惠民保十年启示：让市场的部分归市场

Core Insights - The Huiminbao insurance, launched a decade ago, is currently undergoing a market adjustment phase with a decline in operational products from 74.3% in 2023-2024 to 66.78% in 2024-2025 [1] - The insurance product has faced challenges in maintaining participation rates and expanding risk pools, leading to a contraction in the number of products available [1][2] - Huiminbao has played a significant role in alleviating high out-of-pocket medical expenses for residents, with a reported 15% share of the total compensation for innovative drugs and medical devices in 2024 [1] Summary by Sections Market Performance - The proportion of operational Huiminbao products is expected to decrease to 65.54% by 2024-2025, indicating a contraction in the market [1] - The average participation rate for 53 publicly reported Huiminbao products in 2023 was only 18.9%, significantly below the critical threshold of 70%-80% for effective risk dispersion [2] Product Design and Challenges - Huiminbao combines attributes of public and commercial products, with local health insurance bureaus leading initiatives without government subsidies [2] - The design includes a claims threshold of 10,000 to 15,000 yuan, which has discouraged continued participation among many insured individuals [2] - Some regions have set specific compensation rate requirements, increasing the risk of unsustainable projects and leading to some programs being discontinued after just one year [2] Innovations and Adjustments - To improve participation rates, various regions have expanded eligibility to include flexible employment groups and allowed the use of personal health insurance account balances for payments [3] - The government is encouraged to focus on long-term institutional support rather than short-term gains, which could enhance the willingness of commercial insurers to participate [3] Operational Strategies - Insurance companies are advised to transition towards health management service providers, utilizing data analytics for better risk management and enhancing user engagement through value-added services [4] - Recent additions to Huiminbao projects include services like home care and cancer screening, although awareness and accessibility remain low [4] Systemic Role - Huiminbao is a crucial component of China's multi-tiered medical insurance system, reflecting the expectations of the government, insurance companies, and insured individuals [5] - A balanced approach between government oversight and market dynamics is essential for the sustainable development of this public welfare initiative [5]