The proportion of commercial health insurance in China's total premium income is not only low, but also declining year by year. The proportion of commercial health insurance income decreased from 6.34% in 2005 to 4.66% in 20 10. This shows that the scale of commercial health insurance in China is small and the coverage is insufficient 10%. At present, its role in China's medical security system is still limited. In terms of growth rate, health insurance 20 10 increased by 1 16.93% compared with 2005, only slightly higher than 95.43% of personal accident insurance, but far lower than other types of premium income, such as 194.84% of original premium income and 2/kloc of property insurance. Therefore, it can be seen from the data that the development speed of commercial health insurance in China is not optimistic.
From 65438 to 0999, China's commercial health insurance premium income only accounted for 0.9% of China's total health expenditure; In the same year, the proportion of public medical security system financing in the total health expenditure was also low, only 2.2%. In the following years, with the consolidation and development of the medical insurance system for urban workers, the financing level of the public medical security system and its proportion in the total health expenditure have been greatly improved. By 2007, the proportion of public medical security system financing in total health expenditure will reach 24.1%; At the same time, the premium income of commercial health insurance still accounts for only 3.4% of the total health expenditure, and the maximum value of 1999-2007 is only 3.8% in 2006. From 65438 to 0999, the financing level of commercial health insurance in China was only 1.5%. After years of development, in 2007, the proportion was still only 6.2%, indicating that by 2007, 93.8% of private health expenses in China were still paid by patients themselves, and citizens' medical expenses lacked the effectiveness of commercial health insurance. From the above two aspects, we can see that China's commercial health insurance has a huge market space to be developed.
According to the statistics of China Insurance Regulatory Commission, the overall net rate of return on life insurance and the net rate of return on life insurance in China are between 70% and 90%, which are relatively stable. The net interest rate of health insurance fluctuates greatly, with the highest of 80.3% in 2000 and the lowest of 45.5% in 200 1 year, while the net interest rate is relatively low, basically fluctuating in the range of 50%-70%; Although the overall net interest rate of personal accident insurance is not high, it is in the range of 60%-70%, but it has a steady upward trend. At the same time, this type of insurance accounts for a very small proportion in personal insurance, and the analysis is of little significance. As can be seen from this set of data, China's commercial health insurance is still in the early stage of development, with great fluctuations, greater operational risks and unstable premium income. Moreover, the operating frequency and cost of health insurance claims management are higher than life insurance and personal accident insurance, so the profit margin is the smallest and the profitability is poor.
Problems existing in the development of commercial health insurance in China
Through the analysis of the current situation of China's commercial health insurance, we can easily see various problems existing in the development of China's commercial health insurance. After careful study, I think it can be divided into the following three aspects: insurance companies, external environment and policyholders.
(1) The insurance company has the following problems: 1. Commercial health insurance products are relatively single and diversified. 2, the degree of specialization is not enough, and the resources of professional talents are scarce. 3. The market coverage and profitability of commercial health insurance are low.
(2) From the external environment, China's social medical security system and laws are not perfect enough, and there is no specific policy support similar to foreign tax exemption measures. The boundary between social medical insurance and commercial health insurance is unclear, and the business subject is unclear. Individual social security bureaus impose mandatory pricing on supplementary high medical insurance. These are all obstacles to the development of commercial health insurance.
From the perspective of the insured, adverse selection and moral hazard are serious problems. The adverse selection of the insured (that is, people with higher risks than ordinary people will think that insurance has more investment value and tend to buy insurance) is an important factor affecting the development of commercial health insurance. Due to the existence of adverse selection, people who buy health insurance are often in poor health, and the amount and probability of their claims are far greater than those of the normal population, which is bound to cause insurance companies to calculate premiums according to the health status of the normal population to be insufficient to make up for claims. In China's health insurance market, the moral hazard of the insured mainly refers to the fact that the insured usually chooses a higher cost among various treatment schemes with different costs to achieve a higher treatment standard, which will obviously increase the insurance company's claim cost, and eventually lead to an increase in premiums and a decrease in the supply of health insurance products.
Suggestions on the Development of Commercial Health Insurance in China
In the foregoing, the author analyzes the problems existing in the development of China's commercial health insurance from the perspectives of insurance companies, external environment and policyholders, and puts forward feasible suggestions from three aspects.
First of all, from the perspective of insurance companies: 1, provide diversified and personalized insurance products for people with different economic bases and different spending power. In addition, improve innovation ability and develop new health protection products and protection methods. 2. To improve the degree of specialization of insurance companies, we need to make joint efforts from four aspects: product specialization, service specialization, internal management specialization and talent specialization.
Secondly, from the external environment: 1, increase tax support for commercial health insurance. The specific methods can be considered to reduce the business tax rate of commercial health insurance companies, include enterprise premiums in pre-tax business to encourage enterprises to buy group health insurance for employees, and reduce the income tax for individuals to buy commercial health insurance to encourage and absorb more individuals to participate in insurance. 2. Improve laws and regulations. Specifically, it includes establishing and improving the legal system to ensure the normal development of commercial health insurance and defining the business scope of commercial health insurance.
Finally, from the perspective of the insured, the business model of "managed medical care" can solve the moral hazard problem of the insured well abroad. Managed medical care is a system that combines the provision of medical services with the supply of funds (in this case, insurance companies) needed to provide medical services. This system is a medical insurance model integrating medical service provision and management, and its key lies in the merger of insurance companies and medical service provision systems. Managed medical care provides medical services to the insured at a certain standard and cost, and combining insurance and medical service providers into a community of interests can effectively reduce the moral hazard of the insured, thus controlling costs and reducing costs.
label
The author believes that although the coverage of China's commercial health insurance is small and its role in the insurance system is small, due to its indispensable supplementary role and broad development space, China should vigorously develop commercial health insurance from the aspects of insurance company specialization, strong support of policies and regulations, and promotion of managed medical care. (Author: Lu Muyang Unit: School of Economics, Fudan University)
;