Shanghai Elderly Long-term Care Insurance (ltci)

Based on the basic concept of that the market should play a fundamental role in the resource allocation of the long term care (LTC) security system, this study aimed to provide a overall solution for commercial LTCI in Shanghai, which including to clarify the roles of the government and the market in this issue, to provide entire commercial insurance solution and the necessary technical supports in allusion to the dilemma between the international problem that governments can not adequately finance for LTC and the domestic puzzle that the development of commercial LTCI in China, especially in Shanghai, is holdbacked by a series of technical and non-technical factors, and to emphasize on the study of some key technical issue, i.e. the products development, the business framework, the pricing model, the hospitals investment and the AI anti-frauds system.Part one, the Foreword, expatiated LTCI's basic concept, function, origin and evolution in the world.Part two, the Study on the LTCI's Demand in Shanghai, demonstrated strong demands of LTCI in Shanghai via study on the LTC demand, the health insurance demand, and the data of the existing inpatient in LTC status.Part three, the Study on the LTC's Suppliers in Shanghai, demonstrated the evolving status and the foreground of the LTC's suppliers market in Shanghai by studying on the data of the nursing homes and related others.Part four, the study on the operational model of the LTCI, demonstrated the LTCI's key practicing issues including the product development process, the product designing, the related business structure, the theoretical pricing model, the practicable pricing bases, the practicable actuarial design, the practicable pricing model, and the LTCI Generalized Anti-fraud Model from the situation of that both the absence of the honor system and the heavy fraud in health insurance. The studies on the two practicing difficulties including the medical industrial investment and the AI anti-fraud system were emphasized. The practicability of the models was emphasized in this part.Part five, the Study on the Multilayer LTC Securities System and the Orientation of the Commercial Insurance Development, studied on the relationship between the public insurance sector and the commercial insurance sector whereas the public insurance remains being overwhelming principal part in this market. It was deemed that the public insurance needs strategical orientation instead of unlimited expansion, that the government needs the devepment of the multilayer LTCI...