A symposium on the high-quality development of health insurance was convened in Beijing by the China Insurance Association on January 22. The meeting aimed to implement the guiding principles of the Party's important directives and promote the insurance industry's role in serving the national "Healthy China" strategy. Representatives from the Society of Actuaries, banking and insurance asset management associations, relevant healthcare associations, university experts, pharmaceutical companies, and insurance firms attended the gathering.
Discussions centered on the development of commercial health insurance and deepening cooperation between the insurance sector and the healthcare and pharmaceutical industries. Participants highlighted that a series of supportive policies have fostered a favorable environment for commercial health insurance growth. They noted that with strong policy backing and rising market demand, the sector has seen its business scale expand, product variety increase, and service capabilities improve significantly. Over the past decade, commercial health insurance has achieved a compound annual growth rate exceeding 20%, with over 11,000 medical insurance products currently available, forming a robust pillar for public health protection.
It was pointed out that commercial health insurance has continuously broadened its coverage and enhanced its service capabilities in recent years. High-cost treatments, such as CAR-T therapies exceeding one million yuan, were included in coverage lists a decade ago. Today, most mainstream medical insurance products cover new technologies, drugs, and medical devices, including high-value treatments like targeted cancer therapies and proton/heavy ion therapies. Preliminary estimates suggest that by 2025, total claim payouts for innovative drugs and devices by commercial health insurers will reach approximately 14.7 billion yuan, marking four consecutive years of rapid growth with a compound annual growth rate of 70%. The industry is also actively exploring new claim settlement and payment methods to improve efficiency and enhance the convenience of financial services.
The symposium emphasized that 2026 marks the beginning of the next Five-Year Plan period. The insurance industry must thoroughly implement the Party's guidelines, focusing on accelerating the Healthy China initiative, proactively addressing population aging, and supporting the development of key national industries like innovative pharmaceuticals. There is a need to actively respond to market demands, adhere to the fundamental principles of commercial insurance, continuously enrich product offerings, and improve service quality to better meet the public's need for high-quality health protection.
Since the start of 2025, the China Insurance Association has actively solicited opinions from various stakeholders, promoted cross-industry exchanges, and worked on developing industry model clauses for commercial medical insurance and payment lists for covered drugs. It has strengthened communication with healthcare associations, incorporating feedback from pharmaceutical companies and experts. The association has also organized industry-wide publicity efforts to raise awareness about health insurance. Moving forward, the China Insurance Association will further strengthen industry self-regulation, enhance cooperation with health industry, medical, pharmaceutical, and academic research organizations, and, following market-oriented and legal principles, promote the synergistic development and mutually beneficial cooperation between commercial insurance, healthcare, and the pharmaceutical sector.
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