Higher charges can ease burden on A & E wards at public hospitals
Even with the proposal to raise the fee to HK$180, taxpayers will still be subsidising 85 per cent of the bill
Given public hospitals in Hong Kong charge a mere HK$100 for treatment at their accident and emergency wards, abuse of the service is inevitable. That the fee has not been adjusted for 15 years makes the situation even worse.
While the case for a fee increase is evident, the question is how to deter abuse without adding to the burden of those who cannot afford to pay.
The government has made a compromise, opting for HK$180 instead of HK$220 as recommended by the Hospital Authority earlier this year. It has also offered to expand the fee waiver mechanism to ensure that those with genuine financial difficulties will not be worse off. The measures should be able to address the concerns raised by lawmakers and patients’ groups.
Adjusting fees is an effective management tool. Following the introduction of the HK$100 charge in 2002, the number of less urgent cases dropped by 22 per cent in the following years. But the numbers have picked up again to around 2.2 million annually in recent years, stretching the public health care system to the limit. Currently, the waiting time for treatment ranges from one hour to more than five hours. Insufficient manpower is definitely an issue. But the queue is also lengthened by demands for semi- and non-urgent cases, which account for two-thirds of patients.
There are those who knowingly turn to A & E wards for non-emergency treatment, partly because of the long queues for general consultations in public hospitals. There are also those who cannot tell whether their situation is serious enough to warrant urgent treatment. The pressure is even higher when outpatient services in public and private clinics are unavailable or are substantially scaled down outside standard service hours or during public holidays. The government should perhaps strengthen the general outpatient service, which hopefully will help reduce the burden on A & E services.
A & E services are heavily subsidised by the government, up from 82 per cent in 2003 to 92 per cent last year. The service cost per patient is about HK$1,230, according to the government. Even when the charge is raised to HK$180, taxpayers will still be subsidising 85 per cent of the bill.
The purpose of the review is to reduce the incentive to abuse the system. Inaction is not just turning a blind eye to misuse of public resources; it essentially prolongs the queue and undermines the interests of those with genuine medical needs. It is to be hoped that the new charge, along with other cost adjustments, can help ease the burden on our overloaded health care system.