新兴市场的医疗保健：探索保护差距

The Geneva AssociationThe Geneva Association is the leading international insurance think tank of the insurance industry. The GenevaAssociation identifies fundamental trends and strategic issues where insurance plays a substantial role or whichinfluence the insurance sector. Through the development of research programmes, regular publications and theorganisation of international meetings, The Geneva Association serves as a catalyst for progress in the understandingof risk and insurance matters and acts as a knowledge creator and disseminator. It is the leading voice of the largestinsurance groups worldwide in the dialogue with international institutions. In parallel, it advances— in economic andcultural terms—the development and application of risk management and the understanding of uncertainty in theThe Geneva Association membership comprises a statutory maximum of 90 chief executive officers (CEOs) from theworld’s top insurance and reinsurance companies. It organises international expert networks and manages discussionplatforms for senior insurance executives and specialists as well as policymakers, regulators and multilateral organisations.Established in 1973, The Geneva Association, officially the International Association for the Study of InsuranceEconomics, is based in Zurich, Switzerland and is a non-profit organisation funded by its members.Healthcare in Emerging Markets: Exploring the Protection GapsPublished by The Geneva Association—International Association for the Study of Insurance Economics, Zurich.The Geneva Association—International Association for the Study of Insurance EconomicsTalstrasse 70, CH-8001 ZurichEmail: secretariat@genevaassociation.org | Tel: +41 44 200 49 00 | Fax: +41 44 200 49 99 www.genevaassociation.orgmodern economy.March 2019© The Geneva AssociationPhoto credits:Cover page—Spotmatik Ltd, Shutterstock. Healthcare in Emerging Markets:Exploring the Protection GapsKai-Uwe SchanzDirector, Protection Gap research programmeThe Geneva Association 2www.genevaassociation.orgAcknowledgementsThis publication is a product of the Protection Gap research programme of The Geneva Association, co-sponsored byChristian Mumenthaler, Group CEO of Swiss Re, and Markus Riess, CEO of ERGO.We are very much indebted to the members of the Working Group, established in support of our Protection Gap researchprogramme namely: Manuel Aguilera (Mapfre), Karl Gray (Zurich Insurance), Arne Holzhausen (Allianz), Thomas Holzheu(Swiss Re), Kei Kato (Tokio Marine), Stefan Kröpfl (Zurich Insurance), Gisela Plassmann (ERGO), Flemmich Webb (Lloyd’s)and Clarence Wong (Swiss Re).Our special thanks go to the Swiss Re Institute for their support and guidance in conceptualising and quantifying healthprotection gaps.ContentsForeword1.Management summary2.Funding healthcare2.1.Global healthcare expenditure—Trends and drivers2.2.Healthcare funding options2.3.The financing mix in emerging markets3.Exploring and quantifying the health protection gap3.1.Approaching the challenge3.2.The funding view—Quantifying the gap3.3.A more holistic view—Benchmarking healthcare systems4.A bigger role for private voluntary health insurance (PVHI)?4.1.The economic case4.2.PVHI in emerging markets4.3.A bigger role for PVHI in emerging markets—Prerequisites and limitations5.The digital revolution—New healthcare propositions in emerging markets5.1.E-health5.2.Leapfrogging developed markets in digital health model adoption5.3.Technology as an enabler of a globally converging healthcare paradigm6.Concluding remarksAnnex: Emerging markets covered by this reportReferences @TheGenevaAssoc3466810141415192222242528283132353638 Foreword 3Healthcare in Emerging Markets: Exploring the Protection GapsEmerging countries continue to suffer from gravely insufficient healthcare funding, whichadversely affects access to healthcare, quality and ultimately the health status of citizens.According to the World Bank, some 400 million people lack access to essential healthcareservices, mostly in Africa and South Asia. The low-income countries’ physician perinhabitant ratio is less than one thirtieth of the level enjoyed by high income countries.The maternal mortality ratio exceeds the level recorded in high-income countries by afactor of 60. Life expectancy at birth in low-income countries falls short by more than 20years. Anecdotal evidence of health protection gaps abounds.Funding gaps are widening in middle-income and upper-middle income countries too,primarily as a result of accelerating medical inflation, i.e. the cost of medical treatments,and a higher prevalence of non-communicable lifestyle-related diseases such as cancer,diabetes or cardiac syndromes. Ageing populations in a number of emerging countriesadd to the pressure.Against this backdrop, the following report offers a comprehensive overview of thevarious current sources of healthcare funding in emerging markets. It further attempts toquantify health protection gaps and discusses the potenti