As Hong Kong approaches the fourth anniversary of its return to Chinese sovereignty, its government is refining proposals for reforming the region's publicly funded health care system.
In a discussion paper released in December, Health and Welfare Secretary Yeoh Eng-Kiong outlined a wide-ranging series of proposals for revamping Hong Kong's system of public hospitals and medical clinics. Among the most controversial are plans to introduce individual medical savings accounts to help pay for postretirement medical needs and to establish an office within the health department to investigate complaints about public health care.
Currently, patients using Hong Kong's public hospitals pay approximately HK$68 (Cdn$13) per day for accommodation and medical services. The discussion paper proposes a comprehensive review of this fee structure and suggests the establishment of a compulsory contribution scheme under which Hong Kong residents aged between 40 and 64 contribute 1% to 2% of their salaries to a personal “health protection account.” The money would be available only to fund medical or dental expenses or to purchase medical or dental insurance.
Reaction has been mixed. Dr. Lai Kang-yiu, president of the Hong Kong Public Doctors Association, says the proposals on mandatory health care savings are the “least harmful” option available, particularly when compared with earlier proposals for reform that would have set much higher levels of compulsory contribution. Over the long term, however, he feels that setting fees for public medical services that more closely reflect actual costs will help take pressure off the public system.
“The real solution is to narrow the price gap between the public and private sector and let citizens buy their own private insurance once they have anticipated their future needs,” says Lai.
Bob Neufeld, former editor of MD Management's Strategy magazine, won the 2000 Dateline Hong Kong Fellowship sponsored by the Canadian Association of Journalists and the Hong Kong Trade Office. This article was written after a visit to Hong Kong funded by that fellowship.
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Bob Neufeld
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Figure. Dr. Lai Kang-yiu: least harmful option Photo by: Bob Neufeld