I told you so: the private sector has derailed Hong Kong government’s health insurance scheme

Feng Chi-shun says the insurance industry knows it can boss legislators around when it comes to its health-care proposal – which is all the more reason to exclude it from the scheme

PUBLISHED : Sunday, 15 November, 2015, 11:00am
UPDATED : Sunday, 15 November, 2015, 11:00am

When Hong Kong’s health minister Dr Ko Wing-man announced that the proposed voluntary health insurance scheme might not be successfully launched during his term, because of roadblocks put up by the private insurance industry, what came to my mind was the schoolyard taunt – I told you so.

Many months ago, I suggested in these columns that if the government had to rely on the take-up rate of private insurance companies for it to succeed, the government would be held to ransom by them. And that’s exactly what happened.

The government made two fundamental errors. First, it should not be called an insurance scheme; secondly, private insurance companies should never be allowed to play any role in it

The government made two fundamental errors in trying to implement the programme. First, it should not be called an insurance scheme; secondly, private insurance companies should never be allowed to play any role in it.

Actuary principles of the health insurance business require the majority of subscribers to be non-claimants for the business to be sustainable – hence the numerous exclusion clauses for pre-existing medical conditions.

The scheme doesn’t exclude pre-existing conditions. Many subscribers will be claimants. It is bound to lose money, and the government is ready to pump HK$4.3 billion into subsidising it. Thus it is not an insurance policy.

The insurance scheme’s purpose is to provide value-for-money medical coverage for the middle class, especially those with existing chronic diseases, so that they can use private health care. In this way, the scheme will relieve somewhat the heavy workload of our overstretched public hospitals, subsequently improving their services for those using them.

Currently, 40 per cent of our doctors work in our public hospitals, and they take care of 90 per cent of all the inpatient services in the city. We need to do something about this unhealthy imbalance; and the voluntary health insurance scheme is part of the solution.

Unfortunately for the public, whatever insurance packages the industry pitches will guarantee maximum profit for it, but minimum benefit for us

Insurance sector lawmaker Chan Kin-por said he hoped the government would abandon the proposed scheme, and let the Office of the Commissioner of Insurance continue to regulate the insurance industry. What Chan really wants is to have his industry take over the scheme and dictate what to sell to the public. Unfortunately for the public, whatever insurance packages they pitch will guarantee maximum profit for them, but minimum benefit for us.

Chan has a say in this matter because the voluntary scheme relies on private insurance companies to administer the programme.

It’s still not too late to resurrect the programme. I suggest the government first deletes the word “insurance” from the name of the scheme, then eliminates the private insurance companies from taking part in its implementation.

Dr Feng Chi-shun is a retired pathologist and an author