为推进健康老龄化进程、落实“健康中国”战略,健康保险在制度支持与实践路径中的作用日益突出。本文聚焦“健康保险+健康管理”“健康+保险+护理”“健康保险+保险科技”三种赋能健康老龄化的基本模式,构建健康老龄化与“健康中国”五大战略目标深度耦合的“目标—机制—路径”分析框架,系统梳理健康保险赋能健康老龄化的运行逻辑,揭示其在提升健康素养、控制健康风险、优化医疗服务、推动产业创新与完善制度体系中的作用机制。进一步结合当前现实困境,提出三条实现路径：构建老年人健康素养提升体系、优化资源与人才配置（以缓解区域差距）和打破数据孤岛（以促进多主体协同）。研究旨在为我国健康保险制度改革与健康老龄化政策优化提供理论支撑与实践指引。
Abstract
To advance the process of healthy aging and fulfill the objectives of the Healthy China initiative, health insurance has assumed an increasingly critical role in both institutional design and implementation pathways. This paper identifies three core models through which health insurance empowers healthy aging: health insurance plus health management, health plus insurance plus care, and health insurance plus insurance technology. Building on these models, it develops a “goal-mechanism-pathway” analytical framework that closely aligns healthy aging with the five strategic goals of the Healthy China initiative. This framework systematically explicates the operational logic of health insurance and identifies key mechanisms through which it contributes to enhancing health literacy, mitigating health risks, optimizing healthcare delivery, fostering innovation in the health industry, and strengthening institutional systems. In response to current challenges, the study further proposes three actionable pathways: establishing a system for improving health literacy among older adults; optimizing the distribution of health resources and workforce to reduce regional disparities; and dismantling data silos to facilitate coordination among multiple stakeholders. The study offers theoretical insights and policy recommendations to support the reform of China’s health insurance system and the advancement of healthy aging.
关键词
健康中国战略 /
健康老龄化 /
健康保险 /
保险科技 /
长期护理保险
Key words
Healthy China initiative /
healthy aging /
health insurance /
insurance technology /
long-term care insurance
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