Government's health consultation paper dismissed as 'a massive piece of rhetoric'

PUBLISHED : Tuesday, 27 February, 2001, 12:00am
UPDATED : Tuesday, 27 February, 2001, 12:00am

The head of the Harvard Report team hit back yesterday at the Government for calling its projections on the sustainability of the health-care system wrong and urged it to release its own calculations.

Speaking from Boston, Professor William Hsiao of Harvard University's School of Public Health said the Government's own consultation paper was 'a massive piece of rhetoric'.

If the plan were implemented, he warned: 'Five years from now Hong Kong will have a more serious problem and at that time will have to look for a more fundamental solution.'

The Harvard Report, released in April 1999, pointed to fundamental problems of an outdated and fragmented health-care system that is Hospital Authority-driven and exhibiting a variable quality in health services. It also warned that the system's long-term financial sustainability was questionable - the health budget would swallow 20 to 23 per cent of the budget by 2016.

But in an interview with the South China Morning Post last month, Secretary for Health and Welfare Dr Yeoh Eng-kiong said that when the Government reviewed the Harvard sums, it found the health-care system was not as unsustainable as Harvard made it out to be, and its problems could be addressed through less radical changes. He refused to reveal the administration's calculations.

The Government has proposed a post-retirement health protection account in which employees, from the age of 40 to 65, contribute one to two per cent of their wages.

The Harvard Report proposed two compulsory risk-sharing schemes: an individual savings account to buy long-term care insurance upon retirement, and compulsory insurance for unexpected large medical expenses. Employees and employers would contribute a combined total of three per cent of wages.

Professor Hsiao said he would give favourable odds to the Harvard Report's projections being closer to the mark.

'The Green Paper had to deal with the financing part. But then the way it dealt with it was to say that the Harvard projections were unrealistic, in other words to say our problem would not be that serious, that the Harvard team's projections really exaggerated the problem. But I would then ask the Government to open up its black box on its projection,' he said.

Professor Hsiao believed the data was generated to support the Government's conclusions that the system could continue with only minor changes. 'The Government's black box, being a black box, is producing a forecast which upon closer examination, we believe, has no credibility.'

He said that under the Government's paper, the Hospital Authority-driven system would be further strengthened. 'It's not focused on patients, if I may say bluntly, it's focused on how to protect and strengthen the interests of the Hospital Authority and the specialists.'

Professor Hsiao said he was surprised that the Government had changed its mind after what he claimed was wide public support for the Harvard plan during the consultation process.

Dr Yeoh, the former chief executive of the Hospital Authority who took over as health and welfare chief in September 1999, has said there was little public support for the Harvard plan for social insurance.

Dr Lai Kang-yiu, Public Doctors' Association president, said Hospital Authority staff were often overworked. 'I don't think it is possible to increase efficiency.' But he stressed the Government's funding proposal was sound as it was 'the least damaging to society'.