Under the background of population aging, the industry generally believes that pension or the third pillar is the main asset to deal with population aging. Zheng Bingwen, director of the World Social Security Research Center of China Academy of Social Sciences, pointed out that health insurance also plays an active role in coping with the aging population and should be included in the comprehensive measures to deal with the aging population.
Zheng Bingwen pointed out that health insurance is an important means to make up the lifelong financial security gap and an important supplementary resource to cope with the aging population. In 20 18, the per capita health care expenditure in the United States was about $65,438 +0. 1 10,000, of which commercial health insurance expenditure accounted for 34%. However, in the per capita expenditure of medical and health expenses in China, health insurance only accounts for 4%, which is far from the 34% in the United States.
Regarding the future development trend of health insurance, Wei Xing, president of China Insurance Association, said that commercial health insurance should be transformed into long-term products, diversified and mixed insurance liabilities. At the same time, the inclusiveness of commercial health insurance should be more prominent, and more innovative products like special drug insurance should be developed so that those who really need protection can afford it.
Wei Xing pointed out that the development of commercial health insurance should improve the health management mode through patient behavior management, product innovation, data sharing and service standard construction, accelerate the transformation and extension from post-payment to pre-management and do a good job in risk prevention and control and related services. The industry should strengthen the development of healthy old-age care and provide comprehensive solutions to meet the needs of ordinary people.
Wu, deputy director of the Planning Department of the National Health and Wellness Commission, pointed out that improving the health security system is an important part of promoting the construction of a healthy China and an effective starting point for promoting people's health and overall social development. "Healthy China 2030 Outline" requires a sound multi-level medical security system with basic medical security as the main body, supplemented by other forms of supplementary insurance and commercial health insurance, enriching health insurance products and promoting the cooperation between commercial insurance companies and medical, physical examination and nursing institutions.
In-depth participation in the multi-level medical insurance system, the voice of commercial insurance catalogue is getting higher and higher.
In recent years, the voice of commercial insurance to formulate drug list is getting higher and higher. It is generally believed in the industry that the integration of social security, commercial insurance and insurance is imperative under the dual promotion of policy encouragement and market demand, and the establishment of a supplementary catalogue of commercial insurance other than basic medical insurance will become an important starting point for promoting the high-quality development of the industry.
Zheng Bingwen suggested at the two sessions this year that a comprehensive Supplementary Catalogue of National Commercial Health Insurance Drugs, Diagnosis and Treatment Items and Medical Consumables (hereinafter referred to as the Catalogue of Commercial Insurance) should be formulated. At present, the national drug list of basic medical insurance, industrial injury insurance and maternity insurance refers to the standards for payment of drugs by basic medical insurance, industrial injury insurance and maternity insurance funds, while the commercial insurance list is still vacant in the industry.
In the recent interpretation of "20021National Medical Insurance Drug List Adjustment Work Plan", the National Medical Insurance Bureau mentioned that "the accessibility of new drugs can not be solved only by basic medical insurance, but also by giving full play to various supplementary insurance, commercial health insurance and other channel functions, and by establishing and improving a multi-level medical security system with China characteristics, we can better meet the needs of different levels of drugs." This is a clear appeal for commercial health insurance to deeply participate in the construction of multi-level medical insurance system from the perspective of medical security.
At the beginning of 2020, the CBRC and other 13 ministries and commissions put forward in the Opinions on Promoting the Development of Social Service Commercial Insurance that the application of new medical technologies, new drugs and new devices should be gradually included in the scope of commercial health insurance. On February 9, 2020, People's Republic of China (PRC) Li Keqiang, Premier of the State Council of the People's Republic of China presided over the the State Council executive meeting, pointing out that it is necessary to speed up the development of commercial health insurance, make a good connection with basic medical insurance, and encourage insurance companies to include reasonable medical expenses outside the medical insurance catalogue in the scope of protection.
Huang Hong, former vice chairman of the China Banking Regulatory Commission, said at the policy briefing in the State Council that commercial health insurance should take reasonable medical expenses out of the catalogue as the coverage. At the same time, with the development of Huimin insurance and long-term medical insurance, some insurance companies began to design specific drug lists and positive and negative lists, and some areas of China also introduced municipal self-funded drug lists other than medical insurance.
Secretary-General insurance association of china still said that it is necessary to study and formulate the catalogue standard of commercial health insurance as soon as possible, which is conducive to realizing the dynamic connection between basic medical insurance and commercial insurance, promoting the development of multi-level security system and effectively improving the people's medical and health service security level.
Zheng Bingwen said that the establishment of a commercial health insurance catalogue is a breakthrough to improve the financing level of health insurance, a key to establish a multi-level medical service system and a multi-sector coordination mechanism, an important tool to improve the payment level of the medical device industry after purchasing basic medical insurance, and a necessary supplementary means to meet the health needs of multi-level and diversified people.
"Drugs and consumables in the basic medical insurance catalogue can meet the basic social needs with the largest price drop through quantity procurement, and innovative drugs and innovative medical consumables can realize the integrated supply of commercial insurance and social security through the National Commercial Insurance Catalogue." Zheng Bingwen pointed out that "National Commercial Insurance Catalogue", as a backup catalogue of basic medical insurance, can alleviate the pressure of expanding the catalogue of basic medical insurance, and can also be organically linked with the national drug catalogue of basic medical insurance, industrial injury insurance, maternity insurance and the catalogue of medical consumables of basic medical insurance, so as to realize the integrated development of commercial insurance and social security.
The multi-party project led by China Insurance Association is expected to bear fruit in one year.
To this end, in April this year, China Insurance Association led the China Health Information and Health Medical Big Data Society and the China Medical and Health Culture Association to jointly launch the research work on the topic of "Standard Formulation and Long-term Development of Commercial Health Insurance Catalogue", aiming at clarifying the design path and establishing the system framework for the subsequent formal establishment of commercial insurance catalogue.
The topic of "Commercial Insurance Catalogue" focuses on three major directions: First, the guiding principles and core values of the compilation of commercial insurance catalogue, and the expected values and core principles of the compilation of commercial insurance catalogue are deeply explored from the dimensions of promoting the coordinated development of medical insurance systems at all levels, meeting the diversified medical service needs of residents, and promoting the integrated development of medical insurance industry. The second is to summarize a lot of experience in the practice of insurance and medical insurance catalogue at home and abroad, including participants, formation mechanism, health economics evaluation system and support system. And analyze the formation process and operation effect of the relevant index system. Thirdly, by combing the principles and experience of the Catalogue, this paper puts forward some directional suggestions such as the construction, landing plan and supporting measures to formally promote the compilation of the Commercial Insurance Catalogue in the next step, and forms the research conclusion of the subject.
Representatives of insurance companies and consulting institutions from the pharmaceutical industry recently held the "Third Plenary Session of the Health Insurance Professional Committee", and conducted in-depth discussions on the industrial value, realization objectives and formulation principles of commercial insurance catalogue construction. It is reported that the project regularly holds closed-door seminars, inviting industry representatives from medical, pharmaceutical, insurance and other research groups to fully discuss the key contents of the project research and gradually form industry knowledge.
A research group composed of Pacific Health, China Life Insurance, China Ping An Life Insurance Company of China and other 18 insurance companies, as well as a number of pharmaceutical machinery institutions and scientific and technological consulting companies will carry out research for about one year, and the results of the research are scheduled to be officially released in 2022.