12th Health and Ageing Conference Insuring Health Care for the Elderly in Asia Conference Review Singapore, 16–17 November 2015
January 2016 The Geneva Association
The Geneva Association is the leading international insurance think tank for strategically important insurance and risk management issues. The Geneva Association identifies fundamental trends and strategic issues where insurance plays a substantial role or which influence the insurance sector. Through the development of research programmes, regular publications and the organisation of international meetings, The Geneva Association serves as a catalyst for progress in the understanding of risk and insurance matters and acts as an information creator and disseminator. It is the leading voice of the largest insurance groups worldwide in the dialogue with international institutions. In parallel, it advances—in economic and cultural terms—the development and application of risk management and the understanding of uncertainty in the modern economy. The Geneva Association membership comprises a statutory maximum of 90 chief executive officers (CEOs) from the world’s top insurance and reinsurance companies. It organises international expert networks and manages discussion platforms for senior insurance executives and specialists as well as policymakers, regulators and multilateral organisations. The Geneva Association’s annual General Assembly is the most prestigious gathering of leading insurance CEOs worldwide. Established in 1973, The Geneva Association, officially the ‘International Association for the Study of Insurance Economics’, is based in Zurich, Switzerland and is a non-profit organisation funded by its members. 12th Health and Ageing Conference Insuring Health Care for the Elderly in Asia Conference Review Singapore, 16–17 November 2015
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Cover: ©Fotolia/Chen How Sia The 12th Health and Ageing Conference—Insuring Health Care for the Elderly in Asia—Conference Review ©The Geneva Association, January 2016 Published by The Geneva Association (The International Association for the Study of Insurance Economics), Zurich. The opinions expressed in The Geneva Association newsletters and publications are the responsibility of the authors. We therefore disclaim all liability and responsibility arising from such materials by any third parties. Download the electronic version from www.genevaassociation.org
2 The Geneva Association | 12th Health and Ageing Conference—Conference Review TABLE OF CONTENTS
Introduction, by Dr Christophe Courbage 5 Conference Programme 7 Longevity and Social Aspects of Ageing Populations in Asia 9 Health-care Expenditures and Sustainable Health-care Systems 11 Insurance Opportunities to Cover Health Care for the Elderly in Asia 13 Insurance Solutions and Products to Cover Health Care for the Elderly in Asia 15 Annexes: Our Host and Sponsor 17 Speaker Biographies 19 Forthcoming Conferences of The Geneva Association 30
www.genevaassociation.org @TheGenevaAssoc 3 4 The Geneva Association | 12th Health and Ageing Conference—Conference Review INTRODUCTION by Dr Christophe Courbage
On 16–17 November 2015, the 12th Health and Ageing Conference of The Geneva Association took place in Singapore on the topic of ‘Insuring health care for the elderly in Asia’. The conference was hosted by the Singapore College of Insurance and supported by Asia Capital Re. More than 60 participants originating from Asia and Europe attended the conference. Attendees came from (re)insurance companies, universities, international and (non)governmental organisations, research centres and other private companies. Asia is experiencing population ageing at an unprecedented pace, and the region is currently home to over half of the world’s elderly population. While an ageing population is a great achievement for societies, it is at the same time a major challenge. In particular, population ageing can jeopardise the sustainability of currently organised health systems and calls for the development of new forms of financing, including the development of insurance. The aim of the conference was to better understand the challenges ASIA IS CURRENTLY of organising the financing of the health of an ageing population and the role HOME TO OVER HALF insurance can play in this regard in Asia. The conference proved to be effective not only by raising awareness and by OF THE WORLD’S offering knowledge and solutions to the insurance industry on how to best ELDERLY POPULATION. manage these risks, but also by acting as an international forum for discussion amongst concerned parties, one the main goals of The Geneva Association conferences. The articles that follow summarise the key insights that can be extracted from the conference. I would like to offer our thanks to the Singapore College of Insurance for hosting this meeting and Asia Capital Re for their support. The presentations made at the conference are available on the events page of The Geneva Association website.
www.genevaassociation.org @TheGenevaAssoc 5 6 The Geneva Association | 12th Health and Ageing Conference—Conference Review 12th Health and Ageing Conference Insuring Health Care for the Elderly in Asia 16–17 November 2015 Hosted by the Singapore College of Insurance and supported by ACR Capital Holdings Singapore College of Insurance, Temasek Boulevard, Suntec Tower Two, #14-01/02/03, Singapore 038989
Conference Programme
Day 1 Monday 16 November
8.15-8.45 Registration and Welcome Coffee
8.45-9.00 Welcome Remarks Dr Christophe Courbage, Research Director Health and Ageing, The Geneva Association Seow Yang Kwek, Senior Assistant Director, Singapore College of Insurance
9.00-10.30 Session 1—Longevity and Health Determinants of the Elderly in Asia Chair: Dr Christophe Courbage, Research Director Health and Ageing, The Geneva Association • Longevity evolution: international comparisons and future prospects. Analysis of Asian data Dr Daria Ossipova, Head of R&D—Life related risks, SCOR Global Life, Paris • Ageing and health of older persons in the Asia-Pacific region: success and challenges Prof. David Phillips, Chair Professor of Social Policy, Lingnan University, Hong Kong
10.30-11.00 Coffee Break
11.00-12.30 Session 2—Health Care and New Health Technology for an Ageing Population in Asia Chair: Ooi Chin Heng, Manager, Healthcare Services, Prudential Assurance Company Singapore • Health care technology management—Europe and Asia walking together Dr Nicola Pangher, General Manager Foreign Operations, TBS Telematic & Biomedical Services Group S.p.A., Trieste
12.30-13.30 Lunch Break
13.30-15.00 Session 3—Financing Health Care for the Elderly in Asia Chair: Andrew Wong, Head of Reinsurance Asia Pacific, Munich Health, Munich Re Singapore Branch • The implications of ageing on health costs and health policies: evidence from the East Asia Pacific region and beyond Aparnaa Somanathan, Senior Economist, Health, Nutrition and Population Global Practice, World Bank • Fiscal sustainability of healthcare financing in Asia: Challenges and responses Kelvin Bryan Tan, Director, Policy, Research and Economics Office, Ministry of Health, Singapore
15.00-15.30 Coffee Break
www.genevaassociation.org @TheGenevaAssoc 7 15.30–17.30 Session 4— Insurance opportunities to cover health care for the elderly in Asia Chair: Lye Fook Kong, General Manager, Hannover Re, Shanghai Branch • The consumer perspective on funding the costs of old age care in Asia, and the role of the insurance industry Dr Detloff Rump, Chief Underwriter, Swiss Reinsurance Company Hong Kong Branch • Current and future developments of long-term care needs in China and opportunities for insurers Dr Xian Xu, Director, China Insurance and Social Security Research Center, Fudan University
• Innovative products and service solutions for the elderly Russell Bateman, Chief Operating Officer, CPIC Allianz Health Insurance, Shanghai
19.00 Cocktail and Conference Dinner (Rendezvous Hotel, 9 Bras Basah Road, Singapore 189559)
Day 2 Tuesday 17 November
9.00-10.00 Keynote Address Asia’s diabetes challenge Karl-Heinz Jung, Head of Japan, MENA & International, Asia Capital Re
10.00-10.30 Coffee Break
10.30-12.30 Session 5—Insurance Solutions for Elderly Health Care Coverage in Asia Chair: Dr Christophe Courbage, Research Director Health and Ageing, The Geneva Association • Securing sustainable insurance markets for old age health care—Lessons for Asian economies Freddy Schnitzler, International Health Consulting, Former Vice President of Samsung Fire & Marine Insurance • Using risk based incentives and wellness programs to foster healthier behaviors Jeff Wu, Regional Head of Accident and Health, Generali Asia • Product innovations in Critical Illness Chris Reynolds, Head of Life Solutions Actuarial, PartnerRe, Zurich
13.00 Farewell Buffet Lunch
8 The Geneva Association | 12th Health and Ageing Conference—Conference Review LONGEVITY AND SOCIAL ASPECTS OF AGEING POPULATIONS IN ASIA
Life expectancies amongst countries diverged until 1950. Thereafter, we observe a convergence to best-practice levels from the countries with low life expectancy, but a divergence from those at the top of the distribution of the world population. Today’s highest levels of life expectancy can only be achieved by reducing the mortality of the elderly, and it may be that some countries will find this harder to achieve than the gains they made at younger ages. Three scenarios can occur regarding the survival curve, with different implications for the insurance industry. The first one is a rectangularisation of the curve leading to mortality compression and then little uncertainty as to the duration of human life. In that case, pure saving products are preferred to insurance products. The second scenario is a shifting mortality scenario leading to continuing uncertainty about the individual’s life duration and longer life spans. It implies a demand for protection products at increasingly older ages, as well as increasing demand for annuities and long-term care products. Finally, the third scenario is a derectangularisation of the survival curve leading to greater heterogeneity in life durations with a number of persons surviving much longer than average. In that case, longevity insurance business will face a major shock with increasing demand for annuities and long-term care products, and the emergence of new insurance products, depending on whether the longer life is predictable (e.g. genetic predisposition). The case of cancer offers an illustration of the future drivers of longevity internationally. While the incidence of cancer is highest in North America and Europe, the mortality rate due to cancer is highest in Asia. Such different distributions per cancer site comes from the fact that some Asian countries have a higher proportion of ‘bad’ cancers that are more difficult to cure. This is mainly caused by behavioural factors (smoking, obesity, etc.), environmental factors WHILE THE such as pollution and genetic predisposition. Social changes also have an important impact on the health and needs for care INCIDENCE OF of older people. In Asia, three different aspects need careful attention in that CANCER IS HIGHEST respect. The first one is the effect of environmental issues and climate change IN NORTH AMERICA on older people’s health. Older people are often disproportionately affected by the local and wider environment and climate. Excess heat, low temperatures, AND EUROPE, THE atmospheric pollution and natural events (storms, winds, floods) are the MORTALITY RATE main sources of climate stress. Because older people are more subject to local environments (shops, services, social services, security, topography) DUE TO CANCER IS and the internal environment in their’ homes, if efforts are made to get the HIGHEST IN ASIA. environment right, they can be more independent and less in need of formal and informal care. The second social aspect that affects older people’s health is the role of filial piety. Filial piety is a complex reciprocal relations and duties
www.genevaassociation.org @TheGenevaAssoc 9 SOCIAL CHANGES ALSO HAVE AN IMPORTANT IMPACT ON THE HEALTH AND NEEDS FOR CARE OF OLDER PEOPLE. IN ASIA, THREE DIFFERENT ASPECTS NEED CAREFUL ATTENTION IN THAT RESPECT: THE EFFECT OF ENVIRONMENTAL ISSUES AND CLIMATE CHANGE ON OLDER PEOPLE’S HEALTH, THE ROLE OF FILIAL PIETY, AND ELDERLY POVERTY.
between parents and children. Across the Asia region, filial piety has weakened or is changing form due to various social trends such as smaller families, migration for work and fewer children available at home to share physical and financial responsibilities for ageing parents. Governments are trying to find ways to restore this filial piety and even introduced or expanded legislation/ rules for children’s support. The third aspect concerns elderly poverty, which is important in Asia due to particular low incomes and lack of formal incomes and pensions. Elderly poverty affects all areas—housing, nutrition and access to services, facilities, and health—with dramatic repercussions on the well- being of the older population. These social issues call for urgent inter-sectoral collaboration for improved state support, assistance for family support and an elderly-friendly environment.
Dr Christophe Courbage, Dr Daria Ossipova and Prof. David R. Phillips
10 The Geneva Association | 12th Health and Ageing Conference—Conference Review HEALTH-CARE EXPENDITURES AND SUSTAINABLE HEALTH-CARE SYSTEMS
Health expenditures in Asia, as elsewhere, increase with age in per capita terms and as a share of GDP. However, the relationship between ageing and health costs is not straightforward. The idea that ageing drives up health spending is actually a red herring. What really explains the ‘ageing effect’ are the last few years of life (proximity to death) and the progression of illness (whether disability increases with age or not). The non-demographic drivers of spending are more critical such as income, labour costs, the diffusion and adoption of new technologies in the health sector, and health policies to promote (or not) HEALTH cost control. Ageing per se accounts on average for a third or less of the increase EXPENDITURES IN in health spending even in the older countries. To control spending, various health policy responses exist promoting healthy ageing. The first response is ASIA, AS ELSEWHERE, to reduce exposure to key risk factors via the control of tobacco, alcohol and INCREASE WITH AGE unhealthy food consumption by raising taxes and combatting poor dietary IN PER CAPITA TERMS quality and lack of exercise multi-sectorally. The second policy response is to manage and control cardiovascular risks by improving diagnosis rates of AND AS A SHARE hypertension, cholesterol and diabetes, and strengthening treatment of high OF GDP. risks with the essential package of readily available and off-patent medicines. The third policy response is to transform models of service delivery by putting primary care in the driver’s seat, emphasising coordination of care, training health-care staff to manage needs of elderly, and by preparing for functional and cognitive decline among the elderly. Finally, the fourth policy response is to get better value for money from health systems by better prioritising among new technologies and drugs, and by harnessing purchasing power.
Ooi Chin Heng and Dr Nicola Pangher
www.genevaassociation.org @TheGenevaAssoc 11 Population ageing presents a double whammy for the sustainability of universal health coverage as health-care costs escalate with age and as fewer people in the working population support the elderly. To address these challenges, there is first a need to recognise the shared responsibility of all players. For instance, individuals and families should adopt healthy living and develop saving for health-care expenses. Communities and employees should encourage healthier living. Providers should deliver efficient cost-effective care. Insurers should mitigate the financial risk associated with illness. Government should deliver safety nets, help the needy, channel subsidies to the poor and sick, and regulate markets. The second action is to develop an appropriate set of metrics to measure sustainability and equity. The third action is to keep people active and engaged longer by, e.g. developing their functional capabilities through prevention, adaptation and mitigation. A fourth action is to help people make better decisions and develop saving to pay for health-care expenditures. Finally, it is crucial to develop the right services and the right financing mechanisms to support these services for the future.
Andrew Wong, Dr Kelvin Bryan Tan and Aparnaa Somanathan
12 The Geneva Association | 12th Health and Ageing Conference—Conference Review INSURANCE OPPORTUNITIES TO COVER HEALTH CARE FOR THE ELDERLY IN ASIA
Ageing populations will be a defining characteristic of most Asian societies in the coming decades. As the number of elderly rises, so does the need to prepare for their future care needs. This includes the funding for and provision of relevant care services. According to a recent Swiss Re survey covering six key Asian markets (China, Hong Kong, Japan, Korea, Singapore and Taiwan), most DIABETES IS A HUGE consumers have no confidence in their government’s ability to fund future CONCERN FOR ASIA, care needs. As such, there is a demand for care solutions in terms of private insurance or financial products which provide cash, finance and/or services to SINCE ABOUT 243 those with personal care needs. But not knowing how to initiate the purchase MILLION PEOPLE of care solutions and procrastination are major hurdles in the insurance ARE CONCERNED purchasing decision. Consumers put great emphasis on ‘peace of mind’ and ‘reducing dependency on family’ as major reasons to buy care solutions. OUT OF 387 MILLION Affordability and products that meet consumer requirements are the main GLOBALLY. considerations in a care solution purchase decision, while brands matter less. Consumers are receptive to value-added services like medical check-ups and emergency services, but there is a limit to how much extra they are willing to pay for these services, and this varies by market. Such trends definitely show that insurers have good opportunities in Asia and provide them with some insight about the best products to develop. China, in particular, offers huge opportunities to insurers in the field of aged care. China counts about 40 million disabled elderly, 12 million of whom are completely disabled. Formal long-term care in China is organised around four entities, that is, social welfare institutions funded by government, senior care homes funded by private firms, senior living communities created by real estate developers and insurance companies, and community centres providing recreational activities and lunch services to seniors. While Chinese insurers created LTC policies as early as 2005, nowadays, there are only a handful of insurance companies in China that offer LTC insurance products. Recently the State Council of China expressed its wish to accelerate the development of modern insurance industry. Its goal is to have a rate of insurance penetration at 5 per cent by 2020. Eligible insurance institutions will be engaged to invest in ageing care industries and institutions. Insurance companies will be encouraged to develop products such as disease insurance, long-term care insurance and disability income insurance to supplement basic medical insurance. The future looks bright then, for those insurers which are able to offer the right products. Diabetes is another huge concern for Asia, since about 243 million people are concerned out of 387 million globally. It is mainly explained by increasing Karl Heinz Jung presents Asia’s urbanisation and undesirable lifestyle changes. The financial and economic diabetes challenge
www.genevaassociation.org @TheGenevaAssoc 13 impact of diabetes is catastrophic not only for individuals, but also for governments and societies at large. The public sector cannot solve this issue alone, which opens huge perspectives for private insurers. On the demand side, there is a strong awareness of the impact of diabetes on general health and of its cost. On the supply side, expertise exists for early detection of diabetic conditions and to manage early-stage diabetes cases. The use of new technology can help improving the insurability of diabetes, e.g. by monitoring patients’ actions and level of glucose. The private and public sectors together can improve the financial and non-financial health outcomes. Governments could be responsible for infrastructure, medical expertise, education and training, regulations, and the oversight of health-care institutions and costs. The private sector would have the lead for access to data, technological applications, talent pool, promoting awareness and lifestyle programmes. Finally, for insurers to develop relevant products, it is crucial that data issues are addressed to unlock potential solutions which are likely to be information- and data-driven. Lye Fook Kong
Dr Detloff Rump, Dr Xian Xu and Russel Bateman
14 The Geneva Association | 12th Health and Ageing Conference—Conference Review INSURANCE SOLUTIONS AND PRODUCTS TO COVER HEALTH CARE FOR THE ELDERLY IN ASIA
Korea is an interesting case study to illustrate the gaps in health-care financing and the market potential for voluntary insurance business. Korea is a highly developed industry and insurance market, facing huge problems in sustaining INSURERS CAN health care. Though the medical standard in Korea is world class, health DEVELOP THE USE expenditures appear at a low level compared to other industrialised nations. However, Korea ranks amongst the highest for potentially preventable OF RISK-BASED admissions relating to obesity, asthma and diabetes. If no action is taken, INCENTIVES objective incident rates for chronic diseases will go up. Next to the increasing AND WELLNESS incident rate, increase utilisation and high unit cost for the private sector drive expenditure growth with an immediate impact on reimbursement claims. The PROGRAMMES TO only answer so far is to increase private insurance premiums, which raises the FOSTER HEALTHIER issue of premium affordability. Applying risk-rated premiums leads to high premiums and low insurance penetration at that age group. Out of different BEHAVIOUR AND funding options, the German based adjusted level premium model can be MODIFY RISK used to flatten premium increase for the elderly. It follows the principle of FACTORS. equivalence money needed for lifetime cost brought up by savings in the economically active stage of life. The Korean challenges are valid throughout the Asian region and should be reflected at an early stage. Insurers need to change their overall approach by shifting from passive claims-based premium adjustment to proactive risk-based health management. But insurers need both governmental frameworks and patients’ understanding and cooperation to achieve these goals. Insurers can also develop the use of risk-based incentives and wellness programmes to foster healthier behaviour and modify risk factors. Many risk factors can be modified. For example, diastolic and systolic blood pressure, body weight and cholesterol can be modified though physical activity. Bad habits such as alcohol consumption, smoking and drug use are also modifiable risk factors. The same goes for personal perceptions like perceived health, life satisfaction, stress and job satisfaction. There exit various forms of wellness programmes that can impact modifiable risk factors. For a wellness programme to be successful, it should target risk factors that people can change, force people to take the corrective measures track and verify the result. The fastest growing area of wellness programmes is the discovery programme. This is the world’s largest scientific, incentive-based wellness solution for individuals and corporates rewarding healthy behaviour. It is aimed to give members and their family knowledge and motivation to make healthy living. Wellness programmes can be structured differently within insurance contracts. For instance, the nature of the reward, i.e. a gift or a reduction in Jeff Wu
www.genevaassociation.org @TheGenevaAssoc 15 A SPECIFIC INSURANCE PRODUCT THAT IS OFTEN DISCUSSED TO COVER THE HEALTH OF AN AGEING POPULATION IS CRITICAL ILLNESS (CI).
insurance premium, might offer different incentives. The question is knowing which structure is the most efficient in the long term to engage the higher risk population in healthier behaviours. A specific insurance product that is often discussed to cover the health of an ageing population is Critical Illness (CI). The first CI policy was sold in 1983 in South Africa and only covered four core critical conditions which were heart attack, cancer, stoke and coronary artery bypass graft. Since then, the product has evolved in a multitude of ways. It has been offered as a standalone product or as an acceleration of a death benefit. It has been sold through various distribution channels including tied agents and independent financial advisors. But most significantly, the number of conditions has ballooned. Further core conditions such as kidney failure or major organ transplant have been added. Some products in today’s market cover over 120 conditions. Other innovations are severity-based CI cover for which the amount paid depends upon how severe the diagnosis of a particular condition is. For example, a diagnosis of lower stage cancer may receive a smaller payment than diagnosis of higher stage cancer. In Asia, the product landscape is diverse. In Japan for example the focus is on cancer-only products which pay an initial Chris Reynolds lump sum on diagnosis followed by additional payments for hospital stays or drugs. Korea on the other hand is a market where CI was initially sold by life companies but is now mostly sold by P&C companies. CI products are very comprehensive, and all products in the market offer guaranteed premiums. Finally, China is a very dynamic market with a quick development cycle. There the focus is on providing protection against catastrophic medical expenses, and products have typically been sold as riders to savings products. Potential product innovation could come by simplifying the benefit structure. Actually, 90 per cent of claims come from three core conditions, namely cancer, myocardial infarction and stroke. Instead of having 120 defined conditions, a product covering these core conditions would be much easier for a consumer to understand. To make the product marketable, it could be moved away from a medical definitions concept and offer a ‘life-changing event’ rider on the policy. The idea is that the product would pay on diagnosis of a specified illness or if a condition results in the policyholder experiencing a life-changing event, e.g. is unable to work or a loss of independence. In this way, it meets needs which are very similar to long-term care products, making the future of a CI product a long-term care product over time. Freddy Schnitzler
16 The Geneva Association | 12th Health and Ageing Conference—Conference Review ANNEXES OUR HOST AND SPONSOR
The Singapore College of Insurance The Singapore College of Insurance (SCI) is a not-for-profit professional training and education body set up in 1974 as part of Singapore’s efforts to develop as a financial hub. For more than 41 years, the SCI has remained focused in its efforts to upgrade the technical expertise of insurance and financial services practitioners, and to provide them with professional advancement opportunities through its series of practice- oriented programmes and internationally-accredited qualifications. Since the late 1970s, the SCI has also played the role of an industry examination body to conduct regulatory examinations for those wishing to join the financial advisory, life and general insurance industries. In recent years, the SCI has also expanded its role to include talent development programmes, such as the Insurance Executive Scholarship Programme that has succeeded in attracting and placing numerous fresh tertiary talent into the varied functions in the industry. The SCI was voted the Asia Insurance Industry Educational Service Provider of the Year in 1997, 2001 and 2007. It has international links with professional bodies, such as The Chartered Insurance Institute in the United Kingdom and The American College in the United States of America, as well as with other regional training institutes in the region through its involvement in the ASEAN Insurance Education Committee projects. The SCI has also actively helped to set up the Asia-Pacific Risk and Insurance Association (APRIA) to further insurance education and to promote links between academia and industry.
Sponsor: ACR Capital Holdings Pte. Ltd.
Established in November 2006, ACR Capital Holdings Pte. Ltd. (‘ACR’) is parent company to two wholly-owned subsidiaries, Asia Capital Reinsurance Group Pte. Ltd. (‘Asia Capital Re’) and Asia Risk-Tech Enterprises Management Consulting (Shanghai) Company Limited (‘Asia Risk-Tech’), and a subsidiary, Concord Insurance Company Limited (‘Concord Insurance’). Asia Capital Re is Asia’s first reinsurance company with a focus on providing reinsurance solutions to the pan-Asian region with particular specialties for large and complex risks across non-life business lines. Headquartered in Singapore, the reinsurer has a regional presence in Hong Kong, Dubai, Taiwan, Japan, Korea, Vietnam and India. Asia Risk-Tech, in Shanghai, China, serves the Greater China region with risk consulting, risk engineering and other services. Hong Kong-based Concord Insurance Company Ltd is also an ACR subsidiary. Additionally, ACR has
www.genevaassociation.org @TheGenevaAssoc 17 two associated companies—Asia Capital Reinsurance Malaysia Sdn Bhd and ACR ReTakaful Holdings Limited. All reinsurance operating companies under the ACR brand are rated A- for their financial strength rating by A.M. Best. Asia Capital Re also holds an A- financial strength rating from Standard & Poor’s. For more information, please visit www.acrcapitalholdings.com.
18 The Geneva Association | 12th Health and Ageing Conference—Conference Review SPEAKER BIOGRAPHIES
Welcome Remarks Dr Christophe Courbage Research Director Health and Ageing, The Geneva Association Christophe Courbage, PhD in Economics, is Research Director at The Geneva Association, Head of the Health and Ageing and Insurance Economics research programmes. Christophe is also Editor-in-Chief of The Geneva Papers on Risk and Insurance, Lecturer at the University of Geneva and International Faculty of the Singapore College of Insurance. Christophe is board member of the European Group of Risk and Insurance Economists (EGRIE) and is past member of the Board of Directors of the Asia- Pacific Risk and Insurance Association (APRIA). Prior to joining The Geneva Association Christophe worked for the Geneva- based private bank Lombard Odier & Cie, as an Economist, first in the London office and then in Geneva in the strategic research department. During his PhD, Christophe was research assistant at The University of Geneva and the Catholic University of Mons (Belgium). Christophe was awarded the prestigious Ernst-Meyer Prize for his PhD thesis.
Seow Yang Kwek Senior Assistant Director, Singapore College of Insurance Seow Yang is a Senior Assistant Director with Singapore College of Insurance, and has work through various portfolios, including, Talent Development, Technical Training, Financial Planning as well as Information System. Seow Yang started his career in Human Resource System consulting, and thereafter moves on to project and programme management. He graduated from Nanyang Technological University with Bachelor of Engineering (Electrical and Electronics Engineering) and a Master of Business Administration.
He is currently a member of the SCI’s Examination Board.
www.genevaassociation.org @TheGenevaAssoc 19 Session 1—Longevity and Health Determinants of the Elderly in Asia Chair: Dr Christophe Courbage Research Director Health and Ageing, The Geneva Association Dr Daria Ossipova Head of R&D—Life related risks, SCOR Global Life Daria Ossipova is a Head of longevity and morbidity R&D at SCOR and is leading four centres of excellence situated around the globe: Longevity (Paris), Long Term Care and Disability (Paris), Health (Cologne) and Critical Illness (Singapore). The team specialists, actuaries and researchers, forge SCOR’s expertise of morbidity and longevity risks. They conduct research projects, assist local entities with product development, establish scientific partnerships with academics and contribute to the risk management policy through various research projects, by validating guidelines, conducting referrals and peer reviews. Daria has a PhD in mathematics and taught at the University of Hull in the U.K., subsequently completing a post doctorate at the French National Scientific Research Centre (CNRS). Daria then chose to go into applied research taking the role at SCOR in 2002 to combine research and its practical applications. Prof. David R. Phillips Chair Professor of Social Policy, Lingnan University David R Phillips, PhD (Wales), is Chair Professor of Social Policy and Head of the Department of Sociology and Social Policy at Lingnan University, Hong Kong. He specialises in gerontology, social epidemiology and global health, and development in the Asia-Pacific region. He established Lingnan’s Asia- Pacific Institute of Ageing Studies (APIAS) and was Founder Co-ordinator of the Asia Ageing Research Network of the Asian Development Research Forum. His previous posts include Director of the Institute of Population Studies, University of Exeter and Professor of Human Geography, University of Nottingham. He is an honorary professor at Macquarie University, Sydney, a member of Academia Europaea and a Corresponding Member of the Royal Belgian Academy for Overseas Sciences. Recent books include Ageing in the Asia-Pacific Region (Routledge, 2000), Ageing and Place (Routledge, 2005, 2008) and Global Health (Routledge, 2012, second edition under preparation).
20 The Geneva Association | 12th Health and Ageing Conference—Conference Review Session 2— Health Care and New Health Technology for an Ageing Population in Asia Chair: Ooi Chin Heng Manager, Healthcare Services, Prudential Assurance Company Singapore Chin Heng is the Manager for Healthcare Services at Prudential. Prudential Singapore is one of the leading writers of the Integrated Shield Plans. His current responsibilities include monitoring, analysis and management of the claims and persistency performance of the health insurance plans. Prior to joining Prudential in 2011, Chin Heng worked as an Actuarial Analyst in the United States.
Chin Heng holds a bachelor’s degree in Actuarial Science from the University of Nebraska-Lincoln. He is an Associate of the Society of Actuaries (ASA) and a Fellow of the Life Management Institute (FLMI). He is a member of the Health Insurance Committee for the Singapore Actuarial Society
Dr Nicola Pangher General Manager Foreign Operations, TBS Telematic & Biomedical Services Group S.p.A. Dr Nicola Pangher has been part of the team that has built TBS Group from a small sized Italian company to one of the largest global players in Healthcare Technology Management. With over 2400 staff, and operations on a global scale, TBS provides all biomedical, IT and telecommunication technology to manage successfully existing healthcare facilities, and to set up new healthcare organisations. Nicola Pangher is now leading the effort to expand the activity in high growth and emerging economies: the challenge for 2/3 of the world population is to create healthcare systems that can deliver outcomes and safety at a fraction of the cost per capita in Europe and other advanced countries. The lack of skilled workforce, the need to offer treatment to a large number of patients and the need to develop delivery services at a very fast pace are drivers to innovate in the design of physical infrastructures, the creation of new care processes and a more efficient use of biomedical and ICT technology. A clean slate in much of Asia, Africa and South America offers what is a unique opportunity to import European best
www.genevaassociation.org @TheGenevaAssoc 21 practices, but also to avoid costly mistakes and inefficencies that characterize these advanced systems. Nicola is working in project that include innovative insurance policies, remote care, mobile wellness and disease management, empowerment of patients and professionals and high speed/low cost set up of physical facilities.
22 The Geneva Association | 12th Health and Ageing Conference—Conference Review Session 3—Financing Health Care for the Elderly in Asia Chair: Andrew Wong Chief Executive Officer, Reinsurance Asia Pacific, Munich Health Andrew Wong is currently the CEO of Reinsurance, Asia Pacific for Munich Health based in Singapore. He is responsible for the Health Reinsurance business for the entire Asia Pacific region for Munich Health. Andrew has over 30 years of international experience in executive management positions across Asia Pacific, Europe and the Middle East in both insurance and healthcare industries, delivering extraordinary growth in revenue, profitability and customer base through adherence to corporate governance standards and managing within corporate risk policies and profiles. Prior to joining Munich Re, Andrew was the managing Director of Bupa Health Insurance (Thailand), one of the largest health insurance specialists in the region. Prior to this role, he was the Finance Director, International Businesses of Bupa, based in London. Aparnaa Somanathan Senior Economist, Health, Nutrition and Population Global Practice, World Bank Aparnaa Somanathan is a Senior Economist in the World Bank’s Health, Nutrition and Population Global Practice. She has worked on health financing and health systems strengthening issues for over fifteen years in a range of countries including Bangladesh, China, Indonesia, Kazakhstan, Sri Lanka and Vietnam. In 2012-2014, she led a comprehensive review of the implementation of social health insurance in Vietnam. Currently, she is leading the Bank’s support to the government of Kazakhstan in the design of a new health financing system. She has also worked extensively on the implications of population ageing on health financing and service delivery in the East Asia Pacific region. Prior to joining the World Bank, Aparnaa co-led a 14-country study of equity in health care in the Asia-Pacific Region. Aparnaa read economics at Cambridge University and holds a doctoral degree in International Health Economics and Policy from Harvard University. Aparnaa is the lead author of the 21014 World Bank publication titled, Moving Towards Universal Coverage of Social Health Insurance in Vietnam: Assessment and Options. She is also the co-author of two other World Bank publications: Financing Health Care in the East Asia and Pacific: Best Practices and Remaining
www.genevaassociation.org @TheGenevaAssoc 23 Challenges with Jack Langenbrunner; and the forthcoming publication, Live Long and Prosper: Ageing in the East Asia and Pacific region with Philip O’Keefe and others. Dr Kelvin Bryan Tan Director, Policy, Research and Economics Office, Singapore Ministry of Health Dr Kelvin Bryan Tan is currently Director of Policy, Research and Economics Office and is responsible for driving research efforts within the Ministry of Health. He started his career in the Ministry of Health in 2000 where he was in charge of Medisave, MediShield and Medifund policy. He subsequently spent stints as the General Manager of Central Singapore Community Development Council staffing the Mayor of the Central Singapore district, as well as at the Ministry of Trade Industry where he was in charge of strategic planning, R&D and Small Medium Enterprise policy. Dr Tan graduated summa cum laude from Princeton University and subsequently obtained his MSE and Phd in the Department of Management Science from Stanford University. His research interests are in the area of health economics, health insurance design and cost effectiveness modelling.
24 The Geneva Association | 12th Health and Ageing Conference—Conference Review Session 4—Insurance opportunities to cover health care for the elderly in Asia Chair: Lye Fook-Kong General Manager, Hannover Re Lye Fook-Kong is currently the General Manager of Hannover Re’s Shanghai Branch and at the same time he continues to support the business development activities of the Group in Singapore. Lye as he prefers to be called, has over 20 years of experience in the Insurance/Reinsurance industry and is passionate about issues relating to longevity and health.
Russell Bateman Chief Operating Officer, CPIC Allianz Health Insurance Russell Bateman is currently the Chief Operating Officer of CPIC Allianz Health Insurance a recently formed Joint Venture between Allianz SE and China Pacific Insurance Group the third largest insurer in China. The company has been specifically created to serve the burgeoning Chinese health services market in addition to offering traditional health insurance products. Prior to joining the Joint Venture in 2013 Russell has held multiple leadership and executive roles in healthcare organisations across several continents Including both sides of the payor and provider functions. These positions include, being Founding CEO of the Saudi Enaya Health Insurance company in Saudi Arabia, National Provider and Network Relations director for Medibank Private in Australia. CEO of Latrobe University Private Hospital in Melbourne and Director of Operations of the Royal Melbourne Hospital. Russell’s qualifications include; Bachelor of economics, Post Graduate Diploma in Health Administration and an MBA. He is a Fellow of the Australian Institute of Management.
www.genevaassociation.org @TheGenevaAssoc 25 Dr Detloff Rump Chief Underwriter, Asia, Swiss Reinsurance Company Dr Detloff Rump studied in Germany and Switzerland and graduated with a doctorate in medicine from the Technical University in Munich. He also holds an MBA from Lingnan University, Hong Kong.
Worked at the German Heart Centre and the Hospital of the Ludwig- Maximilian’s University in Munich. Joined Munich Reinsurance as Medical Officer in 1989. From 1995 to 2003 worked as Chief Underwriter Australasia in Munich Re’s Sydney office. Between 2003 and 2008 was the Regional Chief Underwriter for American International Assurance (AIA), based in Hong Kong. Joined General Reinsurance in November 2008, and had responsibility for Life Underwriting and Claims across General Re’s Asian business units. Since January 2013, works as Chief Underwriter Asia, Life & Health at Swiss Re, based in Hong Kong. Is a Fellow of the Australian and New Zealand Institute of Insurance and Finance (ANZIIF), Vice President and member of the Board of the International Committee for Insurance Medicine (ICLAM), a member of the American Academy of Insurance Medicine (AAIM), the Academy of Insurance Medicine in Asia (AIMA), the Australian Life Underwriters and Claims Association (ALUCA) and the Hong Kong Underwriting and Claims Association (HKUCA). Dr Xian Xu Director, China Insurance and Social Security Research Center, Fudan University
Xian Xu is director of the China Insurance and Social Security Research Center, Fudan University, as well as a council member of the Insurance Society of China and senior member of Accounting Society of China and a research associate at the Centre for European Economic Research in Germany. He is now serving as the managing associate director of the Fudan-UC Center on Contemporary China (San Diego), the first academic institution established by a major Chinese university in cooperation with a leading North American university. He holds a doctorate in economics from Karlsruhe Institute of Technology (Germany). Xu’s research focuses on insurance, disaster economics, risk management and insurance management.
26 The Geneva Association | 12th Health and Ageing Conference—Conference Review Keynote Address Karl-Heinz Jung Head of Japan, MENA & International, Asia Capital Re Karl-Heinz has close to 30 years of industry experience and brings to his role in Asia Capital Re a strong background in reinsurance underwriting and client management. An industry veteran, he has a wide network from his experience serving markets in Asia, MENA, Europe, and Latin America. Karl-Heinz joined Asia Capital Re from Allianz SE Reinsurance Branch, Asia Pacific, where he was its Regional Chief Executive Officer. He has also held several senior directorial positions internationally in his 20 over years with the Allianz group. Karl- Heinz has a diploma in agriculture economics from the Universitat Stuttgart, Germany and an Executive Master of Business Administration in Financial Services and Insurance from the University of St. Gallen, Vlerick Leuven-Gent Management School and University of Nyenrode.
www.genevaassociation.org @TheGenevaAssoc 27 Session 5—Insurance Solutions for Elderly Health Care Coverage in Asia Chair: Dr Christophe Courbage Research Director Health and Ageing, The Geneva Association Chris Reynolds Head of Life Solutions Actuarial, PartnerRe As Head of Life Solutions Actuarial, Chris heads a team of actuaries responsible for developing and maintaining PartnerRe’s life propositions. Prior to his current role, Chris worked as the Mortality Actuary for U.K. and Ireland. He is an active volunteer for the UK Actuarial Profession, member of the CMI Assurances Committee and regular presenter at industry events.
Freddy Schnitzler International Health Consulting, Former Vice President of Samsung Fire & Marine Insurance Freddy Schnitzler looks back on 28 years Global Health Insurance Experience working for Affiliates of Munich Re Group, Samsung Group and Assignments by the European Union. During his work for Munich Re Group’s affiliate DKV he was involved in major market strategy projects looking into European and Asian health care systems and health insurance markets. Since 2002, Freddy is dedicated to Asia with a major focus on Korea. He was for four consecutive years Chairman of the Insurance Committee of the European Chamber of Commerce in Korea and conducted several advisory projects for the Chinese regulatory authority on behalf of the EU. Freddy is well connected in the global health environment and is regular speaker and lecturer focusing on sustainable funding of health insurance for aging societies, population health management and solid development of public private partnership models.
The Geneva Association | 12th Health and Ageing Conference—Conference Review 28 Jeff Wu Regional Head of Accident and Health, Generali Asia Based in Hong Kong, Mr. Wu is Generali Asia’s Regional Head of Accident and Health Insurance. Prior to that, Mr. Wu was the Asia Regional A&H Head of the Chubb Group of Insurance Companies. Before Chubb, Mr. Wu was AIA’s Asia Regional A&H Chief Actuary. Mr. Wu started his career at Trustmark Insurance Company in the U.S. in 1996, where he began as an actuarial analyst and progressed to become a Group Health Actuary. He later took the role of National Health Actuarial Consultant with Hewitt Associates, before he moved to Hong Kong in 2004. Mr. Wu received a Bachelor degree in Economics from Fudan University in Shanghai, China, where he grew up. His Master of Science in Statistics was earned at University of Illinois. Mr. Wu is a Fellow of the Society of Actuaries.
www.genevaassociation.org @TheGenevaAssoc 29 FORTHCOMING CONFERENCES OF THE GENEVA ASSOCIATION
February 26 Zurich 32nd Regulation and Supervision (PROGRES) Seminar, “Insurance and Financial Stability: a growing agenda”
March 16-17 The Hague 18th Meeting of the Annual Circle of Chief Economists (ACCE), hosted by NN Group N.V.
April 14-15 Copenhagen 13th ART of CROs, “Risk Management beyond Solvency II”, hosted by Nordea
June 9-10 Rome 43rd General Assembly of The Geneva Association, hosted by Generali Group and Vittoria Assicurazioni (Members only)
September tbc New York 10th Meeting of The Geneva Association’s Chief Investment Officers, hosted by XL Catlin Group 19-21 Nicosia 43rd Seminar of the European Group of Risk and Insurance Economists (EGRIE)
October 7 London 12th Symposium on Insurance Strategies, hosted by Lloyds
November
3-4 Hannover 13th Health and Ageing Conference, “Underserved consumers—Insurance solutions to close the health and longevity protection gap”, hosted by Hannover Re 16-17-18 Munich 12th Annual Liability Conference of The Geneva Association, hosted by Munich Re 28-29 Munich 12th Chief Risk Officer Assembly, hosted by Munich Re
30 The Geneva Association | 12th Health and Ageing Conference—Conference Review
This conference forms part of The Geneva Association’s Global Ageing research programme which aims to investigate the role of demographics, new technologies and insurance in the management of longevity and health risk in society. For more information, please visit our website www.genevaassociation.org
The Geneva Association—‘International Association for the Study of Insurance Economics’ Talstrasse 70, CH-8001 Zurich | Tel: +41 44 200 49 00 | Fax: +41 44 200 49 99