OPINION, Health-care Reform
Permanent Secretary for Health, Welfare and Food Carrie Yau Tsang Ka-lai told a recent seminar on health-care funding reform that establishing a health protection savings account is the equivalent of “putting on a [plaster] to stop the bleeding”. She is right.

Thomas Tang

The health-protection account is aimed at making individuals save 2 percent of their income as a proviso for future post-retirement healthcare costs, when the vulnerabilities brought on by ageing will be pronounced.

But Hong Kong is facing a far graver situation than it realizes while paying (or rather not paying) the price for a world-class healthcare system. Hong Kong must face up to the realities.

We cannot continue to use the Government’s public budget to subsidise expensive healthcare treatment, which is running at a $7.3 billion deficit. In the 1960s, the Government pledged to make public healthcare accessible to all. It has done so and more. Up to the present time the public, whether rich or poor, can secure a hospital bed at a fraction of its real cost (based on such items as rental space, nursing care, doctors’ visits and administration) and, in addition, costly drugs and treatment are made affordable through generous subsidies.

This is not to question the moral rights of health care for all, which is a central tenet of august organisations like the World Health Organisation, but to point out that those who can afford healthcare treatment should – and ought to – pay for it.

At the same seminar, Dr. William Ho Siu-wei, chief executive of the Hospital Authority, raised valid and intelligent arguments against means testing individuals before they treated. However, if we are to change the system, it must be now. We must screen for those who can afford to pay: the rich, the nearly rich and mainland visitors have all taken advantage of the benevolent healthcare system.

Where does it stop? The alternatives to charging the individual directly would be mandatory social insurance payments as part of a raft of tax reforms that includes broadening the tax base. In other words, instead of paying for yourself, you could end up paying for the costs of others, which would be hugely unpopular.

While the administration deliberates on this dilemma, what can Hong Kong do immediately?

One, we must acknowledge the key role that the Hospital Authority plays and how best it can incorporate the resources of the private sector (such as the planned privatisation of outpatient clinics) and civil society (linking up with non-governmental organisations to provide more community care).

Two, we should make use of what Hong Kong is actually very good at – technology – by, for instance, building robust and comprehensive patient information networks using the new smart ID cards to house individual health data (similar to Canada) and to avoid the need for running expensive duplicate databases in the private and the public sectors. The same smart ID cards would also contain relevant income data.

Lastly, we should foster better health promotion and education so that people realize that sensible living and well-being is preferable (as well as less expensive) to obesity, charred lungs and early coronaries.

Thomas Tang is operations director of the Global Institute For Tomorrow.
www.globalinstitutefortomorrow.org/