Our reporter Leng Cuihua
"Internet celebrity" Huiminbao has "walked into" some local government work reports in 2022 that are being released one after another.
For example, Beijing, Jiangsu, Zhejiang and other places have summarized the achievements of the work of benefiting the people in their government work reports, or made arrangements to promote this work.
At the same time, the reporter learned that according to the statistics of the China Banking and Insurance Regulatory Commission, local medical insurance bureaus, insurance companies and local Huimin Insurance official operating platforms, about 140 million people nationwide participated in Huimin Insurance last year, compared with 40 million in 2020. people increased by 100 million.
The development speed of Huiminbao is evident.
However, some people in the industry believe that in order to improve the sustainability of Huiminbao, we must face up to the problems in development and continuously improve and upgrade.
Significantly reduce the public's medical burden
Huimin Insurance is an inclusive supplementary medical insurance led by the local government and underwritten by insurance companies for medical insurance insured persons.
This year is also called the first year of Huiminbao by the industry.
In some local government work reports this year, Huiminbao has already appeared.
"Steady increase the standard of social security benefits, and support the launch of inclusive health insurance that is widely welcomed by the citizens." The Beijing Municipal Government pointed out when summarizing its work in 2021 that inclusive health insurance effectively protects people's livelihoods, and people's quality of life continues to improve.
When summarizing last year's work, the Jiangsu provincial government mentioned that "inclusive commercial medical insurance linked to basic medical insurance will significantly reduce the public's medical burden." The Zhejiang provincial government proposed in its 2022 goals and tasks to improve Serious illness and chronic illness medical insurance system, comprehensively promote commercial supplementary medical insurance, and expand long-term care insurance pilot projects.
Judging from the actual situation, according to the WeChat news of the Beijing Pratt & Whitney Health Insurance Official, as of 24:00 on September 30 last year, the personal insurance channel was closed, and 3.0151 million people successfully participated in the insurance.
At the same time, according to the statistics of Zhongtuobang Company, 10 cities in Zhejiang launched Huimin Insurance last year. Among them, Hangzhou West Lake Yilian Insurance has a total of over 4.7 million insured people, and Jiangsu has both provincial and city versions.
"The inclusion of the relevant content of Huimin Insurance in the government work report not only means that the government attaches great importance to this work, but also guarantees the implementation of specific plans, and also provides government endorsement for the development of related businesses." Xie Yuantao, dean of the School of Insurance, University of International Business and Economics, told " A reporter from Securities Daily said that Huimin Insurance is an important component of the multi-level security system, which is conducive to making up for the gap in medical security and improving welfare.
Zheng Bingwen, director of the World Social Security Research Center of the Chinese Academy of Social Sciences, said that benefiting the people is the result of policy dividends and institutional innovation, and it is also the responsibility of the insurance industry to consolidate itself, actively participate in social services and the construction of the social security system, and satisfy the multi-level and diversified health security of the people. A bold exploration of needs.
Coverage continues to expand
Xie Yuantao believes that there are four main reasons for the rapid development of Huimin Insurance in the country. First, from a macro perspective, with the deepening of population aging, chronic diseases at a younger age, and low fertility rates, medical insurance expenditures will face income and expenditure for a long time. To balance the pressure, Huimin Insurance can not only be closely related to medical insurance, give full play to its characteristics of social business integration, but also use market means to meet the needs of its own sustainable development.
Second, from the perspective of demand, people's demand for health insurance is increasing, but their purchasing power is not balanced, and the proportion of self-payment for medical treatment is still high. Huiminbao, with its advantages in price and insurance conditions, is quickly and widely accepted. It's a matter of course.
Third, from the perspective of supply, commercial health insurance urgently needs to actively change its thinking, explore new development paths, further expand the insured population, explore cooperation with other health industries, and achieve substantial expansion of the coverage of the insured population.
Fourth, from a technical point of view, the rapid development of mobile Internet technology has provided strong technical support for the promotion and accurate reach of Huiminbao. The maturity of big data applications and artificial intelligence technology has also enabled accurate pricing and claims settlement. It has become a reality, which has further deepened the public's perception.
"It is expected that the coverage of Huimin Insurance will continue to expand rapidly. Medical insurance has achieved full coverage of the system. As an important supplement to medical insurance, Huimin Insurance will also have a very wide coverage base." Xie Yuantao said.
The relevant person in charge of China Re Life Insurance believes that from the perspective of the government, the introduction of Huimin Insurance can improve the level of public medical insurance treatment without increasing additional financial expenditures.
Therefore, some urban medical insurance management departments either endorse Huimin Insurance or provide support in terms of medical insurance data resources; from the perspective of insurance companies, Huimin Insurance is essentially commercial insurance. With government support, no matter whether it is the product itself Sales, customer expansion, and corporate brand promotion are all of great benefit; in addition, third-party service companies have also seen business opportunities and are highly motivated.
These three aspects jointly contributed to the rapid development of Huiminbao.
Sustainability gets the most attention
Although Huiminbao has developed rapidly, some problems in its operation have gradually been exposed.
In this regard, the China Banking and Insurance Regulatory Commission issued the "Notice on Regulating the Urban Customized Commercial Medical Insurance Business of Insurance Companies" last year, and the report on the development of commercial health insurance and recommendations issued to life insurance companies on January 11 this year also gave an early warning of related risks. .
The above report pointed out that in recent years, urban customized medical insurance projects have developed rapidly in various places. However, due to the lack of underwriting, flat rates, and short-term insurance products for this type of business, the project may be unsustainable due to the adverse selection of the insured. Some local government departments have also set minimum business compensation level requirements, insurance companies are likely to suffer losses, reducing the enthusiasm for follow-up participation.
Taking Shanghai urban customized commercial supplementary medical insurance Huhuibao as an example, in the half-year period from the effective date of protection to the end of 2021, its total compensation amount reached 378 million yuan, while its accumulated premium income was about 826 million yuan, and the loss ratio reached 45.76 %, with an average monthly loss ratio of 7.6%.
"Even if the subsequent loss rate does not rise, the maturity loss rate is expected to reach 85%, and considering the operating costs, it is difficult to keep the capital and profit." Xie Yuantao analyzed.
He said that basic medical insurance is based on income, and the overall national compensation rate is about 85%, and the compensation rate of commercial medical insurance is about 70%.
Huimin Insurance is self-financed by commercial insurance agencies and does not guarantee renewal. Considering the positioning, he suggested that the loss ratio should be controlled at 75% to 80%.
"A loss ratio that is too low or too high is not a benign outcome, and may make the public feel inadequate or magnify the operating risks of insurance companies," he said.
Xie Yuantao believes that there are other operational risks in Huimin Insurance. For example, the low participation rate of Huimin Insurance in some areas will make the pool of premium funds insufficient, the operating costs cannot be effectively diluted, and the risks of insurance companies are difficult to control. It is possible to introduce products into the market. "Death Spiral".
At the same time, the inclusive feature of Huimin Insurance determines that the current income of commercial insurance institutions participating in this project is relatively limited, which requires insurance companies to make scientific arrangements based on their own market strategies and solvency, and cannot blindly follow the trend to underwrite.
In addition, he said that there are still nearly 30% of Huiminbao without clear government participation or guidance, but there are some misleading behaviors in the propaganda process, which can easily lead to a crisis of credibility and trust.
In this regard, Xie Yuantao put forward four suggestions.
One is to accelerate the innovative development model of social business integration. For example, paying for insurance through personal medical insurance accounts can not only promote the expansion of Huimin Insurance, but also an important way for the government to endorse; Design pricing, market sales promotion, post-insurance service fulfillment, and underwriting risk management supervision and guidance; the third is to cooperate with insurance institutions and pharmaceutical companies to carry out more extensive cooperation, build a unified and open Huimin Insurance service platform, and summarize products and services Fourth, insurance companies should ensure compliance with laws and regulations, and effectively improve service efficiency and risk control.
(Securities Daily)