In this column recently, I argued that at some stage we will have to bring extra funding into our health-care system. Last year, the government spent more than $30 billion, 14 per cent of recurrent expenditure, on health care. Most of that - $28 billion - went to our public hospitals. They charge patients just 2 per cent of the average cost of treatment, so it is hardly surprising that they handle 95 per cent of Hong Kong's inpatient cases. This cannot go on. With an ageing population and new medical technology, demand will rise significantly.
The government has proposed two small first steps. One is to raise outpatient fees from $100 to $150 to give people with minor complaints a greater incentive to use private doctors, who typically charge $150. About 70 per cent who attend public accident and emergency facilities could be treated by a family doctor.
The other proposal is to cap spending on drugs by charging patients extra for medicines that do not appear on a standard list. Put very simply, the list would include most of the drugs that are commonly used - and heavily subsidised - as of today. As new, more expensive medicines are introduced, patients would have to pay extra for them.
Although these measures would help, we are still faced with a major, long-term gap between resources and demand. Many academics and policy analysts look to insurance to bring in additional funds. Although medical insurance is not very profitable, the industry broadly supports the idea.
Public opinion is far more sceptical. People look at the United States, where medical cover is a major burden for employers and individuals, because of malpractice suits and the number of uninsured. No one would want Hong Kong to end up like that, and there is no reason why we have to. There are several plans for affordable and fair systems. For example, working people could obtain cover for more realistic fees through reasonable and regular payments.
However, people will still need an incentive to start paying more for health care. And the best incentive is probably the promise of more choice - of doctor, hospital, treatment, and timing of appointments and admissions. To offer more choice, private hospitals would have to play a bigger role. For instance, they might offer insured people shorter waiting times but higher fees than public hospitals.
