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Medical Reform - Hong Kong
 

Medical Reform - Hong Kong

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Hong Kong Baptist University

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 Medical Reform - Hong Kong Presentation Transcript

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