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12 December 2000
PRESS RELEASE

Dr LEONG Che Hung
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Response to the Consultation Document
on Health Care Reform "Lifelong Investment in Health"

(1) Public must air their views

It is better late than never that Government eventually come up with a review of our health care and health care financing systems, after more than a decade's push by the medical profession and the community. Our latest White Paper on Health Care is already 26-year-old.

Regrettably, most areas of the consultation paper are, at best, skeleton proposals rather than having much substance.

I urge the public to grab hold of the consultation period and express their views.

(2) Revamp Fees Structure

By proposing to carry out a full scale review, Government is further reinforcing the principle that "health care should be a shared responsibility between the users and the public coffer". This is to be welcomed.

Unless taxpayers are willing to put in more public money into health care, or affordable users are willing to share the cost, the high quality of public health care sector could hardly sustain against spiral rise in cost. The current finite resources for public health care simply cannot provide for the infinite demand.

The proposed review of charges for public health care services is, therefore, imminent. Government should come up with a time table on the pace of gradual cost recovery, so that the public can have better plans of their own ahead.

Yet, any fees review is like putting the cart before the horse, if the Administration fail to clearly define what is heavily subsidised public health care for; and for whom? I have always believed that it should be for:-

● poor and indigent (including those likely to suffer from adverse selection of private health insurers, eg chronic ill, aged, mental ill)

● illness and conditions which are life threatening, emergency, severe, or imposing high financial risk onto the patients

(3) Voluntary Insurance vs Compulsory Saving

A mixture of health care financing options rather than a mono-approach is more suitable for the laissez faire society of Hong Kong.

With a proper charging level for public health care to reflect the actual cost, the public can decide on their own whether to save money in their own kitty for the rainy days; or to purchase private health care insurance. The proposed compulsory Health Protection Accounts can only be a complement.

Yet, Government must strengthen its regulation and monitoring of the insurance industry so as to better protect the consumers' rights.

(4) Concerns of the proposed compulsory Health Protection Accounts that need to be addressed

a) Is the level of contribution of 1-2% for 25 years sufficient for the health care cost of a retired? Or, to what extend can such level of savings alleviate the burden of public coffer in public health care?

b) How long will the saving take before the amount is "meaningful"? Can the public health care sector sustain during such "waiting" period?

c) When is the proper timing to introduce the scheme, given that the launching of the Mandatory Provident Fund amidst economic lukewarm recovery has already drawn up heated controversy?

d) What kinds of insurance policy are available for those aged 65 and above? How to tackle adverse selection / hard conditions imposed by insurers?

(5) Quality Assurance and Complaint Mechanism

In these days when the public is much more knowledgeable, it is right that the current monitoring system for the health care professionals be reviewed. Investing the Department of Health with the responsibility to assess and investigate medical mishaps may well be one of the ways forward.

Yet, all precautions must be instigated to prevent duplication of efforts with the various professional disciplinary bodies; interfering with professional autonomy; and abuses for excessive, unnecessary and frivolous complaints.

The proposal that all health care professionals be required to undergo continuing professional education and development is most welcomed. In fact, this is also what I have been promulgating for years. Compulsory Continuous Medical Education for non-specialist doctors and dentists should be one way to consolidate the public's trust.

(6) Traditional Chinese Medicine (TCM)

Now that statutory registration for TCM practitioners are underway; and regulations for governing the use of herbal and patent Chinese Medicine are in the pipeline, Government should consider the proper role of TCM not only in the overall health care arena, but also the subsidised public sector. This, however, must be done on the basis of additional funding.

It is hoped that the proposal of introducing pilot studies on including TCM in public sector would not be Government's mere procrastinating tactic.

(7) Dental Care

There is nothing new in the Consultation Document. Yes, education is essential, but when education ends, where can the ordinary citizen get their actual dental help?

It is disappointing that after all these years, the long awaited Consultation Document has not addressed the crux of the matter. Oral health, despite being an essential component of Total Health, is still being treated as second-rated services.