Health chief seeks cover for chronically ill

PUBLISHED : Saturday, 24 April, 2010, 12:00am
UPDATED : Saturday, 24 April, 2010, 12:00am

The voluntary medical insurance scheme has to provide adequate coverage for people with chronic illnesses, the health chief said yesterday.

York Chow Yat-ngok, who described coverage of pre-existing conditions and other details of the plan as a 'very complicated matter', said he hoped the gap between the government and the insurance sector could be narrowed. And he warned that lengthy talks would be required to come up with a final blueprint.

'We are communicating with the insurance sector on the voluntary scheme, we want to encourage people to enrol ... and at the same time provide adequate protection to those with chronic illness and of different ages. It is a very complicated matter,' Chow said.

His comments came a day after his team and the insurance sector resumed talks on the scheme.

The government wants the scheme to cover at least 500,000 Hong Kong people to encourage them to use private health services. However, talks with the insurance sector have been deadlocked over whether pre-existing conditions should be covered.

The government says the scheme must include such people, but the insurance sector complains that costs will be too high.

The Federation of Insurers put forward a new proposal on Thursday with a three-year 'waiting period' for people with pre-existing conditions to claim full benefits. The sector had earlier proposed a five-year wait.

Under the new proposal there would be no coverage for pre-existing conditions in the first year, 50 per cent coverage in the second year, 75 per cent in the third and full coverage in the fourth year.

Most medical insurance plans in the city provide benefits for individual items ranging from surgeons' fees, hospitals costs, operating theatre fees and in-hospital consultations. Unlike such itemised coverage, the government now wants insurers to introduce 'packaged' plans providing lump sum benefits for a particular condition or treatment. Designing these packaged services with fixed prices will require collaboration with private hospitals and doctors.

Chow yesterday called on private hospitals and doctors to 'position' their charges so patients need not pay too much extra for services. 'If the two parties can reach a consensus, the government won't need to do that much,' he said.

Private Hospitals' Association president Dr Alan Lau Kwok-lam said that providing packaged fees was 'feasible in principle' but some difficulties needed to be overcome.

The association represents all 13 private hospitals in Hong Kong.

'We will explore this matter and consult our members but it is not an easy thing to do,' Lau said.

At present, only a minority of private hospitals offer packaged fees for a limited number of operations.

'Those are hospitals which have more in-house doctors so they can easily work out their costs. For most private hospitals that work with private practitioners, working out an accurate costing for packaged services will be difficult,' Lau said.