(A) the risk characteristics of health insurance products themselves
1. Compared with ordinary life insurance, health insurance has uncertain risk characteristics. Life insurance includes survival insurance, death insurance and old-age security for survival and death, and its actuarial basis is mainly life cycle table, which can generally remain unchanged for decades. The actuarial basis of health insurance is empirical data, which may change at any time. In real life, diseases are accumulated by many factors in the human body, showing a complex process, which increases the uncertainty of disease risk.
2. Compared with accident insurance, health insurance has multiple characteristics. The incidence of personal accidents is often thousands, and the incidence of diseases is several percent or even several tenths. So the randomness of health risks is very obvious.
(B) possible external risks of health insurance
1. Risks caused by rising medical drug prices. According to statistics, during the 25 years from 1980 to 2004, the per capita income increased by 10 times, the medical and health expenditure increased by 35 times, with an average annual increase of 24%, and the personal burden increased from 2 1% to 53.68%. Due to the underwriting cycle of health insurance, the rise of medical expenses and drug prices will inevitably bring the risk of losses to insurance companies.
2. The risk of overtreatment. Excessive medical risks with inconsistent interests between doctors and patients are finally passed on to insurance companies.
3. Moral hazard such as adverse selection.
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