13 May 2000

True Democractisation should not be stumbling block
for Health Care Reform

(Keywords: health care reform, stall tactics, democratisation, elections)

          Rumours are that the long awaited Health Care Reform Green Paper is facing a difficult labour.

          Whatever are the reasons behind such stall tactics, Government's credibility is at stake. The commitment of a health care reform is not a recent one. As early as his first Policy Address three years ago, our Chief Executive has promised to carry out "a comprehensive review of our existing health care system during 1998". Disappointingly, directions of reform, let alone details, were not forthcoming in the subsequent policy addresses.

          The Health and Welfare Bureau, in response to sumptuous submissions from the public on the Harvard Report, gave an undertaking to come out with a Green Paper by the end of last year. This we know was not to be. The new Secretary proclaimed that it would be delivered in the first quarter of this year. Alas, up till now, almost the end of the second quarter, it is still no where in sight.

          What is the hurry, one might ask. The public health care service is still running. After all, even the Harvard Report forecasted that it will be some 18 years before the doomsday scenario will surface. It must be realised, however, that no one is demanding for an overnight reform of our health care system. The public is seeking for an earlier release of a directional document from the Government to give them time to chew, to digest and to make preparations to avoid a disaster.

          It takes years for the details of any funding formulae to be worked out and it takes longer for most to mature. The Mandatory Provident Fund is a typical example. It has been some 5 years since the law was passed that it could be implemented. Even then, many loose strings still need to be tightened. Furthermore, few would dare to predict when the fund could effectively function.

          The Hong Kong public realise that there is no magic wand. Yet, they rightly expect the Government to start making hay while the sun shines, and to be able to take part in the process.

          Rumours are that the Green Paper will be put on hold until after the September LegCo elections. After all, any reform that leans on, or suggests of, fee increases or user charges will be a sure "poison" for the ballot box. It thus appears politically correct for the Administration to withhold the Green Paper, giving no bandwagon for budding politicians and election hopefuls alike to jump onto, to tear the document into bits, and claim credit.

          Yet, while Hong Kong is moving at a unprecedented pace of democratisation, does "people's power" invariably mean objecting to any fee increase and imposition of charges? Does democracy imply that elected representatives be subservient to anything from their electorate, dishing out free lunches as baits for future votes? Or should our elected leaders take on the role as a true leader, arguing, advising and leading the public into, and along, the path that is good for Hong Kong's future, even though each member of the public might have to fork out more from their wallet?

          An election where candidates are returned because of their vision and helmanship for the betterment of Hong Kong, rather than on tickets of free lunches, is a much more successful election that any democratic society would love to embrace. The public too should also realise that democracy could be a farce unless the electorate are fully mature. Maturity in every aspect means that whilst "rights" are essential, "responsibility" is just as necessary.

          In the case of public health care, if those who use the service are not willing to contribute to the cost in spite of affordability, there could only be two alternatives -- larger funding budget from the Government which means perhaps a higher tax; or a deterioration of standards. Both, the public would loath to witness!

(Hongkong Standard)