Who will benefit most from the government's proposed health protection scheme, which aims to standardise and regulate private health insurance? It will probably be those middle-class Hongkongers who buy private insurance. Of the city's 7 million people, 2.4 million are covered by some form of medical insurance.
People who want to stay in the public system, whatever their financial means, can do so. The public system is comprehensive and of reasonable quality and is the one public service where many taxpayers feel they are getting value for money. The government accepts this, and so the public system will remain the default service for the community. The proposed scheme is therefore voluntary for residents, and is intended to be supplementary to the public scheme.
Simple maths shows that 4.6 million people must be relying on the public system or are paying directly for private health care treatment.
For those with adequate financial means, going private is in fact the norm. The long queues and inconvenience of the public system can be circumvented by paying directly the higher costs of private care. People buy private health insurance to cover the cost of routine, preventive and emergency procedures; it gives them a wide choice of doctors, flexibility in doctor visits and greater comfort and fast placement should they need in-hospital care. Some 1 million people in Hong Kong own an individual health insurance policy, while many companies provide health care plans for employees and their families.
People's main concern is the small print about what circumstances and services are covered and not covered. People worry about insurers not covering pre-existing conditions, not renewing policies when a person becomes more susceptible to sickness as they age or suffers an illness requiring long-term care, and not covering the cost of the drugs they need. It is telling that only 4 per cent of the people over 65 years old have cover.
The government says its standardised and regulated scheme addresses all these concerns. It is creating a HK$50 billion fund to cover the higher insurance cost of the old and those with pre-existing conditions, as an incentive for them to opt for private insurance. Moreover, the government wants young people to join the scheme.
The devil is in the detail, of course, but the scheme deserves reflection. After all, it is the second round of a consultation which began in 2008 but which led nowhere. When the public was asked what kind of health care reform they preferred out of various schemes, there was no clear answer. Now, the government says there was a marginal preference for a voluntary private health insurance, which forms the basis of the current consultation.
