The pilot social long-term care insurance covers nearly 120 million people, and the development of commercial care insurance has just started
Our reporter Leng Cuihua
Recently, a reporter from "Securities Daily" in a subway station in Beijing saw the National Medical Security Administration's publicity and display of my country's medical security system. The content of the publicity mainly included four major themes, long-term care social insurance (hereinafter referred to as "social long-term care insurance"). ) Is one of them.
Nursing and elderly care are closely related.
According to the National Bureau of Statistics, as of the end of 2019, there were 254 million people aged 60 and over in my country, of which more than 40 million were disabled and semi-disabled.
The 2021 government work report pointed out: “Promote the integration of medical care, health and wellness, and steadily advance the pilot program of the long-term care insurance system.” The reporter learned in the interview that the country’s social long-term care insurance has been piloted in 49 cities, covering nearly 120 million participants. Guarantor.
However, commercial care insurance has just started, and expanding this market requires efforts from many aspects.
Pilot social long-term care insurance in 49 cities
my country's social long-term care insurance pilot program began in 2016, and it has been five years since, and 15 cities including Shanghai and Chengdu are the first pilots.
In 2020, the second batch of cities will start pilot projects.
Up to now, a total of 49 cities have piloted social long-term care insurance.
Social long-term care insurance provides basic living care.
The pilot is led by local medical insurance bureaus, and is specifically undertaken by commercial insurance companies. Funds are raised from medical insurance funds, enterprises, and individuals, and the standards vary from place to place.
Judging from the first batch of pilot cities in Chengdu, starting from January 1 this year, all persons participating in basic medical insurance can apply for social long-term care insurance without additional payment, and severely disabled persons can receive a monthly subsidy of up to 903 yuan.
A multi-channel financing mechanism combining government subsidies, medical insurance pooling funds and individual payment has been established in 7 pilot areas including Suzhou and Xuzhou.
In the field of social long-term care insurance, commercial insurance companies actively participate in undertaking.
Luo Xi, Chairman of PICC Group, said that in 2020, PICC will undertake 96 social long-term care insurance projects, covering 42 million people.
Currently, PICC Group is exploring this service in all provinces and cities.
Although the pilot cities continue to expand, there are still some problems in the current social long-term care insurance.
Sun Jie, a member of the National Committee of the Chinese People's Political Consultative Conference and a professor at the School of Insurance of the University of International Business and Economics, pointed out that the financing channels for social long-term care insurance are too simple, mainly using medical insurance funds as the source of funds, financial support is small, and there is a lack of independent financing channels and clear personal payment requirements. ; At the same time, it is difficult to unify nursing standards; in addition, the supply and demand of nursing services are not symmetrical.
In this regard, Sun Jie suggested that the top-level design should be strengthened, and the construction of a social long-term care insurance system should be promoted and included in the overall plan for the construction of a multi-level and multi-pillar social security system, and the operation of social long-term care insurance should be regulated and managed in the form of legislation.
Larger commercial care insurance requires much effort
In addition to basic nursing needs, the common people also have more personalized nursing needs.
Just like the relationship between basic medical insurance and commercial insurance, in addition to social long-term care insurance, commercial care insurance is also indispensable.
"Securities Daily" reporter learned in the interview that my country's commercial nursing insurance is still in the early stages of development, and its proportion in health insurance is very low. It takes more efforts to consolidate the potential market space.
Wang Lin (pseudonym) was responsible for product development in a small and medium insurance company and was mainly responsible for promoting the development of commercial care insurance in the past two years.
He has recently moved to other insurance companies.
When talking about the development of commercial nursing insurance, Wang Lin said with emotion, "It's very difficult, and it's a pity."
Wang Lin believes that the difficulties in the development of commercial nursing insurance are mainly reflected in two aspects.
First, consumer acceptance is not high, and insurance demand often lags behind the occurrence of risks.
This phenomenon is also reflected in related surveys.
The "2018-2019 China Long-Term Care Survey Report" jointly released by the Insurance Industry Association of China and the Academy of Social Sciences last year showed that more than 60% of the adults surveyed were overly optimistic about their own disability risks and underestimated their future care needs.
Second, for long-term care insurance, there is no uniform disability assessment standard, service standard, payment standard, etc. that can be implemented nationwide, and the development of insurance products and the implementation of subsequent services are facing constraints.
Although the first battle to promote commercial nursing insurance was defeated, Wang Lin is still optimistic about the future market prospects of commercial nursing insurance. "If there is an opportunity, I will promote the development of commercial nursing insurance. The nursing needs of disabled and semi-disabled people are just needed. There is a lot of room for future development in this market."
How to better promote the development of commercial nursing insurance?
Zhou Yanli, a member of the National Committee of the Chinese People's Political Consultative Conference and former vice chairman of the China Insurance Regulatory Commission, suggested encouraging commercial long-term care insurance products to connect with social long-term care insurance.
Conduct policy guidance and support on data analysis and financing models, such as supporting the purchase of personal account balances of medical insurance cards; in addition, it is recommended that the country, on the basis of the current multi-site pilots, formulate a unified national long-term care standard as soon as possible, select and designate consistent Standard appraisal and evaluation agencies to support the development of commercial long-term protection insurance.
Zhu Minglai, director of the Health Economics and Medical Security Research Center of Nankai University, said that insurance companies should vigorously develop commercial long-term care insurance to meet the needs of multi-level security in an aging society.
For the young and middle-aged customer groups, you can explore the use of long-term care insurance as a personal savings account similar to the second provident fund to pay for medical expenses and nursing expenses after entering the elderly in the future. The accumulation of funds can also provide a source of funds for the medical care industry , To form a whole industry chain development model of "service system + guarantee system".
(Securities Daily)