Patients who join a proposed voluntary health insurance scheme should be asked to pay a higher proportion of the costs of their treatment in public hospitals, then claim the money on their insurance, Hospital Authority chairman Anthony Wu Ting-yuk says. Instead of paying only a heavily subsidised charge of HK$100 a day, public patients covered by the proposed government-regulated scheme would pay part of the full cost of HK$3,300 a day. Wu said: 'The idea is to ask public patients to pay us the reimbursements they can get under the insurance scheme. They will not need to pay extra out of their pocket. With the extra income, we can improve our services and cut waiting time for needy patients.' The proposal, which the authority chief aired for the first time yesterday, is supported by a patients' group. The government plans to consult the public this year on a voluntary medical insurance scheme intended to cover at least 500,000 people, including those with pre-existing conditions. Secretary for Food and Health Dr York Chow Yat-ngok yesterday briefed the Health and Medical Development Advisory Committee on details of an insurance scheme proposed by a consultant. The proposed basic plan will cover a hospital daily room charge of HK$550 and surgical fees ranging from HK$26,000 to HK$124,000. The bureau's spokesman said the government and the committee in general agreed with the proposal but details have to be worked out. Public hospitals now charge patients only HK$100 a day including treatment, meals and accommodation, just 3 per cent of the full cost. Wu, who is a member of the development committee, said in an interview that the authority had no plan to raise its fees and charges. Getting patients' reimbursements from the government-regulated scheme would help recover the full medical costs, he said. Health officials have criticised some insurers for offering special allowances to patients if they opt for public services, instead of private, in order to reduce their payouts. Patients' Rights Association spokesman Tim Pang Hung-cheong supported Wu's proposal. Using patients' insurance to reimburse the authority for the costs of public hospital treatment was a good idea, he said. 'We should no longer use public money to subsidise insurers. The government should also allow the authority to keep this extra money to improve its services,' Pang said. But Chan Kin-por, insurance sector lawmaker and also a member of the development committee, said: 'It is a basic right for Hong Kong citizens to enjoy public hospital services. We should not deprive them of this right just because they have the insurance coverage. The policy owners may, for whatever reasons, not want to make a claim for that specific treatment. Some may want to keep a no-claims bonus. Public hospitals cannot force someone to make a claim.' The vice-chairman of the Alliance for Patients' Mutual Help Organisations, Cheung Tak-hai, said his group did not have any specific view on the issue - as long as patients did not need to pay extra for medical bills. The Hospital Authority is also seeking legal advice on whether it can claim on insurers in case of accidents covered by third-party responsibility. Wu said: 'For example, if a taxi knocks down three people and all the victims come to public hospitals for treatment, the authority should be able to claim the insurance to settle the medical expenses. 'We are still in the process of seeking legal advice in this aspect.' He said the government-designed insurance scheme could help relieve stress on public hospitals by shifting some of their patients to the private sector, but the impact of the scheme would not be seen in the short run. He said most chronically ill and elderly patients already in the public system would be reluctant to give up inexpensive public services. 'Young and healthier people who in the future enrol in the voluntary insurance scheme may consider private services because they don't want to wait for a long time for public services and they want choices, so we will see the impact of the scheme when this healthier group gets older,' Wu said. About a quarter of public patients have a monthly household income of HK$30,000 or above. Wu believes that these patients will find private insurance attractive. The authority is also exploring the possibility of providing different classes of service. Apart from having a very small number of private beds, mostly occupied by civil servants, public hospitals provide a standard service; patients stay in general wards and have no choice of doctors. Wu said since more patients would use private hospitals' services under the insurance scheme, there would be a need for public hospitals to set a benchmark for the private sector. 'Patients can choose the public hospitals in case they are not happy with the services or the prices in the private sector,' he said. Any change in the current system would need a legislative amendment, as the law now caps the number of private beds in public hospitals at 370. Another committee member, Dr Louis Shih Tai-cho, feared that since the proposed plan only covered hospital care, patients would ignore the importance of primary care. 'Patients may overuse hospital care. The government should also put more resources into developing family medicine at the primary level,' he said. Footing the bill Public patients have been urged to pay a higher share of the full daily medical costs per day of, in HK dollars: $3,300
