21 March 1998

Reform of Medical System vital for both Hong Kong and Mainland China

(Keywords:- China, medical reform, HMO, financing)

          The rise of Mr Zhu Rongji to the China premiership is met with universal approval in and out of China. Mr Zhuˇ¦s warm  mannerism, his sincere attitude and his unpretentious rapport with the people and the media must be a breath of fresh air, if not a neo style, in the Central Chinese leadership. Of importance is, of course, the five areas of reform he highlighted, many will no doubt affect Hong Kong.

          Of interest is that medical reform ranks in his ˇ§reform listˇ¨.

          Much in the current China health system needs to be re-examined: ranging from registration of health care professionals to health care financing; from utilization of executed convictsˇ¦ organs for transplantation to euthanasia and more. To wit,  whilst there are over 110 medical schools in the country, there is still no uniformity of standards. This is understandable in the past, when China needed to quickly provide for health care services albeit rudimentary in every coroner of such a vast country, many places being hardly accessible. Yet with economy development in China, there is rising demand for high quality health care system for the people at large.

          A registration system for the medical and dental professions as a start must be daunting to assure that all those who practise the art have attained at least a minimal acceptable standard for the protection of the public. As sophistication finds its way into the country, there will be a call for specialised and specialty medical service. Training programme and vetting mechanism must be planned. There should be no shortage of good people and clinical material for such development.

          No health care system can sustain without a proper funding and financing system. Under a self-financing principle, charges for medical care in Mainland vary greatly from hospitals to hospitals and patients to patients. In the past few years, the problem of ˇ§money first, treatment followsˇ¨ even in life threatening situations faced by Hong Kong people in the Mainland hospitals has also reflected problem with the system. We understand that different pilot projects on health care charging and financing are being carried out in various parts of the country. We look forward to the report. Hopefully, it can shed light to other neighbouring countries.

          Hong Kong, on the other hand, has the good fortune of having an early start in our medical system. Many the Mainland could take experience from.

          Regrettably, much in our health care system has remained in the doldrums for almost a quarter of a century, in particular health care financing.         In the absence of an updated financing policy, there is little wonder that our public medical services are greatly under the pressure of upsurging workload and health care cost are soaring to an exponential high.

          It should come as no surprise that businessmen with profiteering intent are finding the Hong Kong market attractive and come in a big way. Using the sugar coated disguised benefit of ˇ§capping the costˇ¨, they are virtually luring the less informed public to fall into their trap. Yes, ˇ§cost cappingˇ¨ is marvelous at its face value especially to human resources management of big corporations. For with a fixed  up-front contribution, staff could have an unlimited medical attention and treatment without having to pay more.

          Yet, all that glitter is not gold. It takes more than a hat trick to satisfy the businessmen aiming at a profit and at the same time  provide quality medical service with no limit in the face of soaring medical cost with capped budget. Some parts have to give way -- the health care providers cut their charges and/or the patients get a second rate service. Surely you donˇ¦t expect profiteers to do it for charity!

          If Hong Kong is embarking on a reform of health care financing and it should, we have to make it very sure that the principle of free market will not be compromised and that our old and needy will get the best of health care irrespective of means.

(Hongkong Standard)