Don't let private sector hold health care hostage
My medical insurance policy, in line with the industry norm, does not cover 'pre-existing conditions'. Since I have diabetes and hypertension, I won't be covered for a heart attack, a stroke, or kidney failure - problems I need coverage for the most because I'm ageing. And there is a chance the insurer will raise my premium or not cover me when I am older and more decrepit.
The voluntary Health Protection Scheme is part of the government's latest health care reform push and promises to cover pre-existing conditions and guarantee lifelong policy renewal.
I'll be the first to sign up if and when it is available. But can the government deliver on its promises?
Medical insurance in Hong Kong is generally a money-losing business, kept afloat by the parent company or mainstream insurance businesses. Insurers lose money because private doctors and private hospitals milk them dry.
For example, a patient with a deluxe policy can stay in a deluxe room in a private hospital. I can understand the room costs three times as much as a general ward bed, but why should the hospital charge the insurer triple for lab tests, X-rays and even a Band-Aid?
In Hong Kong, it is not unusual for doctors to first ask their patients about their insurance before laying out treatment plans. Insurance gives them carte blanche to charge the insurer as much as they can get away with.
The government's real difficulty in ensuring the Health Protection Scheme's success is that it has to rely on the take-up of both private insurers and private health care providers. The government wants insurance policies with superior coverage at fair rates. But insurance companies want a profit and the private hospitals and doctors don't want to erode their earnings. If they know they hold the trump card, the government will have no choice but to compromise its ideals for their co-operation.
Alternatively, the government could start its own insurance company and private hospitals.
In theory, a government-run insurance scheme would be more cost-effective because of the high costs private insurers face in developing packages, marketing, processing claims and executive salaries. A government scheme could trim most of those expenses and tailor-make simple policies based on standard package prices, saving a lot of grief and paperwork.
Government-run private hospitals could be associated with the two medical schools, which have experience running world-class hospitals, and could provide enough top-notch professorial doctors for patients to choose from.
Private doctors wanting to join the practice would have to abide by the established ethics and prices. For a start, there would be no surcharge for patients in deluxe rooms.
Granted, government-run insurance and health care would be wrought with the usual bureaucratic baggage, but it beats seeing a big chunk of the taxpayers' HK$50 billion the government intends to inject into health care reform going into the pockets of private insurers and private health care providers.
Dr Feng Chi-shun is a Hong Kong-based consultant pathologist
