Health costs still low

PUBLISHED : Monday, 11 November, 2002, 12:00am
UPDATED : Monday, 11 November, 2002, 12:00am

SCMP, November 6, 2002

The problem of financing Hong Kong's escalating costs of public medical services remains fundamentally unresolved despite seemingly staggering rises in hospital fees and charges.

In terms of absolute amount, raising the in-patient service charge from $68 to $100 a day, a 47 per cent rise, is by no means excessive. The same can be said of the $60 fee, a 36 per cent rise from $44, for consulting a specialist at a public clinic. Seeing a general practitioner at an out-patient clinic for $45, a 22 per cent hike from $37, remains a bargain.

Nor can the decision to charge $100 for treatment at the accident and emergency department, whose service has been free, be considered unreasonable. The fee will not even remotely reflect the full costs of providing the service, which is not free in most other countries, even in places where people pay a lot more in taxes and medical levies.

Overall, after the new fees and charges become effective, the services will remain 96 per cent funded by the government, just one percentage point less than the existing level.

Officials are considering introducing a fee schedule based on affordability. This is the right way forward, provided that a suitable assistance programme is put in place to exempt the poor and the chronically ill.

Those who seek to denounce the rise in medical fees and charges should understand that the SAR does not tax like a welfare state. Instead, Hong Kong as a very narrow tax base. It has no general consumption tax, and more than half of government revenue comes from profits and salaries taxes. Even so, fewer than 40 per cent of the work force pay any salary taxes.

That such a low tax regime has been able to provide first-class public medical service is nothing short of a miracle. But that miracle can only be sustained if everyone is prepared to chip in a bit more when they become ill.


fundamentally (adv) primarily; basically

Example: The US Supreme Court ruled that the burden is on the government to keep things secret, rather than restrain the press when the government has failed in this respect. Mr Justice Douglas added: 'Secrecy in government is fundamentally anti-democratic.' (SCMP, November 6, 2002)

staggering (adj) causing great amazement

by no means (phrase) in no way

Example: The legislative process of a law to protect national security under one country, two systems is by no means easier. (SCMP, November 1, 2002)

chronically (adv) in a slowly developing manner and lasting for a long time

chip in (phrasal v) to each give a small amount of money towards payment for something

Discussion points

- How should the government spend taxpayers' money wisely during an economic downturn?

- Which sector should get the biggest share of public funding? Education? Medical and welfare? Or should we distribute the money evenly?