The Hong Kong health care reforms : options and critiques

Pao Yue-kong Library Electronic Theses Database

The Hong Kong health care reforms : options and critiques

 

Author: Koo, Yuk-wah
Title: The Hong Kong health care reforms : options and critiques
Degree: M.Sc.
Year: 2000
Subject: Health care reform -- China -- Hong Kong
Hong Kong Polytechnic University -- Dissertations
Department: Multi-disciplinary Studies
Dept. of Management
Pages: viii, 98 leaves : ill. ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1517950
URI: http://theses.lib.polyu.edu.hk/handle/200/3808
Abstract: This thesis attempted to evaluate the Harvard Report and compare the Harvard's proposed scheme Health Security Plan (HSP) with the Target Subsidy Model (TSM), which was suggested by the Hospital Authority. It argues against the Harvard's projection on public health care expenditure and their conclusion of financial sustainability on the current health care system. The Harvard's options of maintaining at status quo, capping government budget for health care, and raising user fees are controversial. They most likely enable the Government to achieve certain purposes in the reform of the health care system. The long-term care insurance scheme (MEDISAGE) is definitely required in Hong Kong because the existing long-term care services for the old people in the community is extremely unsatisfactory. However, it predicts that the proposed contribution of 1 per cent of employees' wage for the scheme is not sufficient in the long run. The scheme would also attract some old people, who are originally living with their families, to use the facilities resulting in over-demand of the services. There is clear evidence to show that the HSP would result in serious cost-escalation. It would also pose heavy financial burden on working population. In addition, the introduction of the standard payment rate for care providers is difficult to implement in the context of Hong Kong's health care system because there is significant difference of medical charges in private sector. The comparison of HSP and TSM highlights their performance in different univeral health care objectives and impacts on Hong Kong's health care system. The Competitive Integrated Health Care System (CIHCS) would create a monopolized market in Hong Kong's health care system, thereby reducing patients' choice. It would also lead to unhealthy competition and drive up health cost in the health care system. It forecasts that the CIHCS would encounter strong objection from different stakeholders. The Harvard's institutional recommendations are subject to further discussion. The government-funded and independent Institute for Health Policy and Economics would provide the necessary expertise in analyzing health policy, developing options and evaluating policy performance. It however argues that the Office of Quality Assurance might not be helpful to public because patients still lack professional knowledge appraising the quality of care providers. Instead there is need to set up an office, which is responsible for conducting patient surveys, setting information requirements on hospitals and clinics, conducting inter-hospital outcome comparison, and disseminating information to the public. There is no strong ground to set up an office for the patient education because there is currently a Central Health Education Unit, which provides the similar services to the public. Support is given to establish an independent medical ombudsman because it would provide patients with one more channel to help them to complain about unscrupulous care providers.

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