国家金融监管总局发布推动健康保险高质量发展的指导意见

Core Viewpoint - The National Financial Regulatory Administration has issued guidelines to promote the high-quality development of health insurance, aligning with the "Healthy China" strategy and enhancing regulatory measures to mitigate risks in the insurance sector [1][2]. Overall Requirements - The guidelines emphasize the importance of health insurance in the national health security system by 2030, aiming for a multi-level health insurance market that meets diverse needs across the population and lifecycle [2]. Deepening Health Insurance Reform - Development of commercial medical insurance is encouraged, with a focus on creating a comprehensive product system that includes new medical technologies and treatments [3]. - The guidelines support the growth of long-term care insurance and income loss insurance due to disability, integrating cash benefits with care services [3]. - Disease insurance will be developed steadily, with regular updates to disease definitions and incidence rates [4]. - A new health service guarantee system will be established, integrating prevention, management, and protection [4]. - Collaboration between health insurance and the broader health industry is promoted to enhance service networks and support the development of the health sector [4]. Enhancing Sustainable Development Capacity - The guidelines call for strengthening professional capabilities within insurance companies and improving actuarial practices [6]. - Emphasis is placed on advancing digital transformation in health insurance, utilizing AI and big data to enhance operational efficiency and customer satisfaction [7]. - Health insurance companies are encouraged to explore innovative business models that integrate health management with insurance products [7]. Strengthening Health Insurance Regulation - A robust regulatory framework will be established, including independent financial rules and product oversight to ensure compliance and fair pricing [8]. - The guidelines aim to improve market order by enhancing performance management and addressing consumer complaints effectively [8]. - Strict measures will be taken against illegal activities within the insurance market to maintain order and mitigate risks [8]. Optimizing the Health Insurance Development Environment - The establishment of industry standards and simplified insurance terms is prioritized to enhance clarity and accessibility for consumers [9]. - Collaboration among regulatory bodies, industry organizations, and local governments is encouraged to support the development of tailored health insurance products [9]. - Efforts will be made to increase public awareness and understanding of health insurance through educational initiatives [9].