Hongkongers have a new discussion paper on health care. It comes after a warning, last May, of a looming $7 billion gap between our health-care costs and what the public purse can afford. Are we yet again going to have, in former premier Zhu Rongji's words, 'discussion without decision; decision without action'? Or has the time come now for implementation and action?
Some commentators have already summed up the paper with scepticism: 'We've seen it all before.' But have we?
Hongkongers are living, on average, longer than people almost everywhere else in the world. But the queues at public clinics are also getting longer, and this will continue. The reform paper proposes to change this, yet it is short on specifics.
Here, I would like to propose some ideas.
We need to find a more convenient and easy-to-use way to help those who need to queue - for routine check-ups and free medicine - to see a doctor to treat their immediate needs. How can we decide who in the queue is poor and in need of free treatment?
Much of the paper seems to rely on persuasion and good advice. But persuasion is a weak tool against poverty and the need to save even a few dollars. So, should an across-the-board charge be levied, equivalent to a similar visit to a private doctor; and should those seeking exemptions be able to use their social security records to prove their poverty? Or can we give a payment voucher to the poor in the queue who are willing to see a private doctor?
With the queues growing longer at public hospitals and clinics, it is said that underused private doctors should take a share of patients. The paper suggests that more private clinics stay open on a 24-hour basis. These are good ideas, but somehow patients have to be persuaded to go there rather than to the accident and emergency units at our public hospitals.