The best health solution for now
Health chief Dr York Chow Yat-ngok has pitched the government's proposed voluntary health insurance scheme as a means of strengthening the regulation and development of private medical insurance and health-care services. The Legislative Council's health services panel, however, is concerned that HK$50 billion set aside to subsidise insurance for high-risk patients normally refused coverage will ultimately benefit private insurers and medical services rather than patients.
They both have a point. But the government can both achieve its objectives and meet lawmakers' concerns through ensuring transparency of costs and benefits, which Chow has promised under the proposed Health Protection Scheme (HPS).
A new statutory body, the HPS Authority, will be responsible for regulating private health services to strengthen protection for the public through enhanced market transparency, greater competition and higher standards. One of its key tasks will be to gather data on how premium income is distributed between patients, doctors, hospitals and administration.
Heavily subsidised public health-care is now costing the government nearly HK$40 billion a year, or nearly 17 per cent of its recurrent expenditure. Both figures can only rise. There is no question about the need for reform of financing so that those who can afford to pay more do so.
In the absence of consensus on compulsory insurance and health savings, the government's departure from its free-market philosophy to intervene in the market through a voluntary scheme may be the most effective solution for now. Officials hope the new scheme will attract up to 500,000 people, and that this will give the government more influence over standard medical insurance services.
At the same time, the government must maintain public hospitals, along with their mission to serve the poor and disadvantaged, as the core of the health-care system in order to meet lawmakers' fears that the reforms will only push up prices and premiums, worsen the brain drain at public hospitals and turn them into a second-class service.
The Hong Kong Medical Association warns that many doctors will not take part if prices are set too low. But their fees can still find a market level. Doctors can set them and patients can vote with their feet.
The long-term success of the scheme will depend on wider coverage of the population - or a bigger insurance pool. Key to this will be the plan to target the young, with the prospect of eventual premium discounts of up to 30 per cent at a time of life when they are more likely to need medical services. The new authority must vigorously promote this aspect as a form of health savings.