刚刚早上八点，当年由西方传教士创建、目前依然是中国最大的医疗中心的仁济医院（Renji Hospital）就已经人满为患。医院候诊区挤满了焦急等待就诊的患者。首先，他们得在一块巨大的霓虹广告牌下面排长队取号，上面列着了医生们的科室信息。然后，患者们还要排起蜿蜒的队伍交费，最后还得排更长的队伍，等着到油漆脱落的诊室里就诊。中国基础医疗系统匮乏，这样的情景日复一日，每天都在上演。中国的医疗服务虽然便宜，但尚处于起步阶段：如果你患上任何一种疾病，小到感冒大到癌症，都必须去急诊室接受治疗。

    而在距离仁济医院急诊室不到100码的一栋现代化大楼里，我们可以瞥见未来中国的医疗服务。这里是贵宾特需门诊，也就是所谓的VIP医院。在VIP大楼里，患者不需要排队，而是可以坐在舒适的真皮沙发上，看着宽屏电视等着预约的医生。不同于仁济医院普通门诊区的嘈杂喧嚣，VIP门诊区噪声低到几乎可以忽略不计。身穿洁白制服的护士会陪同患者走进私人诊室。人们在仁济医院很难看上的专家，在这里却可以预约——但要支付预约费用。VIP医院的医生每次会诊的费用是60美元甚至更高，而这在马路对面可以看50次医生。

    为了帮助支付这样的VIP待遇（和治疗），越来越多的中国消费者开始选择附加健康保险——这纯粹是美国人的理念。而讽刺的是，虽然中国对各种理财服务的需求急剧增加，但据麦肯锡公司（McKinsey & Co）统计，外国公司在中国银行与保险市场所占的份额仅有2%。国有保险公司在中国市场占据着主导地位，以至于因为收入下滑，纽约人寿保险公司（New York Life）在去年不得不放弃自己在中国的合资公司，转而把它出售给日本的三井住友保险公司（Mitsui Sumitomo Insurance）

    但来自美国康涅狄格州布洛姆菲尔德的信诺集团（Cigna）却正在悄悄赢得中国消费者的青睐。很大程度上这是因为它颠覆了其他美国保险公司在中国的传统做法。信诺于2003年进入中国市场，但它选择的合作伙伴并不是当地的保险公司，而是一家领先的零售——银行中国招商银行（China Merchants Bank）。招商银行以灵活应对消费者的手段而著称。招商信诺（信诺与招商银行的合资企业——译注）并没有招聘大批成本相对较高的销售人员，而是进行创意营销，成立了配备最新数据挖掘技术的电话营销中心，推出由电影明星代言的电视广告，同时进行在线和社交媒体营销，借此逐渐在中国市场站稳了脚跟。销售人员所产生的巨额日常管理费用令许多公司背上了沉重负担。去年，招商信诺在中国的收入达到了3.31亿美元，比上一年增加了32%（虽然与信诺集团290亿美元的总销售额相比仍微不足道）。经过十年的经营，这家公司刚刚在中国售出了第100万份保单。仅仅经过三年，公司就实现了收支平衡，目前已经能够稳定盈利。

    By 8 a.m., Renji Hospital, founded in 1848 by Western missionaries and still one of China's best medical centers, is already in a state of chaos. A veritable sea of patients is crammed into the reception area, waiting impatiently to see a doctor. They first line up under giant neon boards that list physicians' specialties to collect a number on a waiting list, then join another snaking line at a cashier's window, and finally shuffle into even longer queues to wait for a doctor to see them in examination rooms with chipping paint. This scene is played out daily across China, which has a limited primary health care system. Medical services are cheap but rudimentary: If you have any malady, from a bad cold to cancer, you must go to the emergency room to seek medical treatment.

    But in a modern building less than 100 yards from the main Renji emergency ward is a glimpse at China's future. It is the guibin texu, known more commonly by its English translation: VIP hospital. In the VIP building, patients don't line up but wait for appointments on leather sofas, entertained by widescreen TVs. Instead of the shouting heard at Renji's main hospital, the noise level in the VIP section remains an understated murmur. Patients are escorted into private examination rooms by nurses in crisp white uniforms. The specialists who are so very hard to see at Renji are now suddenly available by appointment -- for a price. The physicians at the VIP hospital charge $60 or more for a consultation, 50 times what patients pay across the road.

    To help pay for such VIP treatment (and treatments), a growing number of Chinese consumers are turning to supplemental health insurance -- a thoroughly American concept. The irony is that despite soaring demand for various financial services, foreign firms have just 2% of the banking and insurance market, according to McKinsey & Co. State-owned insurance companies dominate the market to such extent that last year New York Life abandoned its China joint venture, selling out to Japanese firm Mitsui Sumitomo Insurance because of slumping earnings.

    But one U.S. firm, Bloomfield, Conn.-based Cigna (CI), is quietly winning over Chinese consumers, largely by defying conventional wisdom about how an American insurer should operate in China. Cigna entered the China market in 2003, partnering not with a local insurer but with a leading retail lender, China Merchants Bank, which is known for its deft handling of consumers. Rather than deploying an army of relatively expensive salesmen, which has burdened many other firms with a huge overhead, the Cigna joint venture has instead deployed innovative marketing, call centers equipped with the latest data-mining techniques, television commercials featuring a movie star pitchman, and online and social media sales to gain a growing foothold in the Chinese market. Last year Cigna's joint venture in China had revenues of $331 million, up 32% from the year before (though still a small fraction of the company's overall $29 billion in sales). After a decade of operation, the firm just sold its 1 millionth policy in China. The business broke even after just three years and is now solidly in the black.

    信诺在中国的早期成功，使它可以借助正在重塑这个国家的各种力量所产生的合力，其中首当其冲的就是私人医院和诊所的兴起，它们是中国政府谋求为13亿国民提供医疗保健所付出努力的一个关键部分。这些VIP机构针对的是中国日益崛起的中产阶级和富人阶层，这个群体的财富将形成更多对于医疗保健和保险的需求——虽然这一点听起来有些不合常理。他们的寿命将更长，对于老年人常见的疾病，他们将需要特别护理和治疗；他们的饮食将发生变化（虽然不见得变得更加健康），他们会坚持要求服用以前因为成本太高而不会开的药物。

    伯恩斯坦研究公司（Bernstein Research）分析师安娜•古普特称，截止2015年，中国在医疗保健方面的开支将达到6,480亿美元，比2008年的1,820亿美元增加三倍以上。她推测，中国健康保险市场在2015年将达到150亿美元，而信诺集团在中国的年收入将接近10亿美元，几乎相当于它目前国际业务总收入的三分之一。信诺集团CEO柯伟健在访问上海时曾表示：“在我们的国际业务中，中国业务的增长是最快的。未来5至10年里，中国将成为集团业务中至关重要的部分，因为我们将为这个市场的个人和越来越多的雇主们带来更多产品和服务。这是我们未来业务中令人激动的一部分。”

    招商信诺在中国的心脏位于深圳市一栋普通办公楼的二层和三层，这是一个电话营销中心。这里的300名销售代表正仔细凝视着电脑屏幕上的销售脚本。25岁的电话销售员陶伟（音译）对着耳机，用礼貌的语气开始销售：“您知道的，治疗癌症的费用每年都在增加。”

    技术是信诺的优势：陶伟并不是随机给潜在客户打电话，他所联系的都是经信诺确认具有很强预期的客户，而且他会给客户推荐针对他们的需求而量身定制的保险产品。一切都得益于信诺的自有软件。这套软件从300个数据点进行筛选，如信用卡使用和人口统计特征等，进而帮助公司营销人员调整营销策略，当然，它自称这一切都会保护客户信息的隐私。目前负责信诺预测性产品业务的戴维•J•福格迪认为：“这就像是FICO得分一样。”他曾担任通用电气金融服务公司（GE Capital）高管，因此引用了信用评分模型FICO。信诺的软件会显示“这是出售给那位顾客最合适的产品。”

    例如，如果技术手段发现用户使用信用卡支付过多次国外旅行，这套软件就会将该持卡人与专门针对海外旅行的中国人设计的健康保险关联起来。在深圳等地的电话销售中心，接线员会使用预测外拨技术：电话营销人员的电脑屏幕上会自动提示客户的背景和适合推销的产品，以及量身定做的营销策略。

    仅深圳的电话营销中心每个月便能卖出80,000份保险。另外两个跨省电话营销中心分别位于上海和武汉，在有需要的附属公司附近还有一些规模较小的电话营销中心。深圳电话营销中心负责人之一科恩•杨认为，大多数中国人都会向银行提供他们的手机号码，好在他们并没有形成美国人挂断推销电话的习惯。杨表示，公司的客户实际上很愿意了解更多关于健康保险的信息。电话营销中心的营销人员形成了一种良性竞争，可以获得冰箱和国外旅游的销售奖励。

    Cigna's early success in China sets the company up to capitalize on a confluence of forces reshaping the nation, starting with the rise of private hospitals and clinics as a key pillar in Beijing's evolving efforts to provide health care to 1.3 billion people. These VIP institutions target China's rising middle class and wealthy, a group whose affluence will -- and this may seem counterintuitive -- actually create more demand for health care and insurance. They will live longer, requiring special care and treatments for diseases common among the elderly; their diets will change (not necessarily for the better); and they'll insist on drugs and medicines that previously had not been prescribed because of costs.

    Ana Gupte, an analyst at Bernstein Research, says spending on health care in China is expected to more than triple, to $648 billion in 2015 from $182 billion in 2008. She reckons that the market for health insurance in China will reach $15 billion in 2015, and that Cigna's revenues there could approach $1 billion a year, nearly a third of what the company now earns from its international business. "China is the fastest growing asset in our international portfolio," says David Cordani, Cigna's CEO, during a visit to Shanghai. "Over a five- to 10-year horizon, China will become the critical part of our business portfolio because we will bring multiple products and services to the market, both for the individual and the emerging employer landscape here. It's an exciting part of our future."

    On the second and third floors of a nondescript office building in the southern city of Shenzhen lies the beating heart of the Cigna venture in China: a call center with 300 sales agents in cubicles, peering at sales scripts on computer screens. "You know, the costs of cancer treatment are increasing every year," Tao Wei, a 25-year-old telemarketer, intones politely into his headset, beginning a sales call.

    Technology is Cigna's edge: Tao isn't simply cold-calling potential customers, he's contacting consumers Cigna has identified as strong prospects -- and offering them insurance products tailored to their needs. Cigna does this through proprietary software that sifts through 300 data points such as credit card use and demographics to help its marketers fine-tune their pitch -- all while claiming to protect the privacy of the customers' information. "It's like a FICO score," says David J. Fogarty, who now runs Cigna's predictive products business. He's a former GE Capital executive, thus the reference to FICO, the credit scoring system. Cigna's software shows "this is the best product to sell that customer."

    When the technology sees a lot of foreign travel charged to credit cards, for example, it associates that cardholder with a health policy that is designed specifically for Chinese who travel overseas. In call centers like the one in Shenzhen, operators have what is called predictive dialing: The telemarketer has the customer's background and what products to sell automatically cued up on their computer screen, along with a tailored pitch.

    At this one site in Shenzhen alone, they are selling 80,000 policies a month. There are two other multiprovince call centers in Shanghai and Wuhan, along with smaller centers based near affiliates who want them. Cohen Yang, one of the managers who runs the Shenzhen call center, notes that most Chinese provide a cellphone number to their banks and haven't yet adopted the American habit of hanging up on telemarketing calls. The customers, Yang says, are actually keen to learn more about health insurance. The call center telemarketers are in a friendly competition for sales bonuses that include refrigerators and trips abroad.

    此外，信诺还非常重视电视与互联网营销。招商信诺在中国的代言人是曾在1994年凭借处女作获得威尼斯电影节（Venice Film Festival）最佳男主角奖的演员夏雨。夏雨为招商信诺代言的是一款癌症保险产品，之所以选中夏雨是因为他的家庭故事在中国家喻户晓：一位亲人罹患癌症，于是夏雨工作之余抽出时间悉心照料，在中国引起了很多人的共鸣。

    信诺比其他竞争对手更早地预见到了中国市场的发展。它在中国的业务与美国国内的业务存在巨大差异。与所有竞争对手一样，公司在美国市场几乎只销售集体保险，而且鉴于奥巴马医改计划所带来的不确定性，目前公司的利润也面临缩水。如果保险公司永远都无法拒绝客户，不管他们是多么地不情愿，那么公司的会计人员还能如何确定风险敞口？由于国内盈利能力下降，信诺集团在很早以前便将重心转移到国外市场，在20年前打开的韩国市场，以及印尼和澳大利亚等地区，个人保险销售均取得了令人瞩目的业绩。目前，韩国市场占它国际销售额的三分之一。

    由于中国法律规定，保险公司必须在开展业务的每一个省都获得独立的许可。而信诺刚刚获得了其第11个省级许可，因此在中国可以获得沃伦•巴菲特所称的“宽护城河”的保护。所谓“宽护城河”是指牢固的竞争壁垒，因为新竞争对手要想进入市场，必须遵循同样冗长乏味、耗时耗力的过程，获得许可。

    当然，其他美国保险公司，如美国国际集团（AIG）和安泰保险金融集团（Aetna）等，也在中国销售健康保险，但它们在中国市场的渗透程度远远不及信诺。

    韦德布什证券（Wedbush Securities）分析师萨拉•詹姆斯表示，由于冗长的注册过程，其他大型保险公司紧跟信诺进入中国市场的可能性不大。她说：“这对于他们而言是个很好的机会。我没有看到有其他公司进入这个市场。”

    信诺集团CEO柯伟健表示，招商信诺的成功很大一部分要归因于中国招商银行这个合作伙伴。柯伟健解释称，公司选择合作伙伴不看它是否具有保险行业的经验，而是选择优秀的市场营销者。

    中国招商银行是中国最大的股份制银行，负责人是一位激情澎湃的商人马蔚华。哈佛商学院（Harvard Business School）两次将他的经验作为案例。招商银行是中国首家真正以零售市场、而非企业市场作为重心的中国银行，推出的各种创新业务包括“一卡通”借记卡和网上银行，用户通过一个账号便可以控制其所有银行活动——这对于一个不久之前还必须到窗口填各种表格才能办理银行业务的国家来说，实属一项巨大的创新。马蔚华告诉《财富》杂志（Fortune）：“我的策略是我们必须早一点、快一点、好一点。这样我们就能比其他国有竞争对手提前三年或五年想到和做到一些事情。”今年六月，马蔚华将从银行行长的职位上卸任，但退休之后，他仍将担任招商信诺人寿保险有限公司（Cigna & CMB Life Insurance Co. Ltd.）董事长。

    Cigna also is selling hard on television and the Internet. As its TV pitchman Cigna uses a popular Chinese movie star named Xia Yu, who won the best actor award at the Venice Film Festival for his debut film in 1994. Xia, who sells a cancer policy in the commercial, was selected in part because he is well known among Chinese for his family story: A relative had cancer, and Xia took time out from his career to be a caregiver, a problem that resonates with many Chinese in a country where an estimated 80% of the people still smoke cigarettes.

    Cigna had the foresight to see this market developing long before most of its competitors. It's a big contrast to the company's domestic business, which is focused almost exclusively on selling group plans and, like all of its competitors, now faces thin margins because of the uncertainties raised by Obamacare. How, for example, will the number crunchers determine risk exposure when they can never turn away a customer, no matter how sick? As a result of declining domestic profitability, Cigna long ago turned to the overseas market, building an impressive record selling policies to individuals in South Korea, a market it opened 20 years ago and which now accounts for a third of its international sales, and such other countries as Indonesia and Australia.

    Because of Chinese regulations, insurance companies need to obtain a separate license for each province they operate in. Cigna, which just obtained its 11th provincial license, thus enjoys in China what Warren Buffett has termed "a wide moat," a tough barrier to competition because any new rival would have to follow the same tedious and time-consuming process of obtaining licenses in order to enter the market.

    To be sure, other American insurers, such as AIG (AIG) and Aetna (AET), are selling health products in China, but they haven't yet achieved Cigna's depth of market penetration.

    Wedbush Securities analyst Sarah James says that because of the lengthy registration process, it's unlikely that other big insurers will follow Cigna into the market. "It's a great opportunity for them," she says. "I don't see anyone else entering the market there."

    Cigna CEO Cordani ascribes much of the success of the joint venture to the choice of China Merchants Bank as its partner. Cordani explains that the company seeks partners that are primarily great marketers, regardless of their insurance experience.

    The largest shareholder-owned bank in China, CMB is run by an ebullient businessman named Ma Weihua, the focus of not one but two case studies at the Harvard Business School. CMB was the first Chinese bank to really focus on the retail market rather than the corporate world, introducing such innovations as the first "all-in-one" debit card and Internet banking, so that customers could control all their banking activities with one account number -- a huge innovation in a country where banking was until very recently confined to multiple slips of colored paper. "My strategy was we had to be a little earlier, a little faster, and a little better," Ma tells Fortune. "So we always have to think and do things three to five years ahead of our state-owned competitors." Ma is retiring as president of the bank in June, but he will remain chairman of the joint venture with Cigna, known as Cigna & CMB Life Insurance Co. Ltd.

    中国招商银行同样称自己是一家私人银行机构。银行对于信诺扩大在海外出差的高净值客户（资产为350,000美元至150万美元）中的份额至为关键，而且它可以利用信诺集团在中国境外，如新加坡、中国香港，甚至欧洲等地成熟的医院和医生网络。

    信诺集团开始在中国销售保险时，只销售健康险和意外险，如当灾难降临时，一次性给付保险金的癌症保险等。2012年加入信诺负责中国业务的巴西人费尔南多•莫雷估计，信诺在中国的业务约70%为附加健康、人寿和意外保险市场，年保费最低为150美元。加入信诺之前，莫雷曾在中国大型人寿保险公司平安保险（Ping An）任顾问一职。

    但目前，信诺正在努力争取每年愿意为保险支付15,000美元的客户。电脑网络公司CEO、36岁的李政（音译）就是一个例子。李政对《财富》杂志表示，他之所以购买了一份信诺的保险，是因为他希望获得私人医疗机构提供的更优质的服务。李政说：“在公立医院，必须等很长时间。”此外，他的妻子在加拿大出生，而且他需要经常进行国外旅行，因此他希望为自己在国外和国内的旅行投保。

    上海中国市场研究集团（CMR China Market Research Group）的高级分析师本•凯文德表示，跨国企业的许多更年轻的中国高管积累的财富远远多于上一辈，现在他们更关心年迈的父母。凯文德说：“对于信诺提供的个人健康保险产品的需求，肯定会愈加迫切。”

    信诺在中国扩张的下一步是为中国公司提供美国式的工作场所保险。这些保险产品相对昂贵，所以它们将仅面向中高层管理人员提供。到目前为止，中国尚未向提供医疗保险的公司提供任何税收优惠，但据报道，中国正在考虑进行这方面的改革，而这将大幅增加信诺的业务。

    当然，不论是在中国还是其他发展中国家，信诺都不会坐等政府立法或政策改革来增加公司业务。之前公司凭借出人意料的策略取得成功。受此鼓舞，公司将继续在中国进行尝试。信诺与另外12家银行、信用公司、航空公司甚至零售商签署了合约，将有权访问这些公司客户名单，而这些客户将成为它潜在的销售对象。此外，它还推出了“管家服务”，帮助中国中产阶级享受全新的资本主义式的按诊疗收费医疗。它还将延续与优秀营销者合作的做法，而不是选择成功的保险公司。它在印度新成立的合资公司选择了另外一家非常规的合作伙伴：当地一家多样化经营的著名炊具制造商。印度的中产阶级同样在日益壮大，同时开始对VIP医疗和保险产生需求。（财富中文网）

    译者：刘进龙/汪皓

    China Merchants Bank, which also boasts a private banking unit, is key to Cigna's efforts to expand its market to high-net-worth customers ($350,000 to $1.5 million in assets) who travel abroad and can take advantage of Cigna's established network of hospitals and doctors outside of China, in places like Singapore, Hong Kong, and even Europe.

    When Cigna began selling insurance in China, it began with simple health and accident policies such as the cancer product that offers a lump sum payout when a catastrophic event happens. Fernando Moreira, a Brazilian who joined Cigna in 2012 to head the China operation after working as an adviser to Ping An, a huge Chinese life insurance company, estimates that about 70% of Cigna's business in China is in the supplemental health, life, and accident market, with annual premiums as low as $150.

    These days, though, Cigna is making a push for clients who will spend $15,000 a year or more on insurance. Customers like Li Zheng, the 36-year-old CEO of a computer network company. Li toldFortune he signed up for a Cigna policy because he wanted access to the better service offered by private health care. "At public hospitals you have to wait a long time," Li says. He also has a Canadian-born wife and often travels abroad, so he wants to be covered on his overseas trips as well as in China.

    Ben Cavender, associate principal at CMR China Market Research Group in Shanghai, says a lot of younger Chinese executives at multinationals have more money than previous generations, and they now must care for their aging parents. "There's absolutely going to be very strong demand for the kind of individual health care policies Cigna is offering," Cavender says.

    The next chapter in Cigna's expansion is offering U.S.-style workplace insurance plans to Chinese companies. These are relatively expensive, so they would be available only to executives and middle managers. So far, China does not offer any tax benefits to companies that provide health care insurance, but is reported to be considering making a change, which could vastly increase Cigna's business.

    Not that Cigna is sitting back and waiting for legislative or policy changes to boost its business in China, or elsewhere in the developing world for that matter. Emboldened by its wins using unexpected tactics, the company continues to experiment in China. Cigna has signed deals with another 12 banks, credit companies, airlines, and even retailers to get access to their customer lists as potential sales leads. It has also created a concierge service to help middle-class Chinese deal with the brave new world of capitalist-style fee-for-service medicine. And its practice of teaming up with great marketing partners -- rather than successful insurers -- continues. For its new joint venture in India, which also has a rising middle class that is starting to demand VIP health care and insurance, Cigna chose another unconventional partner: a diversified local manufacturing company best known as a maker of cooking pots.