以全民健康保險資料庫探討長壽風險對防癌險之影響

Abstract

隨著醫療水準和經濟、環境等因素的進步，各國人民的平均壽命延續20世紀趨勢而繼續延長，退休生活的規劃變成個人、國家必須考慮的議題，與延壽議題相關的長壽風險（Longevity Risk）越來越受重視。長壽風險意指存活時間超乎預期，對個人、產業、國家都帶來不可忽視的影響，以近年引發社會各界熱議的年金改革，就是與長壽風險有關的範例之一。對商業保險或社會保險而言，長壽風險過去大多聚焦於年金或壽險商品，探討低估死亡率及平均餘命的影響，較少著墨於老年人在健康醫療、生活照顧的需求。\n\n有鑑於此，本文以老年人口的健康醫療為研究目標，探討長壽風險對這類型保險商品的影響，並考量以自然避險作為因應對策。其中，本文選擇臺灣壽險業暢銷的癌症保險為探討對象，根據全民健康保險資料庫的就醫紀錄，計算國人歷年的癌症發生率及死亡率，並討論是否能透過自然避險因應癌症保險之長壽風險。研究發現，癌症發生率及死亡率分別滿足逐年上升及下降的趨勢，若能適當調整罹癌後（亦即生存）及死亡兩種給付，可透過自然避險的機制降低癌症商品的長壽風險。另外，因為臺灣現行的商業癌症保險多半同時擁有生存及死亡給付，吻合自然避險的特性，經過適當設計可消除長壽風險帶來的衝擊，尤其針對長年期防癌險，長壽風險引發的震盪幾乎可完全透過自然避險規避。本文研究結果可作為保險公司擬定癌症保險的參考，將自然避險的機制引進保單設計，以降低損失率、確保收支均衡，因應壽命延長帶來的挑戰。

With the advance in medical technology and overall environment, the human life span continues the prolonging trend similar to that of the 20th century. Retirement planning becomes essential to both the individuals and nations and people are paying more attention to the issue of longevity risk. Longevity risk means that the actual life expectancy is longer than expected and thus increases the burden of economic burden after retirement. Pension reform is the most famous example of longevity risk and in recent years it triggers quite a lot of debates in both commercial insurance and social insurance. We think that the longevity risk is not restricted to the pension and annuity products, and it would also occur in the health insurance products, particularly for the products with longer durations. Unfortunately, only a few past studies mentioned the issue of longevity risk for the health insurance products. \n\nThus, this study aims to explore the longevity risk of health insurance products and adapt the idea of natural hedge to deal with the prolonging life. Specifically, we focus on applying the natural hedge to cancer insurance, a popular product in Taiwan insurance market. We use computer simulation and empirical data to evaluate whether the natural hedge can reduce the impact of longevity risk in cancer insurance products. The cancer incidence rates and mortality rates are based on the National Health Insurance (NHI) database. Our results show that, through the proper design, the natural hedge can reduce the impact of longevity risk for the cancer insurance products with longer durations. The insurance companies can apply the natural hedge to cancer products, in order to deal with the challenge of longevity risk.