数据不通，“健康险”只敢保“健康人”

Group 1 - The core issue in the commercial health insurance market is the mismatch between product offerings and the actual health status of potential insured individuals, leading to a high rate of policy rejections for those with pre-existing conditions or health anomalies [1][2] - Data connectivity issues between insurance companies and medical institutions hinder effective risk assessment and pricing, resulting in a focus on healthy individuals and a lack of coverage for those with existing health issues [2][3] - The total premium income for commercial health insurance in China is projected to approach 1 trillion yuan in 2024, yet the market has struggled to break this threshold for three consecutive years due to supply-demand mismatches [1][4] Group 2 - The integration of health data can transform the healthcare system from a treatment-centric model to a preventive one, promoting a combination of prevention and treatment [3][4] - The implementation of health management regulations has been inadequate, with only a few companies meeting the requirement to allocate 20% of premiums for customer health management, suggesting a need for a more robust approach [4][5] - Experts advocate for cross-departmental collaboration to establish a unified health data platform, which could enhance the efficiency of the health insurance sector and support the broader health industry [5]