic million medical insurance market.
On the one hand, the "10000 deductible" design helped insurance companies reduce the occurrence of small claims and hold the risk bottom line while reducing the cost of claims settlement when pricing data were generally missing and the ability of claims settlement was insufficient at that time; On the other hand, it also allows insurance companies to reduce premiums and increase insurance coverage.
But now, the "quota free setting", a flattering product design, has also been criticized by consumers. According to the data of the Blue Book, 43.9% of the existing consumers still think that the deductible is high.
New citizens interviewed in good health said: "At present, the economy is under great downward pressure, and they have a conservative attitude towards future income expectations. At the same time, because there is no serious illness expenditure, deductible is one of the product attributes they mainly focus on".
Sun Xiaojun, the head of PICC Health Internet Business Department, told the Associated Press of Finance and Economics that the quota free setting was one of the reasons for the low compensation rate of short-term million medical insurance, which to some extent made it difficult for consumers to apply for reimbursement of minor illnesses and reduced the sense of gain of the insured. However, "0 deductible" products require insurance companies to have sufficient data to support product pricing. At the same time, the rise in the loss ratio also requires insurance companies to have stronger ability to handle claims.
More than 60% of consumers expect to improve the level of responsibility guarantee inside and outside the medical insurance directory
Among the factors that affect existing consumers to choose commercial medical insurance, the coverage and reimbursement ratio are the most concerned by consumers. Relatively speaking, the government support and the reimbursement ceiling line received less attention.
In terms of expectations for the upgrading of commercial medical insurance, more than 60% of existing consumers hope to improve the level of protection of responsibilities inside and outside the medical insurance directory. Among them, young people aged 18-39 are relatively willing to improve these two security levels.
It is worth noting that, from the perspective of product security upgrade, most potential consumers are consistent with the expectations of existing consumers, and can accept the additional payment to improve the security level of responsibilities inside and outside the medical insurance directory. In particular, most potential consumers can achieve sick insurance by increasing the quota and reducing the reimbursement ceiling, but they are less willing to narrow the coverage. Zhu Minglai said: "This shows that most consumers pay more attention to commercial medical insurance as the most basic protection function of insurance products."
New citizen groups expect to launch commercial medical insurance focusing on disability income loss
At present, the total population of new citizens in China is about 300 million, accounting for more than 20% of the total population. New citizens have become an important force to promote social and economic development, but the construction of a synchronized security system is also imminent.
Due to the poor job stability of some new type practitioners, such as new citizens, and their weak resistance to medical, disease and accident risks, helping this group to have a stronger security ability, through the cycle of economic and life fluctuations, has also become an important subject to promote harmonious social development.
A Didi driver from Zhanjiang, Guangdong, said, "I hope to introduce some minor surgery insurance. For example, myopia surgery insurance, because I want to do it but fear that the surgery will fail or there will be some very obvious sequelae after the surgery. After having insurance, there will be some psychological comfort for the future."
An employee from an insurance technology company said: "There are many uncertain factors in life that affect our health. If we can't work normally due to accidental injuries or diseases, we hope to still have an uninterrupted and stable income to maintain a normal life."
"We hope to make some innovations in the aspects of nursing responsibility and disability income compensation liability, rather than sticking to the insurance type itself. For example, we will introduce a medical insurance with a main insurance of one million yuan, with additional insurance covering disability income compensation. At the same time, disability liability can also follow the main insurance guarantee to renew commercial medical insurance products for 20 years." The above person said
In Zhu Minglai's view, insurance companies need to re-examine the supply and demand relationship of commercial medical insurance and clarify the crux of the current situation of commercial medical insurance in order to open up new growth points for the development of the industry.
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