Medical Reform Course Code : POLS7050 Course Name : Public Administration Semester : Autumn 2009 Prepared by: Rex Chan & V...
Why we need a Medical Reform?
Problems has been induced   <ul><li>Foreseeable non-sustainable healthcare system </li></ul><ul><li>Long waiting time for ...
Problem 1: Foreseeable non-sustainable healthcare system <ul><li>Evidence 1 </li></ul>“ HONG KONG'S DOMESTIC HEALTH SPENDI...
Problem 2: Long waiting time for public medical services <ul><li>Evidence 2 </li></ul><ul><li>Waiting time for first appoi...
Problem 3: Limited alternative choice for medical services  <ul><li>Examples </li></ul><ul><li>- Chinese medical services ...
Problem 4: Insufficient safety net  <ul><li>cannot afford the fee in private hospitals </li></ul><ul><li>rely on public se...
Factors inducing the problems <ul><li>Rapidly ageing population </li></ul><ul><li>Increasing occurrence of lifestyle-relat...
Existing policy to deal with the problems   Increase Funding!!!!
Advantages of increasing medical funding <ul><li>Cope with with the rising medical costs </li></ul><ul><li>Enhance the med...
Disadvantages of increasing medical funding <ul><li>Does not solve the existing problems comprehensively </li></ul><ul><li...
Solution   Six Supplementary Financing Proposals
Supplementary Financing Proposals <ul><li>Social Health Insurance (SHI) </li></ul><ul><li>Increasing the user fees--Out-of...
Selecting the best solution <ul><li>Out-of-pocket payments (user fees) </li></ul><ul><li>a simple, direct and efficient me...
Selecting the best solution <ul><li>2. Voluntary Private Health Insurance (VHI) </li></ul><ul><li>offer the voluntary choi...
Selecting the best solution <ul><li>3.  Personal Healthcare Reserve (PHR) </li></ul><ul><li>Deposit part of income into a ...
Selecting the best solution <ul><li>Out-of-pocket(user fee)   </li></ul><ul><li>will have the most widespread effect on me...
Benefits <ul><li>a simple, direct and efficient means </li></ul><ul><li>create healthy competition between the public and ...
Benefits <ul><li>5. ensure the medical services would not be overused </li></ul><ul><li>As a result, fair for the users to...
Costs <ul><li>lead to rising medical costs in private market </li></ul><ul><li>pose great burden to the elderly, patients ...
Implementation <ul><li>Food and Health Bureau (FHB)  the Panel on Health Services of the legislative Council(Lego)  Commit...
Implementation <ul><li>The Secretary for Food and Health  Dr. York Chow Yat-ngok </li></ul>
Political Strategy <ul><li>Mr. Lee Cheuk Yan concerns user fee pose great burden </li></ul><ul><li>representative of publi...
Political Strategy <ul><li>Solution </li></ul><ul><li>different working scopes  equal proportion </li></ul><ul><li>represe...
Assessing the impact
<ul><li>Q & A </li></ul>
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Medical Reform - Hong Kong

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Hong Kong Baptist University
MPA
Course Code: POLS7050
Case study of Medical Reform
Prepared by 09425632 & 09422218

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Medical Reform - Hong Kong

  1. 1. Medical Reform Course Code : POLS7050 Course Name : Public Administration Semester : Autumn 2009 Prepared by: Rex Chan & Veronica Lau
  2. 2. Why we need a Medical Reform?
  3. 3. Problems has been induced <ul><li>Foreseeable non-sustainable healthcare system </li></ul><ul><li>Long waiting time for public medical services </li></ul><ul><li>Limited alternative choice for medical services </li></ul><ul><li>Insufficient safety net </li></ul>
  4. 4. Problem 1: Foreseeable non-sustainable healthcare system <ul><li>Evidence 1 </li></ul>“ HONG KONG'S DOMESTIC HEALTH SPENDING” Source from Hong Kong Medical Journal
  5. 5. Problem 2: Long waiting time for public medical services <ul><li>Evidence 2 </li></ul><ul><li>Waiting time for first appointment for patients triaged into the &quot;routine&quot; category at Ambulatory Care Centre, TMH </li></ul>
  6. 6. Problem 3: Limited alternative choice for medical services <ul><li>Examples </li></ul><ul><li>- Chinese medical services </li></ul><ul><li>Evidence: only 12 clinic offering such services, but none of them was established in hospital </li></ul><ul><li>- natural medical treatment </li></ul>
  7. 7. Problem 4: Insufficient safety net <ul><li>cannot afford the fee in private hospitals </li></ul><ul><li>rely on public services </li></ul><ul><li>growth in service demand deteriorate service quality </li></ul><ul><li>patients will not be secured </li></ul>
  8. 8. Factors inducing the problems <ul><li>Rapidly ageing population </li></ul><ul><li>Increasing occurrence of lifestyle-related diseases </li></ul><ul><li>Rising medical costs brought about by advances in medical technology and expectations for improved quality of care </li></ul><ul><li>Insufficient emphasis on primary care </li></ul><ul><li>Over-reliance on hospital services </li></ul><ul><li>Significant public-private imbalance </li></ul><ul><li>limited continuity and integration of care </li></ul>
  9. 9. Existing policy to deal with the problems Increase Funding!!!!
  10. 10. Advantages of increasing medical funding <ul><li>Cope with with the rising medical costs </li></ul><ul><li>Enhance the medical education for professionals </li></ul><ul><li>Promote general medical knowledge among the public </li></ul><ul><li>subsidy the hospitals for better equipment </li></ul>
  11. 11. Disadvantages of increasing medical funding <ul><li>Does not solve the existing problems comprehensively </li></ul><ul><li>Not sustainable </li></ul><ul><li>Limited by simple taxation and low medical charges </li></ul><ul><li>over-reliance on public hospital services will be worsen </li></ul>
  12. 12. Solution Six Supplementary Financing Proposals
  13. 13. Supplementary Financing Proposals <ul><li>Social Health Insurance (SHI) </li></ul><ul><li>Increasing the user fees--Out-of-pocket payments </li></ul><ul><li>Medical Savings Accounts (MSA) </li></ul><ul><li>Voluntary Private Health Insurance (VHI) </li></ul><ul><li>Mandatory Private Health Insurance (MHI) </li></ul><ul><li>Personal Healthcare Reserve (PHR) </li></ul>Reference : http:// www.beStrong.gov.hk Report on First Stage, Public Consultation on Healthcare Reform, published by the Food and Health Bureau(December 2008)
  14. 14. Selecting the best solution <ul><li>Out-of-pocket payments (user fees) </li></ul><ul><li>a simple, direct and efficient means to provide additional resources </li></ul><ul><li>Encourage using the public healthcare services more judiciously </li></ul><ul><li>more self-responsibility for people’s own health </li></ul><ul><li>help in coping with increasing healthcare needs </li></ul>Reference : http:// www.beStrong.gov.hk Report on First Stage, Public Consultation on Healthcare Reform, published by the Food and Health Bureau(December 2008)
  15. 15. Selecting the best solution <ul><li>2. Voluntary Private Health Insurance (VHI) </li></ul><ul><li>offer the voluntary choice to choose their own insurance products </li></ul><ul><li>like insurance exclude pre-existing conditions </li></ul><ul><li>not guarantee renewal of policies </li></ul><ul><li>not provide any assurance on future premium </li></ul><ul><li>Not highly likely be an effective solution </li></ul>Reference : http:// www.beStrong.gov.hk Report on First Stage, Public Consultation on Healthcare Reform, published by the Food and Health Bureau(December 2008)
  16. 16. Selecting the best solution <ul><li>3. Personal Healthcare Reserve (PHR) </li></ul><ul><li>Deposit part of income into a personal account </li></ul><ul><li>For mandatory regulated medical insurance </li></ul><ul><li>For savings to invest & meet healthcare expenses, e.g. insurance premium </li></ul><ul><li>However, a two-tier service structure </li></ul><ul><li>Unlikely be an effective solution </li></ul>Under PHR First-class healthcare services Not under PHR Second-class healthcare services
  17. 17. Selecting the best solution <ul><li>Out-of-pocket(user fee) </li></ul><ul><li>will have the most widespread effect on meeting the increasing needs of healthcare </li></ul>Reference : http:// www.beStrong.gov.hk Report on First Stage, Public Consultation on Healthcare Reform, published by the Food and Health Bureau(December 2008)
  18. 18. Benefits <ul><li>a simple, direct and efficient means </li></ul><ul><li>create healthy competition between the public and private sectors to solve the public-private imbalance </li></ul><ul><li>encourage using the public healthcare services more judiciously </li></ul><ul><li>be more self-responsibility for people’s own health </li></ul>Reference : http:// www.beStrong.gov.hk Report on First Stage, Public Consultation on Healthcare Reform, published by the Food and Health Bureau(December 2008)
  19. 19. Benefits <ul><li>5. ensure the medical services would not be overused </li></ul><ul><li>As a result, fair for the users to take up more responsibility for their own healthcare expenses </li></ul>Reference : http:// www.beStrong.gov.hk Report on First Stage, Public Consultation on Healthcare Reform, published by the Food and Health Bureau(December 2008)
  20. 20. Costs <ul><li>lead to rising medical costs in private market </li></ul><ul><li>pose great burden to the elderly, patients with chronic illness, low-income families and other underprivileged groups </li></ul><ul><li>no risk-pooling effect, burden fall on the people who fell ill </li></ul><ul><li>could not afford the heavy medical fee </li></ul><ul><li>e.g. poor elderly, chronic patients and low-income families </li></ul>Reference : http:// www.beStrong.gov.hk Report on First Stage, Public Consultation on Healthcare Reform, published by the Food and Health Bureau(December 2008)
  21. 21. Implementation <ul><li>Food and Health Bureau (FHB) the Panel on Health Services of the legislative Council(Lego) Committee </li></ul><ul><li>Public Government </li></ul><ul><li> Professional </li></ul><ul><li>Create a fair atmosphere for different levels to express their opinions </li></ul><ul><li>set on a personal or family-based limit on medical expenses to moderate the effect of fee increase </li></ul>
  22. 22. Implementation <ul><li>The Secretary for Food and Health Dr. York Chow Yat-ngok </li></ul>
  23. 23. Political Strategy <ul><li>Mr. Lee Cheuk Yan concerns user fee pose great burden </li></ul><ul><li>representative of public are not allow to get equal treatment </li></ul><ul><li>because unequal proportion </li></ul><ul><li>a phenomenon : all the decisions might be made by Government department, but not the public </li></ul><ul><li>E.g. high range rising medical costs in private healthcare market </li></ul>
  24. 24. Political Strategy <ul><li>Solution </li></ul><ul><li>different working scopes equal proportion </li></ul><ul><li>representative of underprivileged can participate in the decision-making process </li></ul><ul><li>set control on a personal or family-based limit on medical expenses to moderate the effect of fee increase </li></ul><ul><li>create an advisory board to review the decisions made by the committee </li></ul>
  25. 25. Assessing the impact
  26. 26. <ul><li>Q & A </li></ul>
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