中国医疗改革市场调研和分析报告（英文版）-2024年1月上传培训课件

POLITICS

&

SOCIETYChina′s

healthcare

reform

andits

effectsAreport

onchallenges

facing

China′s

healthcare

system,

its

reform,andoutcomesThe

transformation

of

China‘s

healthcare

systemExecutive

summaryChina'shealthcare

system

hasevolved

rapidly

inthe

lasttwo

decades.

Thecountrynow

enjoys

the

world's

largest

public

healthinsurance

system,

covering

over

95percent

of

itspopulation(see

page14).

Itsmore

than

onemillion

healthcareproviders

received

almost

8.5

billionvisitsin2021,

and

thequality

of

carekeepsimproving.Inadequategovernment

investment

inpublicly-owned

healthcare

institutionshasput

pressure

on

hospitalsanddoctors

togenerate

more

revenues,

whileoverdiagnosis

andoverprescription,

combined

withinsufficient

reimbursementratesof

statutory

medical

insurance,

haveresulted

inhighout-of-pocket

expensesformany

patients.However,

the

evolution

ofChina‘shealthcare

system

hasnotbeen

straightforward.SincethestartofChina'seconomic

reforms

inthe

late1970s,

the

country'shealthcare

system

haswitnessed

multipleroundsofmajor

adjustments,resultingInaneffort

toaddressthese

issuesandimprove

the

country'shealthcare

system,Beijing

hasadoptedseveral

initiatives,thelatestof

which

isananti-corruptioncampaigntargeting

publichealthcare

providers

andstaff

inthesecond

half

of

2023.inthe

collapse

and

restoration

of

the

basicmedical

insurancesystem,

accompanied

Regulators

hopetoimprove

thecapacityandquality

of

careinthehealthcarebythe

marketization

of

healthcareproviders.sector,

reduce

hospitals'

dependence

ondrugrevenue,

andease

the

financialburden

onpatients.These

adjustmentscreated

complications

inthesector,

many

ofwhich

continuetoaffectChinese

patientstothis

day:By

summarizing

the

most

compelling

challenges

facingChina'shealthcaresystemandreviewing

thecourse

of

the

reforms,

thisreport

will

discussthe

effects

andshortcomings

ofthetransformations

of

China’spublic

insurance

programs

andmedical

institutionsbefore

outliningtherealistic

possibilities

of

howthecountry’shealthcare

sector

might

develop

inthe

future.Early

effortstowards

marketization

of

the

healthcare

system

led

to

theprevalenceof

the

so-called

"PutianNetwork"

ofunregulated

or

unqualifiedmedicalinstitutions,which

accounted

for80

percent

of

allprivatehealthcare

providers

in2018

and

undermined

thehealthofasignificantnumberof

patients(page25).3Sources:

NHC

(China)01Challenges

facing

China′s

healthcaresystem•

Surgingdemand

forhealthcare

services•

Over-reliance

on

hospitalsforbasiccare•

Highout-of-pocket

costsfor

patients•

Rural-urban

and

regional

disparitiesA

system

under

pressureSurgingtreatment

demandsandupcoming

demographic

changesNumberofinpatientsat

Chinese

hospitals

between2011

and

2021

(inmillions)Thanksto

China’seconomic

prosperity

since

the1980s,

healthcare

services

havebecome

substantiallymore

accessible

to

theChinesepeople,

especially

tothose

indisadvantagedregions,

manyof

whom

wereonly

served

byso-called

barefoot

doctors

before

(seeglossary

fordefinition).

Inthe

decade

before

theCOVID-19

outbreak

andthe

subsequent

“Zero-COVID”policy

disrupted

the

normal

operations

of

China’shealthcare

providers,

the

number

ofinpatientstreatedbyChinesehospitalsannuallygrew

bymore

than

100million.

Manyhospitalswere

reportedlyunderequipped

and

understaffed,with

doctors

andnurses

working

undersignificant

pressure

forlongshifts,while

patientsatisfaction

was

alsocompromised.

Arapidlyagingpopulation,andconsequently,

thegrowing

prevalence

of

chronicdiseases,

will

placeChina’shealthsystem

underfurtherstraininthecoming

years.Number

ofpatients

inmillions265.9620193002001000253.84244.36247.322021227.28230.132020204.41210.54192.15178.572012152.982011201320142015201620172018Share

ofpopulation

aged65

andoverinChinafrom

1980

to2020,

with

forecasts

until

2050Shareofpersons

aged65andover40%30%20%10%0%198019902000201020202030*2040*2050*5Notes:(1)

China;

2011

to2021;

(2)

China;

1980

to2050;

*forecastSources:

(1)

MOH

(China);

National

BureauofStatistics

ofChina;

ID:279386;

(2)

National

BureauofStatistics

ofChina;

UNDESA;

ID:1370918;

Text:MOH

(China);

National

BureauofStatistics

ofChinaA

dysfunctional

patient

referral

systemRate

ofhospital

bed

occupancy

inChinafrom

2019

to2021,

byhospital

classificationChina'shealthcare

system

ishighlyreliant

onhospitals.

Given

theabsence

of

aneffective

referral

system

andthe

low

level

of

publictrustinprimary

healthcare

facilities,

people

inChina

tendtoself-refer

to

hospitalsfordiagnosisand

treatment

of

minor

illnessessuchasheadaches

and

thecommon

cold.

Consequently,aconsiderable

proportion

ofhospital

resources

arediverted

toproviding

the

most

basiccare,

undermining

the

accessibility

andqualityofother

operations.

Theburden

isparticularly

heavy

onhigh-tier

general

hospitals.

In2021,

thecountry's3,275

tier-threehospitalsreceived

more

than

2.2

billion

patientvisitsand

hadan85

percent

bedoccupancy

rate.

Althoughtier-three

hospitalsrepresented

only

0.32

percent

ofallhealthcare

facilities

inthecountry,they

handledover

aquarterof

allmedical

consultationsandmore

than45

percent

of

allhospital

admissions.

Primaryhealthcare

facilities,which

were

originally

designated

to

treatminor

illnesses

andprovide

basiccare,

remain

underutilized,with

more

than

half

of

the

bedsinthese

facilitiesbeing

leftempty.Hospital

bedoccupancy

rateTier3hospitalsTier2hospitalsTier1hospitals85.3%71.1%52.1%Distribution

ofoutpatient

visits

inChinain2019,

bytypeofhealthcare

facilityPrimarycarecentersHospitals52%45%Otherhealthcarefacilities4%6Notes:(1)

China;

2019

to2021;

details

ofthe

hospital

classification

systemin

China

can

be

found

onpage

29;

(2)

China;

2019Sources:

(1)

NHC;

ID:1285390;

(2)

NHC

(China);

U.S.-China

Economic

and

Security

Review

Commission;

Text:NHC

(China)Unaffordable

medical

bills,

especially

for

rural

residentsHighout-of-pocket

costsandpoverty

caused

bymedical

expensesShare

ofillness-related

poverty

amongall

poverty

casesinChinain2017Medical

expenses

havelongbeen

asource

of

financialhardshipforChinesepatients,especially

forthoselivinginrural

areas.

Dueto

inadequateinsurancecoverage,

manypatientsmust

payhigh

out-of-pocketratesor,

insome

cases,

fund

theentire

treatmentthemselves.

A

2018

studycovering

more

than

7,000people

over

the

ageof

60

showed

thatthe

probabilityof

catastrophic

medical

expenditure

(CME)amongolder

Chinese

adults

remained

above11

percent,

withthe

risk

significantlyhigheramong

ruralresidents,especially

the

poor.

According

tothe

latest

availabledata,the

Ministry

of

CivilAffairsnoted

thatin2017,

40percent

of

China's

poverty

could

beattributabletomedical

costs.60%OtherreasonsIllnessrelated

poverty40%7Notes:China;

2017Sources:

Ministry

ofCivil

Affairs

(China);

Xinhua

News

Agency;

Text:Hu

etal.The

imbalance

between

urban

and

rural

healthcare

providersChina'shealthcare

system

ischaracterized

byitschronic

mismatch

between

medical

demands

andresources.

Primary

healthcare

facilitiesandruralpractices

areinsufficientindensity

and

inferior

inquality(see

page

28).

Better

healthcare

providers

aremostly

located

inmajor

urbancenters,

while

over

halfof

the

country's50

leading

hospitalsareconcentratedinBeijing

and

Shanghai.

Many

patientsinneed

musttravel

long

distancesfortheirdiagnosisandtreatment,andreputablehospitalsareconsistently

packed

withpatientsfrom

allover

the

country.

Itisoften

difficultforpatientstoregister

forconsultations,forcing

manytoqueuefromtheearly

morning

or

resort

tobribes.Flatsaround

hospitals,often

divided

into

smaller

unitsandin

poor

conditions,

arealsoextensively

rented

outtopatientsandtheirfamilies.Inverted

pyramid

ofmedical

resourcesBetter

healthcareresources

areconcentrated

inurbancentersFlow

of

patientstohospitalslocated

inurbancenters,resulting

inadditionalburdensonpatientsPyramid

ofmedical

demandsHealthcare

demands

aremoreprevalent

atthe

grassroot

level8Sources:

Fudan

University;Hospital

Management

Institute;

Sohu02Reforms

to

China′s

basic

medicalinsurance

programs•

Initialmarket

reform

and

itsconsequences•

Medical

insurancereforms

since1994•

Effectsand

limitationsof

the

reforms•

Funding

structure

improvements•

TheprivatehealthinsurancemarketMarket

reformandits

consequencesSurgingout-of-pocket

costsandunequalaccess

to

healthcare

servicesShare

ofout-of-pocket

healthexpenditure

intotal

healthexpenditure

inChina,from

1980

to

2000Before

the

1978

market

reform,

China’smedical

insurance

system

was

organizedbased

onemployment

status.

Three

schemes

were

implemented

across

thecountry,includingthe

1951

LaborInsuranceSystem

covering

employees

ofthestate-owned

and

collective-owned

enterprises

and

theirfamily

members,

the

1952Government

InsuranceSystemserving

officials,retired

officials,and

universitystudents,andthe

Cooperative

Medical

Scheme

covering

rural

residents,

individuallyorganized

bypeople’s

communes.

Despite

thepoormedical

standardsinthecountry,these

systems

ensured

thatmost

Chinese

people

would

notbedeniedaccess

tohealthcareservices

owing

to

theirfinancialsituation.Theendof

China’scentrally

plannedeconomy

sawthedisintegration

of

agriculturalcommunes,causingtherateofparticipation

inthe

Cooperative

Medical

Scheme

to

plummet,while

theLaborInsuranceSystem

alsocollapsed

afterprivatization

andwaves

ofredundancies

instate-owned

andcollective-owned

enterprises.

Asaresult,

people’sout-of-pocket

medical

costsincreased

extensively,

fromaround

20

percent

ofthetotalhealthcare

expenditure

toalmost

60

percent

bytheendof

the

century.Shareoftotalhealthexpenditure70%60%50%40%30%20%10%0%1980

1985

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

200010

Notes:China;

1980

to2000Sources:

National

BureauofStatistics

ofChina;

NHC;ID:1285916Building

a

functional

statutory

medical

insurance

systemTheimplementation

ofthebasicmedical

insuranceprograms

since

1994The

startofthe

mergerbetweenthe

UrbanResidentBasic

MedicalInsuranceprogramandthe

NewRural

Cooperative

MedicalSchemeUrbanEmployeeBasicNationwide

roll-out

of

theEmployeeBasicMedicalInsuranceprogramThe

introduction

of

the

UrbanResidentBasic

MedicalInsuranceprogramMedicalInsurance

trialprogrambegins

inthecities

ofZhenjiang

andJiujiang19941996199820032007201020162018Trialprogramextendedto56citiesThe

introduction

of

theNew

Rural

CooperativeMedicalSchemeThe

enactmentof

the“SocialInsurance

Law

ofthe

People’s

Republic

ofChina”Founding

ofthe

NationalHealthSecurityAdministration11Sources:

National

Healthcare

Security

Administration;

NHC;

Sinolink

SecuritiesThe

Employee

Basic

Medical

Insurance

programMandatory

insurance

scheme

thatoffers

betterservicesIncome

andexpenditure

of

employeebasicmedical

insurancefund

inChinain2021,bytypeofaccountInChina's

basicmedical

insurance

system,

allemployees

arerequired

toenroll

inthe

Employee

BasicMedical

Insurance(EBMI)

program.

Every

employee

is

assigned

amandatorypersonal

account

and

mustdeposit

twopercent

of

theirpretax

salary

tocover

theexpenses

ofmost

outpatientservices.

Meanwhile,

the

employer

is

obliged

tocontributeanothereight

percent

oftheemployee's

salary

to

thehealthinsurancefund,

themajority

ofwhich

is

allocated

toapooledfund,

covering

the

expenses

forhospitalizations,

surgeries,andoutpatienttreatments

forserious

illnesses

of

allparticipants.People

of

pension

agecanalsocontinuetobenefit

from

EBMI,provided

thatthey

havecontributed

to

thesystem

foraqualifying

period

prior

totheirretirement

(seepage18).

Dueto

therelatively

adequatefunding,

thecoverage,

rates,andcapson

reimbursements

offered

byEBMIare

betterthanotherbasicmedical

insuranceprograms.Income

andexpenditure

inbillionyuan2,0001,8001,6001,4001,186.41,2001,0008006004002000932.13542.55713.91IncomeExpenditureMandatorypersonalaccountPooled

fund,includingmaternityinsurance12

Notes:China;

2021Sources:

National

Healthcare

Security

Administration;

ID:1371727The

Urban

and

RuralResident

Basic

Medical

Insurance

programVoluntary

medical

insurance

scheme

forrural

residents

and

the

economically

inactivepopulationIncome

andexpenditure

of

the

Urban

andRural

ResidentBasic

Medical

Insurance

Fund,from

2012

to2021Rural

residents

andthosenot

engagingineconomic

activitiescanparticipateinthe

UrbanandRural

Resident

BasicMedicalInsurance(URRBMI)

program.

Theprogram

is

the

result

of

arecent

merger

ofthe2003

New

Rural

Cooperative

MedicalScheme

and

the2007

BasicMedical

InsuranceforUrbanResidents

(see

page11).

Unlikethemedical

insuranceschemeforemployees,

the

URRBMI

program

isvoluntary.

Participantsarenot

assigned

personal

accounts,and

fixed-rate

insurancepremiums

remain

highlyaffordable.

Forinstance,the

2023annual

insurance

contribution

inBeijing

is665

yuanforworking-age

participants,while

senior

citizens,

students,andchildren

payless

than

400

yuan.

Althoughthe

insurance

fundisalso

subsidizedbytaxrevenue,

funding

shortfallsresultedinlower

reimbursement

ratesandinferior

coverageIncome

andexpenditure

inbillionyuan1,2001,0008006004002000compared

to

themedical

insurance

offered

toemployees.2012201320142015201620172018201920202021IncomeExpenditure13

Notes:China;

2012

to2021Sources:

National

Healthcare

Security

Administration;

ID:1369674;

Text;The

People‘s

GovernmentofBeijing

MunicipalityEffect:

Near-universal

insurance

participationNumberofpeopleenrolledinthebasic

medicalinsuranceprogram

inChina,from

2011

to

2021Withtheintroduction

ofvariousstatutory

basicmedical

insuranceschemes,

andespecially

since

the

recentmerger

oftheNew

Rural

CooperativeScheme

and

theUrbanResident

BasicMedical

InsuranceProgram,

thenumberof

participants

inbasicmedicalinsuranceinChina

hasincreasedcontinuously.

Thankstothe

compulsorynatureofEBMI

and

therelatively

lowinsurancepremium

oftheURRBMIprogram,

by2021,

more

than

95percent

of

the

Chinesepopulation

wasinsured

throughone

of

the

basicmedical

insuranceprograms.Number

ofcontributors

in

millions1,6001,354.071,3611,362.971,344.591,4001,2001,00080060040020001,176.81743.92665.82597.47570.73536.412012473.43201120132014201520162017201820192020202114

Notes:China;

2011

to2021Sources:

National

Healthcare

Security

Administration;

ID:233878Effect:More

affordable

basic

healthcare

for

the

insuredShare

ofout-of-pocket

healthexpenditure

in

total

healthexpenditure

inChina,from

2001

to2021Theimplementation

ofChina'sbasicmedical

insuranceprograms

hassubstantiallyeased

thefinancialburdensborne

bypatients.Since2000,the

proportion

of

out-of-pocket

medicalspendinginthecountry'stotalhealthcare

expenditure

hasbeendroppingcontinuously,

to

under30percent

by2021.

Withthe

recentintroduction

of

critical

illnessinsuranceschemes,

which

cover

manyseriousmedical

conditions,theriskofdisadvantagedpatientswithdrawingfrom

treatment

owing

tofinancialconstraintshasbeen

furtherreduced,savingmany

families

fromlosses

andhardships.Shareoftotalhealthexpenditure70%60%50%40%30%20%10%0%20012003200520072009201120132015201720192021*15

Notes:China;

2001

to2021;

*preliminary

figuresSources:

National

BureauofStatistics

ofChina;

NHC;ID:1285916Limitation:

Funding

shortfalls

and

inadequate

coverageWhile

the

affordablepremiums

forChina'sbasicmedical

insurancehavekeptthefinancialburdensofitsparticipantslow,

consequent

funding

shortfallsalsolimited

itssuccess.

Medical

expenses

are

most

oftenonly

partiallyreimbursed,

as

some

treatments,

drugs,andmedical

consumables

arenotcovered.

Manyadvanced

and

imported

drugsnecessary

forthetreatment

ofcertain

illnesses

are

alsonoteligible

forreimbursement.

Inaddition,expenses

exceeding

themaximum

reimbursement

limit

ofcritical

illnessmedical

insuranceareborne

entirely

bypatientsoutoftheirown

pockets.

Allthesefactorshaveled

manydisadvantagedpatients,especially

thosewith

seriousor

chronic

conditions,toremain

unableto

affordtreatment,

even

thoughtheyare

insured

throughoneof

the

basicmedical

insuranceprograms.out-of-pocket

expensesMaximum

reimbursement

limitimported

drugs,medicalexpensereimbursementsthrough

EBMIandURRBMIout-of-pocketmedical

costsafterreimbursementsadvancedprocedures,

value-addedservicesMinimum

reimbursement

thresholdout-of-pocketexpenses16Sources:

SohuLimitation:

Inequality

between

regionsComparison

betweenout-of-pocket

healthcare

costsintotal

healthexpenditure

inBeijingandHebei

in2020Themerger

of

the

Urban

Resident

BasicMedicalInsuranceandthe

New

Rural

Cooperative

MedicalScheme

inrecent

years

was

intended

to

level

upthemedical

insurancecoverage

inrural

areas

anddisadvantagedregions.

However,

as

medical

insurancefunds

remain

localized

andaremanaged

byprovinces,the

regional

disparityremains

significant.Residents

inthe

more

prosperous

eastern

provinces

suchasBeijing

and

Shanghai

enjoy

significantlybetter

medicalinsurancecoverage,

more

generous

reimbursementrates,

and

higherreimbursement

ceilings

overall

thanthose

residing

inthe

less

wealthy

regions

likeHebeiandGuizhou.Althoughmedical

costs

may

becheaperinrural

and

poorer

regions,

major

diseases

oftenrequire

patientsto

travel

across

regions

fortreatmentdueto

poor

local

medical

standards,and

theBEIJING13.39%

Out-of-pocketspending86.61%

Government

andsocial

healthexpenditure30.93%

Out-of-pocketspendingHEBEI69.07%

Government

andsocial

healthexpenditureadditionalexpenses

canadd

furtherbarriers

forthepatientsandtheirfamilies.17

Notes:China;

2022Sources:

Liand

Zhang;

National

BureauofStatistics

ofChina;

NHCLimitation:

Unequal

treatment

between

EBMI

and

URRBMI

resulting

in

failuresto

protect

thevulnerableReimbursementrate

comparison

for

inpatienttreatments

intiertwo

hospitalsbetweenEBMI

andURRBMI

participants

inBeijing

in2023Thebenefitsoffered

byEmployee

BasicMedicalInsurance(EBMI)

andUrbanandRural

Resident

BasicMedical

Insurance(URRBMI)

arealso

substantiallyunequal.AsEBMIis

relatively

well-funded,

with

eachparticipanthaving

apersonal

account

foroutpatienttreatment,

in2023,

itsreimbursement

rateswerebetween

seven

and19

percent

higherthan

thoseoffered

byURRBMI

forcarecosts

up

to250,000

yuan.In2022,

the

annualper

capita

expenditure

ofEBMIexceeded

4,100

yuan,

more

than

three

times

higherthan

thatof

URRBMI.

Consequently,

China'scurrentmedical

insurancesystem

provides

inadequateprotections

forthe

vulnerable,

given

thatEBMIparticipantsaremostly

urbanresidents

receivingregular

salaries

or

pensions

and

are

already

inbetterfinancialpositionsthan

those

covered

byURRBMI.97%100%90%80%70%60%50%40%30%20%10%0%92%87%85%85%78%78%78%78%0%1,300

to30,000yuan30,000

to

40,000

yuan40,000

to

100,000yuan100,000

to250,000yuan250,000

to500,000yuanRetiredEBMIparticipantsURRBMIparticipants18

Notes:China;

2023Sources:

Haidian

DistrictPeople‘s

GovernmentofBeijing

Municipality;

National

Healthcare

Security

Administration;

Text:National

Healthcare

Security

AdministrationLimitation:

Dormant

funds

in

EBMI

personal

accountsShare

ofdormant

fundsin

personal

accounts

ofhealthyEBMI

participants

inGuangdongin2022TheEmployee

BasicMedical

Insurance(EBMI)

stillenjoys

anannualsurplus.Yet

thepressure

ontheinsurancefund

will

only

continueto

intensify

asfeweryounger

employees

will

beparticipating

inEBMIduetodemographic

changes,while

itsaging

participantswillrequire

more

medical

attention

and

funding.

Thisisnothelped

byEBMI'spersonal

account

system,resulting

inunderutilized

dormant

funds.Underthecurrent

system,

every

EBMI

participant'smandatorypersonal

account

canonlybeused

to

payfortheirown

outpatienttreatments.

80

percent

ofdormantfunds

belong

to

young

and

healthy

participants,

whooften

haveaconsiderable

sumoffunds

lying

intheiraccounts,while

thosefrequently

seeking

outpatientcare

often

haveto

payoutof

pocket

for

theirvisitsduetoinsufficientfunds

intheiraccounts.

MedicalFunds

inother

accounts20%80%Funds

inaccounts

ofhealthyparticipantsinsurancehastosome

extent,

become

compulsorysavings,failing

toserve

patientsinneed.19

Notes:China;

2022Sources:

People's

GovernmentofGuangdong

ProvinceOutlook:

Funding

structure

reformsThedecliningsurplusratesandthe

upcoming

rise

inmedical

demandsOver

the

pasttwo

decades,

China

established

andgraduallyimproved

itsbasicmedical

insurancesystem,

relieving

manycitizensofunaffordablemedicalexpenses.

Theproportion

of

percapitaout-of-pocket

healthexpenditure

tototalmedical

expenditure

inthe

country

more

than

halved

between

2001

and2021(see

page15),

and

thegovernment

plansto

reduce

thisfigurefurtherby2030.Atthesame

time,theutilizationoftheEBMIinsurance

fund

isalsosubject

toimprovement.

In2022

and2023,

several

provinces

inChina

havealready

reducedthe

role

ofEBMI

personal

accountsby

allocating

more

funding

to

pooled

funds

inaneffort

toimprove

efficiency

and

provide

better

services

topatients.Reforms

ofthisnaturearenecessary

forthehealthyoperation

anddevelopment

of

China'smedical

insurancesystem.Nevertheless,

with

arapidlyagingpopulation,thefinancialpressure

on

thehealthinsurancefund

will

continueto

rise

asthedemand

forhealthcare

services

grows.Inthe

lastdecade,

the

annualincome

of

the

URRBMI

insurance

fund

increasedmore

than

tenfold,while

thesurplusrate,or

theratioof

the

fund'sannual

surplustoitsincome,

fell

continuously

from

23

percent

in2012

to4.4

percent

in2021.Thecurrent

fixed-rate

system

implies

thatonce

premiums

increase,

the

financialburdensarefelt

most

acutely

bythosewith

low

incomes,

which

could

lead

tosome

droppingoutof

the

program

andfallingbackinto

therisk

ofillness-relatedpoverty.

Therefore,

improving

URRBMI's

funding

while

reforming

itspremiumstructureandproviding

additionalaidto

thedisadvantagedisamajor

issuethatmustbeaddressed

intheupcoming

reforms

of

China's

medical

insurancesystem.20Sources:

National

Healthcare

Security

Administration;

U.S.-China

Economic

and

Security

Review

CommissionOutlook:

the

growing

private

health

insurance

marketPremium

revenue

from

private

healthinsuranceinChina,from

2012

to2021Given

thedrawbacks

ofChina'sbasicmedicalinsuranceprograms,

especially

therisk

associatedwith

the

annualceiling

onthecost

oftreating

criticalillnesses,

the

privatehealth

insurancemarket

inthecountry

isbooming.

Incomes

frominsurancePremium

revenue

inbillion

yuan900844.7817.38007006005004003002001000706.6premiums

inthesector

increased

bymore

than

800percent

in