Once more unto the breach on health reform
Is it the best of times, or the worst of times? The latest consultation paper on reforming health-care financing, 'My Health My Choice', is the sixth document of its kind from the government in 17 years. And there is still a big question mark over whether officials can make the proposed voluntary medical scheme a reality.
'We are confident this time, but we will not underestimate the views of various stakeholders and individuals,' Secretary for Food and Health Dr York Chow Yat-ngok said yesterday as he began three months of public consultation on the plans.
He said it would have been irresponsible not to have acted now.
Even if the public approves the controversial scheme, it will not be in operation until 2013, as the government needs time to build the infrastructure and pass the relevant laws.
For health officials, there is never a 'best time' to reform health-care financing. There is always resistance to change from some members of the community who are used to enjoying free and accessible public medical services.
One person familiar with health-care reform said the challenge facing the government was that under the voluntary medical-insurance scheme being proposed, individuals would feel the immediate pain of paying extra for their health.
'In a booming economy, people doubt the need for change; when the economy turns bad, they then worry about the affordability of their premiums.
'It is human nature that people tend not to think about the long-term benefits of any reform,' this person said.
Professor Ma Ngok, a political scientist at Chinese University, said a lack of a sense of crisis lay behind the past failures to push through financing reform.
'The public health-care system is running quite well in Hong Kong, and is cheap. To most people, there is no sense of crisis for a change. Not many people have the vision to consider its long-term financial sustainability,' Ma said.
'Health care is a very distributive issue that affects every individual. The situation is like the government's bid to push through the sales tax. While many people agree that our tax base is too narrow, they don't want to pay extra.
'And I don't see the government having a strong political determination for health-care reform. It does not bring to mind US President Barack Obama, who made health-care reform a top priority at a very early stage,' Ma said.
Professor Ho Lok-sang, director of the Centre for Public Policy Studies at Lingnan University, said the government might face less public resistance this time because the insurance scheme was voluntary.
But he had reservations about the popularity of the scheme.
'As the median monthly income of Hong Kong households is just HK$17,000, not many people will be willing to pay extra out of their pockets for their insurance,' he said.
The 5 previous consultations
1993 Towards Better Health, known as the 'rainbow document'
1999 Improving Hong Kong's Health Care System: Why and For Whom? (also known as the 'Harvard report')
2001 Lifelong Investment in Health
2005 Building a Healthy Tomorrow
2008 Your Health Your Life
2010 My Health My Choice
