Explainer | Hong Kong’s health voucher scheme for the elderly has been running for a decade – so why are curbs on usage being imposed and what effect will they have?

Over the past decade, a voucher scheme for private health care that began with HK$250 (US$32) given to each elderly resident annually, and rose to HK$2,000 five years ago, has become part and parcel of life for many. It is commonplace for users to get flu treatment or a new pair of eyeglasses in clinics and optical shops displaying a characteristic green sticker. So why is the government now imposing restrictions on the vouchers’ usage and how does that affect the elderly and practitioners?

When and why were the vouchers launched?

The vouchers were first introduced in the form of a pilot scheme in 2009 for the elderly to use private health services, including preventive care, to supplement existing public services. Five vouchers of HK$50 each were provided annually to each resident aged 70 or above. In 2014, the scheme became a recurrent programme and the annual voucher amount was increased to HK$2,000. In 2017, the government lowered the age threshold to 65. Last year, elderly residents also received a one-off additional voucher of HK$1,000. The arrangement will continue this year, according to the recent budget announcement.

Do the vouchers serve their purpose?

A study by Chinese University found that although the percentage of elderly residents who used vouchers rose from 28 per cent in 2009 to 94 per cent in 2018, the scheme failed to bring down the number of public hospital visits. Former health secretary Professor Yeoh Eng-kiong, who led the study, said even years after the programme was adopted, 78 per cent of elderly patients still went to public clinics, while 73 per cent did so before the vouchers were introduced.