Lawmakers attack government's retreat on standardising private hospital charges

Private hospitals seen as sole winners as proposed reform leaves charges unregulated and provides little transparency for patients

PUBLISHED : Tuesday, 04 June, 2013, 12:00am
UPDATED : Tuesday, 04 June, 2013, 3:51am

Lawmakers and the insurance industry have lashed out at the government's proposed standardised medical insurance plan, saying it has backed down from regulating private hospital prices.

Under the new Health Protection Scheme (HPS), insurers would offer clients the choice of not paying, or paying a known extra amount, for certain procedures.

But pressure on private hospitals to provide fixed-price packages for their services - suggested by the previous administration - would be dropped.

"We are disappointed to see the government backing down on package prices for private hospitals," insurer Swiss Re's David Alexander, a member of the Federation of Insurers' governing council, told the South China Morning Post.

"There should be packaged pricing to enhance the transparency and predictability of medical costs for the benefit of customers," he said.

A preliminary draft of the long-delayed medical reform, released last week, said the government would not push private hospitals to issue package prices for similar or related conditions - a system proposed by the previous government in 2008 to offer more certainty for patients. After a consultancy study, the latest report rejected it.

"Hong Kong currently does not possess such a sophisticated mechanism for conducting [such] work," it said. "The consultant considers that there will be significant challenges [for such a system] in the short term."

Instead, it proposed offering patients the option of "informed financial consent" before non-emergency treatment.

Insurers would also offer clients the choice of a "no-gap" or "known-gap" plan - referring to the difference between charges and insurance payouts - for certain medical procedures.

Civic Party lawmaker Dr Kwok Ka-ki said private hospitals might emerge as the ultimate winners under the scheme, as there would be no supervision of their charges.

Alexander agreed with that assessment, saying: "We have done a lot of things on our side, and we would like to see more commitment from private health care providers."

The draft arrangements are part of a series of reforms aimed at encouraging the public to buy their own medical insurance and use private health care services, easing the burden on public hospitals, which care for 90 per cent of the city's patients with only 40 per cent of its doctors.

Health insurance products would be standardised under the HPS Standard Plan, with a minimum requirement that insurers offer standardised plans for hospital admissions and procedures not requiring admission.

Insurers would be required to accept all prospective customers, including those more likely to require treatment, such as people with pre-existing medical conditions, whom the government is considering subsidising via a premium-pool arrangement.

Having met that basic requirement, insurers would be free to innovate and offer "top-up", or tailor-made "flexi" plans to suit specific peoples' needs.

Alexander said some people might now be reluctant to buy medical insurance as they were confused by the different plans and standards, and he welcomed the government's proposed standardisation. But he insisted that insurers should remain free to offer insurance packages of different prices and quality.

"There should be a free market," he said. "The HPS should come alongside existing medical insurance products."

According to the federation, about 200,000 people take up private medical insurance in the city each year.

The government proposal will go before a Legislative Council panel today.