联合研究 保险最初的功能主要包括分散和转移风险、补偿经济损失及融通资金等；随着行业发展，部分保险衍生出社会管理功能。考虑我国医疗保 障缺口和保险、医疗行业现状，我们认为商业健康险潜在社会管理功能或尤为突出，本文为商保支付系列报告首篇，着重讨论我国商保作 为医疗费用支付方的现状、困境与破局可能。 （本文节选自中金公司研究报告 《 中国商保支付系列（1）：现状、困境与破局 》 ，完整 内容详见报告原文） 理想情况下，商业健康险可发挥较大的社会管理功能。 宏观层面上，当前我国医疗卫生费用中居民自费占比较高；微观现状表明，主流商业健康险因缺 乏行业基建和产品开发能力导致有效供给不足；我们认为，商业健康险若能聚合大部分的居民自费支出，向医疗体系提供相对确定的预期购买额并换取折 扣，可以在一定程度上改善医疗资源的价格和可及性，发挥社会管理功能： ► 我们认为居民有效需求受限、医保广覆盖为居民带来一定"充分保障错觉"、商保支付力弱难以与医疗体系深入合作、保险行业早期经营理念与上述外 部困难相互交织是过往商保支付占比提升缓慢的重要原因，这些阻碍之间具有一定的反身性，使得过往健康险的发展陷入了某种负反馈，需要外部力量介 入带领 ...

他进一步指出，我们看到，通过持续的结构性改革和精准的货币政策，中国金融体系正在构建起应对周 期波动的能力，这正是我们能够从容面对未来挑战的信心所在。在政策引导和市场驱动的双重作用下， 金融机构正在积极谱写科技金融、绿色金融、普惠金融、养老金融和数字金融这"五篇大文章"。这五大 领域已成为我国金融强国战略目标体系的重要抓手，为金融机构在利率周期中的差异化发展指明了方 向。 "作为中国金融改革的见证者和记录者，我们还在媒体里比较早注意到了中国经济增长逻辑及金融在其 中所扮演角色的深刻变化，也就是中国经济正在从'房地产--金融--地方政府基建'的旧三角循环走向'科 技--金融--产业'的新三角循环。"邓红辉总编辑提到，围绕着新旧三角循环的切换，21世纪经济报道基 于"媒体+智库+数据"的"基于媒体，超越媒体，赋能媒体"的业务布局，通过深度报道、智库研究、数据 挖掘、资源链接来促进资金链与创新链、产业链的更高效对接，从而让21世纪经济报道与高质量发展的 中国经济一起成长。 21世纪经济报道记者 唐婧 北京报道 11月22日，由南方财经全媒体集团指导、21世纪经济报道主办的"第二十届21世纪金融年会"，在北京盛 大召开 ...

在养老金生态方面，商敬国提出两项关键点，一是提升长期资产管理能力，二是将年金产品竞争力融入 养老生态产业链。他表示，这两项能力是年金产品竞争力融入养老生态产业链的关键所在。 南方财经全媒体记者 林汉垚 在全球经济格局深刻调整与国内高质量发展战略全面推进的背景下，金融业如何在复杂环境中寻找新的 发展路径，成为业界关注的焦点。 11月22日，中国精算师协会党委委员、副秘书长商敬国在由南方财经全媒体集团指导、《21世纪经济报 道》主办的"第二十届21世纪金融年会"上表示，一味追求经济规模和发展速度的模式已不适应当下的环 境，行业粗放高速发展周期已经结束，因时而变，因势而变，高质量发展是应对复杂多变环境的最优选 择。 行业所处的内外部环境已发生巨大变化，全球地缘政治与地缘经济冲突重创全球化，经济增长放缓；与 此同时，AI技术的崛起正在深刻影响各行各业的发展路径。 商敬国指出，全球投资者风险偏好不断提升，资本市场屡创新高，但最大的确定性是不确定性本身。面 对复杂多变的环境，传统依赖规模扩张和高速发展的模式已不再适应。 他强调，行业发展已进入跨领域融合的生态时代，呈现出外溢性特征。从"重产品、重销售"的外延式发 展，转向 ...

Core Insights - The article highlights a significant gap between the recognition of the necessity of commercial health insurance among professionals and their actual purchasing behavior, with over 80% acknowledging its importance but only about one-third incorporating it into their lives [1][3]. Group 1: Consumer Behavior and Attitudes - Professionals tend to prioritize immediate gratification through spending on entertainment and leisure, such as coffee and travel, rather than investing in insurance, reflecting a lack of risk awareness [3][4]. - Data from the white paper indicates that individuals aged 25-30 spend an average of 665.6 yuan on beverages monthly, while over 53.6% spend less than 200 yuan on insurance, showcasing a trend of lavish spending coupled with cautious insurance purchasing [3][4]. Group 2: Barriers to Insurance Purchase - The complexity of insurance terms and the overwhelming number of product choices are major obstacles for professionals, with 55.8% citing these as reasons for not purchasing insurance [4][5]. - Many young individuals exhibit an optimistic bias, underestimating their health risks and believing that significant health issues are unlikely, which contributes to their reluctance to buy insurance [4][5]. Group 3: Urgency of Insurance Awareness - Over 40% of professionals are unable to purchase suitable critical illness insurance due to pre-existing conditions, with rejection rates exceeding 30% for certain health issues, indicating an urgent need for tailored insurance solutions [5][6]. - The article emphasizes the importance of insurance in mitigating financial risks associated with major health issues, as professionals often serve as economic pillars for their families [5][6]. Group 4: Building an Insurance Portfolio - Professionals are advised to prioritize commercial medical insurance, critical illness insurance, and accident insurance as foundational elements of their insurance portfolio [7][8]. - The article suggests a dynamic approach to insurance planning, recommending that individuals adjust their coverage based on life stages and responsibilities, such as prioritizing medical and accident insurance in early career stages and adding critical illness and life insurance as family responsibilities grow [8][9]. Group 5: Key Considerations for First-Time Buyers - First-time insurance buyers should focus on essential coverage to protect against significant financial losses from health issues or accidents, avoiding overly complex financial products [9][10]. - It is crucial for buyers to understand key insurance terms and to accurately disclose their health status during the application process to ensure smooth claims in the future [9][10].

Investment Rating - The report indicates a positive outlook for the health insurance industry, suggesting a potential increase in value exceeding 15% over the next 3-6 months [5]. Core Insights - The report emphasizes the importance of health insurance in the national health security system by 2030, as outlined in the recent regulatory guidance [1]. - It highlights the need for differentiated requirements across various segments of health insurance, with a focus on commercial medical insurance as a core growth area [2]. - The report advocates for the development of innovative insurance products that cater to specific groups, such as those with pre-existing conditions and rare diseases [2]. - It stresses the importance of collaboration among regulatory bodies, insurance organizations, and information-sharing platforms to enhance the health insurance ecosystem [3]. - The report outlines key future regulatory priorities, including the promotion of floating yield health insurance and the enhancement of health management services within insurance products [3]. Summary by Sections Commercial Medical Insurance - The report supports the active development of commercial medical insurance, which is expected to be a significant growth driver in the health insurance sector [2]. - It encourages the inclusion of new medical technologies and treatments in insurance coverage and the establishment of a pricing mechanism based on risk categories [2]. Disease Insurance - The report suggests a steady development approach for disease insurance, with a focus on supporting well-rated insurance companies in offering dividend-based long-term health insurance products [2]. Long-term Care Insurance - There is a call to accelerate the development of commercial long-term care insurance and income loss insurance due to disability [2]. Collaboration and Policy Support - The report emphasizes the need for enhanced cooperation between regulatory authorities and local governments to support the development of regional and specialized insurance products [3]. - It also highlights the importance of leveraging existing policies to promote group health insurance and facilitate quick claims processing in commercial medical insurance [3].

Investment Rating - The industry investment rating is "Overweight" (maintained) [1] Core Insights - The report highlights the significant potential for growth in the health insurance sector, driven by increasing health awareness and an aging population. The recent regulatory guidance aims to enhance the quality and scope of health insurance products [4][5] - Major insurance companies are strategically positioning themselves in the health management sector, which is expected to improve profitability and valuation as they leverage their comprehensive advantages [6] Summary by Sections Industry Overview - The health insurance market is projected to expand significantly due to demographic changes and rising health consciousness among the population [5] - The report notes a decline in the proportion of health insurance premiums in recent years, attributed to factors such as profitability of insurance products and market standardization [5] Regulatory Developments - The China Banking and Insurance Regulatory Commission issued guidelines to promote the high-quality development of health insurance, emphasizing the need for a multi-layered health insurance market by 2030 [4] - Key initiatives include expanding coverage to include new medical technologies and supporting the integration of health insurance with health management services [4][5] Company Strategies - Leading insurance firms like China Pacific Insurance, China Life, and Ping An are enhancing their health management capabilities and developing innovative insurance products [6] - These companies are expected to benefit from regulatory support, which will help them reduce risk and improve profitability through a higher proportion of health insurance in their portfolios [6]

Investment Rating - The report maintains an "Outperform" rating for the biopharmaceutical industry [1] Core Viewpoints - The growth of healthcare expenses, which reached 9.06 trillion yuan in 2023, is outpacing GDP growth, indicating that commercial health insurance may provide a solution to the pressures faced by the medical insurance system [3][15] - The commercial health insurance sector is expected to grow significantly, with premiums projected to reach 97.74 billion yuan by 2024, driven by low penetration rates and the need for additional funding sources [20][24] - Policies are increasingly supportive of commercial health insurance, particularly in relation to innovative drugs, which are now being included in the commercial health insurance directory [71][76] Summary by Sections Part 1: Healthcare Financing System - The healthcare financing system in China consists of government, social, and personal contributions, with social contributions being the main driver for future growth [10][15] Part 2: Growth of Health Insurance - The commercial health insurance market is expected to fill a significant funding gap, with an estimated shortfall of over 1.7 trillion yuan by 2030 [21][22] - Medical insurance is the primary source of compensation within commercial health insurance, with a compensation rate of approximately 68.79% in 2022 [27][31] Part 3: Core Products of Medical Insurance - The report highlights the importance of medical insurance as a key focus area, noting that it directly compensates for medical expenses, unlike critical illness insurance [31][35] Part 4: Policy Support for Health Insurance Development - A series of policies since 2009 have aimed to promote the development of commercial health insurance, with specific targets for market size and coverage [71][72] Part 5: Investment Recommendations - The report suggests focusing on innovative drug companies with rich pipelines, DTP pharmacies, and companies in the TPA industry, as well as innovative medical devices and high-end medical service providers [77]

Core Insights - The insurance industry in China is projected to see a significant increase in premium income and total assets by 2025, with a growth of over 25% in premium income and 68% in total assets compared to 2020 [1] Group 1: Strengthening Social Welfare - The insurance sector has expanded its capacity to improve and guarantee livelihoods, with personal insurance payouts reaching 1.2 trillion yuan in 2024, an increase of 88.08% from 2020, and property insurance payouts at 1.1 trillion yuan, up 57.14% [2] - The insurance industry is actively developing commercial insurance products, enhancing the supply of insurance for new industries and urban residents, and improving the inclusive insurance system to better meet public needs [2] - Catastrophe insurance has achieved full coverage for common natural disasters in China, with over 20 provinces piloting comprehensive catastrophe insurance [2] Group 2: Enhancing Support for the Real Economy - The insurance industry provides risk protection across various sectors, including agriculture, with agricultural insurance premiums increasing from 97.6 billion yuan in 2021 to 148.37 billion yuan in 2024 [3] - The introduction of innovative insurance products, such as weather index insurance for oil tea plantations, demonstrates the industry's commitment to supporting agricultural resilience [3] - Insurance funds are increasingly being utilized for long-term investments in major projects, with the balance of insurance company funds rising from 21.68 trillion yuan at the end of 2020 to 34.93 trillion yuan by the first quarter of this year [4] Group 3: Ongoing Reforms in Key Areas - The insurance industry is undergoing significant reforms, including the establishment of a dynamic adjustment mechanism for life insurance product pricing linked to market rates, aimed at enhancing pricing accuracy [7] - The implementation of the "Car Insurance Good to Insure" platform has facilitated the coverage of over 880,000 new energy vehicles, with total insured amounts reaching 888.95 billion yuan [6] - Reforms in the auto insurance sector have led to a 21.2% decrease in average premiums, while the compulsory insurance coverage has increased significantly [6]

Core Insights - The insurance industry in China is projected to see a significant increase in original insurance premium income, with a growth of over 25% by 2024 compared to 2020, and total assets expected to rise by 68% by mid-2025 compared to the end of 2020 [1] - The insurance sector has enhanced its capacity to safeguard and improve people's livelihoods, with personal insurance payouts reaching 1.2 trillion yuan in 2024, an increase of 88.08% from 2020, and property insurance payouts at 1.1 trillion yuan, up 57.14% from 2020 [2] - The insurance industry is actively developing commercial insurance products, optimizing coverage for new industries and urban residents, and improving the inclusive insurance system to better meet public needs [2] Group 1: Enhancements in Livelihood Protection - The insurance industry has expanded its coverage and improved service capabilities, with a focus on commercial insurance annuities and long-term care insurance [2] - Catastrophe insurance has achieved full coverage for common natural disasters in China, with over 20 provinces piloting comprehensive catastrophe insurance [2] - In 2024, the urban and rural residential catastrophe insurance community provided 22.36 trillion yuan in catastrophe risk protection for 64.39 million households [2] Group 2: Support for the Real Economy - The insurance sector has provided risk protection across various aspects of the real economy, including agricultural insurance, which saw premium income grow from 97.6 billion yuan in 2021 to 148.37 billion yuan in 2024 [3] - Innovative insurance products, such as weather index insurance for oil tea gardens, have been developed to mitigate losses from adverse weather conditions [3] - The insurance industry has also supported major projects and infrastructure through long-term investments, with the balance of insurance funds increasing from 21.68 trillion yuan at the end of 2020 to 34.93 trillion yuan by early 2023 [4] Group 3: Ongoing Reforms in Key Areas - The implementation of comprehensive reforms in auto insurance has led to a 21.2% decrease in average premiums, with significant increases in coverage limits [6] - The insurance industry is undergoing reforms to enhance product pricing accuracy and operational efficiency, including the establishment of a dynamic adjustment mechanism for life insurance product rates [6] - These reforms aim to improve the competitiveness and risk management capabilities of insurance companies while better serving national strategic goals and enhancing social governance [6] Group 4: Future Directions - The financial regulatory authority plans to continue enhancing risk management, regulatory oversight, and high-quality development within the insurance sector [7] - The focus will be on strengthening the insurance industry's role as an economic stabilizer and social stabilizer, while improving insurance protection capabilities and service levels [7]

Core Insights - The insurance industry in China is expected to see significant growth during the 14th Five-Year Plan period, with original insurance premium income projected to increase by over 25% compared to 2020, and total assets expected to grow by 68% by mid-2025 [1] Group 1: Strengthening Social Welfare - The insurance sector has expanded its capacity to improve and guarantee livelihoods, with personal insurance payouts expected to reach 1.2 trillion yuan in 2024, an increase of 88.08% from 2020, while property insurance payouts are projected at 1.1 trillion yuan, up 57.14% from 2020 [2] - The insurance industry is actively developing commercial insurance products, including annuities and long-term care insurance, to better serve the needs of new citizens and emerging industries [2] - Catastrophe insurance has achieved full coverage for common natural disasters in China, with over 20 provinces piloting comprehensive catastrophe insurance [2] Group 2: Enhancing Support for the Real Economy - The insurance industry provides risk protection across various sectors, with agricultural insurance premiums rising from 97.6 billion yuan in 2021 to 148.37 billion yuan in 2024, reflecting an increase in coverage and protection levels for staple crops [3] - The establishment of the China Integrated Circuit Mutual Insurance Body has provided approximately 4.2 trillion yuan in risk protection since its inception, while technology insurance is expected to cover around 9 trillion yuan in 2024 [4] Group 3: Long-term Investment and Financial Support - Insurance funds are increasingly supporting large-scale projects, with the balance of insurance company funds invested rising from 21.68 trillion yuan at the end of 2020 to 34.93 trillion yuan by the first quarter of this year [5] Group 4: Ongoing Reforms in Key Areas - The launch of the "Car Insurance Easy to Insure" platform has facilitated the underwriting of over 880,000 new energy vehicles, with total coverage reaching 888.95 billion yuan, addressing high compensation risks in this sector [6] - The average car insurance premium has decreased by 21.2% to 2,773 yuan per vehicle since the implementation of comprehensive car insurance reforms [6] - The insurance industry is undergoing significant reforms to enhance operational standards and improve service quality, with a focus on risk management and regulatory compliance [7]