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Marché canadien de l’assurance de soins de santé et médical 2019 par Services, Application, Revenu, Acteurs principaux, Taille, Tendances et opportunités d’affaires

Aperçu du marché
Le marché canadien de l’assurance maladie devrait enregistrer un TCAC effectif de 7,5% au cours de la période de prévision (2019-2024). Il avait été évalué à 41 milliards USD en 2017. Cependant, il est confronté à des défis en termes de fourniture de services de santé dans les temps impartis, en raison de certains écarts de fonctionnement.

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Alors que Medicare fournit tous les services de santé requis gratuitement à tous les résidents, certains employeurs proposent une assurance maladie complémentaire privée comme couverture pour attirer des employés de qualité. Chaque province a la responsabilité de générer des revenus, de planifier, de réglementer et d’assurer la bonne prestation des services de santé, bien que le gouvernement fédéral réglemente certains aspects des médicaments sur ordonnance et subventionne la couverture des services fournis par la province aux populations vulnérables.
Partenariats public-privé dans la prestation du système de santé.

Facteurs
– Population gériatrique en croissance.
– Augmentation des revenus et préférence pour de meilleurs avantages pour la santé, afin de répondre aux besoins de santé urgents.
– Augmentation des coûts des soins médicaux dans les différents services de santé offerts.
Contraintes
– Manque de connaissance des changements de politique ou des détails du plan de santé approprié.
– Manque de connaissances pour choisir le fournisseur légitime.
– L’activité accrue des concurrents exerce une pression sur les habitudes de consommation des consommateurs en matière de santé.

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Portée du rapport
Le rapport couvre une analyse de fond complète du secteur canadien de l’assurance maladie, qui comprend une évaluation des comptes nationaux de la santé, de l’économie et des tendances des marchés émergents, ainsi que des changements importants dans la dynamique du marché et une vue d’ensemble du marché.

Principales tendances du marché
L’assurance-maladie privée au Canada et ses conséquences sur la couverture santé
Les dépenses de santé privées au Canada représentaient environ 31% du total des dépenses de santé (assurance privée, OOP et autres) au Canada en 2018. En 2018, environ 25 millions de Canadiens bénéficiaient d’une assurance maladie complémentaire pour répondre à leurs besoins en matière de sécurité sanitaire. Environ 12% du total des dépenses de santé en 2018 provenaient de l’assurance privée. L’assurance maladie complémentaire basée sur l’emploi est le statu quo chez les grands employeurs et couvre des services tels que l’optométrie, l’assurance dentaire et l’assurance médicaments étendue. Au Canada, la majorité de la population est financée par des fonds publics, tandis que la prestation de soins de santé privés est assurée par 10 régimes d’assurance maladie provinciaux et deux territoires. Trois provinces, à savoir la Colombie-Britannique, l’Alberta et l’Ontario, restent au cœur des services de Medicare avec la perception des primes nationales de santé.

Prior to 1940, the healthcare was essentially financed privately. However, with the advent of the 1984 act on Medicare and its principles, public had wide scope to receive a lot health benefits. Canada’s national public health insurance is characterized by local control, doctor autonomy, and consumer choice, i.e., patients can choose for themselves which physician and hospital to attend to receive services within their province. Healthcare providers are mostly private funded by public monies via provincial budgets. Hospitals are largely privately owned not for profit organizations who receive an annual global operating budgets from the provinces. Physicians practice privately, with their remunerations on fee for service basis received through the provincial health plans.
Spotlight on the Popular Channels Used to Distribute Health Insurance in Canada
Canada is home to more than 130 health insurers serving the healthcare needs of its people. Group sales through the medium- and large-sized employers is the dominant channel of distribution in health insurance, which is best utilized by the Canadian population. Together with the traditional career agent or exclusive sales force, health insurers may as well use any combination of independent agents, Managing General Agencies (MGAs), and national accounts, to distribute their products. Each of these channels is further divided into sub-categories. So independent agents may be either individuals working on their own or Personal Producing Groups of Agents (PPGAs), MGAs include Associate General Agencies, and national accounts include both IIROC dealers and MFDA dealers.

MGA’s: Managing General Agencies – This is supposedly the largest channel of distribution for life, as well as health insurance in Canada, which contributes about 30% of all the new premiums. The MGA channel utilizes a wide variety of business models large, national organizations to small, local operations. Though there is no clear and consistent description of how the channel operates, there is no evidence of any systemic problems in the channel.

The Functions of an MGA include:
– Back office support between advisor and insurer for sales transactions
– Sales and marketing support for the advisor
– Market conduct compliance support for the insurer
AGA’s Associate General Agencies – They too support independent financial advisors on a smaller scale, compared to the MGAs. It is mostly a sub to one or more MGAs.
Competitive Landscape
It is a fragmented market, with the leading players, such as SunLife, ManuLife, Great Westlife, contributing about 25-30% of the total health insurance market, in 2018. The competition is, however, tightening up, based on the consumer awareness about having an additional private health cover. The consumers are resorting to additional health benefits offered by the private players, besides receiving Medicare benefits free of costs. Sunlife, in 2018, had acquired MaxWell Health, a digital platform that makes it easy for plan members to make good benefit plan enrolment decisions, along with administration tools for employers and brokers.
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Table of Contents

1 INTRODUCTION
1.1 Scope of the Study
1.2 Key Deliverables of the Study
1.3 Study Assumptions

2 RESEARCH METHODOLOGY
2.1 Analysis Methodology
2.2 Research Phases

3 EXECUTIVE SUMMARY

4 GOVERNMENT REGULATIONS AND INITIATIVES
4.1 Canada Health Act and Its Implications on the Overall Healthcare Coverage in Canadian Population
4.2 Insights on the Public or Social Security Health Insurance Coverage in Canada
4.3 Latest Government Rules Pertaining to Health Insurance Plans in Canada

5 INDUSTRY DYNAMICS AND INSIGHTS
5.1 Current Market Scenario
5.2 Market Dynamics
5.2.1 Drivers
5.2.2 Restraints
5.2.3 Opportunities
5.3 Brief on Health Insurance Premiums and Study on the Effect of Medical Trend Rate on Health Plans
5.4 Role of Private Health Insurance Service Providers in Serving the Healthcare Needs of Canadians
5.5 Insights on the Private Health Insurance Premiums Growth by Type of Coverage and Duration of Plans
5.6 Industry Attractiveness – Porter’s Five Forces Analysis
5.7 Value Chain/Supply Chain Analysis

6 MARKET SEGMENTATION
6.1 By Product Type
6.1.1 Private Health Insurance (PMI)
6.1.1.1 Individual Policy Coverage
6.1.1.2 Group Policy Coverage
6.1.2 Public/Social Security Schemes
6.2 By Term of Coverage
6.2.1 Short-term
6.2.2 Long-term
6.3 By Channel of Distribution
6.3.1 Brokers/Agents
6.3.2 Banks
6.3.3 Direct
6.3.4 Companies
6.3.5 Other Channels of Distribution

7 COMPETITIVE LANDSCAPE
7.1 Overview (Market Concentration and Major Players)
7.2 Company Profiles
7.2.1 Manulife
7.2.2 Sun life Financial
7.2.3 GreatWest Life

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