A Case Study On Adverse Selection In Commercial Health Insurance Market

The report of the 20 th National Congress of the Communist Party of China proposed to“promote the orderly connection of multi-level medical security,improve the serious illness insurance and medical assistance system,implement the settlement of medical treatment in different places,establish a long-term care insurance system,and actively develop commercial medical insurance.” The research in this thesis takes the adverse selection behavior of the commercial health insurance market as the research object,which has strong research value.From the literature research in this thesis,there are abundant literatures on adverse selection in the insurance market at home and abroad.In recent years,literatures on adverse selection in the commercial health insurance market have gradually increased.However,at present,there is a lack of literature to measure the degree of adverse selection in the insurance market.Secondly,most literatures on the factors affecting adverse selection in the commercial health insurance market lack empirical evidence.This thesis makes up for the shortcomings of the above two aspects,and moderately innovates in the measurement method.Empirical analysis method and case analysis method are adopted to study and analyze the influencing factors of adverse selection behavior in the commercial health insurance market.This thesis takes the method of combination of points and aspects,takes the study of adverse selection behavior in the commercial health insurance market as the “aspect”,and makes an empirical analysis on the influencing factors of adverse selection behavior in the commercial health insurance market.Then taking the adverse selection problem of “Huimin Bao” products as the “point”,the empirical facts of “Huhuimin Bao” products are selected for analysis,and the influencing factors of adverse selection behavior are analyzed according to the indicators data of “Huimin Bao” products.The combination of points is not only conducive to solving the problem of under-representation of cases,but also conducive to avoiding the possible confirmation bias in empirical tests.This paper designs and constructs a measurement model based on the PIN model to obtain the measurement results.Subsequently,the Probit model was used to empirically test the influencing factors of adverse selection in the commercial health insurance market,and the results showed that the subjective health risks and objective health risks of residents significantly affected the adverse selection behavior of residents,and the test results of samples of different age groups,genders and places of residence were basically consistent with the whole.The content of the case analysis of this paper first makes a basic introduction to the “Huimin Insurance” product,secondly,uses the case of “Huimin Insurance” for empirical fact analysis,and then uses the proxy variable method to measure the adverse selection behavior of “Huimin Insurance”,showing that there is a serious adverse selection of Huimin Insurance products,and by analyzing the relationship between the relevant data and indicators of “Huimin Insurance”,not only the conclusion is basically consistent with the aforementioned empirical results,but also finds that when the insurance participation rate reaches a certain level,the overall adverse selection risk will also be reduced.Based on the empirical evidence and case analysis results,this paper puts forward three effective policy suggestions to form an inclusive government-enterprise cooperation model to promote the development of commercial health insurance,optimize health management services and improve refined operation capabilities,and use big data analysis to optimize the design of commercial health insurance products.