Long protection pilot to obtain staged results, commercial insurance ushered in development opportunities

China Commercial Daily (Reporter Wang Tongxu) "The pilot work of the long -term care insurance system is progressing smoothly and achieved staged results." Recently, Hu Meiying, a representative of the National People's Congress and the leader of the Jiangxi Provincial Children's Hospital, "Suggestions", the State Medical Insurance Bureau gave such a reply.

Long -term care insurance system is an important deployment made by the Party Central Committee and the State Council to deal with the aging of the population and improve the social security system. The continuous expansion of the pilot scope and the accumulation of practical experience have laid a solid foundation for the next step in the comprehensive development of long -term care insurance work across the country. Insiders believe that in the process of expanding the pilot of the long -term care insurance system, the top -level design needs to be further improved, and the implementation path of long -term nursing insurance that can be replicated and promoted to ensure that it meets the aging social needs that are continuously accelerated.

The picture shows the China Life Building on Financial Street, Xicheng District, Beijing. China Business Daily reporter Yang Hongsheng/Photo

The staged effects in many places are prominent

Long -term nursing insurance is also known as the "sixth insurance" of social security. It is a institutional arrangement for the insured to provide nursing protection and economic compensation when losing daily life ability, old age or death. It is of great significance to continuously meet the continuous growth of pension services and properly and effectively handle the nursing problems of the elderly.

In 2016, the long -term nursing insurance system was officially launched in 15 cities including Shanghai and Chongqing, marking the start and development of the national nursing insurance system to promote the construction and development of the national nursing insurance system.

In July 2018, multiple departments jointly drafted the "Guiding Opinions on Promoting the Reform and Development of the Nursing Service Industry" to encourage social forces to invest in the field of care service industry in various forms, expand the supply of nursing services, and improve the quality and efficiency of nursing services and efficiency. in principle.

In September 2020, the State Medical Insurance Administration issued the "Guiding Opinions on Expanding the Pilot of Long -term Nursing Insurance System" with the Ministry of Finance. The pilot cities of long -term care insurance increased to 49, which basically covered the national key provinces, and the relevant system measures were further improved. As of now, a total of 14 insurance companies have participated in, and the cumulative funds have exceeded 8 billion yuan.

When a reporter from China Commercial Daily sorted out policies documents in various localities, it was found that in terms of guarantee content, most pilot cities stipulated that they took home care, on -site care for the institution, and institutional care as the main form. The insured objects include urban employees and urban and rural residents.

Most pilot cities have explored the establishment of a diversified fund raising model: personal payment, unit payment, medical insurance overall fund transfer, and government financial subsidies for multiple responsibilities and co -sharing mechanisms.

In order to ensure the quality of service and strengthen service supervision, most pilot cities adopt management methods such as designated institutional qualification access and protocol management model to set up strict institutional qualification access conditions, access processes, service content management, and exit mechanism.

The pilot work has been implemented for several years, and the beneficiary population has geometry? The National Medical Insurance Administration gave data from Hu Meiying's proposal: As of the end of March 2022, the long -term care insurance system has covered 49 cities and 145 million people, and a total of 1.72 million people have enjoyed treatment.

Difficulty to be resolved to the funds need to be supplemented

Although the pilot work of long -term nursing insurance effectively relieves the situation of "one person's disability and the family's imbalance", there is still something to improve.

China Insurance Industry Association and Switzerland Revolution Research Institute recently released the "Research on Long -term Nursing Service Guarantee of Chinese Commercial Nursing Insurance -China Urban and Town Regions" shows that my country's long -term care service guarantee will face funding gaps: by 2030, 2040, 2040 In the year, the demand for long -term nursing services in my country will reach about 3.1 trillion yuan and 6.6 trillion yuan, respectively, and the gap in long -term nursing service guarantee will reach 1.9 trillion yuan and 3.8 trillion yuan, respectively.

Public information shows that long -term care insurance and commercial long -term care insurance for social insurance are the two major parts of the long -term care insurance system framework. Insiders believe that in the face of a fast -growing aging society, the long -term nursing insurance system is established with national strength and resolving the long -term nursing risks of the elderly, which will inevitably bring tremendous pressure on public financial expenditure. Essence

However, from the current pilot situation, the operation of long -term care insurance still depends mainly on social security funds. The development of long -term business insurance insurance markets is relatively slow, the size of the premium is small, and it is still a niche product. According to research reports, the long -term nursing insurance premium income of human insurance companies in 2020 was about 12.3 billion yuan, accounting for only about 1.5%of the health insurance premiums.

"Social insurance long -term nursing insurance provides the most basic long -term care funds for the broader population, which to a certain extent relieves the pressure of long -term nursing funds of the disabled personnel, but the overall funds and scale are still relatively limited.虽然更早（2005年国泰人寿率先推出我国第一款具有商业性质的长期护理保险产品），但整体规模同样十分有限，参与其中的险企还不够多，推出的产品也较为单一。而且多数长期Nursing insurance only provides fund claims and lacks nursing services. In addition, from the perspective of residents' awareness of insurance, due to the high -end commercial care insurance positioning, residents have insufficient awareness of long -term care demand and risk. The extensive knowledge is popular. "A insurance industry who did not want to be named said in an interview with China Business Daily reporter.

Therefore, in the view of the industry, in order to achieve the sustainable development of long -term care insurance financing and supply, it is urgent to establish and improve multi -party cooperation mechanism, including commercial insurance.

Breaking the pain point Commercial insurance ushered in development opportunities

In fact, the development of commercial nursing insurance is increasingly valued. The "Fourteenth Five -Year Plan" outline is clear, encouraging commercial insurance institutions to develop long -term nursing insurance products. The research report believes that in order to cope with the challenges such as accelerating the aging process of my country's population and changes in family structure in the future, and alleviating the pressure of the social security fund's expenditure, commercial nursing insurance can be strengthened, the service level of the elderly, the level of service, and the multiple levels of the people's many levels of diversification The demand for service has played a more important role and ushered in greater development opportunities. In terms of the macro system, the research report proposes that the government should clarify the market positioning of commercial nursing insurance in long -term nursing insurance mechanisms and establish a multi -level nursing security system.

"But in terms of the design rules of long -term business care insurance, it is necessary to think more." Luo Pan, executive dean of practical financial business, said in an interview with the China Business Daily reporter that the care of the elderly people is not only related to age, but also with its body. Regarding the situation, everyone's situation is different, and the needs of nursing often have different needs. How to design it into insurance products, how to designate the scope of insurance and set prices is critical. In addition, insurance identification specifications, compensation specifications, compensation period, deductible rules, etc. are all related to whether the insurance can be recognized by the market.

In terms of industry development environment, research reports suggest, accelerate the improvement of industry infrastructure and system construction, establish industry databases, standardize nursing service standards and rating systems, and give encouragement policies.

How to market and implement it also requires careful consideration. Luo Pan said that because the aging groups of commercial nursing insurance services often feel unsuitable in the face of insurance products, it is likely that the children are insured for the elderly in the family, and the separation of the policyholder and the insurer is separated. Therefore, the key to the marketing of insurance institutions is young people. How to obtain the recognition of the insured is the key guarantee for the smooth implementation.

"You can learn from the experience of Huiminbao and try to carry out long -term nursing insurance for inclusive business. This will not only expand the audience of long -term care insurance, but also popularize the knowledge of long -term care insurance to the public." The above -mentioned insurance industry experts told reporters.

In addition, the reporter also noticed that the long -term nursing insurance system in China as soon as possible and unifying my country's long -term nursing insurance system has also become a common voice for people in the industry.

Chen Kai, an associate professor of the Department of Risk Management and Insurance of Peking University School of Economics, wrote that through the experience of learning pilot cities and analyzing relevant data, some common problems can be refined and improved in the top -level design of the long -term care insurance system. The long -term nursing standard system with a long -term care insurance system is set.

Regarding the next step, the National Medical Insurance Bureau said in the response to Hu Yongmei that it will increase its exploration efforts with relevant departments, further deepen the pilot, strengthen the summary and evaluation, form experience that can be replicated and promoted, and strive to be in the "14th Five -Year Plan". During the period, the long -term nursing insurance system framework that adapted to the level of economic development and aging development trends in my country was basically formed.

"Establishing long -term nursing insurance is a major system innovation and a complex system project, involving multiple industries and multi -field functions. As a new system, foreign related systems do not run for a long time, and there is no mature experience in China. There is no mature experience in China. It can be followed by the management and operation mechanism. We must also increase exploration in the pilot. We will continue to explore and improve the system and incorporate them in the track of the rule of law in a timely manner. "The National Medical Insurance Administration said.

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