Advancing Triple Transformation in Health Insurance: Accelerating Integration and Innovation of Insurance and Health Management

Deep News07-03 18:15

Shao Liduo emphasized the critical role of health insurance as a vital tool for personal investment, family protection, corporate care, and social security. It serves as a key lever for enhancing the quality of human capital, a crucial driver for boosting domestic demand and stimulating consumption, and a significant pillar supporting the Healthy China initiative.

In implementing the "Investing in People" strategy, health insurance acts as a fundamental vehicle. On one hand, it functions as a stabilizer for preserving and increasing the value of human capital. Through its risk compensation mechanism, it hedges against large medical expenses and income interruption risks, effectively mitigating family crises caused by illness, preventing the erosion of human capital, and securing the baseline of public welfare. On the other hand, health insurance serves as a connector for full-cycle health management. It propels health protection to extend from back-end claims settlement to front-end proactive health services, establishing a continuous and systematic health management framework that allows the public to better perceive the tangible benefits of investing in people.

Regarding the expansion of domestic demand, health insurance possesses the dual attributes and unique value of service consumption and industry empowerment. Firstly, it boosts residents' consumption confidence. By fulfilling its core functions of risk transfer and loss compensation, health insurance effectively alleviates the risks of poverty due to illness or relapse into poverty, reduces the propensity for precautionary savings, stabilizes public expectations, and fosters a virtuous cycle of security coverage, consumption release, and stable economic growth. Secondly, it empowers the upgrading of the health industry. Relying on sustained and stable payment support and market incentives, it aids the development of sectors such as innovative pharmaceuticals and medical devices, health technology, and wellness care. It bridges the collaborative development chain of healthcare insurance, medical services, and pharmaceuticals, leveraging financial leverage to enhance industrial quality and efficiency, thereby creating a favorable development scenario of industrial upgrading, income growth, and consumption expansion.

In the context of building a Healthy China, the period of the 15th Five-Year Plan marks a crucial construction phase. According to the strategic deployment of Healthy China, health insurance bears a significant mission in promoting comprehensive transformation in China's health work concepts, service models, and governance approaches. Institutionally, the modern commercial insurance service industry is maturing, and the multi-level healthcare security system framework is taking full shape. Structurally, group health insurance and individual health insurance are developing in synergy, covering the differentiated health needs of the entire population across all life stages. In terms of value, the proportion of commercial insurance payouts in total health expenditure continues to rise, making it an indispensable force for payment and services in the Healthy China endeavor. Functionally, it aims to achieve a trinity of protection payment, health management, and elderly care, contributing to the improvement of life expectancy, comprehensive prevention and control of chronic diseases, and the realization of national health indicators.

From Shao Liduo's perspective, the current healthcare insurance system is undergoing profound restructuring, the pharmaceutical industry is accelerating innovation, and public health demands are continuously evolving, heralding systematic and deep-seated changes for the industry. Firstly, top-level policy design is reshaping the industry's value proposition. Secondly, the innovative development of the biopharmaceutical industry urgently requires support from health insurance. Thirdly, evolving public demand is giving rise to a rigid need for full-cycle health services. Fourthly, mid-to-high-end medical demands are upgrading.

Shao Liduo stated that, based on national strategic deployment, the trend of healthcare insurance reform, opportunities for industrial upgrading, and evolving public needs, commercial health insurance must proactively adapt and drive changes in its development logic. It should transition from purely passive compensation to active intervention, from single coverage to full-cycle management, and from cost payment to health services. Accelerating the integration and innovation of insurance and health management will cultivate new momentum and solidify a new foundation for high-quality development during the 15th Five-Year Plan period.

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