长护险九年试点覆盖近3亿人，“社保第六险”转向全面建制

Core Viewpoint - The long-term care insurance (LTCI) system in China is transitioning from pilot programs to a comprehensive national framework by the end of 2025, aiming to address the challenges of an aging population and provide essential care services for disabled individuals [1][3]. Group 1: LTCI System Development - The LTCI system, referred to as the "sixth social insurance," aims to provide basic living care and medical services for long-term disabled individuals, covering nearly 300 million people by the end of 2025 [1][3]. - The pilot phase of LTCI has been ongoing since 2016, with significant variations in implementation across different regions, leading to a fragmented system that hinders nationwide promotion [3][4]. - The current funding mechanisms for LTCI primarily rely on medical insurance funds and local government subsidies, raising concerns about sustainability and equity [4][5]. Group 2: Funding and Assessment Standards - The LTCI system faces significant risks due to its reliance on a single funding source, with projections indicating that the disabled population could reach 62 million by 2050, necessitating an estimated 1.7 trillion yuan in annual care expenditures [4][5]. - There is an urgent need for standardized disability assessment criteria to ensure equitable access to services and benefits across regions, as disparities have created "welfare gaps" [5][6]. - The National Healthcare Security Administration plans to implement unified standards for funding, benefits, and payment policies to support the sustainable development of the LTCI system [5][6]. Group 3: Role of Insurance Companies - Insurance companies are positioned as third-party administrators in the LTCI system, managing funds and overseeing service quality rather than directly providing care [7][8]. - The current business model for insurance companies in LTCI is characterized by low profitability, prompting a shift towards value creation through enhanced operational efficiency and innovative service offerings [8][10]. - Leading insurance firms are exploring technology-driven solutions to improve service delivery and reduce operational costs, aligning with national standards for service quality [9][10]. Group 4: Market Opportunities and Challenges - The comprehensive establishment of LTCI is expected to stimulate supply-side upgrades in the care industry, creating new growth opportunities for commercial insurance [11][12]. - The LTCI framework allows for the development of supplementary commercial insurance products targeting gaps in coverage, particularly for moderate disabilities and specialized care needs [12][13]. - Insurance companies are encouraged to leverage their capital and expertise to invest in care facilities, train professionals, and innovate service models, transitioning from mere payers to integral players in the elder care ecosystem [13].